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From scinti-mammography and metabolic imaging to receptor targeted PET-new principles of breast cancer detection
Institution:1. Departamento de Materiales Radiactivos, Instituto Nacional de Investigaciones Nucleares, Ocoyoacac 52750, Estado de México, Mexico;2. Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca 50180, Mexico;3. Catedrática CONACyT, Instituto Nacional de Investigaciones Nucleares, Ocoyoacac 52750, Estado de México, Mexico;1. Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, 400085, India;2. Radiation Biology & Health Sciences Division, Bhabha Atomic Research Centre, Mumbai, 400085, India;3. Homi Bhabha National Institute, Anushakti Nagar, Mumbai, 400 094, India;1. Department of Medical Oncology, Campus Bio-Medico University of Rome, 00128, Rome, Italy;2. Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy;3. Department of Nuclear Medicine Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014, Meldola, Italy
Abstract:Early detection of breast cancer is a prerequisite for treatment success and improvement of survival. In tumors under 10mm diameter the standard morphological methods of imaging such as sonography, mammography and MRI imaging are of lesser specificity and loose sensitivity. Under 5mm detection of breast cancer remains a chalenge.Since recent years scinti-mammography using perfusion weighted enrichment of 99m-Tc-MIBI for imaging has become a standard technique indetection of breast cancer. It is superior when ever small lesions with increased perfusion are to be expected. it is used specially in dense breast patients. Other functional methods such as F-18-FDG-PET, C-11-Methionine-PET and the use of Ga-68-Somatostatin- or Ga-68-Bombesin-PET have been discussed for the early detection and therapy control of breast cancer patents. Especially the high specific low background receptor-PET imaging exels over the standard methods because of its ability to detect lesions even below 2 mm, as it has been shown for the Ga-68-DOTA-somatostatins. Because simple exchange of the diagnostic PET isotope against a therapeutical isotope like Lu-177, Y-90, Ga-67 or Cu-67 the receptor PET is directly linked to radio-peptide therapy.As the studies of J. C. Reubi et alii have been shown several peptide receptors are expressed in breast cancer, like the sms receptors and the gastrin releasing peptide receptors (bombesin receptors). One of the most widely expressed receptors expressed in breast cancer, which tends to be relatively selective, is NPY1 receptor. Intensive work had been done on the development of peptide ligands by A. Beck-Sicklinger and her group. These new developed peptides are very promising in combination with somatostatin and bombesin derivatives. Dedicated breast pet devices in combination with these high specific tracers have great potential to open and entire new quality in early detection of breast cancer and may lead to its radiopeptide therapy.
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