¹²⁴J/¹³¹J-Theranostik des Natrium-Jodid-Symporters beim Schilddrüsenkarzinom

Zusammenfassung

Eines der vielversprechendsten Konzepte in der Nuklearmedizin ist die Theranostik, die im Wesentlichen die Diagnostik und Therapie eines bestimmten Targets beinhaltet, insbesondere, wenn es darum geht, Krebstherapien zu optimieren und zu individualisieren. In der Nuklearmedizin werden Theranostika bereits seit über 60 Jahren in der klinischen Routine mit ¹³¹J/¹²³J für diagnostische und therapeutische Zwecke bei Schilddrüsenerkrankungen eingesetzt. Dieser Artikel gibt einen kurzen Überblick über die Verwendung von 2 Radiojod-Isotopen (¹³¹J und ¹²⁴J) für das Targeting des Natrium-Jodid-Symporters bei Schilddrüsenkarzinomen und nicht thyreoidalen Tumoren. Insbesondere wird die Rolle der ¹²⁴J-basierten Dosimetrie diskutiert. Abschließend zeigen wir an einem Patientenbeispiel, wie die Expression des Natrium-Jodid-Symporters bei einem Patienten mit Radiojod-refraktärem fortgeschrittenem Schilddrüsenkarzinom durch Medikamente manipuliert werden kann.

Abstract

One of the most promising concepts of nuclear medicine is theranostic that combines diagnostic and therapy with respect to specific targets. Using this approach, cancer therapies can be optimized and individualized. Theranostic concepts have been applied in nuclear medicine already for more than 60 years as part of clinical routine using ¹³¹I/¹²³I for therapeutic and diagnostic purposes in thyroid disorders and thyroid cancer. This review provides a short overview over the application of two isotopes of radioiodine (¹³¹I and ¹²⁴I) for targeting the sodium-iodine-symporter in thyroid cancer but also in other, non-thyroid carcinomas. In addition, the role of ¹²⁴I dosimetry is discussed in detail. Furthermore, we show in a patient case, how sodium-iodinesymporter expression may be manipulated by using targeted drugs in radioiodine refractory advanced thyroid cancer.

Schlüsselwörter

¹²⁴J - ¹³¹J - Natrium-Jodid-Symporter - Schilddrüsenkarzinom - Redifferenzierung

Key words

Iodine Theranostics - ¹²⁴I - ¹³¹I - Sodium-Iodine Symporter - re-differentiation

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