Nuclear Medicine in Endocrine Disorders: Diagnosis and Therapy

Preface
Contents
Part I: Basics and Principles of Nuclear Medicine
Chapter 1: Basic Principles of Radiopharmaceuticals
1.1 Introduction
1.2 Cyclotron-Produced Radionuclides
1.3 Nuclear Reactor-Produced Radionuclides
1.4 Radionuclide Generators
1.5 Ideal Diagnostic Radiopharmaceuticals
1.6 Diagnosis: SPECT Radionuclides
1.7 Diagnosis: PET Radionuclides
1.8 Therapeutic Radiopharmaceuticals
1.9 Factors Affecting the Biodistribution of Radiopharmaceuticals
1.10 Quality Control
References
Chapter 2: Basic Principles of Scintigraphy and SPECT (Single-Photon Emission Computed Tomography)
2.1 Introduction
2.2 Main Modalities of Scintigraphic Acquisitions
2.3 Gamma Camera Systems
2.4 Gamma Camera SPECT Systems
2.5 Main Forms of Radiation Used in Nuclear Imaging in Endocrinology
References
Chapter 3: Basic Principles of Positron Emission Tomography
3.1 Positron Emission Tomography (PET)
3.2 Coincidence Timing Window
3.3 Image Acquisition
3.4 Events Detection
3.5 PET Scanner Design
3.6 Spatial Resolution
3.7 Time of Flight
3.8 PET/CT
References
Chapter 4: Principles of Radionuclide Treatments
4.1 Introduction
4.2 Alpha and Beta Particles Characteristics
4.3 Energy Transfer to Tissues and Associated Biological Effects
4.4 Post-treatment Radionuclide Imaging
4.5 Basic Concepts of Medical Internal Radiation Dosimetry
4.6 The General Use of Radionuclide Treatments in Endocrinological Disorders
References
Chapter 5: Basic Principles of Radioguided Surgery
5.1 Introduction
5.2 Scintigraphy and Radioguidance Protocols for Occult Lesion Localization General Advantages
5.3 Concepts of Sentinel Lymph Node Localization
References
Part II: Benign Thyroid Diseases
Chapter 6: Thyroid Diseases: Procedures and Techniques
6.1 Thyroid Scan
6.2 Patient Preparation
6.3 Radiopharmaceuticals
6.4 Protocol
6.5 Image Acquisition/Instrumentation
References
Chapter 7: Thyroid Scintigraphy in the Workup of a Thyroid Nodule
7.1 Introduction
7.2 Benign Nodules
7.3 Malignant Nodule and Thyroid Cancer
7.4 Pediatric Thyroid Nodules
7.5 Initial Evaluation of Thyroid Nodules
7.6 Scintigraphy Evaluation of Thyroid Nodules
7.7 Indications
7.8 Image/Interpretation
7.9 Toxic Multinodular Goiter
7.10 Radioiodine Thyroid Uptake (RAIU)
7.11 99mTc-Sestamibi (MIBI) Scan
7.12 Contraindications of Thyroid Scintigraphy
References
Chapter 8: Positron Emission Tomography-Computed Tomography (PET-CT) in Thyroid Nodules
8.1 Introduction
8.2 PET/CT Techniques
8.3 Indeterminate Thyroid Nodules
8.4 Preoperative 18F-FDG PET/CT
8.5 Malignancy in Thyroid Incidentalomas Detected with Whole-Body PET/CT
References
Chapter 9: Scintigraphy in Hyperthyroidism
9.1 Introduction
9.2 Hyperthyroidism
9.3 Scintigraphy in Hyperthyroidism
9.3.1 Radiopharmaceuticals
9.3.1.1 Technetium-99m
9.3.1.2 Iodine Isotopes: 123 I and 131 I
9.3.2 Procedure and Imaging Protocols
9.3.2.1 Measurement of Iodine Uptake
9.4 Indications
9.4.1 Contraindications
9.4.2 Interpretation Images
9.5 Suppression Thyroid Scintigraphy
9.6 Potassium Perchlorate Test
9.7 Scintigraphy in Graves’ Disease
9.8 Marine-Lenhart Syndrome
9.9 Autonomously Functioning Thyroid Nodule
9.10 Toxic Autonomous Thyroid Nodule
9.11 Toxic Multinodular Goiter
9.12 Hyperthyroidism in Pregnancy
9.13 Hyperthyroidism in Children
9.14 Subclinical Hyperthyroidism Associated with Decreased RAIU
9.14.1 Iatrogenic
9.14.2 Subacute Thyroiditis
9.15 Diagnostic Provisional Dosimetry
9.16 99m-Tc-Sestamibi Scintigraphy for Thyroid Nodule Assessment
References
Chapter 10: Hyperthyroidism and Benign Thyroid Nodules Therapy: Role of Nuclear Medicine
10.1 Introduction
10.2 Graves’ Disease
10.3 Toxic Multinodular Goiter
10.4 Toxic Adenoma
10.5 Thyroiditis
10.6 Treatment-Induced Hyperthyroidism
10.7 Tumors
10.8 Diagnostic Work-Up
10.9 Treatment
10.10 Radioactive Iodine
10.11 Contraindications
10.12 Cares Before Radioiodine Therapy
10.13 Stimulation with Recombinant Human Thyrotropin Prior to Iodine 131 Therapy
10.14 Radioiodine Therapy Recommended Activity
10.15 Care After Therapy
10.16 Costs
10.17 Adverse Effects
References
Part III: Parathyroid Diseases
Chapter 11: Parathyroid Diseases: Procedure’s Techniques
11.1 Introduction to Hyperparathyroidism
11.2 Scintigraphy, SPECT, and SPECT-CT
11.3 PET-CT
References
Chapter 12: Scintigraphy in Hyperparathyroidism
12.1 Parathyroid Scintigraphy
12.2 Diagnostic Performance
12.3 Combination with Thyroid Scintigraphy and Subtraction Technique
12.4 SPECT-CT
12.5 Combined Interpretation with Ultrasound
12.6 Cost-Effectiveness
References
Chapter 13: Hyperparathyroidism and Positron Emission Tomography
13.1 Introduction
13.2 Radiopharmaceuticals: 18F-Fluoro-D-Deoxyglucose (18F-FDG)
13.3 Radiopharmaceuticals: L-11C-Methionine (11C-MET)
13.4 Radiopharmaceuticals: 11C or 18F Radiolabeled Choline (11C-Choline or 18F-Fluorocholine)
13.5 Radiopharmaceuticals: Other Tracers
References
Chapter 14: Radioguided Localization of Parathyroid Glands
14.1 Introduction
14.2 Images Before Surgery
14.3 Radioguided Surgery Performance
References
Chapter 15: Bone Scan in Hyperparathyroidism
15.1 Introduction
15.2 Bone Scan
15.3 Positron Emission Tomography (PET)
References
Part IV: Thyroid Cancer
Chapter 16: Differentiated Thyroid Cancer: Procedure’s Techniques
16.1 Introduction to Well Differentiated Thyroid Cancer (DTC)
16.2 Patient Preparation for Radioiodine Procedures
16.3 Radioiodine Whole-Body Scan
16.4 Radioiodine Treatment
16.5 PET-CT in DTC Management
References
Chapter 17: Scintigraphy in Differentiated Thyroid Cancer
17.1 Radioiodine Whole-Body Scan (WBS)
17.2 Diagnostic Performance
17.3 SPECT-CT
References
Chapter 18: Radioiodine Therapy in Differentiated Thyroid Cancer
18.1 Introduction
18.2 Radioiodine Therapy (RIT) Indications in Adults
18.3 Pediatric Population
18.4 Contraindications
18.5 RIT Adverse Effects
18.6 Internal Dosimetry
18.7 Radiation Protection
References
Chapter 19: Sentinel Lymph Node Biopsy in Differentiated Thyroid Cancer
19.1 Sentinel Lymph Node Biopsy (SLNB) Indications
19.2 SLNB Effectiveness Using Radioactive Tracers
References
Chapter 20: Radioiodine Refractory Thyroid Cancer
20.1 Introduction
20.2 Iodine Refractory Disease
20.3 Radioiodine Refractory Thyroid Cancer Follow-Up
20.4 Therapeutic Possibilities for Radioiodine Refractory Disease
20.5 Therapies to Recover Radioiodine Uptake
20.6 Radiolabeled Somatostatin Analogs in the Management of Radioiodine Refractory Thyroid Cancer
References
Chapter 21: PET-CT in Differentiated Thyroid Cancer
21.1 Introduction
21.2 FDG PET-CT
21.3 Radioiodine PET-CT
21.4 Somatostatin Analogs PET-CT
21.5 Other Radiopharmaceuticals
References
Chapter 22: Nuclear Medicine in Medullary Thyroid Cancer
22.1 Introduction
22.2 Scintigraphy in Medullary Thyroid Cancer
22.3 PET-CT in Medullary Thyroid Cancer
22.4 Radionuclide Therapy in Medullary Thyroid Cancer
References
Chapter 23: Nuclear Medicine in Anaplastic Thyroid Cancer
23.1 Introduction
23.2 PET-CT in Anaplastic Thyroid Cancer
References
Part V: Adrenal Benign and Malignant Disorders
Chapter 24: Nuclear Medicine in Adrenal Lesions
24.1 Introduction
24.2 Adrenal Scintigraphy
24.3 Adrenal Evaluation by PET-CT
References
Chapter 25: Procedures and Techniques in Pheochromocytomas and Paragangliomas
25.1 Introduction
25.2 Confirmation of Diagnosis of PCC/PGL and Other Findings
25.3 Whole-Body Scintigraphy and SPECT Imaging Protocol
25.4 131I-/123I-Metaiodobenzylguanidine Scintigraphy
25.4.1 Radiopharmaceutical
25.4.2 Mechanism of Cellular Uptake
25.4.3 Pharmacokinetics
25.4.4 Synthesis and Quality Control
25.4.5 Drug Interactions
25.4.6 Side Effects
25.4.7 Patient Preparation
25.4.8 Recommended Activity and Administration
25.4.9 Radiation Dosimetry
25.4.10 Pregnancy and Breastfeeding
25.4.11 Renal Insufficiency
25.4.12 Image Acquisition and Reconstruction
25.4.13 Reconstruction
25.4.14 Image Processing
25.5 111In-Pentetreotid/Octreotide Scintigraphy
25.5.1 Radiopharmaceutical
25.5.1.1 Mechanism of Uptake
25.5.1.2 Pharmacokinetics
25.5.2 Synthesis and Quality Control
25.5.2.1 Drug Interactions and Side Effects
25.5.2.2 Recommended Activity and Administration
25.5.2.3 Radiation Dosimetry
25.5.2.4 Pregnancy
25.5.2.5 Breastfeeding
25.5.2.6 Renal Failure
25.5.2.7 Patient Preparation
25.5.2.8 Image Acquisition
25.5.2.9 Reconstruction
25.5.3 SPECT/CT Images
25.6 PET Imaging Protocol
25.6.1 Radiopharmaceuticals
25.6.2 Mechanism of Cellular Uptake
25.6.3 Pharmacokinetics
25.6.4 Drug Interactions and Side Effects
25.6.5 Pregnancy
25.6.6 Breastfeeding
25.6.7 Patient Preparation
25.6.8 Image Reconstruction
25.6.9 Image Analysis
25.6.10 Quantification
25.7 Radionuclide Therapy for Neuroendocrine Tumors
25.8 131I-MIBG Therapy
25.8.1 Administration
25.9 Peptide Receptor Radionuclide Therapy with 177Lu-DOTATATE and 90Y-DOTATOC
25.9.1 Administration
References
Chapter 26: Scintigraphy in Pheochromocytomas and Paragangliomas
26.1 Introduction
26.2 131I-MIBG and 123I-MIBG Scintigraphy
26.3 Image Interpretation
26.4 False Positive
26.5 False Negative
References
Chapter 27: Positron Emission Tomography in Pheochromocytomas and Paragangliomas
27.1 Introduction
27.2 Head and Neck Paragangliomas (HNPGL)
27.3 Retroperitoneal, Extra-Adrenal, and Non-metastatic PGLs
27.4 Metastatic PPGLs
27.5 VHL and RET (MEN2)-Associated PPGLs
27.6 Screening SDHx Mutations
27.7 Pediatric PHEO/PPGL
27.8 68Ga-DOTA-SSA PET/CT
27.8.1 False-Positive Findings in 68Ga-DOTA-SSA PET/CT
27.8.2 False-Negative Findings in 68Ga-DOTA-SSA PET/CT
27.9 18F-FDOPA PET/CT
27.9.1 False-Positive Findings in 18F-FDOPA PET/CT
27.9.2 False-Negative Findings in 18F-FDOPA PET/CT
27.10 18F-FDG PET/CT
27.10.1 False-Positive Findings
27.10.2 False-Negative Findings
References
Chapter 28: Pheochromocytomas and Paragangliomas Radionuclide Treatments
28.1 Introduction
28.2 Radionuclide Therapy
28.2.1 [131I] MIBG (Metaiodobenzylguanidine) Therapy
28.2.1.1 Mechanism of MIBG Uptake in Neuroendocrine Tumors
28.2.1.2 Dose Recommended and Administration
28.2.1.3 Indications and Contraindications of I-131 MIBG Therapy
28.2.1.4 Pre Therapy
28.2.1.5 Efficiency
28.2.1.6 Side Effects of I-131 MIBG Therapy
28.2.2 Peptide Receptor Radionuclide Therapy (PRRT)
28.2.2.1 177Lu-DOTATATE Therapy
28.2.2.2 Dose Recommended and Administration
28.2.2.3 Indications and Contraindications
28.2.2.4 Side Effects of PR
28.2.2.5 Efficiency
28.2.3 [90Y]DOTATOC Therapy
28.2.4 Pediatric Neuroendocrine Tumors: Treatment by Radioisotopes
28.2.4.1 131I-MIBG Therapy in NBL
References
Part VI: Neuroendocrine Tumors (NET)
Chapter 29: Procedures and Techniques in Neuroendocrine Tumors
29.1 Introduction to Neuroendocrine Tumors
29.2 SPECT and SPECT/CT Somatostatin Analogs Imaging
29.3 PET/CT Imaging for NETs
References
Chapter 30: Scintigraphy in Neuroendocrine Tumors
References
Chapter 31: Positron Emission Tomography in Neuroendocrine Tumors
31.1 Somatostatin Analogs PET/CT
31.2 18F-DOPA PET/CT
31.3 64Cu-DOTATATE PET/CT
References
Chapter 32: Neuroendocrine Tumors Radionuclide Therapy
32.1 Introduction
32.2 Indications, Contraindications, and Warnings
32.3 Procedure
32.4 PRRT Variants
32.5 Side Effects
32.6 Clinical Trials and Results
32.7 Alpha Emitters
References
Index