{"title":"Total Body PET/CT: A Role in Drug Development?","authors":"Xiangxi Meng, Xiangxing Kong, Runze Wu, Zhi Yang","doi":"10.1053/j.semnuclmed.2024.09.006","DOIUrl":null,"url":null,"abstract":"<p><p>Nowadays, total body PET has already entered the medical centers and enabled various clinical applications due to its superior imaging capabilities, especially the high sensitivity. However, the potential of the total body PET in the clinical evaluation of radiopharmaceuticals remains underexplored. The development and regulatory processes for radiopharmaceuticals present unique challenges that total body PET could address. In the safety evaluation of radiopharmaceuticals, the internal radiation dosimetry demands images with high quality and quantitative accuracy, which can be achieved using the total body PET. The current clinical pharmacokinetic study for radiopharmaceuticals still relies on invasively sampling of blood and other body fluid, causing discomfort of participant and difficulty in implementation. With the total body PET, the radioactive concentration of the drug in various blood vessels can be assessed noninvasively, facilitating the pharmacokinetic study. The parametric analysis over the total body based on compartment models also sheds light on the pharmacokinetics of the radiopharmaceutical. A special requirement for multi-center clinical research involving PET and SPECT is the harmonization of the quantitative performance among different imaging equipment, and the discrepancy between the total body PET and short axial field of view PET scanners may add to the complexity. To date, there are several successful examples of clinical trials of innovative radiopharmaceuticals using the total body PET, involving different types of tracers ranging from small molecules, peptides, nanobodies, minibodies, and aptamers. In conclusion, total body PET has the potential to revolutionize the clinical evaluation of radiopharmaceuticals and will play a crucial role in future drug development.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in nuclear medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.semnuclmed.2024.09.006","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Nowadays, total body PET has already entered the medical centers and enabled various clinical applications due to its superior imaging capabilities, especially the high sensitivity. However, the potential of the total body PET in the clinical evaluation of radiopharmaceuticals remains underexplored. The development and regulatory processes for radiopharmaceuticals present unique challenges that total body PET could address. In the safety evaluation of radiopharmaceuticals, the internal radiation dosimetry demands images with high quality and quantitative accuracy, which can be achieved using the total body PET. The current clinical pharmacokinetic study for radiopharmaceuticals still relies on invasively sampling of blood and other body fluid, causing discomfort of participant and difficulty in implementation. With the total body PET, the radioactive concentration of the drug in various blood vessels can be assessed noninvasively, facilitating the pharmacokinetic study. The parametric analysis over the total body based on compartment models also sheds light on the pharmacokinetics of the radiopharmaceutical. A special requirement for multi-center clinical research involving PET and SPECT is the harmonization of the quantitative performance among different imaging equipment, and the discrepancy between the total body PET and short axial field of view PET scanners may add to the complexity. To date, there are several successful examples of clinical trials of innovative radiopharmaceuticals using the total body PET, involving different types of tracers ranging from small molecules, peptides, nanobodies, minibodies, and aptamers. In conclusion, total body PET has the potential to revolutionize the clinical evaluation of radiopharmaceuticals and will play a crucial role in future drug development.
如今,全身正电子发射计算机断层成像技术凭借其卓越的成像能力,尤其是高灵敏度,已经进入医疗中心,并实现了各种临床应用。然而,全身 PET 在放射性药物临床评估方面的潜力仍未得到充分挖掘。放射性药物的开发和监管过程提出了独特的挑战,而全身 PET 可以应对这些挑战。在放射性药物的安全性评估中,内部辐射剂量测定要求图像质量高、定量准确,而全身正电子发射计算机断层显像可以实现这一点。目前,放射性药物的临床药代动力学研究仍然依赖于有创的血液和其他体液采样,造成受试者的不适和实施上的困难。全身 PET 可以无创评估药物在不同血管中的放射性浓度,为药代动力学研究提供了便利。基于分区模型的全身参数分析还能揭示放射性药物的药代动力学。涉及 PET 和 SPECT 的多中心临床研究的一个特殊要求是协调不同成像设备的定量性能,而全身 PET 扫描仪和短轴向视野 PET 扫描仪之间的差异可能会增加复杂性。迄今为止,已有多个利用全身 PET 进行创新放射性药物临床试验的成功案例,涉及小分子、肽、纳米体、迷你体和适配体等不同类型的示踪剂。总之,全身 PET 有可能彻底改变放射性药物的临床评估,并将在未来的药物开发中发挥至关重要的作用。
期刊介绍:
Seminars in Nuclear Medicine is the leading review journal in nuclear medicine. Each issue brings you expert reviews and commentary on a single topic as selected by the Editors. The journal contains extensive coverage of the field of nuclear medicine, including PET, SPECT, and other molecular imaging studies, and related imaging studies. Full-color illustrations are used throughout to highlight important findings. Seminars is included in PubMed/Medline, Thomson/ISI, and other major scientific indexes.