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Nuclear Medicine and Molecular Imaging Dec 2019Radioembolization using Y microspheres (glass or resin) has been introduced as an effective intraarterial therapy for unresectable primary and metastatic liver cancers.... (Review)
Review
Radioembolization using Y microspheres (glass or resin) has been introduced as an effective intraarterial therapy for unresectable primary and metastatic liver cancers. Although the basic therapeutic effect of chemoembolization results from ischemia, the therapeutic efficacy of radioembolization comes from radiation. Furthermore, compared with surgical resection and local ablation therapy, radioembolization is available with less limitation on the sites or number of liver cancers. The radioisotope Y is a β-radiation emitter without γ-radiation, with the emission of secondary bremsstrahlung photons and small numbers of positrons. Administration of Y microspheres into the hepatic artery can deliver a high dose of radiation selectively to the target tumor with limited radiation exposure to the surrounding normal parenchyma, and has low systemic toxicity. In general, radioembolization has been considered for patients with unresectable primary or metastatic liver-only or liver-dominant cancers with no ascites or other clinical signs of liver failure, life expectancy of > 12 weeks, and good performance status. Here, we review the current radioactive compounds, pretreatment assessment, and indications for radioembolization in patients with hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and liver metastases from colorectal cancer.
PubMed: 31867071
DOI: 10.1007/s13139-019-00615-9 -
The Cochrane Database of Systematic... Apr 2009The outcome of glaucoma surgery can be affected by the rate at which the surgical wound heals. Beta radiation has been proposed as a rapid and simple treatment to slow... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
The outcome of glaucoma surgery can be affected by the rate at which the surgical wound heals. Beta radiation has been proposed as a rapid and simple treatment to slow down the healing response.
OBJECTIVES
To assess the effectiveness of beta radiation during glaucoma surgery (trabeculectomy).
SEARCH STRATEGY
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (which includes the Cochrane Eyes and Vision Group Trials Register) (Issue 4 2008), MEDLINE (January 1966 to October 2008) and EMBASE (January 1980 to October 2008). The databases were last searched on 24 October 2008.
SELECTION CRITERIA
We included randomised controlled trials comparing trabeculectomy with beta radiation to trabeculectomy without beta radiation.
DATA COLLECTION AND ANALYSIS
We collected data on surgical failure (intraocular pressure > 21 mmHg), intraocular pressure and adverse effects of glaucoma surgery. We pooled data using a fixed-effect model.
MAIN RESULTS
We found four trials that randomised 551 people to trabeculectomy with beta irradiation versus trabeculectomy alone. Two trials were in Caucasian people (126 people), one trial in black African people (320 people) and one trial in Chinese people (105 people). People who had trabeculectomy with beta irradiation had a lower risk of surgical failure compared to people who had trabeculectomy alone (pooled risk ratio (RR) 0.23 (95% CI 0.14 to 0.40). Beta irradiation was associated with an increased risk of cataract (RR 2.89, 95% CI 1.39 to 6.0).
AUTHORS' CONCLUSIONS
Trabeculectomy with beta irradiation has a lower risk of surgical failure compared to trabeculectomy alone. A trial of beta irradiation versus anti-metabolite is warranted.
Topics: Beta Particles; Cataract; Combined Modality Therapy; Glaucoma; Humans; Randomized Controlled Trials as Topic; Trabeculectomy; Treatment Outcome; Wound Healing
PubMed: 19370589
DOI: 10.1002/14651858.CD003433.pub2 -
Journal of Nuclear Cardiology :... Apr 2022We have set out to develop a catheter-based theranostic system that: (a) identifies diseased and at-risk myocardium via endocardial detection of systemically delivered...
BACKGROUND
We have set out to develop a catheter-based theranostic system that: (a) identifies diseased and at-risk myocardium via endocardial detection of systemically delivered β-emitting radiotracers and (b) utilizes molecular signals to guide delivery of therapeutics to appropriate tissue via direct intramyocardial injection.
METHODS
Our prototype device consists of a miniature β-radiation detector contained within the tip of a flexible intravascular catheter. The catheter can be adapted to incorporate an injection port and retractable needle for therapeutic delivery. The performance of the β-detection catheter was assessed in vitro with various β-emitting radionuclides and ex vivo in hearts of pigs following systemic injection of F-fluorodeoxyglucose (F-FDG) at 1-week post-myocardial infarction. Regional catheter-based endocardial measurements of F activity were compared to regional tissue activity from PET/CT images and gamma counting.
RESULTS
The β-detection catheter demonstrated sensitive in vitro detection of β-radiation from Na (β), F (β), and Tl (β), with minimal sensitivity to γ-radiation. For F, the catheter demonstrated a sensitivity of 4067 counts/s/μCi in contact and a spatial resolution of 1.1 mm FWHM. Ex vivo measurements of endocardial F activity with the β-detection catheter in the chronic pig infarct model demonstrated good qualitative and quantitative correlation with regional tissue activity from PET/CT images and gamma counting.
CONCLUSION
The prototype β-detection catheter demonstrates sensitive and selective detection of β and β emissions over a wide range of energies and enables high-fidelity ex vivo characterization of endocardial activity from systemically delivered F-FDG.
Topics: Animals; Fluorodeoxyglucose F18; Heart; Humans; Myocardial Infarction; Myocardium; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Swine
PubMed: 32820423
DOI: 10.1007/s12350-020-02317-8 -
Seminars in Nuclear Medicine Mar 2020Neuroendocrine tumors (NET) are a heterogeneous group of neoplasms, arising from cells of the endocrine system, with various clinical behaviors. Although these neoplasms... (Review)
Review
Neuroendocrine tumors (NET) are a heterogeneous group of neoplasms, arising from cells of the endocrine system, with various clinical behaviors. Although these neoplasms are considered rare, a significant increase in the incidence and detectability of NET has been noted in many epidemiological studies in recent years. Among the various therapeutic options, peptide receptor radionuclide therapy (PRRT), using somatostatine has been shown to be highly effective and a well-tolerated therapy, improving survival parameters. The current use of radionuclides for PRRT is β-emitters. Due to hypoxia cancer tissue could be resistant for β-emitters. Quite long penetration range had a significant impact on side effects. α-particles with higher energy and shorter penetration range in comparison to β-particles, have distinct advantages for use in targeted therapy. The clinical experience with somatostatine based targeted α therapy (TAT) in NET showed very promising results even in patienicts refractory to treatment with β-emitters. This article summarizes current developments in preclinical and clinical investigation on TAT in NET.
Topics: Alpha Particles; Animals; Clinical Trials as Topic; Humans; Molecular Targeted Therapy; Neuroendocrine Tumors; Treatment Outcome
PubMed: 32172802
DOI: 10.1053/j.semnuclmed.2019.11.003 -
Nuclear Medicine and Molecular Imaging Apr 2022is required for cancer cell proliferation and tumor angiogenesis. Radioactive copper-64 chloride (CuCl) is a useful radiotracer for cancer imaging with position... (Review)
Review
is required for cancer cell proliferation and tumor angiogenesis. Radioactive copper-64 chloride (CuCl) is a useful radiotracer for cancer imaging with position emission tomography (PET) based on increased cellular uptake of copper mediated by human copper transporter 1 (hCtr1) expressed on cancer cell membrane. Significant progress has been made in research of using CuCl as a radiotracer for cancer imaging with PET. Radiation dosimetry study in humans demonstrated radiation safety of CuCl. Recently, CuCl was successfully used for PET imaging of prostate cancer, bladder cancer, glioblastoma multiforme (GBM), and non-small cell lung carcinoma in humans. Based on the findings from the preclinical research studies, CuCl PET/CT also holds potential for diagnostic imaging of human hepatocellular carcinoma (HCC), malignant melanoma, and detection of intracranial metastasis of copper-avid tumors based on low physiological background of radioactive copper uptake in the brain. Copper-64 radionuclide emits both β and β particles, suggesting therapeutic potential of CuCl for radionuclide cancer therapy of copper-avid tumors. Recent progress in production of therapeutic copper-67 radionuclide invites clinical research in use of theranostic pair of CuCl and CuCl for cancer imaging and radionuclide therapy.
PubMed: 35464672
DOI: 10.1007/s13139-022-00738-6 -
Frontiers in Medicine 2021Targeted alpha therapy (TAT) using alpha particle-emitting radionuclides is in the spotlight after the approval of RaCl for patients with metastatic castration-resistant... (Review)
Review
Targeted alpha therapy (TAT) using alpha particle-emitting radionuclides is in the spotlight after the approval of RaCl for patients with metastatic castration-resistant prostate cancer and the development of several alpha emitter-based radiopharmaceuticals. It is acknowledged that alpha particles are highly cytotoxic because they produce complex DNA lesions. Hence, the nucleus is considered their critical target, and many studies did not report any effect in other subcellular compartments. Moreover, their physical features, including their range in tissues (<100 μm) and their linear energy transfer (50-230 keV/μm), are well-characterized. Theoretically, TAT is indicated for very small-volume, disseminated tumors (e.g., micrometastases, circulating tumor cells). Moreover, due to their high cytotoxicity, alpha particles should be preferred to beta particles and X-rays to overcome radiation resistance. However, clinical studies showed that TAT might be efficient also in quite large tumors, and biological effects have been observed also away from irradiated cells. These distant effects are called bystander effects when occurring at short distance (<1 mm), and systemic effects when occurring at much longer distance. Systemic effects implicate the immune system. These findings showed that cells can die without receiving any radiation dose, and that a more complex and integrated view of radiobiology is required. This includes the notion that the direct, bystander and systemic responses cannot be dissociated because DNA damage is intimately linked to bystander effects and immune response. Here, we provide a brief overview of the paradigms that need to be revisited.
PubMed: 34386508
DOI: 10.3389/fmed.2021.692436 -
Environmental Health : a Global Access... Jun 2021Exposure to ionizing radiation has been associated with insulin resistance and type 2 diabetes. In light of recent work showing an association between ambient...
BACKGROUND
Exposure to ionizing radiation has been associated with insulin resistance and type 2 diabetes. In light of recent work showing an association between ambient particulate matter (PM) gross β-activity and gestational diabetes mellitus (GDM) among pregnant women, we examined pregnancy glucose levels in relation to PM gross β-activity to better understand this pathway.
METHODS
Our study included 103 participants receiving prenatal care at Beth Israel Deaconess Medical Center in Boston, MA. PM gross β-activity was obtained from US Environmental Protection Agency's RadNet program monitors, and blood glucose levels were obtained from the non-fasting glucose challenge test performed clinically as the first step of the 2-step GDM screening test. For each exposure window we examined (i.e., moving average same-day, one-week, first-trimester, and second-trimester PM gross β-activity), we fitted generalized additive models and adjusted for clinical characteristics, socio-demographic factors, temporal variables, and PM with an aerodynamic diameter ≤ 2.5 μm (PM). Subgroup analyses by maternal age and by body mass index were also conducted.
RESULTS
An interquartile range increase in average PM gross β-activity during the second trimester of pregnancy was associated with an increase of 17.5 (95% CI: 0.8, 34.3) mg/dL in glucose concentration. Associations were stronger among younger and overweight/obese participants. Our findings also suggest that the highest compared to the lowest quartile of one-week exposure was associated with 17.0 (95% CI: - 4.0, 38.0) mg/dL higher glucose levels. No associations of glucose were observed with PM gross β-activity during same-day and first-trimester exposure windows. PM was not associated with glucose levels during any exposure window in our data.
CONCLUSIONS
Exposure to higher levels of ambient PM gross β-activity was associated with higher blood glucose levels in pregnant patients, with implications for how this novel environmental factor could impact pregnancy health.
Topics: Adult; Air Pollutants; Beta Particles; Blood Glucose; Female; Humans; Maternal Exposure; Particulate Matter; Pregnancy
PubMed: 34126994
DOI: 10.1186/s12940-021-00744-9 -
Cancers Feb 2020Pancreatic ductal adenocarcinoma (PDAC) has long been associated with low survival rates. A lack of accurate diagnostic tests and limited treatment options contribute to... (Review)
Review
Pancreatic ductal adenocarcinoma (PDAC) has long been associated with low survival rates. A lack of accurate diagnostic tests and limited treatment options contribute to the poor prognosis of PDAC. Radioimmunotherapy using α- or β-emitting radionuclides has been identified as a potential treatment for PDAC. By harnessing the cytotoxicity of α or β particles, radioimmunotherapy may overcome the anatomic and physiological factors which traditionally make PDAC resistant to most conventional treatments. Appropriate selection of target receptors and the development of selective and cytotoxic radioimmunoconjugates are needed to achieve the desired results of radioimmunotherapy. The aim of this review is to examine the growing preclinical and clinical trial evidence regarding the application of α and β radioimmunotherapy for the treatment of PDAC. A systematic search of MEDLINE and Scopus databases was performed to identify 34 relevant studies conducted on α or β radioimmunotherapy of PDAC. Preclinical results demonstrated α and β radioimmunotherapy provided effective tumour control. Clinical studies were limited to investigating β radioimmunotherapy only. Phase I and II trials observed disease control rates of 11.2%-57.9%, with synergistic effects noted for combination therapies. Further developments and optimisation of treatment regimens are needed to improve the clinical relevance of α and β radioimmunotherapy in PDAC.
PubMed: 32092952
DOI: 10.3390/cancers12020481 -
Journal of Clinical Medicine Dec 2022Copper is required for cancer cell proliferation and tumor angiogenesis. Copper-64 radionuclide (Cu), a form of copper chloride (CuCl), is rapidly emerging as a... (Review)
Review
Copper is required for cancer cell proliferation and tumor angiogenesis. Copper-64 radionuclide (Cu), a form of copper chloride (CuCl), is rapidly emerging as a diagnostic PET/CT tracer in oncology. It may also represent an interesting alternative to gallium-68 (Ga) as a radionuclide precursor for labelling radiopharmaceuticals used to investigate neuroendocrine tumors and prostate cancer. This emerging interest is also related to the nuclear properties of CuCl that make it an ideal theragnostic nuclide. Indeed, CuCl emits β and β particles together with high-linear-energy-transfer Auger electrons, suggesting the therapeutic potential of CuCl for the radionuclide cancer therapy of copper-avid tumors. Recently, CuCl was successfully used to image prostate cancer, bladder cancer, glioblastoma multiforme (GBM), and non-small cell lung carcinoma in humans. Copper cancer uptake was related to the expression of human copper transport 1 (hCTR1) on the cancer cell surface. Biodistribution, toxicology and radiation safety studies showed its radiation and toxicology safety. Based on the findings from the preclinical research studies, CuCl PET/CT also holds potential for the diagnostic imaging of human hepatocellular carcinoma (HCC), malignant melanoma, and the detection of the intracranial metastasis of copper-avid tumors based on the low physiological background of radioactive copper uptake in the brain.
PubMed: 36615024
DOI: 10.3390/jcm12010223 -
Journal of Cancer 2016Adult colorectal epithelium undergoes continuous renewal and maintains homeostatic balance through regulated cellular proliferation, differentiation, and migration. The... (Review)
Review
Adult colorectal epithelium undergoes continuous renewal and maintains homeostatic balance through regulated cellular proliferation, differentiation, and migration. The canonical Wnt signaling pathway involving the transcriptional co-activator β-catenin is important for colorectal development and normal epithelial maintenance, and deregulated Wnt/β-catenin signaling has been implicated in colorectal carcinogenesis. Colorectal carcinogenesis has been linked to radiation exposure, and radiation has been demonstrated to alter Wnt/β-catenin signaling, as well as the proteasomal pathway involved in the degradation of the signaling components and thus regulation of β-catenin. The current review discusses recent progresses in our understanding of colorectal carcinogenesis in relation to different types of radiation and roles that radiation quality plays in deregulating β-catenin and ubiquitin-proteasome pathway (UPP) for colorectal cancer initiation and progression.
PubMed: 26819641
DOI: 10.7150/jca.13387