Clinical Applications of Nuclear Medicine Targeted Therapy

This book offers a practical and modern update on radioisotope therapy. Clinically oriented, it provides a thorough guide to patient management, with the latest indications and procedures for the current radioisotopic treatments. It addresses the clinical problems associated with each respective pathology, discussing the management of patients (diagnosis and non-radioisotope therapy), the radiopharmaceuticals available today, and the current radioisotopic procedures. Wherever possible, information on dosimetry is included at the end of each topic, together with a list of and comments on the most recent guidelines with their recommendations for radiometabolic therapy.

The book is divided into six main sections: thyroid diseases, hepatic tumors (HCC and hepatic metastases), bone metastases from prostate cancer, lymphomas, and neuroendocrine tumors. The last section is dedicated to new perspectives of radioisotope treatment. Based on contributions from of a multidisciplinary team of specialists: oncologists, surgeons, endocrinologists, hematologists, urologists, radiopharmacists and nuclear medicine physicians, it provides a comprehensive analysis of the position of radioisotope treatments among the various therapeutic options.

Readers interested in targeted therapy, radiometabolic therapy, radioimmunotherapy and radiometabolic imaging will find this book both informative and insightful.

THYROID DISEASES.- Diagnosis and treatment of hyperthyroidism (Endocrinologist).- Radiopharmaceuticals for therapy of thyroid diseases ( chemistry, mechanism of uptake, biodistribution, doses)  (Radiochemist).- Radioiodine therapy of hyperthyroidism (indications , procedures and results) ( Nucl Medicine Physician).- Dosimetry (Physicist).- Clinical management of thyroid cancer (Oncologist).- Radioidine therapy of thyroid cancer (ablation, loco-regional and distant metastases, indications procedures and results) (Nucl Medicine Physician).- Dosimetry (Physicist).- Novel approaches of radiometabolic treatment of thyroid cancer (Nucl Medicine Physician).- Published guidelines on radioisotopic treatments of thyroid diseases (Nucl Medicine Physician and Oncologist).- HEPATIC CANCER.- Clinical options  for treatment of hepatocellular carcinoma (HCC) (Oncologist, Surge

on).- Radiopharmaceuticals for radioembolization  (characteristics, mechanism of uptake,   biodistribution, doses) (Radiochemist).- HCC radioembolization with ⁹⁰Y microspheres (indications and procedures) (Nucl Medicine Physician).- Dosimetry (Physicist).- The clinical problem of hepatic metastases (Oncologist, Surgeon).- Radioembolization of hepatic metastases with ⁹⁰Y microspheres (indications and procedures) (Nucl Medicine Physician).- Dosimetry (Physicist).- Published guidelines on radioisotope treatment of hepatocellular cancer (Nucl Medicine Physician and Oncologist).- NEUROENDOCRINE TUMORS.- Radiopharmaceuticals for treatment of neuroendocrine tumors (mechanisn of action, biodistribution, doses) (Radiochemis inPaediatric tumors of neuroendocrine origin (Oncologist).- Treatment with ¹³¹I – MIBG (indications procedures and results) (Nucl Medicine Physician).- Dosimetry (Physicist).- GEP neuroendocrine tumors (Oncologist).- PPRT with ⁹⁰Y labeled peptides  (indications ,procedures and results) (Nucl Medicine Physician).- Dosimetry (Physicist).- Published guidelines on radioisotope treatment of Neuroendocrine tumors(Nucl Medicine Physician and Oncologist).- LYMPHOMAS.- Selection of lymphoma patients candidates for Radioimmunotherapy (Haematologist).- Radiopharmaceuticals for treatment of neuroendocrine tumors (mechanisn of action, biodistribution, doses) (Radiochemist).- Treatment with anti-CD20 Antibodies ( ⁹⁰Y- ibritumomab /¹³¹ I- Tositumomab) (indications and procedures  and results) (Nucl Medicine Physician).- Radioimmunotherapy at high doses of lymphomas (Nucl Medicine Physician).- Published guidelines on radioisotope treatment of Lymphomas (Nucl Medicine Physician and Oncologist).- PROSTATE CANCER.- Overview on bone metastases from prostate cancer (Urologist, Oncologist).- Radiopharmaceuticals for treatment of bone metastases (mechanisn of action, biodistribution, doses) (Radiochemist).- Targeted therapy with ²²³Ra dichloride of bone metastases(Nucl Medicine Physician).- Novel approaches of treatment with ²²³Ra based targeted therapy (Nucl Medicine Physician).- Dosimetry (Physicist).- Published guidelines on radioisotope treatment of Bone Metastases (Nucl Medicine Physician and Oncologist).

Emilio Bombardieri graduated in Oncology and Nuclear Medicine at the University of Milan. In 1972 he joined the Istituto Nazionale Tumori, Milan, where he worked as a Nuclear Medicine Physician in the area of Oncology, Diagnosis and Therapy and later became Director of the Nuclear Medicine Division and Director of the Department of Diagnostic Imaging and Radiotherapy. In 2013 he was appointed

Scientific Director of Nuclear Medicine Division at Humanitas Gavazzeni Hospital and Coordinator of the Scientific Committee. Since 1982 he has been Professor of Physiology and Endocrinology at the Catholic University, ISEF, Milan. He served as President of the Italian Association of Nuclear Medicine (AIMN); he has chaired the EANM (European Association of Nuclear Medicine)Oncology Committee and was nominated President of the EANM Congress 2012 in Milan.

Ettore Seregni is the Head of the Nuclear Medicine Therapy and Endocrinology Unit at the IRCCS National Cancer Institute of Milan. His current research interests include the development and clinical validation of different radiopharmaceuticals for cancer therapy. His main fields of clinical research are neuroendocrine tumors, prostatic and thyroid cancer, and metastatic bone lesions.

Laura Evangelista is a nuclear medicine physician working at Veneto Institute of Oncology IOV – IRCCS in Padova, Italy. She worked as a research fellow at University “Federico II” of Napoli Italy, Memorial Sloan Kettering of New York City, USA and th

e Mayo Clinic of Rochester (Minnesota, USA) focusing on PET/CT in breast cancer, prostate cancer and molecular imaging. In 2009 she joined the Veneto Institute of Oncology, where she is currently pursuing a special interest in the nuclear diagnostic evaluation of cancer.

Carlo Chiesa 

Since October 2005, member of Dosimetry Committee of the European Association of Nuclear Medicine. Senior advisor member since 2013. From September 2006, coordinator of the of Italian Internal Dosimetry Group.
Teacher to IAEA dosimetry course in November 2013 & 2016, and EFOMP dosimetry course in 2016. In September 2016, IAEA expert mission to implement dosimetry in Kuwait City hospital.
From 2004 to the present, teacher of “Nuclear Medicine Equipment” at the postgraduate Nuclear Medicine School for physicians.
Consultant for Biocompatibles BTG L.t.d. for dosimetry and safety of Therasphere treatment of liver disease. In 2015, consultant of MedPace corelab (Cincinnati OHIO USA) for instrument validation in an international multicenter study.

Arturo Chiti graduated with a degree in Medicine and Surgery from the Univer

sity of Milan and joined the Training Program in Nuclear Medicine at the University of Milan. He subsequently worked as Associate Chief at the National Cancer Institute in Milan, where he began his clinic and scientific experience in Oncology. He was appointed Full Professor in Diagnostic Imaging and Radiotherapy at the Humanitas University in Milan and is currently Director of the Training Program in Diagnostic Imaging at Humanitas University. He served as President of the European Association of Nuclear Medicine and has advised the International Atomic Energy Agency for many years, and his contributions have been recognized with an honorary membership in the European Society for Therapeutic Radiology and Oncology.