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Edit Comment Close Premium member Presentation Transcript Nuclear medicine in oncology : Nuclear medicine in oncology Presentation :Dr.MUSTAFA IBRAHIM Slide 2: diagnosis staging follow-up treatment of malignancy post-therapy management Nuclear medicine contributes to: Applications of Radiopharmaceuticals in Oncology : Applications of Radiopharmaceuticals in Oncology Commonly used R.ph : Commonly used R.ph MDP MIBI Ga67 CITRATE In-111-OCTERIOTIDE MIBG CONTTTTTTTTT : CONTTTTTTTTT MONOCLONAL ANTIBODY DMSA (V) TI 201 PET SCAN I-131 Slide 6: Bone scan is indicated in staging primary bone tumors and detecting bone metastases( prostate, breast, lung cancer, renal tumors ….etc) Bone scan is the method of choice to investigate patients with known malignancy and clinically suspected bone metastases. Tc-99m MDP Tc-99m MDP : Positivity many months before an abnormality can be detected on radiological examination . Bone scan has high sensitivity and ability to image the whole skeleton . Metastases Usually appear as hot lesions (osteoblastic mets),and less likely cold lesions (lytic mets),and could be mixed (hot and cold) Tc-99m MDP Ewing Sarcoma : Ewing Sarcoma Meatastases : Meatastases Neuroblastoma : Neuroblastoma Prostate Cancer : Prostate Cancer Tc-99m MIBI : 99mTc-methoxyisobutyl isonitrile (MIBI) diffuses into tumor cells and is thought to localize in the mitochondria The main clinical role for scintimammography is in evaluation of indeterminate mammographic lesions , for further investigation of patients with a palpable abnormality but negative mammography and dense breast . Sensitivity has ranged from 62% to 93%, with specificity from 79% to 94%. Sensitivity is greater for palpable lesions. Tc-99m MIBI Breast Cancer : Breast Cancer Ga-67 Citrate : Indications are: lymphoma , hepatoma ,seminoma, melanoma, bronchogenic carcinoma 67Gallium (Ga) citrate binds to transferrin and to leucocytes . Lymphoma :Gallium uptake prior to therapy and residual uptake after therapy almost always indicate viable tumor. Failure of the tumor to accumulate gallium following therapy usually indicates adequate therapeutic effect, so it is useful to determine if a patient requires additional therapy Ga -67 sensitivity for lymphoma is 80% to 90% Ga-67 Citrate Lymphoma : Lymphoma Lymphoma : Lymphoma Lymphoma : Lymphoma In-111 Octeriotide : Indications are : neuroendocrine tumors (carcinoid tumors,Vipomas ,glucagonoma,insulinoma) pheochromocytoma ,neuroblastoma, 111-In- octreotide, which binds to membrane somatostatin receptors The presence of somatostatin receptors on neuroendocrine tumors allows their detection using radiolabelled somatostatin analogues. This technique has high sensitivity for localization of the primary and metastatic lesion, but this varies with tumor type because of expression of different sub-classes of somatostatin receptor In-111 Octeriotide Gluconoma : Gluconoma Carcinoid Tumor : Carcinoid Tumor Neuroblastoma : Neuroblastoma I-131 MIBG : 123-iodine (I)-metaiodobenzyl-guanidine (MIBG), which is taken up into cells of neural crest tumors which contain chromaffin granules, such as phaeochromocytoma I-131 MIBG is the procedure of choice in case of extra-adrenal pheochromocytoma. I-131 MIBG has sensitivity about 90% in pheochromocytoma. I-131 MIBG is the most sensitive procedure to dedect bone metastases in neuroblastoma . I-131 MIBG Pheochromocytoma : Pheochromocytoma I-131 : I-131 I-131 scanning is indicated in detecting remnant and metastatic thyroid cancer (papillary ,follicular). Common sites for thyroid cancer metastases are lung ,lymph nodes and bone, Scanning usually 4-6 weeks post operation. Scanning dose is 1-5 mCi. I-131 in higher doses is used to treat hyper thyrodisim and thyroid cancer . Thyroid Cancer : Thyroid Cancer Monoclonal Antibody Scan (radioimmunoscintigraphy : Anti CEA antibodies is the most widely used for CEA positive tumors( like : colorectal cancer and Ca. lung). Current clinical practice is largely confined to detection of recurrent colorectal cancer, metastases, and investigation of patient with elevated tumor marker (CEA). Monoclonal Antibody Scan (radioimmunoscintigraphy colorectal cancer : colorectal cancer colorectal cancer : colorectal cancer Tc-99m DMSA V : Indication is to detect and stage medullary thyroid cancer . Sensitivity is about 90 % . FALSE POSITIVE UPTAKE MAY BE OBSERVED IN PATIENTS WHO HAVE RECENTLY HAD A STERNOTOMY OR WHO HAVE BENIGN BONE DISEASE** Tc-99m DMSA V Medullary Thyroid Cancer : Medullary Thyroid Cancer TI201 : Indications are :lumphoma, thyroid cancers ,bone tumors . 201Thallium (201T1) acts as a potassium analogue and shows uptake into a number of tumours. TI-201 is indicated in thyroid cancer in case of negative I-131 scan with increased thyroglobulin. TI-201 is indicated in lymphoma in case of low grade non-Hodgkin lymphoma. TI201 Ga 67 and TI201 : Ga 67 and TI201 PET –Scan in Oncology : PET –Scan in Oncology Positron Emission Tomography has been most applied in evaluating lung cancer, colon cancer, melanoma, lymphoma and breast cancer. Tumor cells have been found to take up F-18-FDG more avidly than normal cells. General Oncological applications Of PET Scan : General Oncological applications Of PET Scan 1.Initial diagnosis of malignant tumors. 2.Tumor staging . 3. Diagnosis of suspected tumor recurrence. 4. Evaluation of response to therapy Lung cancer : Lung cancer Lung cancer : Lung cancer Lymphoma : Lymphoma Colon cancer : Colon cancer Melanoma : Melanoma Breast Cancer : Breast Cancer lymphoma : lymphoma Slide 42: Thank You You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
nuclear medicine &oncology abuohool Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 1189 Category: Education License: All Rights Reserved Like it (6) Dislike it (0) Added: November 16, 2008 This Presentation is Public Favorites: 6 Presentation Description nuclear medicine Comments Posting comment... By: hkhishaim (12 month(s) ago) Great lecture that benifit every person want to learn about Nuclear medicine technology. Hashem Khishaim, Nuclear medicine technologist. KSA Madeena Monawara. Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Nuclear medicine in oncology : Nuclear medicine in oncology Presentation :Dr.MUSTAFA IBRAHIM Slide 2: diagnosis staging follow-up treatment of malignancy post-therapy management Nuclear medicine contributes to: Applications of Radiopharmaceuticals in Oncology : Applications of Radiopharmaceuticals in Oncology Commonly used R.ph : Commonly used R.ph MDP MIBI Ga67 CITRATE In-111-OCTERIOTIDE MIBG CONTTTTTTTTT : CONTTTTTTTTT MONOCLONAL ANTIBODY DMSA (V) TI 201 PET SCAN I-131 Slide 6: Bone scan is indicated in staging primary bone tumors and detecting bone metastases( prostate, breast, lung cancer, renal tumors ….etc) Bone scan is the method of choice to investigate patients with known malignancy and clinically suspected bone metastases. Tc-99m MDP Tc-99m MDP : Positivity many months before an abnormality can be detected on radiological examination . Bone scan has high sensitivity and ability to image the whole skeleton . Metastases Usually appear as hot lesions (osteoblastic mets),and less likely cold lesions (lytic mets),and could be mixed (hot and cold) Tc-99m MDP Ewing Sarcoma : Ewing Sarcoma Meatastases : Meatastases Neuroblastoma : Neuroblastoma Prostate Cancer : Prostate Cancer Tc-99m MIBI : 99mTc-methoxyisobutyl isonitrile (MIBI) diffuses into tumor cells and is thought to localize in the mitochondria The main clinical role for scintimammography is in evaluation of indeterminate mammographic lesions , for further investigation of patients with a palpable abnormality but negative mammography and dense breast . Sensitivity has ranged from 62% to 93%, with specificity from 79% to 94%. Sensitivity is greater for palpable lesions. Tc-99m MIBI Breast Cancer : Breast Cancer Ga-67 Citrate : Indications are: lymphoma , hepatoma ,seminoma, melanoma, bronchogenic carcinoma 67Gallium (Ga) citrate binds to transferrin and to leucocytes . Lymphoma :Gallium uptake prior to therapy and residual uptake after therapy almost always indicate viable tumor. Failure of the tumor to accumulate gallium following therapy usually indicates adequate therapeutic effect, so it is useful to determine if a patient requires additional therapy Ga -67 sensitivity for lymphoma is 80% to 90% Ga-67 Citrate Lymphoma : Lymphoma Lymphoma : Lymphoma Lymphoma : Lymphoma In-111 Octeriotide : Indications are : neuroendocrine tumors (carcinoid tumors,Vipomas ,glucagonoma,insulinoma) pheochromocytoma ,neuroblastoma, 111-In- octreotide, which binds to membrane somatostatin receptors The presence of somatostatin receptors on neuroendocrine tumors allows their detection using radiolabelled somatostatin analogues. This technique has high sensitivity for localization of the primary and metastatic lesion, but this varies with tumor type because of expression of different sub-classes of somatostatin receptor In-111 Octeriotide Gluconoma : Gluconoma Carcinoid Tumor : Carcinoid Tumor Neuroblastoma : Neuroblastoma I-131 MIBG : 123-iodine (I)-metaiodobenzyl-guanidine (MIBG), which is taken up into cells of neural crest tumors which contain chromaffin granules, such as phaeochromocytoma I-131 MIBG is the procedure of choice in case of extra-adrenal pheochromocytoma. I-131 MIBG has sensitivity about 90% in pheochromocytoma. I-131 MIBG is the most sensitive procedure to dedect bone metastases in neuroblastoma . I-131 MIBG Pheochromocytoma : Pheochromocytoma I-131 : I-131 I-131 scanning is indicated in detecting remnant and metastatic thyroid cancer (papillary ,follicular). Common sites for thyroid cancer metastases are lung ,lymph nodes and bone, Scanning usually 4-6 weeks post operation. Scanning dose is 1-5 mCi. I-131 in higher doses is used to treat hyper thyrodisim and thyroid cancer . Thyroid Cancer : Thyroid Cancer Monoclonal Antibody Scan (radioimmunoscintigraphy : Anti CEA antibodies is the most widely used for CEA positive tumors( like : colorectal cancer and Ca. lung). Current clinical practice is largely confined to detection of recurrent colorectal cancer, metastases, and investigation of patient with elevated tumor marker (CEA). Monoclonal Antibody Scan (radioimmunoscintigraphy colorectal cancer : colorectal cancer colorectal cancer : colorectal cancer Tc-99m DMSA V : Indication is to detect and stage medullary thyroid cancer . Sensitivity is about 90 % . FALSE POSITIVE UPTAKE MAY BE OBSERVED IN PATIENTS WHO HAVE RECENTLY HAD A STERNOTOMY OR WHO HAVE BENIGN BONE DISEASE** Tc-99m DMSA V Medullary Thyroid Cancer : Medullary Thyroid Cancer TI201 : Indications are :lumphoma, thyroid cancers ,bone tumors . 201Thallium (201T1) acts as a potassium analogue and shows uptake into a number of tumours. TI-201 is indicated in thyroid cancer in case of negative I-131 scan with increased thyroglobulin. TI-201 is indicated in lymphoma in case of low grade non-Hodgkin lymphoma. TI201 Ga 67 and TI201 : Ga 67 and TI201 PET –Scan in Oncology : PET –Scan in Oncology Positron Emission Tomography has been most applied in evaluating lung cancer, colon cancer, melanoma, lymphoma and breast cancer. Tumor cells have been found to take up F-18-FDG more avidly than normal cells. General Oncological applications Of PET Scan : General Oncological applications Of PET Scan 1.Initial diagnosis of malignant tumors. 2.Tumor staging . 3. Diagnosis of suspected tumor recurrence. 4. Evaluation of response to therapy Lung cancer : Lung cancer Lung cancer : Lung cancer Lymphoma : Lymphoma Colon cancer : Colon cancer Melanoma : Melanoma Breast Cancer : Breast Cancer lymphoma : lymphoma Slide 42: Thank You