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Radioactivity is given to the patient
orally/i.v
Functional Evaluation
Radiopharmaceutical
123
99m
I or
99m
Tc-pertechnetate
Tc-V-DMSA
Lymphoma
67
Neuroendocrine tumors
111
123
Breast carcinoma
99m
Tc-MIBI
99m
Tc-MDP
Ga citrate
In-octreotide
I-MIBG
I-131
Gastroenteropancreatic
Neuroendocrine Tumors (GEP-NET)
Radioactive somatostatin analogues ( In-111
octreotide, Lu-177 DOTA-TATE) is used
because of the presence of somatostatin
receptors
Primary gastrinoma
In-111 octreotide
Pheocromacytoma -MIBG
Bone scan
Prostate Ca
Breast Ca
Lung Ca
Multiple metastases
Sentinel node
PET
Positron emission tomography
Functional and whole body imaging
Evaluation of tumor metabolism via
radioactive glucose or aminoacids
PET
Tumor
localisation ,
Differentiation
between benign /
malign
Detection of
tumour viability
after treatment
18F-florodeoxyglucose
(FDG)
Cell
FDG
Hexokinase
FDG-6-fosfat
FDG PET
FDG
Glucose
Transporter
FDG
Hexokinase
Glucose-6-isomerase
FDG-6-PO4
Glucose-6Glycolysis
phosphatase
PET/CT
PET
Shorter
Less radiation
Better resolution
Better lesion detection
RADIONUCLIDE
THERAPY
Radionuclide Therapy
Therapy
Differentiated thyroid cancer
Radiopharmaceutical
I-131
I-131 MIBG
GEP-NET Tumors
P-32
Radionuclide Synovectomy
Radio-iodine Threapy
Differentiated thyroid cancer
Post-op.
Ablation of functional thyroid tissue
100-200 mCi
In-patient
MIBG therapy
Pheocromacytoma and neuroblastoma
Rarely medullary thyroid cancer
Pre or post-op
Pallation or curative
Abdominal SPECT
4
hours
66
hours
139
hours
Abdominal CT
Wiseman et al. Cancer 2002;94:13491357
Gastroenteropancreatic
Neuroendocrine Tumours (GEP-NET)
Lu-177 DOTA-TATE
32
153
Radionuclide Synovectomy
Radiolabeled colloids
Intra articular injection
Combination of glucocorticoids
Hemophilic Arthritis
Rheumatoid Arthritis
Intra articular pigmented villonodular synovitis
(PVNS)