The Added Value of Diagnostic and Theranostic PET Imaging for the Treatment of CNS Tumors

Abstract

This review highlights the added value of PET imaging in Central Nervous System (CNS) tumors, which is a tool that has rapidly evolved from a merely diagnostic setting to multimodal molecular diagnostics and the guidance of targeted therapy. PET is the method of choice for studying target expression and target binding behind the assumedly intact blood–brain barrier. Today, a variety of diagnostic PET tracers can be used for the primary staging of CNS tumors and to determine the effect of therapy. Additionally, theranostic PET tracers are increasingly used in the context of pharmaceutical and radiopharmaceutical drug development and application. In this approach, a single targeted drug is used for PET diagnosis, upon the coupling of a PET radionuclide, as well as for targeted (nuclide) therapy. Theranostic PET tracers have the potential to serve as a non-invasive whole body navigator in the selection of the most effective drug candidates and their most optimal dose and administration route, together with the potential to serve as a predictive biomarker in the selection of patients who are most likely to benefit from treatment. PET imaging supports the transition from trial and error medicine to predictive, preventive, and personalized medicine, hopefully leading to improved quality of life for patients and more cost-effective care.

Chemical exchange saturation transfer for detection of antiretroviral drugs in brain tissue

“…In traditional theranostic technologies, drug molecules are tagged with imaging agents or loaded with imaging agents into one nanoparticle. Paramagnetic metals are commonly used for MRI [43][44][45] and radioactive materials used for PET and SPECT [46][47][48][49]. The limitations of the methods are obvious.…”

Novel Receptor Tyrosine Kinase Pathway Inhibitors for Targeted Radionuclide Therapy of Glioblastoma

“…The latter approach is called targeted radionuclide therapy (TRT) [ 12 , 13 ]. Our group recently published a perspective on the requirements for a successful TRT agent for GB treatment and the existing TRT strategies for GB were recently reviewed by others [ 14 , 15 , 16 , 17 ].…”

Theragnostic Aspects and Radioimmunotherapy in Pediatric Tumors

“…The diagnostic approach evaluates potential targets that can predict if a patient will benefit from a particular treatment. Increasing literature on the genetic and molecular aspects of tumor subtypes describes the intra-personal variability and the importance of the development of potentially effective targeted therapies [3]. Therefore, rapid growth in the radiopharmaceuticals and diagnostic fields has led to the continually increasing use of theragnostic agents [4].…”

“…Positron emission tomography (PET) traces can be used to predict the behavior of radioactive or non-radioactive targeted drugs (i.e., radiopharmaceuticals or pharmaceuticals). In the case of pharmaceuticals, the role of nuclear medicine tracers is to target the pharmaceutical compound biodistribution [3].…”