Oncologic nuclear medicine has provided significant advances through the use of radiopharmaceuticals that localize related to the biochemistry of the tissue. Radionuclide bone imaging is an important imaging study in the evaluation of patients with suspected osseous metastatic disease because it detects disease prior to abnormalities being present on plain radiographs. The bone chemical changes occur prior to anatomic changes. The imaging of chemistry affords the opportunity to detect disease prior to anatomic changes and to provide specificity to anatomic lesions.
Several radiopharmaceuticals are now available for use in oncology.
Gallium-67 citrate has been available for many years, but its role in staging patients with lymphoma and following the effects of therapy has only recently been documented. Gallium imaging after therapy has proven to be accurate in determining the presence of persistent disease and is used to guide therapeutic decisions. Receptor imaging is beginning to have a role in nuclear oncology. Gallium-67 binds to transferrin, and its localization in tumors is dependent on the presence of transferrin receptors. We now have the ability to image somatostatin receptors by the use of an indium-111 labeled analogue of somatostatin octreotide.