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A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Radiopharmaceutical Theranostics in Primary Adrenal Malignancies: A Surgeon's Perspective
Styliani Laskou1, George Geropoulos1, Petre Adrian Radu2
13rd Surgical Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Abstract:
Radiopharmaceutical Theranostics defines the combination of molecularly targeted imaging and therapy in two consecutive phases. Targeted theranostic approaches are most established for the management of advanced prostate, thyroid and hepatocellular cancer, as well as neuroendocrine tumors (NETs). Adrenal malignancies present a complex challenge, requiring highly specialized management. The two primary entities addressed by targeted radiotheranostics-pheochromocytoma/paraganglioma (PPGL) and adrenocortical cancer (ACC)-consist of fundamentally distinct molecular targets and, consequently, different radiopharmaceutical agents. While most existing literature focuses on nuclear medicine-driven perspectives, the implications of theranostic advances for surgical decision-making remain underexplored. This narrative review aims to integrate available clinical evidence with multidisciplinary practice considerations, in reshaping the role of surgery in adrenal malignancies.
Insights
Radiopharmaceutical theranostics offers targeted imaging and therapy for cancers like pheochromocytoma/paraganglioma (PPGL) and adrenocortical cancer (ACC). This review explores its impact on surgical decisions for adrenal malignancies.
Area of Science:
- Oncology
- Nuclear Medicine
- Surgical Oncology
Background:
- Radiopharmaceutical theranostics combines targeted imaging and therapy.
- Established for prostate, thyroid, hepatocellular cancers, and neuroendocrine tumors (NETs).
- Adrenal malignancies, including pheochromocytoma/paraganglioma (PPGL) and adrenocortical cancer (ACC), require specialized management with distinct molecular targets.
Purpose of the Study:
- To review the role of radiopharmaceutical theranostics in adrenal malignancies.
- To explore the implications of theranostic advances for surgical decision-making.
- To integrate clinical evidence and multidisciplinary considerations for adrenal cancer surgery.
Main Methods:
- Narrative review of existing clinical evidence.
- Integration of multidisciplinary practice considerations.
- Focus on theranostic advances and their impact on surgical management.
Main Results:
- Radiotheranostic approaches are established for specific cancers but less explored for adrenal malignancies.
- Pheochromocytoma/paraganglioma (PPGL) and adrenocortical cancer (ACC) utilize different molecular targets and radiopharmaceuticals.
- Current literature predominantly focuses on nuclear medicine perspectives, overlooking surgical implications.
Conclusions:
- Theranostic advances are reshaping treatment paradigms for adrenal malignancies.
- There is a need to better understand and integrate theranostics into surgical decision-making for PPGL and ACC.
- Multidisciplinary collaboration is crucial for optimizing the role of surgery in managing these complex cancers.
