Is there a clinical usefulness for radiolabeled somatostatin analogues beyond the consolidated role in NETs?

The somatostatin (SS) receptor scintigraphy (SRS), using octreotide radiolabelled with 111In (Ocreoscan©, OCT), is a consolidated diagnostic procedure in patients with neuroendocrine tumors (NET) because of an increased expression of somatostatin receptors (SS-R) on neoplastic cells. Uptake of SS analogues (SSA) can also be due to SS-R expression on nonmalignant cells when activated as lymphocytes, macrophages, fibroblasts, vascular cells. Because of this uptake, clinical indications can be found either in neoplasms not overexpressing SS-R, as nonsmall cell lung cancer, and in active benign diseases. Nevertheless, clinical application of SRS has not found clinical relevance yet. In this paper, we discuss the nononcologic fields of clinical interest in which SRS could play a clinical role such as diagnosis, prognosis, and therapy of benign and chronic diseases such as sarcoidosis, histiocytosis, rheumatoid arthritis, idiopathic pulmonary fibrosis, and Graves' ophthalmopathy.

[Virtual colonoscopy and PET/CT for diagnosis and staging of colorectal cancer]. / Colonscopia virtuale e PET/TC per la diagnosi e stadiazione del cancro del colon-retto.

Colo-rectal cancer is the most common malignancy of the gastrointestinal tract and is the third frequency for malignancy in humans. CT and MRI development allows an early diagnosis and a modulation of the therapeutic approach. Many papers seem to confirm the role of PET/CT and virtual colonography in the evaluation of primary lesions. The PET/CT appears mode accurate in assessing lymph node metastases. Today, new approaches such as virtual colonoscopy and PET/CT open new horizons in the diagnosis and staging of cancer of the colon and rectum.

[Choice of the imaging technique for the diagnosis of bone metastases]. / Scelta della tecnica di imaging nello studio delle metastasi ossee.

Bone is the third common site of distant metastases in cancer patients. Bone metastases may have implications for prognosis, quality of life, and local and systemic therapy. Numerous imaging modalities may be used to detect bone metastases. The two main anatomical modalities are computed tomography (CT) and magnetic resonance imaging (MRI), with many variants proposed for the MRI procedure, including diffusion-weighted imaging. The two main functional modalities are scintigraphy and PET/CT, also with many variants in the radiopharmaceuticals. Aim of our paper is to review the most important radio-compounds that can be successfully used to detect and/or characterize bone metastases.

[Multimodal imaging in bone metastases]. / Imaging multimodale delle metastasi ossee: le nuove frontiere della medicina nucleare.

The skeleton is one main sites of metastasis of solid tumors, and metastatic bone disease are most common malignant disease of the bone. The diagnosis and assessment of bone metastases require integrated multimodality combined approach of different diagnostic methods, including both different radionuclides that radiological techniques such as X-rays, CT and MRI. In this scenario the nuclear medicine gives a significant contribution to the evaluation of skeletal metastases. In this article we will analyze the main approaches.

[Peptide imaging: the somatostatine model]. / Imaging recettoriale con analoghi della somatostatina.

Radiolabeled cell-surface peptide receptor-binding molecules are emerging as an important class of radiopharmaceuticals. Main approach has been the use of 111In Octreotide as functional imaging to find NETs. In some tumor types, it is considered the diagnostic gold standard. This article focuses on the current status of peptide-receptor scintigraphy in different tumors, in other oncologic and non oncologic applications and on future developments in these fields.

[New diagnostic imaging approaches in multiple myeloma]. / Nuovi approcci alla diagnostica per immagini nel mieloma multiplo.

Multiple myeloma (MM) is a neoplastic monoclonal proliferation of plasma cells, mainly involving bone marrow. To properly stage and manage patients with MM the clinician needs at first a complete skeletal survey. Today none of diagnostic imaging methods is able to answer alone to all questions in staging, treatment and follow up. Bone scintigraphy is affected by a low sensitivity. Tc-99m MIBI has been proposed in staging and in follow-up , with most relevant clinical information deriving from the correlation of its whole body uptake's distribution with extent and activity of the disease. PET - FDG has been proposed in MM for its skill to detect whole-body metabolic active disease, producing relevant information in staging and prognosis. First studies demonstrated that PET-FDG is more sensitive than other imaging modalities for localizing extra medullary sites of disease.