Ferdinando Calabria - Radiopharmaceuticals: A Guide to PET/CT and PET/MRI

2017

by Servizi Scientifici - via Treviso 17/A, 00161 Roma

This Springer imprint is published by the registered company Springer Nature Switzerland AG

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Two years have elapsed since the publication of the book Radiopharmaceuticals , 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 knowledge 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 68 Ga-PSMA and imaging of tau pathology. 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 preliminary results.

In this scenario, the most useful PET tracer, the 18 F-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, amyloid tracer, and other radiopharmaceuticals are becoming a valid alternative to 18 F-FDG in specific clinical settings.

Nevertheless, all PET tracers do not completely satisfy an important characteristic of the ideal tracer : the capability to be largely, quickly, and selectively taken up at the target site.

Moreover, the PET imaging has been rapidly improved by the development and commercial availability of hybrid PET/CT and, more lately, PET/MRI scanners, which afford us to enlarge our understanding on the applications 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 18 F-FDG, the milestone among radiopharmaceuticals, in order to describe its actual applications, with a specific paragraph focused on 18 F-FDG PET/MRI.

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.

Considering the continuous innovation process of nuclear medicine, all chapters are focused on the role of a single tracer or few radiopharmaceuticals. Actually, some chapters are focused on the amino acid radiopharmaceuticals, such as 11 C-methionine, 18 F-DOPA, and 18 F-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 variants of this useful tracer: 11 C-choline, 18 F-methylcholine, and 18 F-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 18 F-NaF, the myocardial perfusion imaging with 82 Rb, and the -amyloid imaging of dementia.

Considering the importance of targeted radionuclide therapy, two chapters, respectively, regard PET/CT imaging with 68 Ga-labeled somatostatin receptors analogs and the therapy with 223 Ra.

A special section is also focused on the 64 Cu as a versatile nuclide for PET imaging, its possible ligands PSMA, ATSM, and DOTATOC, and their potential clinical applications.

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.