Radio theranostics in paragangliomas and pheochromocytomas

Rev Esp Med Nucl Imagen Mol (Engl Ed). 2024 Jul-Aug;43(4):500017. doi: 10.1016/j.remnie.2024.500017. Epub 2024 May 10.

Abstract

This continuing education aims to present in a clear and easy-to-understand manner the biology of paragangliomas and pheochromocytomas (PPGLs), the functional imaging studies available for their diagnosis and therapeutic planning, the requirements necessary to administer radioligand therapy (RLT) and the characteristics of these treatments (inclusion criteria, administration protocols, adverse effects and future perspectives). In this pathology we have two RLT options: [131I]MIBG and [177Lu]Lu-DOTA-TATE. The indication for treatment is determined by the expression of its therapeutic target in functional imaging studies, allowing precision and personalized medicine. Although most of the results we have for both treatments have as origin small retrospective series, RLT is presented as a safe and well-tolerated therapeutic option in PPGLs with slow-moderate progression or with uncontrollable symptoms, obtaining high disease control rates.

Keywords: Feocromocitoma; Paraganglioma; Pheochromocytoma; Teragnosis; Theranostics; [(131)I]MIBG; [(177)Lu]Lu-DOTA-TATE.

Publication types

  • Review

MeSH terms

  • 3-Iodobenzylguanidine* / therapeutic use
  • Adrenal Gland Neoplasms* / diagnostic imaging
  • Adrenal Gland Neoplasms* / radiotherapy
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Octreotide / analogs & derivatives
  • Octreotide / therapeutic use
  • Organometallic Compounds / therapeutic use
  • Paraganglioma* / diagnostic imaging
  • Paraganglioma* / radiotherapy
  • Pheochromocytoma* / diagnostic imaging
  • Pheochromocytoma* / radiotherapy
  • Precision Medicine
  • Radiopharmaceuticals* / pharmacokinetics
  • Radiopharmaceuticals* / therapeutic use
  • Theranostic Nanomedicine / methods

Substances

  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine
  • lutetium Lu 177 dotatate
  • Octreotide
  • Organometallic Compounds
  • Iodine Radioisotopes
  • Iodine-131