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Radiotracer Administration for High Temporal Resolution Positron Emission Tomography of the Human Brain: Application to FDG-fPET
Published on: October 22, 2019
Adrenal functional imaging - which marker for which indication?
Rudolf A Werner1,2, Philipp E Hartrampf1, Andreas Schirbel1
1Department of Nuclear Medicine, University Hospital, University of Würzburg, Germany.
Purpose Of Review:
In recent years, a broad spectrum of molecular image biomarkers for assessment of adrenal functional imaging have penetrated the clinical arena. Those include positron emission tomography and single photon emission computed tomography radiotracers, which either target glucose transporter, CYP11B enzymes, C-X-C motif chemokine receptor 4, norepinephrine transporter or somatostatin receptors. We will provide an overview of key radiopharmaceuticals and determine their most relevant clinical applications, thereby providing a roadmap for the right image biomarker at the right time for the right patient.
Recent Findings:
Numerous radiotracers for assessment of adrenal incidentalomas ([ 18 F]FDG; [ 123 I]IMTO/IMAZA), ACC ([ 123 I]IMTO/IMAZA; [ 18 F]FDG; [ 68 Ga]PentixaFor), pheochromocytomas and paragangliomas ([ 123 I]mIBG; [ 18 F]flubrobenguane; [ 18 F]AF78; [ 68 Ga]DOTATOC/-TATE), or primary aldosteronism ([ 11 C]MTO, [ 68 Ga]PentixaFor) are currently available and have been extensively investigated in recent years. In addition, the field is currently evolving from adrenal functional imaging to a patient-centered adrenal theranostics approach, as some of those radiotracers can also be labeled with ß-emitters for therapeutic purposes.
Summary:
The herein reviewed functional image biomarkers may not only allow to increase diagnostic accuracy for adrenal gland diseases but may also enable for achieving substantial antitumor effects in patients with adrenocortical carcinoma, pheochromocytoma or paraganglioma.
Insights
Molecular imaging biomarkers like positron emission tomography and single photon emission computed tomography radiotracers are advancing adrenal gland disease diagnosis and treatment. These functional imaging tools offer a roadmap for selecting the optimal biomarker for each patient.
Area of Science:
- Nuclear medicine
- Molecular imaging
- Radiopharmaceutical science
Background:
- Molecular imaging biomarkers are increasingly used for adrenal functional assessment.
- Radiotracers targeting glucose transporters, CYP11B enzymes, CXCR4, norepinephrine transporters, and somatostatin receptors are available.
- The field is transitioning towards patient-centered adrenal theranostics.
Purpose of the Study:
- To provide an overview of key radiopharmaceuticals for adrenal functional imaging.
- To determine the most relevant clinical applications of these biomarkers.
- To offer a roadmap for selecting the appropriate image biomarker for specific patient needs.
Main Methods:
- Review of current literature on molecular imaging biomarkers for adrenal glands.
- Analysis of radiotracers used for adrenal incidentalomas, adrenocortical carcinoma, pheochromocytomas, paragangliomas, and primary aldosteronism.
- Discussion of the evolving theranostics approach in adrenal imaging.
Main Results:
- Numerous radiotracers are available for diagnosing various adrenal conditions, including [18F]FDG, [123I]IMTO/IMAZA, [68Ga]PentixaFor, and [123I]mIBG.
- These biomarkers can enhance diagnostic accuracy for adrenal gland diseases.
- Some radiotracers are being developed for therapeutic applications (theranostics).
Conclusions:
- Functional image biomarkers significantly improve the diagnostic accuracy of adrenal gland diseases.
- These biomarkers hold potential for achieving antitumor effects in patients with adrenal cancers and tumors.
- The development of theranostic approaches promises personalized treatment strategies for adrenal conditions.
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