This book is intended to provide the state-of-the-art in the present knowledge of the fast growing field of nuclear oncology. The enormous sum of data it gathers is presented by the leading authors in their respective fields. Recent breakthrough as well as validated techniques are explained in details. Among the most stimulating issues, it becomes clear that the long awaited era of radioimmunotherapy is finally coming to reality and is close to enter into routine clinical use. Several chapters are devoted to this future important aspect of our practice. They should allow the reader to become quickly and completely informed about the main results of the recent trials and also to comprehend the expected evolutions in this field. Positron emission tomography (PET) also occupies a large place. Numerous illustrations help the reader to appreciate the wide capabilities of this technique. The more usual radiopharmaceuticals labeled by single photons emitters are not forgotten and all the aspects of the daily practice of nuclear oncology are covered, from thyroid and bone imaging to sentinel lymph node detection.

The first part of the book covers transversally the field of nuclear oncology.

A radiopharmaceuticals chapter provides an in-depth review of the properties and chemistry of the single-photon and positron emitters radionuclides. The various mechanisms of localization are also described at the membrane level as well as for metabolic substrates. The properties of the agents aiming at hormone receptors and tumor antigens are excellently described, as well as the recently introduced gene expression imaging. Multidrug resistance (MDR) is divided in two parts. The breast cancer chapter retraces the history and background of sestamibi in the detection of MDR. It also describes the methodology and clinical results of the most important scintigraphic studies that have demonstrated the possibility to detect the early development of resistance to chemotherapy. An interesting series of other agents with a high potential in this indication, particularly positron emitters, is discussed. The role of technetium and positron agents for MDR detection in other tumor localisations, especially in the lung, is also well covered.

An instrumentation chapter goes through the fundamentals of planar and SPECT imaging, and also presents the new reconstruction and correction algorithms. A large section is occupied by positron imaging. The pros and cons of dedicated detector and camera coincidence are very well detailed. This part should definitely help to decide those who are trying to make a choice between these two options.

The general principles of radiolabeled monoclonal antibodies imaging and therapy are covered in two very interesting chapters. Then radiotherapy of painful bone metastases compares the capabilities of the various agents available. A large chapter deals with pediatric nuclear oncology, in particular neuroblastoma, bone and central nervous system tumors. Finally, the often forgotten role of nuclear medicine in the detection, and possibly in the prevention, of the cardiotoxicity and nephrotoxicity resulting from cancer therapy are addressed at the end of that first part.

The second part of the book goes by organ and begins by addressing brain tumors. A vast chapter is devoted to PET imaging. Besides the tracers and instrumentation issues, patient management occupies a central place, in particular with discussion on the role of nuclear medicine in tissue characterization, treatment planning and assessment of treatment response. Cerebrospinal fluid and shunt imaging are described, with particular attention paid to ventriculoperitoneal shunts. After PET imaging of head and neck carcinoma, a chapter extensively reviews thyroid carcinoma. Iodine therapy and long-term monitoring are covered with great details and useful practical recommendations are provided. Emerging radioimmunotherapy is discussed apart. Parathyroid scintigraphy also occupies a large and well documented chapter. PET imaging of lung carcinoma is particularly well illustrated by several cases. The potential of peptide scintigraphy is presented.

Breast cancer occupies five chapters, namely, scintimammography, PET imaging, lymphatic mapping, monoclonal antibody imaging and radionuclide therapy. This provides an extensive review of the present and potential possibilities of nuclear medicine in one of the most frequent tumors. Then the role of PET imaging and the capabilities of radioimmunotherapy for maligancies of the gastrointestinal and genitourinary tracts are presented, in particular in two chapters entirely dedicated to prostate carcinoma and in two others to ovarian carcinoma.

Radiolabeled somatostatin analogues and their value in the diagnosis and treatment of the neuroendocrine tumors are reviewed. Hepatic neoplasia are addressed through the utilization of technetium-labeled galactosyl neoglycoalbumin and hepatic artery infusion. For lymphomas, besides gallium and PET imaging, a very complete chapter is devoted to monoclonal antibody therapy. The extremely promising results obtained with several radiolabeled-anti-CD monoclonal antibodies in the treatment of B-cell non-Hodgkin’s lymphomas are reviewed in depth. Additional chapters cover adrenal tumors, melanoma, musculoskeletal tumors, in particular imaging of bone metastases.

This comprehensive, didactic, up-to-date, well illustrated review of nuclear oncology should help nuclear medicine physicians as well as oncologists to optimize their practice.