Adrenal functional imaging

Werner, Rudolf A.; Schirbel, Andreas; Buck, Andreas K.; Fassnacht, Martin; Hahner, Stefanie

doi:10.1016/j.lpm.2022.104114

Cited by 4 publications

(6 citation statements)

References 72 publications

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“…Furthermore, new PET radiotracers have emerged that target specific components of the adrenal cortex, such as CYP11B enzymes (e.g., Iodometomidate or IMAZA) or CXCR4 receptors (e.g., PentixaFor) that are particularly valuable for the diagnosis of tumors originating from the adrenal cortex [60].…”

Section: Pet/ct In Adrenal Disordersmentioning

confidence: 99%

“…While conventional imaging methods have their merits, advanced PET tracers have emerged as promising tools in the detection and localization of pheochromocytomas and paragangliomas [68]. The diagnostic sensitivity of [ 18 F] FDG PET/CT is variable, being higher in malignant pheochromocytomas compared to benign ones (82% versus 58%) [60]. This variation is expected due to the increased glucose metabolic activity observed in more aggressively growing tumors.…”

Section: Pet/ct In Adrenal Disordersmentioning

confidence: 99%

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Endocrinology application of molecular imaging: current role of PET/CT

Calderoni,

Giovanella,

Fanti

2024

J Endocrinol Invest

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Background In recent years, nuclear medicine imaging methods have proven to be of paramount importance in a wide variety of diseases, particularly in oncology, where they are crucial for assessing the extent of disease when conventional methods fall short. Moreover, nuclear imaging modalities are able to better characterize lesions using target agents related to specific pathways (e.g. glucose metabolism, cellular proliferation, amino acid transport, lipid metabolism, specific receptor ligands). The clinical presentation of endocrine diseases encompasses a broad spectrum of sign and symptoms. Moreover, endocrine tumors show varying degrees of aggressiveness from well differentiated and indolent to highly aggressive cancers, respectively. Rationale With the application of new medicinal radio-compounds and increasingly advanced tomographic imaging technology, the utility of Positron Emission Tomography/Computed Tomography (PET/CT) in the field of endocrine diseases is expanding. Aim This review aims to analyze and summarize the primary indications of PET/CT, providing a practical approach for clinicians. A comprehensive literature search on PubMed was conducted to provide an updated overview of the available evidence regarding the use of PET/CT in endocrinology. Within this review, we will discuss the applications of PET/CT, compare different radiopharmaceuticals and highlight the uptake mechanism, excluding neuroendocrine carcinomas from discussion. Conclusions PET/CT is a valuable tool in diagnosing and managing endocrine disorders due to its capacity to furnish both functional and anatomical information, facilitate early lesion detection, guide treatment decisions, and monitor treatment response. Its non-invasive nature and precision make it an integral component of modern endocrine healthcare. This review aims to provide physicians with a clear perspective on the role of PET/CT imaging, discussing its emerging opportunities and appropriateness of use in endocrinological diseases.

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Section: Pet/ct In Adrenal Disordersmentioning

confidence: 99%

Section: Pet/ct In Adrenal Disordersmentioning

confidence: 99%

Endocrinology application of molecular imaging: current role of PET/CT

Calderoni,

Giovanella,

Fanti

2024

J Endocrinol Invest

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“…Such an approach, however, would be restricted to refractory end-stage disease patients having exhausted all other treatment lines. For instance, in ACC patients, treatment options are limited [ 51 ] and, thus, administration of [ 90 Y]PentixaTher may be feasible as a salvage approach, e.g., after having harvested stem cells during previous chemotherapeutic protocols [ 52 ].…”

Section: Future Aspectsmentioning

confidence: 99%

CXCR4-targeted theranostics in oncology

Buck

Serfling

Lindner

et al. 2022

Eur J Nucl Med Mol Imaging

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A growing body of literature reports on the upregulation of C-X-C motif chemokine receptor 4 (CXCR4) in a variety of cancer entities, rendering this receptor as suitable target for molecular imaging and endoradiotherapy in a theranostic setting. For instance, the CXCR4-targeting positron emission tomography (PET) agent [68 Ga]PentixaFor has been proven useful for a comprehensive assessment of the current status quo of solid tumors, including adrenocortical carcinoma or small-cell lung cancer. In addition, [68 Ga]PentixaFor has also provided an excellent readout for hematological malignancies, such as multiple myeloma, marginal zone lymphoma, or mantle cell lymphoma. PET-based quantification of the CXCR4 capacities in vivo allows for selecting candidates that would be suitable for treatment using the theranostic equivalent [177Lu]/[90Y]PentixaTher. This CXCR4-directed theranostic concept has been used as a conditioning regimen prior to hematopoietic stem cell transplantation and to achieve sufficient anti-lymphoma/-tumor activity in particular for malignant tissues that are highly sensitive to radiation, such as the hematological system. Increasing the safety margin, pretherapeutic dosimetry is routinely performed to determine the optimal activity to enhance therapeutic efficacy and to reduce off-target adverse events. The present review will provide an overview of current applications for CXCR4-directed molecular imaging and will introduce the CXCR4-targeted theranostic concept for advanced hematological malignancies.

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Section: Introductionmentioning

confidence: 99%

“…Accordingly, we and others have proposed molecular imaging with positron emission tomography (PET) computed tomography (PET/CT) as an alternative method for distinguishing unilateral and bilateral causes of PA due to their advantage of being able to image the actual biological function of the adrenals, as well as being able to distinguish between both incidentalomas and APA, which is very advantageous. Although several radiotracers have been proposed, 8 the strongest evidence to date supporting a role for molecular imaging in subtyping PA comes from studies with the radiotracer [ 11 C] methyl-1-[(1R)-1-phenylethyl]-1H-imidazole-5-carboxylate ([ 11 C]Metomidate). 9,10 Importantly, in a recent large-scale prospective, within patient trial, dexamethasone-suppressed [ 11 C]Metomidate PET/CT was shown to be non-inferior to AVS in identifying surgically curable PA. 11 Etomidate and the related 1-[(1R)-1-phenylethyl]-1Himidazole-5-carboxylic acid esters [ 11 C]Metomidate and para-chloro-2-[ 18 F] fluoroethyl-etomidate ([ 18 F]CETO) (Figure 1) selectively bind to the highly homologous cytochrome P-450 enzymes CYP11B1 (11β-hydroxylase) and CYP11B2 (aldosterone synthase), which are expressed in the zona fasciculata (ZF) and zona glomerulosa (ZG) of the adrenal cortex respectively.…”

Section: Introductionmentioning

confidence: 99%

Automated radiosynthesis of [¹⁸F]CETO, a PET radiotracer for imaging adrenal glands, on Synthra RNplus

Hird,

Russell,

Corrigan

et al. 2023

Labelled Comp Radiopharmac

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Primary aldosteronism (PA) is the leading secondary cause of hypertension. Determining whether one (unilateral) or both (bilateral) adrenal glands are the source of PA in a patient remains challenging, and yet it is a critical step in the decision whether to recommend potentially curative surgery (adrenalectomy) or lifelong medical therapy (typically requiring multiple drugs). Recently, we have developed a fluorine‐18 radiopharmaceutical [18F]CETO to permit greater access to PA molecular imaging. Herein, we report an automated synthesis of this radiotracer. To manufacture the radiopharmaceutical routinely for clinical PET studies, we implemented an automated radiosynthesis method on a Synthra RNplus© synthesiser for which Cl‐tosyletomidate was used as the precursor for radiolabelling via nucleophilic [18F]fluorination. [18F]CETO was produced with 35 ± 1% (n = 7), decay corrected and 25 ± 4% (n = 7) non‐decay corrected radiochemical yield with molar activities ranging from 150 to 400 GBq/μmol. The GMP compliant manufacturing process produces a sterile formulated [18F]CETO injectable solution for human use as demonstrated by the results of quality control. Automation of the radiosynthesis of [18F]CETO should facilitate uptake by other adrenal centres and increase access to molecular imaging in PA.

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Adrenal functional imaging

Cited by 4 publications

References 72 publications

Endocrinology application of molecular imaging: current role of PET/CT

Endocrinology application of molecular imaging: current role of PET/CT

CXCR4-targeted theranostics in oncology

Automated radiosynthesis of [¹⁸F]CETO, a PET radiotracer for imaging adrenal glands, on Synthra RNplus

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Adrenal functional imaging

Cited by 4 publications

References 72 publications

Endocrinology application of molecular imaging: current role of PET/CT

Endocrinology application of molecular imaging: current role of PET/CT

CXCR4-targeted theranostics in oncology

Automated radiosynthesis of [18F]CETO, a PET radiotracer for imaging adrenal glands, on Synthra RNplus

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Automated radiosynthesis of [¹⁸F]CETO, a PET radiotracer for imaging adrenal glands, on Synthra RNplus