Nuclear Oncology

This book discusses the role of nuclear medicine in the diagnosis, staging, and treatment of patients with specific cancers. It presents the incidence, pathophysiologic and clinical aspects of the disease, the use of nuclear imaging in diagnosis, staging requirements, management of specific tumors, and surveillance after primary treatment of cancers. It addresses the various diagnostic/therapeutic options that are currently available or are most likely to become available in the near future according to a prioritized approach, thereby keeping to a minimum the number of diagnostic imaging procedures the patient is expected to undergo.

Topics include basic science, clinical applications, radionuclide therapy, radioguided surgery, heart disease in the cancer patient, and adverse effects of cancer therapy. Each clinical chapter discusses the radionuclide procedures within an integrated framework, thereby identifying the information required for effective treatment of specific tumors. The book concludes with a series of updated cases that define and expand the didactic material in the clinical application chapters. Thoroughly updated and revised, the third edition incorporates new clinical evidence validating the use of radionuclides for diagnosis and therapy in oncology, new radiotracers, and the growing integration of imaging modalities into different types of hybrid imaging.

With contributions from a group of internationally distinguished practitioners, Nuclear Oncology: From Pathophysiology to Clinical Applications, Third Edition, is a valuable reference for nuclear medicine physicians, radiologists, medical and surgical oncologists, and other clinicians involved in the care and management of cancer patients.

Duccio Volterrani is currently Full Professor of Nuclear Medicine at the University of Pisa (Pisa, Italy), where he is also Director of the Postgraduate Specialty School in Nuclear Medicine, and Director of the Regional Center of Nuclear Medicine of the University Hospital of Pisa. Before serving at the University of Pisa, between 1993 and 1998, he has been staff member of the Nuclear Medicine Unit of the University Hospital of Siena (Siena, Italy), while between 1990 and 1993 he had been the recipient of a Research Fellowship at the CNR Institute of Clinical Physiology in Pisa. His curriculum studiorum at the University of Pisa includes MD graduation in 1987 and degree of Specialist in Nuclear Medicine in 1990. In 2003, he was Visiting Scientist at the Nuclear Medicine Service at the Memorial Sloan Kettering Cancer Center in New York (NY, USA).

Professor Volterrani’s research interests span across several fields of clinical Nuclear Medicine, including radionuclide investigations on renal function (with special focus on arterial hypertension), brain perfusion, metabolism, and receptor status in dementias and in parkinsonian syndromes, nuclear cardiology, diagnostic and therapeutic applications of Nuclear Medicine in endocrinology, and diagnostic and therapeutic applications of Nuclear Medicine in oncology.

He is member of the Editorial Board of the Quarterly Journal of Nuclear Medicine and Molecular Imaging and has published over 115 full articles in international peer-reviewed journals. In addition, he has co-edited five books covering the clinical applications of Nuclear Medicine.

Paola A. Erba is Associate Professor in Nuclear Medicine at the University of Pisa (Pisa, Italy) and is also affiliated with the Department of Nuclear Medicine and Molecular Imaging at the University Medical Center Groningen (Groningen, The Netherlands). She is currently Vice-Director of the Regional Center of Nuclear Medicine of the University Hospital of Pisa, as well as Vice-Director of the Postgraduate Specialty School in Nuclear Medicine of the University of Pisa (Pisa, Italy), where she also holds teaching appointments at the Medical Faculty and for several courses, residency programs, and Master courses.

Her curriculum studiorum includes MD graduation at the Insubria University (Varese, Italy), the Specialty in Nuclear Medicine at the University of Pisa (Pisa, Italy), followed by Specialty in Clinical Biochemistry at the University of Rome Tor Vergata (Rome, Italy), and Ph.D. in “Imaging Cardio-vascular Infection ” at the University Medical Center Groningen (Groningen, The Netherlands).

Dr. Erba ’s research interests in Nuclear Medicine span across several fields, including development of new tumor-seeking radiopharmaceuticals in animal models and in human phase-I/II studies, as well as clinical studies on the diagnostic and therapeutic applications of Nuclear Medicine. She has been, or still is, Principal Investigator for several projects funded by local and international agencies (including the European Union), focusing on the latest advances based on the “theragnostic” approach using molecular imaging techniques as a tool for personalized medicine in patients with cancers and on the use of artificial intelligence for radiomics analysis.

Dr. Erba has co-authored over 200 full articles published in international peer-reviewed journals and has co-edited 5 books covering the clinical applications of Nuclear Medicine. She is also an active member of the European Associationof Nuclear Medicine (EANM) where she currently serves as Education Chair of the European School of Multimodality Imaging and Therapy (ESMIT).

H. William Strauss is an Emeritus Professor of Radiology at the Weill Cornell Medical Center and Emeritus Attending Physician at the Molecular Imaging and Therapy Service at the Memorial Sloan Kettering Cancer Center (New York, NY, USA). Some of his previous positions include Chief of Nuclear Medicine and Professor of Radiology at Stanford University School of Medicine (Stanford, CA, USA), Chief of Nuclear Medicine at the Massachusetts General Hospital, and Professor of Radiology at Harvard Medical School (Boston, MA, USA). He also served as Vice President of Diagnostics Drug Discovery at Bristol-Myers Squibb (Princeton, NJ, USA).

Professor Strauss is a prolific investigator with over 700 articles published in the peer-reviewed literature. He is a co-author of 70 book chapters and coeditor of 11 books. He has been widely recognized for his work with named lectureships, life memberships, and honorary degrees. He is a member of the American Society of Clinical Investigation and a life member of the American Board of Nuclear Medicine, as well as a fellow of both the American College of Nuclear Physicians and the American College of Nuclear Medicine.

In recognition of his seminal studies particularly in cardiovascular nuclear medicine, which have greatly advanced nuclear medicine science and have had exceptionally high clinical impact, he has been awarded the two most prestigious prizes in the field of nuclear medicine, the Georg Charles de Hevesy Nuclear Pioneer Award and the Benedict Cassen Prize.

He is a Past President of the Society of Nuclear Medicine, former editor of The Journal of Nuclear Medicine, and has served on the editorial board of that journal, as well as six other juried publications, which include the European Journal of Nuclear Medicine and Molecular Imaging, Journal of Nuclear Cardiology, and Quarterly Journal of Nuclear Medicine and Molecular Imaging.

Giuliano Mariani Before retiring from academia, between 2001 and 2014 Giuliano Mariani served as Full Professor of Nuclear Medicine at the University of Pisa (Pisa, Italy), where he was also Director of the Postgraduate Specialty School in Nuclear Medicine and Director of the Regional Center of Nuclear Medicine of the University Hospital of Pisa. Before serving at the University of Pisa, between 1994 and 2001, he held similar appointments at the University of Genoa Medical School and at the University Hospital of Genoa (Genoa, Italy). His curriculum studiorum includes MD graduation in 1968 at the Catholic University in Rome (Rome, Italy) and graduation at the Specialty schools of the University of Pisa (Pisa, Italy) in Internal Medicine (1972), Nuclear Medicine (1974), Medical Nephrology (1976), and Radiology (1979), all graduations having been obtained maximum cum laude. His academic career also includes an appointment as Visiting Scientist and Expert Consultant at the Metabolism Branch, National Cancer Institute of the National Institutes of Health (Bethesda, Maryland, USA) between 1974 and 1978, and as Visiting Professor and Lecturer of Radiology at the Harvard Medical School (Boston, Massachusetts, USA) between 1986 and 1990. In addition, has received several appointments as an Expert Consultant of the International Atomic Energy Agency (IAEA, Vienna, Austria) for carrying out and developing training programs in Nuclear Medicine throughout the world.

Giuliano Mariani ’s interests span over virtually all clinical applications of Nuclear Medicine, including both diagnostic and therapeutic applications, with an emphasis on the development of novel techniques for radionuclide-based diagnosis and therapy of different tumors. He has published 330 articles in international peer-reviewed journals and has edited or coedited 25 books covering the diagnostic and therapeutic applications of Nuclear Medicine. He is a member of the Editorial Board of the most prestigious international journals of Nuclear Medicine and diagnostic imaging in general, which include European Journal of Nuclear Medicine and Molecular Imaging, The Journal of Nuclear Medicine, and AJR American Journal of Roentgenology .

In recognition of his established role as an “opinion leader ” in the national and international arena, Giuliano Mariani has been named as Honorary Member of the Italian Association of Nuclear Medicine and of the European Association of Nuclear Medicine.

Steven M. Larson, MD, is Hedvig Hricak Chair, Attending Physician and Member, Molecular Imaging and Targeted Therapy Service of the Department of Radiology, Memorial Hospital; Member and Lab Head of the Larson Laboratory of the Molecular Pharmacology Program, Memorial Sloan-Kettering Institute; all such positions are components of Memorial Sloan-Kettering Cancer Center (MSKCC, New York, NY, USA). Dr. Larson has board Certification in Nuclear Medicine (1972) and Internal Medicine (1973). He is currently Co-Leader of the Imaging and Radiation Sciences Program for the MSKCC Cancer Center Grant. He is Professor of Radiology of Weil-Cornell Medical Center and a Fellow of the American College of Nuclear Medicine (ACNM) and of the American College of Radiology (ACR).

From 1988 to 2013, Dr. Larson was Chief of Nuclear Medicine at MSKCC during a time of unprecedented growth incapability and relevance of Molecular imaging (MI) and Targeted Radio[1]therapy (TRT), to both clinical practice and oncologic research. In 2013, he transitioned to full[1]time development of radiotracers for molecular imaging in oncology and TRT. Over the last decade, more than 25 MI and TRT radiopharmaceuticals recorded in over 200 patents have originated from the Larson Laboratory, for MI of anticancer drugs, Pre-targeted Radioimmunotherapy, and Precision Medicine of common cancers.

Dr. Larson has emphasized a team approach to clinical and research developments in nuclear oncology. Clinical interests of his group include the use of positron emission tomography for diagnostic and molecular imaging, and specialexpertise in the care and management of patients who receive TRT, particularly for thyroid cancer. Advances include development of novel analytic paradigms now widely used in radiotracer clinical research, including “Bone Scan Index,” Total Lesion Glycolysis, Radiographic Progression for 99mTc-diphosphonate bone scans, “PET-VCAR,” and, most recently, “Soothsayer” (a precision bio[1]marker for dosimetry). His CV includes more than 700 peer-reviewed publications.

Dr. Larson has received numerous awards from professional organizations for advances in nuclear medicine, including the Cassen Prize, the Hevesy Award, the Henry Wagner Lecture-Medal, the Saul Hertz and Aebersold Award, SNMMI/ERF, the Pendergrass Award, the Radiology Researcher of the Year (RSNA), and the Gold Medal from the American College of Nuclear Medicine. He is a Member of the National Academy of Medicine of the US National Academy of Sciences.