Targeted alpha therapy (TAT) can deliver high localized burden of radiation selectively to cancer cells as well as the tumor microenvironment, while minimizing toxicity to normal surrounding cell. Radium-223 (223 Ra), the first-in-class a-emitter approved for bone metastatic castration-resistant prostate cancer has shown the ability to prolong patient survival. Targeted Thorium-227 (227 Th) conjugates represent a new class of therapeutic radiopharmaceuticals for TAT. They are comprised of the a-emitter 227 Th complexed to a chelator conjugated to a tumor-targeting monoclonal antibody. In this review, the authors will focus out interest on this therapeutic agent. In recent studies 227 Th-labeled radioimmunoconjugates showed a relevant stability both in serum and vivo conditions with a significant antigen-dependent inhibition of cell growth. Unlike 223 Ra, the parent radionuclide 227 Th can form highly stable chelator complexes and is therefore amenable to targeted radioimmunotherapy. The authors discuss the future potential role of 227 Th TAT in the treatment of several solid as well as hematologic malignancies.
This systematic review aimed to evaluate the prognostic value of Iodine123 Metaiodobenzylguanidine (123I-mIBG) SPECT myocardial imaging in patients with heart failure (HF) and to assess whether semi-quantitative SPECT scores can be useful for accurate risk stratification concerning arrhythmic event (AE) and sudden cardiac death (SCD) in this cohort. A systematic literature search of studies published until November 2020 regarding the application of 123I-mIBG SPECT in HF patients was performed, in Pubmed, Scopus, Medline, Central (Cochrane Library) and Web Of Science databases, including the words “MIBG”, “metaiodobenzylguanidine”, “heart”, “spect”, and “tomographic”. The included studies had to correlate 123I-mIBG SPECT scores with endpoints such as overall survival and prevention of AE and SCD in HF patients. According to the sixteen studies included, the analysis showed that 123I-mIBG SPECT scores, such as summed defect score (SDS), regional wash-out (rWO), and regional myocardial tracer uptake, could have a reliable prognostic value in patients with HF. An increased SDS or rWO, as well as a reduced 123I-mIBG myocardial uptake, have proven to be effective in predicting AE- and SCD-specific risk in HF patients. Despite achieved results being promising, a more reproducible standardized method for semi-quantitative analysis and further studies with larger cohort are needed for 123I-mIBG SPECT myocardial imaging to be as reliable and, thus, accepted as the conventional 123I-mIBG planar myocardial imaging.
Our aim was to assess the detection rate (DR) of positron emission computed tomography (PET/CT) with anti-1-amino-3-[18F]-flurocyclobutane-1-carboxylic acid (18F-FACBC) in patients with biochemical recurrence (BCR) from prostate cancer (PC). As a secondary endpoint, we evaluated 18F-FACBC PET/CT’s impact on patients management. Clinical records of 81 patients submitted to 18F-FACBC PET/CT due to PC BCR in two Italian Nuclear Medicine Units were retrospectively assessed. DR was gauged in the whole cohort and stratifying patients by discrete intervals of PSA levels. PET/CT’s impact on clinical management was scored as (1) major if it entailed an intermodality change (e.g., from systemic to loco-regional therapy); (2) minor if it led to an intramodality change (e.g., modified radiotherapy field). PET/CT’s DR resulted in 76.9% in the whole cohort, with a positive predictive value of 96.7%. Stratified by PSA quartile intervals, PET/CT’s DR was 66.7%, 71.4%, 78.9% and 90% for PSA 0.2–0.57 ng/mL, 0.58–0.99 ng/mL, 1–1.5 ng/mL and >1.5 ng/mL without significant difference among groups (p = 0.81). The most common sites of relapse were prostate bed and pelvic lymph nodes (59.3%). PET/CT impacted on clinical management in 33/81 cases (40.7%), leading to a major change in 30 subjects (90.9%). 18F-FACBC PET/CT localized recurrence in patients with BCR, with meaningful DR also at low PSA levels and significantly impacted on clinical management.
Background Multiple myeloma (MM) is the second most common hematological malignancy after non-Hodgkin lymphoma. Recently, the use of 18F-FDG PET/CT has become more and more diffused thanks to its ability to combine functional and morphological information for diagnosis, prognosis assessment, and evaluation of treatment response. This study aims to describe the semiquantitative parameters obtained from 18F-FDG PET/CT in a population of patients with MM. A comparative analysis was performed with existing literature. Methods This retrospective study included 50 patients with suspected MM who had undergone whole-body 18F-FDG PET/CT. The semiquantitative parameters obtained from 18F-FDG PET/CT positive scans were analyzed, specifically the number of focal lesions (FLs), the SUVmax of the “hottest” lesion, the ratio between SUVmax of the bone marrow and the spleen (marrow-to-spleen SUVmean ratio), marrow-to-spleen SULpeak ratio, and MTV. Results Of the total cohort of 50 patients submitted to 18F-FDG PET/CT for suspected MM, 39 subjects resulted affected by MM. The 11 negative 18F-FDG PET/CT scans of the remaining subjects were not included. 59% of patients were males, and mean age (SD) was 65 ± 7.8 years. Based on the number of FLs, the entire cohort was divided into three groups: 14 patients in group A with more than 10 lesions; 5 patients in group B had a number of lesions between 5 and 10; and 24 patients in group C presented with less than 5 lesions. Conclusions Semiquantitative parameters obtained through 18F-FDG PET can be useful in the assessment of staging criteria for MM, as the metabolic activity of lesions is higher in patients with extensive disease at the time of diagnosis. The predictive and prognostic relevance of these parameters as well as their role in guiding the therapeutic process toward ASCT worths further research.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.