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核医学中的治疗诊断学方法:现状与未来展望。

Theranostic approaches in nuclear medicine: current status and future prospects.

机构信息

Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy.

Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.

出版信息

Expert Rev Med Devices. 2020 Apr;17(4):331-343. doi: 10.1080/17434440.2020.1741348. Epub 2020 Mar 19.

Abstract

: Theranostics is an emerging field in which diagnosis and specific targeted therapy are combined to achieve a personalized treatment approach to the patient. In nuclear medicine clinical practice, theranostics is often performed utilizing the same molecule labeled with two different radionuclides, one radionuclide for imaging and another for therapy.: The authors review the clinical applications of different radiopharmaceuticals in the field of interest, including the well-established use of radioactive iodine in differentiated thyroid cancer, radiolabeled metaiodobenzylguanidine (MIBG) in neuroblastoma and the clinical impact of peptide radionuclide receptorial therapy (PRRT) in the management of neuroendocrine tumors. Furthermore, the more cutting-edge and recently introduced theranostic approaches will be reviewed, such as the radioligand therapy with Lu-prostate specific membrane antigen (PSMA) and targeted alpha therapy in castration-resistant prostate cancer. Finally, the main applications of PET for the imaging of biomarkers suitable for the non-radionuclide targeted therapy will be covered.: Theranostics is envisaging a revolutionary clinical approach which is deeply connected with the concept of personalized medicine and ruled by a 'patient-centered' vision. In this perspective, the theranostic applications will need well-trained specialists, capable to manage not only the technological aspects of the discipline, but also to deal with the more innovative oncological therapies in a multidisciplinary setting.

摘要

治疗诊断学是一个新兴的领域,它将诊断和特定的靶向治疗相结合,为患者提供个性化的治疗方法。在核医学临床实践中,治疗诊断学通常利用同一分子标记两种不同的放射性核素来实现,一种放射性核素用于成像,另一种用于治疗。作者综述了不同放射性药物在感兴趣领域的临床应用,包括放射性碘在分化型甲状腺癌中的广泛应用、放射性标记间碘苄胍(MIBG)在神经母细胞瘤中的应用,以及肽放射性核素受体治疗(PRRT)在神经内分泌肿瘤治疗中的临床影响。此外,还将回顾一些更前沿和最近引入的治疗诊断方法,如 Lu-前列腺特异性膜抗原(PSMA)放射性配体治疗和去势抵抗性前列腺癌的靶向α治疗。最后,将介绍 PET 用于成像适合非放射性靶向治疗的生物标志物的主要应用。治疗诊断学设想了一种革命性的临床方法,它与个性化医疗的概念密切相关,并以“以患者为中心”的理念为指导。在这种观点下,治疗诊断学的应用需要训练有素的专家,他们不仅能够掌握该学科的技术方面,还能够在多学科环境中处理更具创新性的肿瘤治疗方法。

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