Radiopharmaceuticals : a guide to PET/CT and PET/MRI

239 Pages·2020·27.559 MB·English

by  Orazio Schillaci (editor), Ferdinando Calabria (editor)

Radiopharmaceuticals
A Guide to PET/CT
and PET/MRI
Ferdinando Calabria
Orazio Schillaci
Editors
Second Edition
123
Radiopharmaceuticals
Ferdinando Calabria • Orazio Schillaci
Editors
Radiopharmaceuticals
A Guide to PET/CT and PET/MRI
Second Edition
Editors
Ferdinando Calabria Orazio Schillaci
Department of Nuclear Medicine and Department of Biomedicine and
Theranostics Prevention
Mariano Santo Hospital University of Rome Tor Vergata
Cosenza Rome
Italy Italy
© Servizi Scientifici 2017 First Edition
© Springer Nature Switzerland AG 2020 Second Edition
ISBN 978-3-030-27778-9 ISBN 978-3-030-27779-6 (eBook)
https://doi.org/10.1007/978-3-030-27779-6
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Preface
Two years have elapsed since the publication of the book Radiopharma­
ceuticals, a well-received volume reflecting the state of the art in hybrid
PET/CT and PET/MR imaging with novel radiopharmaceuticals. Since its
publication, the necessity to cover a larger spectrum of PET tracers has
emerged, allowing physicians, residents, and students to deepen their knowl-
edge about PET molecular imaging in a single volume.
Therefore, this edition is enriched by two new chapters, respectively, that
focus on prostate cancer imaging with 68Ga-PSMA and imaging of tau pathol-
ogy. Previous chapters are also updated by new interesting clinical cases and
novel applications.
The panorama of PET molecular imaging has been improved in the last
decades by the development of several novel radiopharmaceuticals; some of
them play an established role while other tracers are showing interesting pre-
liminary results.
In this scenario, the most useful PET tracer, the 18F-FDG, shows a limited
role in several diseases due to its intrinsic molecular properties while PET
imaging is increasingly changing into a diagnostic technique, where the
radiopharmaceuticals rather than the scanner can help clinicians in reaching
the diagnostic goal. Therefore, amino acid tracers, radiolabeled choline, amy-
loid tracer, and other radiopharmaceuticals are becoming a valid alternative
to 18F-FDG in specific clinical settings.
Nevertheless, all PET tracers do not completely satisfy an important char-
acteristic of the “ideal tracer”: the capability to be largely, quickly, and selec-
tively taken up at the target site.
Moreover, the PET imaging has been rapidly improved by the develop-
ment and commercial availability of hybrid PET/CT and, more lately, PET/
MRI scanners, which afford us to enlarge our understanding on the applica-
tions of molecular imaging, taking advantage of the concurrent functional
and anatomical depiction of the human body.
For the reasons above expressed, the aim of our work is to describe the
most common tracers actually used in PET imaging. An essential, synthetic
chapter is still targeted on the 18F-FDG, the “milestone” among radiopharma-
ceuticals, in order to describe its actual applications, with a specific para-
graph focused on 18F-FDG PET/MRI.
vii
viii Preface
Thereafter, several novel tracers are presented in each chapter. For all of
them, we have described bio-distribution, physiopathology, and kinetics,
aiming to describe their specific “molecular pathways.” For all tracers, we
have tried to provide the essential diagnostic features and the most common
clinical indications. Moreover, a special paragraph in each chapter describes
and comments some diagnostic pitfalls which can occur in clinical practice,
while another paragraph describes the most used PET/CT acquisition
protocols.
A special interest is given to a large number of clinical cases (more than
170 figures in this new edition), in order to get the reader close to the typical
imaging features, pathologic findings, or to the diagnostic pitfalls of all
radiopharmaceuticals.
Figures of our book (with several multimodal imaging pictures) also try to
achieve different goals, as follows:
• Compare potential differences between SPECT and PET imaging
• Show the importance of the hybrid-integrated evaluation of PET/CT imag-
ing with the expertise on CT diagnostic criteria
• Describe the added value of contrast-enhanced PET/CT in some limited
cases
• Explain mismatches or overlapping among two different radiopharmaceu-
ticals in the same patient
• Realize all the potentiality of correlative MRI and of the hybrid PET/MRI
evaluation
Considering the continuous innovation process of nuclear medicine, all
chapters are focused on the role of a single tracer or few radiopharmaceuti-
cals. Actually, some chapters are focused on the amino acid radiopharmaceu-
ticals, such as 11C-methionine, 18F-DOPA, and 18F-FET. All these tracers are
useful for brain tumor imaging with some analogies, but we have also tried to
describe some peculiar applications beyond neuro-oncology.
A specific chapter is focused on “radiolabeled choline,” including all vari-
ants of this useful tracer: 11C-choline, 18F-methylcholine, and 18F-ethylcholine.
This chapter is also enriched by new interesting cases, bibliography, and
applications other than prostate cancer.
Other important chapters concern imaging of the skeletal system by 18F-
NaF, the myocardial perfusion imaging with 82Rb, and the β-amyloid imaging
of dementia.
Considering the importance of targeted radionuclide therapy, two chap-
ters, respectively, regard PET/CT imaging with 68Ga-labeled somatostatin
receptors analogs and the therapy with 223Ra.
A special section is also focused on the 64Cu as a versatile nuclide for PET
imaging, its possible ligands PSMA, ATSM, and DOTATOC, and their poten­
tial clinical applications.
Preface ix
As in the previous edition, particular mention is given to fields other than
oncology. In fact, new approaches are described in the study of brain tumors,
urological malignancies, functional imaging, forensic use, and the evaluation
of phlogosis and inflammation.
Humbly, we still hope to have centered our ambitious and arduous scope,
without exceeding technical aspects, trying to give the readers (clinicians,
nuclear medicine physicians, radiologists, and young colleagues or students)
an easy-to-consult, practical and concise atlas guide to the PET, PET/CT, and
PET/MR molecular imaging with novel radiopharmaceuticals.
Cosenza, Italy Ferdinando Calabria
Rome, Italy Orazio Schillaci
Contents
1 18F-FDG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Ferdinando Calabria, Andrea Cimini, Antonio Bagnato,
Domenico Gullà, Giuseppe L. Cascini, Nicoletta Urbano,
and Orazio Schillaci
2 1 8F-DOPA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Ferdinando Calabria and Orazio Schillaci
3 Lipogenesis Pathway: Radiolabeled Choline . . . . . . . . . . . . . . . . 57
Ferdinando Calabria, Marzia Colandrea, Giuseppe L. Cascini,
and Orazio Schillaci
4 18F-FET . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Giorgio Treglia, Barbara Muoio, and Luca Giovanella
5 18F-NaF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Ferdinando Calabria and Orazio Schillaci
6 Somatostatin Receptor Analogs (68Ga-DOTATOC,
68Ga-DOTANOC, 68Ga-DOTATATE) . . . . . . . . . . . . . . . . . . . . . . . 99
Luca Filippi, Patrizia Pizzichini, Oreste Bagni,
and Francesco Scopinaro
7 64Cu-Radiopharmaceuticals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Ferdinando Calabria, Antonio Bagnato, Vincenzo Gangemi,
Rosina Paonessa, Mario Leporace, Nicoletta Urbano,
and Giuseppe Lucio Cascini
8 Amyloid Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Agostino Chiaravalloti, Ferdinando Calabria,
Antonio Bagnato, and Orazio Schillaci
9 PET Myocardial Perfusion Imaging: 82Rb . . . . . . . . . . . . . . . . . . 143
Maria Luisa De Rimini and Giovanni Borrelli
10 The Bone Pathway: 223Ra-Dichloride . . . . . . . . . . . . . . . . . . . . . . 179
Laura Evangelista and Alessandra Zorz
11 11C-Methionine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Sebastiano Cosentino, Fabrizio Scopelliti, Gabriella Murè,
Sara Baldari, and Massimo Ippolito
xi
xii Contents
12 6 8Ga-PSMA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Robert Pichler, Johannes Wolfsgruber, Ferdinando Calabria,
Orazio Schillaci, and Andreas Dunzinger
13 PET Biomarkers for Tau Pathology . . . . . . . . . . . . . . . . . . . . . . . 227
Antoine Leuzy, Kerstin Heurling, and Michael Schöll