Radiotheranostics is here to help

The COVID-19 pandemic did not diminish interest in radiotheranostics. However, the demand for visualization of pathological processes using cross-sectional and hybrid imaging (CT, MRI, SPECT, and PET) is increased. Over the past 15 months, the world has seen an exponential increase in investment in new radiopharmaceuticals for radiotheranostics. The list of antibodies and ligands labeled with "medical" radioactive isotopes is expanding as the molecular mechanisms of regulation and implementation of metabolic processes become clearer. The range of diagnostic and therapeutic radioactive isotopes is also expanding, ultimately increasing the range and availability of radiotherapy in nuclear medicine centers worldwide. It is necessary to unite the efforts of physicists, radiopharmacists, chemists, biologists, doctors, and mathematicians to develop radio technology. Usage and improvement of personalized dosimetry for planning radionuclide therapy is also a priority. For example, the International Foundation Oncidium helps with information and exchange of experience, while the international diagnostic study NOBLE increases the availability and reduces the cost of PSMA receptor scintigraphy. An association for the development of theranostics was created to intensify the integration renewal of nuclear medicine.

Debulking surgery for functional pleural dissemination of parathyroid carcinoma-case report

Background A rare cause of primary hyperparathyroidism (PHPT) is a parathyroid carcinoma. Hypercalcemia with an elevated parathyroid hormone (PTH) level seen in recurrent and metastasis disease cases is often refractory to medical therapy, thus surgical resection is recommended when possible. We performed debulking surgery for pleural dissemination of parathyroid cancer for improvement of symptoms in a patient with hypercalcemia. Case presentation A 30-year-old male with hypercalcemia was diagnosed with parathyroid cancer. Following surgery, intact PTH level elevation and hypercalcemia progression due to recurrent disease were noted. An active status of functional left pleural dissemination was revealed in 99mTc-methoxyisobutylisonitrile and somatostatin receptor scintigraphy results, but not in the area of pulmonary metastasis, and debulking surgery was performed. Thereafter, the PTH level was decreased temporarily and activities of daily living improved. Conclusion Aggressive resection of metastatic disease in patients with a parathyroid carcinoma is taken into consideration to control hypercalcemia.

Pelvic MRI, FDG-PET/CT, and Somatostatin Receptor Scintigraphy Findings of Treatment-Related Neuroendocrine-Differentiated Prostate Cancer

Treatment-related neuroendocrine-differentiated prostate cancer (NEPC) is a rare tumor entity that transdifferentiates from adenocarcinoma as an adaptive response to androgen receptor pathway inhibition. We report a 79-year-old male with treatment-related NEPC, presenting as rectal bleeding after hormonal therapy. MRI showed a 51 × 52 × 65 mm tumor occupying almost the whole prostate gland and invading the seminal vesicle and rectum as moderately heterogeneous hypointensity on T2-weighted image, restricted diffusion on apparent diffusion coefficient map and diffusion-weighted imaging, and heterogeneous enhancement on Gd-enhanced T1-weighted image. FDG-PET/CT showed strong FDG uptake of the prostate tumor, and somatostatin receptor scintigraphy (SRS) showed mild uptake of the prostate tumor. The surgically resected specimen revealed NEPC. If prostate cancer worsens despite conventional therapy, treatment-related NEPC should be considered, and the benefit of imaging examinations including prostate MRI, FDG-PET/CT, and SRS is in localizing lesions with neuroendocrine differentiation.

Debulking Surgery for Functional Pleural Dissemination of Parathyroid Carcinoma-case Report

BackgroundA rare cause of primary hyperparathyroidism (PHPT) is a parathyroid carcinoma. Hypercalcemia with an elevated parathyroid hormone (PTH) level seen in recurrent and metastasis disease cases is often refractory to medical therapy, thus surgical resection is recommended when possible. We performed debulking surgery for pleural dissemination of parathyroid cancer for improvement of symptoms in a patient with hypercalcemia.Case presentationA 30-year-old male with hypercalcemia was diagnosed with parathyroid cancer. Following surgery, intact PTH level elevation and hypercalcemia progression due to recurrent disease were noted. An active status of functional left pleural dissemination was revealed in 99mTc-methoxyisobutylisonitrile and somatostatin receptor scintigraphy results, but not in the area of pulmonary metastasis, and debulking surgery was performed. Thereafter, the PTH level was decreased temporarily and activities of daily living improved. ConclusionAggressive resection of metastatic disease in patients with a parathyroid carcinoma is taken into consideration to control hypercalcemia.