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Rivista di Medicina Nucleare e Imaging Molecolare

A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
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The Quarterly Journal of Nuclear Medicine and Molecular imaging 2010 Agosto;54(4):411-28

lingua: Inglese

Therapeutic nuclear medicine in pediatric malignancy

Schmidt M. 1, Baum R. P. 2, Simon T. 3, Howman-Giles R. 4

1 Department of Nuclear Medicine, University of Cologne, Cologne, Germany;
2 Department of Nuclear Medicine/Center for PET, Bad Berka, Germany;
3 Children´s Hospital, Department of Hemato-Oncology, University of Cologne, Germany;
4 Department of Nuclear Medicine, The Children’s Hospital at Westmead, University of Sydney, Australia


The following review aims to provide contemporary information on therapeutic nuclear medicine procedures in paediatric malignancies. Neuroblastoma is the most common paediatric extra cranial solid cancer characterized by meta-iodobenzylguanidine (mIBG) avidity in ≥90% of patients. There exists approximately a 30-year experience with I-131-mIBG treatment. Ongoing efforts include a more standardized approach including dosimetric data for patient selection and treatment guidance of I-131-mIBG therapy. Neuroendocrine tumours (NETs) are very rare neoplasms in the paediatric population accounting for <1% of all paediatric malignancies. These neoplasms are characterized by the presence of neuroamine uptake mechanisms and/or peptide receptors at the cell membrane. These features constitute the basis of the clinical use of peptide receptor radionuclide therapy (PRRNT) using radiolabeled somatostatin analogues. Osteosarcoma is the most common primary bone tumour in children usually treated with chemotherapy and surgery. In palliative situations bone seeking radionuclide therapies (strontium-89 [Sr-89], rhenium-186 hydroxyethylene diphosphonate [Rh-186 HEDP] and Samarium-153-ethylene diamine tetramethylene phosphonic acid [Sm-153-EDTMP]) may be offered to patients with painful metastatic osteosarcoma or in case of recurrent bone sites inaccessible to local therapies (surgery, external irradiation). Thyroid cancer is a rare childhood malignancy with an approximate incidence of 0.54 per 100000 per year but is the most frequent tumour of endocrine glands in children and adolescents. Management includes radioiodine therapy but there are some distinct differences in comparison to adult thyroid cancer management.

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