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Imaging Molecolare
Anno: 2009-2010, Semestre: 2
Descrizione
Nella lezione verranno illustrate le basi metodologiche e le applicazioni dell'imaging molecolare
Sede
Aula Uslenghi, Radiologia AO San Paolo
Orario delle Lezioni
29 Gennaio 2010 ore 15-16
Bibliografia aggiuntiva
1: Clin Transl Oncol. 2009 Mar;11(3):143-53.
Use of radionuclides in cancer research and treatment.
Macías MT.
Servicio de Protección Radiológica, Instituto de Investigaciones Biomédicas
"Alberto Sols" CSIC-UAM, Madrid, Spain. mtmacias@iib.uam.es
Cancer occurs as a result of misregulation of cell growth, which appears to be a
consequence of alteration in the function of oncogenes and tumour suppressor
genes. Ionising radiation has been used, since the discovery of X-rays in 1896 by
Roentgen, both in cancer research and treatment of the disease. The main purpose
of cancer research is to understand the molecular alterations involved in the
development and progression of the disease in order to improve diagnosis and
develop personalised therapies, by focusing on the features of the tumoral cell
and the biological events associated to carcinogenesis. Radioisotopic techniques
have been used routinely for in vitro research in the molecular and cellular
biology of cancer for more than 20 years and are in the process of being
substituted by alternative non-radioactive techniques. However in vivo techniques
such as irradiation of cells in culture and/or experimental animal models and
radioactive labelling are in development, due in part to advances in molecular
imaging technologies. The objective of this review is to analyse in an
integrative way the applications of ionising radiation in cancer research and
therapy. It had been divided into two parts. The first one will approach the
techniques applied to cancer research and the second will summarise how ionising
radiation is applied to the treatment of neoplastic disease.
Publication Types:
Review
PMID: 19293051 [PubMed - indexed for MEDLINE]
2: Med Phys. 2008 Nov;35(11):4955-66.
PET/CT in radiation oncology.
Pan T, Mawlawi O.
Department of Imaging Physics, M. D. Anderson Cancer Center, The University of
Texas, Houston, Texas 77030, USA. tpan@mdanderson.org
PET/CT is an effective tool for the diagnosis, staging and restaging of cancer
patients. It combines the complementary information of functional PET images and
anatomical CT images in one imaging session. Conventional stand-alone PET has
been replaced by PET/CT for improved patient comfort, patient throughput, and
most importantly the proven clinical outcome of PET/CT over that of PET and that
of separate PET and CT. There are over two thousand PET/CT scanners installed
worldwide since 2001. Oncology is the main application for PET/CT. Fluorine-18
deoxyglucose is the choice of radiopharmaceutical in PET for imaging the glucose
uptake in tissues, correlated with an increased rate of glycolysis in many tumor
cells. New molecular targeted agents are being developed to improve the accuracy
of targeting different disease states and assessing therapeutic response. Over
50% of cancer patients receive radiation therapy (RT) in the course of their
disease treatment. Clinical data have demonstrated that the information provided
by PET/CT often changes patient management of the patient and/or modifies the RT
plan from conventional CT simulation. The application of PET/CT in RT is growing
and will become increasingly important. Continuing improvement of PET/CT
instrumentation will also make it easier for radiation oncologists to integrate
PET/CT in RT. The purpose of this article is to provide a review of the current
PET/CT technology, to project the future development of PET and CT for PET/CT,
and to discuss some issues in adopting PET/CT in RT and potential improvements in
PET/CT simulation of the thorax in radiation therapy.
Publication Types:
Review
PMID: 19070229 [PubMed - indexed for MEDLINE]
3: Eur J Nucl Med Mol Imaging. 2008 Apr;35(4):821-37. Epub 2007 Oct 31.
Current concepts on imaging in radiotherapy.
Lecchi M, Fossati P, Elisei F, Orecchia R, Lucignani G.
Institute of Radiological Sciences, University of Milan, Milan, Italy.
New high-precision radiotherapy (RT) techniques, such as intensity-modulated
radiation therapy (IMRT) or hadrontherapy, allow better dose distribution within
the target and spare a larger portion of normal tissue than conventional RT.
These techniques require accurate tumour volume delineation and intrinsic
characterization, as well as verification of target localisation and monitoring
of organ motion and response assessment during treatment. These tasks are
strongly dependent on imaging technologies. Among these, computed tomography
(CT), magnetic resonance imaging (MRI), ultrasonography (US) and positron
emission tomography (PET) have been applied in high-precision RT. For tumour
volume delineation and characterization, PET has brought an additional dimension
to the management of cancer patients by allowing the incorporation of crucial
functional and molecular images in RT treatment planning, i.e. direct evaluation
of tumour metabolism, cell proliferation, apoptosis, hypoxia and angiogenesis.
The combination of PET and CT in a single imaging system (PET/CT) to obtain a
fused anatomical and functional dataset is now emerging as a promising tool in
radiotherapy departments for delineation of tumour volumes and optimization of
treatment plans. Another exciting new area is image-guided radiotherapy (IGRT),
which focuses on the potential benefit of advanced imaging and image registration
to improve precision, daily target localization and monitoring during treatment,
thus reducing morbidity and potentially allowing the safe delivery of higher
doses. The variety of IGRT systems is rapidly expanding, including cone beam CT
and US. This article examines the increasing role of imaging techniques in the
entire process of high-precision radiotherapy.
PMID: 17972074 [PubMed - indexed for MEDLINE]
Related Links
Clinical applications of positron emission tomography/computed tomography
treatment planning. [Semin Nucl Med. 2008] PMID:18243849
Advances in 4D medical imaging and 4D radiation therapy. [Technol Cancer Res
Treat. 2008] PMID:18198927
Dose to normal tissues outside the radiation therapy patient's treated volume: a
review of different radiation therapy techniques. [Health Phys. 2008]
PMID:18849701
Imaging and alignment for image-guided radiation therapy. [J Clin Oncol. 2007]
PMID:17350941
Current status of PET/CT for tumour volume definition in radiotherapy treatment
planning for non-small cell lung cancer (NSCLC). [Lung Cancer. 2007]
PMID:17478008
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