[Evaluation of the therapeutic response: role of isotopic imaging].
In comparison with conventional imaging, nuclear medicine offers an original metabolic approach for the assessment of the therapeutic response. Gallium 67, thallium 201, technetium 99m-labeled sestamibi and diphosphonates can be performed for therapeutic response assessment in lymphoma, brain and breast tumours, sarcoma, or bone metastasis. PET-CT facilities are now easily available in France and are ready to provide a new and accurate tool in oncology, specially for therapeutic evaluation. The procedure consists in the injection of fluor-18-fluoro-déoxyglucose (18FDG), an analogue of glucose, followed by a PET then a CT acquisition for FDG uptake abnormalities location. Therapeutic response is assessed by a decrease of 18FDG tumoral uptake between two consecutive studies. Methodology and interpretation criteria have been recently defined in international guidelines. 18FDG-PET-CT seems to be a valuable tool for therapeutic response assessment of patients with Hodgkin or non Hodgkin malignant lymphoma. Promising preliminary results have been recently published for lung, gastro-intestinal and head and neck cancers. PET-CT could also be able to predict the therapeutic response after the first courses of chemotherapy, allowing an early treatment optimization. Finally, new PET agents pave the way for molecular imaging with promising results in gene therapy and targeted treatment in oncology.
Cachin
Florent
F
Unité de médecine nucléaire, CRLCC Jean-Perrin, Faculté de Médecine, Université de Clermont-Ferrand I, Clermont Ferrand.
Kelly
Antony
A
Maublant
Jean
J
D004164:Diphosphonates; D019788:Fluorodeoxyglucose F18; D005710:Gallium Radioisotopes; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D004164:Diphosphonates; D005710:Gallium Radioisotopes; D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D013794:Thallium Radioisotopes; D019788:Fluorodeoxyglucose F18; C029045:technetium Tc 99m diphosphonate; D017256:Technetium Tc 99m Sestamibi