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Machine Learning Approach to Overcome the Challenges in Theranostics
Published in Shampa Sen, Leonid Datta, Sayak Mitra, Machine Learning and IoT, 2018
Bishwambhar Mishra, Sayak Mitra, Karthikeya Srinivasa Varma Gottimukkala, Shampa Sen
The key theranostic players in nuclear medicine are the small molecules with covalently attached chelators for labeling with radiometals. The nuclide of Ga-68 is used as positron emitter in diagnosis and visualization of receptors or antigen expression. Peptide receptor radionuclide therapy (PRRT) is a theranostic approach mainly targets somatostatin receptor subtypes 2 (SSTR2) for the detection of neuroendocrine tumors (NET). Peptides are covalently bound to the chelator DOTA (1,4,7,10-Tetraazacyclododecane-1,4,7,10-tetraacetic acid), which enables the coordination of Ga-68 for PET imaging and Lu-177 (and Y-90) for radiotherapy. The ability of all these derivatives to address somatostatin receptor expression is comparable to neuroendocrine tumors (Blankenberg and Strauss 2012; Maecke and Reubi 2017).
Progress in large field-of-view interventional planar scintigraphy and SPECT imaging
Published in Expert Review of Medical Devices, 2022
Martijn M.A. Dietze, Hugo W.A.M de Jong
Peptide Receptor Radionuclide Therapy (PRRT) [16,17] and radioimmunotherapy (RIT) [18,19] are forms of radionuclide therapy that target tumor cells by binding radioisotopes with tumor receptors and antigens, respectively. This specific binding to the tumor cells (instead of normal cells) accomplishes a relatively local deposition of radiation. PRRT and RIT are normally performed by an intravenous administration. It has, however, for these procedures been proposed to instead inject the radiopharmaceuticals intra-arterially in a procedure done in the operation room [20–22]. The hypothesis is that the deposition of radiopharmaceuticals close to the tumors increases their relative uptake (the ‘first-pass effect’), which in turn increases the dose to the tumors and decreases the dose to healthy tissue.
Theranostic approaches in nuclear medicine: current status and future prospects
Published in Expert Review of Medical Devices, 2020
Luca Filippi, Agostino Chiaravalloti, Orazio Schillaci, Roberto Cianni, Oreste Bagni
The demonstration of SSTRs in NET opened the door to targeted radionuclide therapy based on the administration of synthetic analogs of somatostatin labeled with beta-emitting radioisotopes, especially 90Y and 177Lu. This theranostic approach is known as peptide radionuclide receptor therapy (PRRT). Lutathera® (177Lu-DOTATATE) has been approved in January 2018 by Food and Drug Administration (FDA) and in September 2017 in Europe by European Medicines Agency (EMA) as the first radiopharmaceutical for PRRT in progressive gastroenteropancreatic NET. It consists in the administration of 177Lu-DOTATATE, fractioned in four cycles of fixed activity of 7.4 GBq at the interval of 8 weeks [43]. The approval of Lutathera® was preceded by a huge number of clinical studies aimed to assess the efficacy and safety of PRRT in the last 20 years.