The Future of Nuclear Medicine, Molecular Imaging, and Theranostics

Weber, Wolfgang; Czernin, Johannes; Anderson, Carolyn J.; Badawi, Ramsey D.; Barthel, Henryk; Bengel, Frank M.; Bodei, Lisa; Buvat, Irène; DiCarli, Marcelo F.; Graham, Michael M.; Grimm, Jan; Herrmann, Ken; Kostakoglu, Lale; Lewis, Jason S.; Mankoff, David A.; Peterson, Todd E.; Schelbert, Heinrich R.; Schöder, Heiko; Siegel, Barry A.; Strauss, H. William

doi:10.2967/jnumed.120.254532

Cited by 93 publications

(79 citation statements)

References 44 publications

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“…In recent years, nuclear medicine emerged as an increasingly important area in the diagnosis and treatment of both oncological and non-oncological diseases (Weber et al 2020 ). In particular, in the field of diagnosis, Single Photon Emission Computed Tomography (SPECT) has been used for many years as a non-invasive imaging technique.…”

Section: Introductionmentioning

confidence: 99%

Cyclotron production and radiochemical purification of terbium-155 for SPECT imaging

Favaretto

Talip

Borgna

et al. 2021

EJNMMI radiopharm. chem.

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Background Terbium-155 [T1/2 = 5.32 d, Eγ = 87 keV (32%) 105 keV (25%)] is an interesting radionuclide suitable for single photon emission computed tomography (SPECT) imaging with potential application in the diagnosis of oncological disease. It shows similar decay characteristics to the clinically established indium-111 and would be a useful substitute for the diagnosis and prospective dosimetry with biomolecules that are afterwards labeled with therapeutic radiolanthanides and pseudo-radiolanthanides, such as lutetium-177 and yttrium-90. Moreover, terbium-155 could form part of the perfect “matched pair” with the therapeutic radionuclide terbium-161, making the concept of true radiotheragnostics a reality. The aim of this study was the investigation of the production of terbium-155 via the 155Gd(p,n)155Tb and 156Gd(p,2n)155Tb nuclear reactions and its subsequent purification, in order to obtain a final product in quantity and quality sufficient for preclinical application. The 156Gd(p,2n)155Tb nuclear reaction was performed with 72 MeV protons (degraded to ~ 23 MeV), while the 155Gd(p,n)155Tb reaction was degraded further to ~ 10 MeV, as well as performed at an 18 MeV medical cyclotron, to demonstrate its feasibility of production. Result The 156Gd(p,2n)155Tb nuclear reaction demonstrated higher production yields of up to 1.7 GBq, however, lower radionuclidic purity when compared to the final product (~ 200 MBq) of the 155Gd(p,n)155Tb nuclear reaction. In particular, other radioisotopes of terbium were produced as side products. The radiochemical purification of terbium-155 from the target material was developed to provide up to 1.0 GBq product in a small volume (~ 1 mL 0.05 M HCl), suitable for radiolabeling purposes. The high chemical purity of terbium-155 was proven by radiolabeling experiments at molar activities up to 100 MBq/nmol. SPECT/CT experiments were performed in tumor-bearing mice using [155Tb]Tb-DOTATOC. Conclusion This study demonstrated two possible production routes for high activities of terbium-155 using a cyclotron, indicating that the radionuclide is more accessible than the exclusive mass-separated method previously demonstrated. The developed radiochemical purification of terbium-155 from the target material yielded [155Tb]TbCl3 in high chemical purity. As a result, initial cell uptake investigations, as well as SPECT/CT in vivo studies with [155Tb]Tb-DOTATOC, were successfully performed, indicating that the chemical separation produced a product with suitable quality for preclinical studies.

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Section: Introductionmentioning

confidence: 99%

Cyclotron production and radiochemical purification of terbium-155 for SPECT imaging

Favaretto

Talip

Borgna

et al. 2021

EJNMMI radiopharm. chem.

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“…Nuclear medicine has become an important discipline in modern medicine. It can be used not only for diagnosis in oncology, cardiology, neurology, infectious and inflammatory diseases, but also for the treatment of malignant tumors and some benign diseases [1]. Nuclear medicine can be divided into diagnostic nuclear medicine and therapeutic nuclear medicine.…”

Section: Introductionmentioning

confidence: 99%

Hydroxypyridinones as a Very Promising Platform for Targeted Diagnostic and Therapeutic Radiopharmaceuticals

Zhou¹,

Dong²,

Shen

2021

Molecules

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Hydroxypyridinones (HOPOs) have been used in the chelation therapy of iron and actinide metals. Their application in metal-based radiopharmaceuticals has also been increasing in recent years. This review article focuses on how multidentate HOPOs can be used in targeted radiometal-based diagnostic and therapeutic radiopharmaceuticals. The general structure of radiometal-based targeted radiopharmaceuticals, a brief description of siderophores, the basic structure and properties of bidentate HOPO, some representative HOPO multidentate chelating agents, radiopharmaceuticals based on HOPO multidentate bifunctional chelators for gallium-68, thorium-227 and zirconium-89, as well as the future prospects of HOPO multidentate bifunctional chelators in other metal-based radiopharmaceuticals are described and discussed in turn. The HOPO metal-based radiopharmaceuticals that have shown good prospects in clinical and preclinical studies are gallium-68, thorium-227 and zirconium-89 radiopharmaceuticals. We expect HOPO multidentate bifunctional chelators to be a very promising platform for building novel targeted radiometal-based diagnostic and therapeutic radiopharmaceuticals.

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“…Tracing its roots back to the 1940s [ 1 ], theranostics in nuclear oncology has seen an unprecedented success, mainly due the beneficial effects of such image-guided therapeutic concepts for patients afflicted with radioiodine avid thyroid cancer [ 2 ]. Recent years, however, have witnessed an expanded use of novel molecular imaging agents tied to an individually tailored treatment decision [ 3 , 4 ]. Such a theranostic approach enables systemic or locoregional radiation of various cancer entities with mainly β-emitting radionuclides, which are linked to the identical molecule used for positron emission tomography (PET) or single-photon emission computed tomography (SPECT) imaging [ 4 ].…”

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confidence: 99%

Theranostics in Oncology—Thriving, Now More than Ever

et al. 2021

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Tracing its roots back to the 1940s, theranostics in nuclear oncology has proved successful mainly due to the beneficial effects of image-guided therapeutic concepts for patients afflicted with a variety of different cancers. The majority of these treatments are not only characterized by substantial prolongation of progression-free and overall survival, but are also generally safe, rendering theranostic agents as an attractive treatment option in various clinical scenarios in oncology. In this Special Issue Novel Theranostic Agents, nine original articles from around the globe provide further evidence on the use of the theranostic concept for neuroendocrine neoplasm (NEN), prostate cancer (PC), meningioma, and neuroblastoma. The investigated diagnostic and therapeutic radiotracers target not only established structures, such as somatostatin receptor, prostate-specific membrane antigen or norepinephrine transporter, but also recently emerging targets such as the C-X-C motif chemokine receptor 4. Moreover, the presented original articles also combine the concept of theranostics with in-depth read-out techniques such as radiomics or novel reconstruction algorithms on pretherapeutic scans, e.g., for outcome prediction. Even 80 years after its initial clinical introduction, theranostics in oncology continues to thrive, now more than ever.

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The Future of Nuclear Medicine, Molecular Imaging, and Theranostics

Cited by 93 publications

References 44 publications

Cyclotron production and radiochemical purification of terbium-155 for SPECT imaging

Cyclotron production and radiochemical purification of terbium-155 for SPECT imaging

Hydroxypyridinones as a Very Promising Platform for Targeted Diagnostic and Therapeutic Radiopharmaceuticals

Theranostics in Oncology—Thriving, Now More than Ever

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