School of Biomedical Engineering and Imaging Sciences, King's College London, 4th Floor Lambeth Wing, St Thomas' Hospital, London, SE1 7EH, England.
Cancer Imaging. 2021 Jan 30;21(1):18. doi: 10.1186/s40644-021-00385-8.
Nuclear medicine has evolved over the last half-century from a functional imaging modality using a handful of radiopharmaceuticals, many of unknown structure and mechanism of action, into a modern speciality that can properly be described as molecular imaging, with a very large number of specific radioactive probes of known structure that image specific molecular processes. The advances of cancer treatment in recent decades towards targeted and immune therapies, combined with recognition of heterogeneity of cancer cell phenotype among patients, within patients and even within tumours, has created a growing need for personalised molecular imaging to support treatment decision. This article describes the evolution of the present vast range of radioactive probes - radiopharmaceuticals - leveraging a wide variety of chemical disciplines, over the last half century. These radiochemical innovations have been inspired by the need to support personalised medicine and also by the parallel development in development of new radionuclide imaging technologies - from gamma scintigraphy, through single photon emission tomography (SPECT), through the rise of clinical positron emission tomography (PET) and PET-CT, and perhaps in the future, by the advent of total body PET. Thus, in the interdisciplinary world of nuclear medicine and molecular imaging, as quickly as radiochemistry solutions are developed to meet new needs in cancer imaging, new challenges emerge as developments in one contributing technology drive innovations in the others.
核医学在过去的半个世纪中经历了发展，从使用少数放射性药物的功能成像方式发展成为一种现代的专业领域，可以恰当地描述为分子成像，具有大量已知结构的特定放射性探针，可对特定的分子过程进行成像。最近几十年癌症治疗的进展朝着靶向和免疫治疗方向发展，加上对患者之间、患者体内甚至肿瘤内癌细胞表型异质性的认识，为支持治疗决策，对个体化分子成像的需求不断增长。本文描述了过去半个世纪中，利用各种化学学科，放射性探针（放射性药物）的广泛应用的演变。这些放射性化学创新是为了支持个体化医学而产生的，也是为了支持新的放射性核素成像技术的平行发展而产生的，这些技术从伽马闪烁成像，通过单光子发射断层扫描（SPECT），到临床正电子发射断层扫描（PET）和 PET-CT 的兴起，或许在未来，还将出现全身 PET。因此，在核医学和分子成像的跨学科领域中，随着放射性化学解决方案的快速发展，以满足癌症成像的新需求，随着一种贡献技术的发展推动了其他技术的创新，新的挑战不断出现。
