EANM’05 – CME Session IV
October 16, 2005, 16:30 – 18:00
Interventional Radionuclide Therapy
Moderator: C.A. Hoefnagel (Amsterdam)
Co-Moderator: B. Brans (Heerlen)
Upon completion of this course the attendee will be able to:
- understand what interventional radionuclide therapy means
- understand what may cause recurrences or metastases of differentiated thyroid carcinoma to show little or no concentration of 131I-iodide
- know a number of pharmacological interventions or alternatives for the management of 131I-nonavid tumours
- understand indications, interventional procedure and results of radionuclide therapy by direct intratumoural or intracystic administration
- know the meaning, indication and procedural aspects of ROLL
- understand how this diagnostic interventional technique in breast cancer may evolve into a therapeutic application.
Radionuclide therapy is characterised by selective delivery of radiation doses to target tissues and by limited immediate and longterm side effects in comparison to other treatment modalities, e.g. chemotherapy and external beam radiotherapy.
For many indications it is a systemic treatment, administered by oral or intravenous route. However, localised disease may be treated more effectively by locoregional application of therapeutic radiopharmaceuticals. Several of these applications can be considered as interventional, as they require either multidisciplinary cooperation with regard to the administration technique (e.g. with radiology and/or surgery) or pharmacological intervention to enhance uptake and/or retention of the therapeutic radiopharmaceutical.
Clinical examples are:
- intracavitary administration of radiolabelled colloids, chelates or antibodies to treat malignant effusions, as well as arthritic diseases (radiosynoviorthesis)
- intracoronary radionuclide therapy of coronary artery disease
- intraarterial targeting of localised tumours using radiolabelled lipiodol, resin particles, glass microspheres or peptides
- direct intratumoural or intracystic injection of radiopharmaceuticals, e.g. the use of 131I-labelled monoclonal antibodies or 90Y-DOTA-octreotide in glioma and 32P-colloids in unresectable pancreatic or hepatic tumours
- intraoperative instillation of radiopharmaceuticals in early breast cancer
- pretargeting or multistep techniques in radioimmunotherapy
- pharmacological intervention to enable radionuclide therapy of 131I-nonavid thyroid carcinoma
- pharmacological and other interventions to enhance uptake and/or retention and effectivity of 131I-MIBG therapy of neuroendocrine tumours
Several types of interventional radionuclide therapy have been discussed during previous ESNM CME programs in 2003 and 2004. The upcoming CME Therapy session will focus on pharmacological intervention in thyroid cancer, direct intratumoral/intracystic administration into tumours, and interventional techniques in early breast cancer.
- Interventional techniques
- Radionuclide therapy
- Thyroid carcinoma
- Brain tumours
- Breast carcinoma