Nuclear Oncology

H. William StraussGiuliano MarianiDuccio VolterraniSteven M. LarsonEditors

Nuclear Oncology

From Pathophysiology to ClinicalApplications

Second Edition

With 992 Figures and 166 Tables

EditorsH. William StraussMolecular Imaging and Therapy ServiceMemorial Sloan Kettering Cancer CenterNew York, NY, USA

Giuliano MarianiUniversity of PisaRegional Center of Nuclear MedicinePisa, Italy

Duccio VolterraniUniversity of PisaRegional Center of Nuclear MedicinePisa, Italy

Steven M. LarsonMolecular Imaging and Therapy ServiceMemorial Sloan Kettering Cancer CenterNew York, NY, USA

ISBN 978-3-319-26234-5 ISBN 978-3-319-26236-9 (eBook)ISBN 978-3-319-26235-2 (print and electronic bundle)https://doi.org/10.1007/978-3-319-26236-9

Library of Congress Control Number: 2017949354

1st edition: # Springer Science+Business Media New York 2013# Springer International Publishing Switzerland 2017This work is subject to copyright. All rights are reserved by the Publisher, whether the whole orpart of the material is concerned, specifically the rights of translation, reprinting, reuse ofillustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way,and transmission or information storage and retrieval, electronic adaptation, computer software, orby similar or dissimilar methodology now known or hereafter developed.The use of general descriptive names, registered names, trademarks, service marks, etc. in thispublication does not imply, even in the absence of a specific statement, that such names are exemptfrom the relevant protective laws and regulations and therefore free for general use.The publisher, the authors and the editors are safe to assume that the advice and information in thisbook are believed to be true and accurate at the date of publication. Neither the publisher nor theauthors or the editors give a warranty, express or implied, with respect to the material containedherein or for any errors or omissions that may have been made. The publisher remains neutral withregard to jurisdictional claims in published maps and institutional affiliations.

Printed on acid-free paper

This Springer imprint is published by Springer NatureThe registered company is Springer International Publishing AGThe registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

This book is dedicated to the scientists and clinicians who havedeveloped the technology and life-saving procedures that we useto diagnose and treat our patients

Preface to the Second Edition

The role of nuclear medicine and molecular imaging in the diagnosis andtherapy of cancer patients is growing. The rapid pace of change has beenfueled by advances in understanding tumor biology, on the one hand, and thedevelopment of specifically targeted medical therapies, diagnostic agents, andradiotherapies, on the other. These advances suggested that an update andexpansion of the contents of Nuclear Oncology would be timely. The secondedition offers specialists in imaging, radiotherapy, cancer surgery, and oncol-ogy information that is current to manage patients with cancer.

There are three major changes in this edition: first, the text has beenexpanded to include more detailed information on performing specific pro-cedures (e.g., radioguided surgery); second, the number of clinical cases hasbeen increased to 170, to provide a broader range of examples, reflecting theclinical range of findings; and third, this edition will be available on Springer’selectronic platform, allowing authors to continuously update the content oftheir chapters.

The second edition is divided into seven parts:

Part 1 consists of 13 chapters of basic science. The first chapter describes ourunderstanding of cancer biology, including mechanisms of initiation ofcancer and key tumor pathways that are attacked by specific therapeuticagents. This is followed by a discusion of mechanisms of moleculartargeting and approved radiopharmaceuticals for single photon and posi-tron imaging as well as therapy. These chapters are mirrored by threechapters describing agents in development for diagnosis and therapy.Chapters on physics, instrumentation, and radiobiology complete thebasic science section.

Part 2 has 26 chapters that address the roles of imaging in the diagnosis andstaging in specific types of cancer. Each chapter starts with a review of theepidemiology of the cancer, followed by a description of the typical clinicalpresentation, criteria for staging, therapeutic alternatives, and monitoringthe effectiveness of treatment and suveillance following therapy.

vii

Part 3 has seven chapters that address radionuclide therapy for the treatment of:LymphomaMultiple myeloma and leukemiasThyroid cancerNeuroendocrine tumors, with separate chapters discussing the use ofMIBG

and peptide therapySkeletal metastasesTumors of the liver and biliary tree with radiolabeled particulates

Part 4 has four chapters on specific applications of radioguided surgery. Threechapters describe the instrumentation, radiopharmaceuticals, and clinicalgoals of radioguided surgery in patients with breast cancer, malignantmelanoma, and head and neck cancer. The last chapter of this section coversnovel applications of the technology.

Part 5 describes the detection and management of heart disease in the cancerpatient.

Part 6 presents adverse effects of cancer therapy.Part 7 consists of 25 chapters of cases. These chapters of cases supplement the

case examples illustrating specific points in each of the clinical chapters.

The text has a detailed index, which will help readers locate the informationthey seek to care for their patients.

We would like feedback from our readers about the text. Please addressyour comments to the editors.

New York, NY, USA H. William Strauss, M.D.Pisa, Italy Giuliano Mariani, M.D.Pisa, Italy Duccio Volterrani, M.D.New York, NY, USA Steven M. Larson, M.D.

viii Preface to the Second Edition

Preface to the First Edition

Cancer is a disease that was first described over 3500 years ago. While thedesignation cancer was coined by Hippocrates centuries later, descriptions ofindividual patients with the disease are found in Egyptian papyri dating from1600 BCE [1]. Two papyri, the Edwin Smith papyrus (circa 1600 BCE) and theGeorge Ebers papyrus (circa 1500 BCE), contain case descriptions consistentwith modern observations of patients with cancer [2]. Hippocrates, in the fifthcentury BCE, suggested there was no cure for these maladies. Clinical obser-vations and laboratory studies in the intervening 2500 years have led to a betterunderstanding of the pathophysiology of cancer and the realization that thedisease can be effectively treated.

There are four phases of most common malignant tumors: (1) Multiplegenetic alterations lead to a cell losing control of cell division, apoptosis, andDNA repair, resulting in a malignant change, commonly referred to as trans-formation. (2) The transformed cells are genetically programmed to grow.(3) The proliferating transformed cells invade surrounding local tissues.(4) Some of the transformed cells depart from the local tumor mass andcolonize a distant site, resulting in distant metastases [3].

Our current understanding of the pathophysiology of neoplasia has pro-vided specific information on the numerous genetic changes in the transformedcell and on the impact of these changes on protein production by the trans-formed genome. Altered protein production may lead to an increase ordecrease in the expression of receptors, production of unique epitopes on thecell surface, and changes in substrate utilization by the transformed cells.

Understanding the molecular mechanisms of specific neoplasms has led tothe development of novel therapies, addressing specific control points in thelife cycle of the transformed cell, and defined the need for detailed staging andcharacterization of the tumor, to develop a plan of treatment for the patient.This textbook provides the reader with information on the role of nuclearmedicine in the diagnosis, staging, and treatment of patients with specificcancers. Each chapter provides material on the incidence, main pathophysio-logic and clinical aspects of the disease, staging, and management of specifictumors, with a major focus on the points to be addressed by the nuclearmedicine procedures.

The book is composed of seven parts: Basic science is covered inChaps. 1–6: The first chapter reviews fundamental aspects of the biology ofcancer and the tumor mass. The next two chapters describe the chemistry and

ix

radio pharmacy for manufacturing single photon and positron emitting radio-pharmaceuticals. The next three chapters deal with the physics of radionuclidedecay, principles of instrumentation, followed by radiobiology and dosimetry.Clinical applications are covered in Chaps. 7–25. Radionuclide therapy iscovered in Chaps. 26 and 27, and radioguided surgery is discussed inChap. 28. Heart disease in the cancer patient is covered in Chap. 29, andadverse effects of cancer therapy in Chap. 30. In Part VII, Teaching Cases, thebook concludes with a series of cases.

Each clinical chapter discusses the radionuclide procedures within anintegrated framework identifying the information required for effective treat-ment of that specific tumor. The first part of each chapter provides a descriptionof the epidemiology, etiology, histologic and pathophysiologic classification,prognosis, treatment, and the most common outcome for each type of cancer.This information on basic/clinical oncology is essential for the nuclear med-icine specialist to understand how radionuclide imaging and therapy should beintegrated with other imaging/therapeutic modalities to the benefit of thecancer patient. These discussions also highlight elements that should becontained in the report of the nuclear imaging procedure(s): depending onthe type of cancer and the specific goal of imaging (initial staging, evaluationof response to therapy, or surveillance for recurrence), the Impression sectionof the report should clearly answer the clinical question.

New York, NY, USA H. William Strauss, M.D.Pisa, Italy Giuliano Mariani, M.D.Pisa, Italy Duccio Volterrani, M.D.New York, NY, USA Steven M. Larson, M.D.

References

1. Dib EG, Kidd MR, Saltman DC. Case reports and the fight against cancer.J Med Case Reports. 2008;2:39.

2. Ebers Papyrus. http://www.newworldencyclopedia.org/entry/Ebers_papyrus.Accessed 2 Aug 2011.

3. Kumar V, Abbas AK, Fausto N. editors. Neoplasia. In: Robbins and Cotranpathologic basis of disease. 7th ed. St. Louis: Elsevier Saunders; 2005.p. 269–342.

x Preface to the First Edition

Acknowledgment

The editors are indebted to our colleagues from different groups who contrib-uted additional teaching cases in the concluding section of the book. Theircontributions provide examples of how nuclear oncology plays a practical rolein patient management at critical points in the care of patients. The following isa list of the groups and contributors:

• Biomedical Photonic Imaging Group, University of Twente, Enschede, TheNetherlands: R.H.J.A. Slart.

• Department of Nuclear Medicine and PET Centre, Aarhus UniversityHospital, Denmark: K. Bouchelouche, C.M. Hoff, M.R. Jochumsen,M.A. Pedersen.

• Department of Nuclear Medicine and Molecular Imaging, UniversityMedical Center Groningen, The Netherland: E.D. Telenga,A.W.J.M. Glaudemans, R.H.J.A. Slart.

• Division of Nuclear Medicine, Department of Biomedical Sciences,Humanitas University, Milan, Italy: A. Chiti, M. Kirienko, G. Manfrinato,L. Olivari.

• Endocrine Unit, Department of Clinical and Experimental Medicine, Uni-versity of Pisa, Pisa, Italy: V. Cappagli, R. Elisei, C. Giani, A. Matrone,E. Molinaro, L. Pieruzzi, D. Viola.

• Institute of Nuclear Medicine, UCLHNHS Foundation Trust, London, UK:K. Al-Riyami, S. Al Shammari, J.P. Connelly, F. Fraioli, D. Neriman,S. Wan.

• Nuclear Medicine Department, Hospital Clinic Barcelona, Barcelona,Spain: S. Vidal-Sicart.

• Nuclear Medicine Service, Great Ormond Street Hospital, London, UK:L. Biassoni.

• Nuclear Medicine Unit, “S. Andrea” Hospital, La Spezia, Italy:A. Ciarmiello, V. Duce.

• Nuclear Medicine Unit, “S. Orsola-Malpighi” Hospital, Bologna, Italy:I. Bossert, S. Fanti, C. Nanni, E. Tabacchi.

• Nuclear Medicine Unit, “Santa Maria della Misericordia” Hospital,Rovigo, Italy: A.M. Maffione.

• Nuclear Medicine, University of Pretoria and Steve Biko Academic Hos-pital, Pretoria, South Africa: T. Boshomane, T. Lengana, F. Reyneke,M. Sathekge.

xi

• Nuclear Medicine/PET-CT, Dana-Farber Cancer Institute, Harvard MedicalSchool, Boston, Massachusetts, USA: H.A. Jacene, C.G. Sakellis,A.D. Van den Abbeele, V. Yerubadi.

• Radiotherapy Unit, “Maggiore della Carità” University Hospital andDepartment of Translational Medicine, University of “Piemonte Orientale,”Novara, Italy: L. Deantonio, M. Krengli.

• Section of Medical Physics, “Maggiore della Carità” University Hospital,Novara, Italy: R. Matheoud.

• Section of Nuclear Medicine, “Maggiore della Carità” University Hospital,Novara, Italy: F. Orsini, G.M. Sacchetti.

xii Acknowledgment

Contents

Volume 1

Part I Basic Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

1 Cancer Biology of Molecular Imaging . . . . . . . . . . . . . . . . . . 3Steven M. Larson

2 Principles of Molecular Targeting for RadionuclideTherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35William C. Eckelman, Marie Boyd, and Robert J. Mairs

3 Single-Photon-Emitting Radiopharmaceuticals forDiagnostic Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67Federica Orsini, Erinda Puta, Alice Lorenzoni, Paola AnnaErba, and Giuliano Mariani

4 Positron-Emitting Radiopharmaceuticals for DiagnosticApplications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85Federica Orsini, Alice Lorenzoni, Erinda Puta, and GiulianoMariani

5 Radiopharmaceuticals for Therapy . . . . . . . . . . . . . . . . . . . . 99Federica Orsini, Sara Mazzarri, Erinda Puta, FedericaGuidoccio, Alice Lorenzoni, and Giuliano Mariani

6 Novel Single-Photon-Emitting Radiopharmaceuticals forDiagnostic Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115Federica Orsini, Federica Guidoccio, Erinda Puta, andGiuliano Mariani

7 Novel Positron-Emitting Radiopharmaceuticals . . . . . . . . . . 129Mirkka Sarparanta, Dustin W. Demoin, Brendon E. Cook,Jason S. Lewis, and Brian M. Zeglis

8 Novel Radiopharmaceuticals for Therapy . . . . . . . . . . . . . . . 173Federica Guidoccio, Sara Mazzarri, Federica Orsini, PaolaAnna Erba, and Giuliano Mariani

xiii

9 Physics of Nuclear Oncology . . . . . . . . . . . . . . . . . . . . . . . . . . 199Dale L. Bailey and John L. Humm

10 Instrumentation for Positron Emission Imaging . . . . . . . . . . 217Pat Zanzonico

11 Instrumentation for Single-Photon Emission Imaging . . . . . 251Pat Zanzonico

12 Instrumentation for Intraoperative Detection . . . . . . . . . . . . 275Pat Zanzonico

13 Radiobiology and Radiation Dosimetry in NuclearMedicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305Massimo Salvatori, Marta Cremonesi, Luca Indovina, MarcoChianelli, Massimiliano Pacilio, Carlo Chiesa, and PatZanzonico

Part II Diagnostic Applications of Nuclear Medicine . . . . . . . . . 351

14 Diagnostic Applications of Nuclear Medicine:Lymphomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353Heather A. Jacene, Sree Harsha Tirumani, and Richard L.Wahl

15 Diagnostic Applications of Nuclear Medicine: MultipleMyeloma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395Martina Sollini, Sara Galimberti, Roberto Boni, andPaola Anna Erba

16 Diagnostic Applications of Nuclear Medicine:Leukemias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435Martina Sollini, Sara Galimberti, Roberto Boni, andPaola Anna Erba

17 Diagnostic Applications of Nuclear Medicine:Brain Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 467Giampiero Giovacchini, Mattia Riondato, ElisabettaGiovannini, and Andrea Ciarmiello

18 Diagnostic Applications of Nuclear Medicine: Head andNeck Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 507Heiko Schöder

19 Diagnostic Applications of Nuclear Medicine:Thyroid Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 545Rossella Elisei, Laura Agate, Sara Mazzarri, Valeria Bottici,Federica Guidoccio, Eleonora Molinaro, Giuseppe Boni,Marco Ferdeghini, and Giuliano Mariani

20 Diagnostic Applications of Nuclear Medicine:Parathyroid Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 585Federica Guidoccio, Sara Mazzarri, Salvatore Mazzeo, andGiuliano Mariani

xiv Contents

21 Diagnostic Applications of Nuclear Medicine: BreastCancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 613Marsha Camilla Lynch, Jean H. Lee, and David A. Mankoff

22 Diagnostic Applications of Nuclear Medicine: Lung andMediastinal Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 639Elite Arnon, Thida Win, Ora Israel, Ludmila Guralnik, andSimona Ben-Haim

Volume 2

23 Diagnostic Applications of Nuclear Medicine: EsophagealCancers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 685Christopher G. Sakellis, Heather A. Jacene, andAnnick D. Van den Abbeele

24 Diagnostic Applications of Nuclear Medicine: GastricCancers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 697Christopher G. Sakellis, Heather A. Jacene, andAnnick D. Van den Abbeele

25 Diagnostic Applications of Nuclear Medicine:Gastrointestinal Stromal Tumors . . . . . . . . . . . . . . . . . . . . . . 709Christopher G. Sakellis, Heather A. Jacene, andAnnick D. Van den Abbeele

26 Diagnostic Applications of Nuclear Medicine: Tumors ofthe Liver and Biliary Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . 725Mustafa Raoof, Steven M. Larson, and Yuman Fong

27 Diagnostic Applications of Nuclear Medicine: PancreaticCancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 749Elena Tabacchi, Cristina Nanni, Irene Bossert, AnnaMargherita Maffione, and Stefano Fanti

28 Diagnostic Applications of Nuclear Medicine: ColorectalCancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 777Ettore Pelosi, Désirée Deandreis, Laura Cassalia, andDaniele Penna

29 Diagnostic Applications of Nuclear Medicine:Neuroendocrine Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 799Lisa Bodei, Mark Kidd, Laura Gilardi, Duccio Volterrani,Giovanni Paganelli, Chiara M. Grana, and Irvin M. Modlin

30 Diagnostic Applications of Nuclear Medicine: Kidneyand Bladder Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 839Kirsten Bouchelouche

31 Diagnostic Applications of Nuclear Medicine: ProstaticCancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 883Emilio Bombardieri, Maria Grazia Sauta, Lucia Setti,Roberta Meroni, Gianluigi Ciocia, and Laura Evangelista

Contents xv

32 Diagnostic Applications of Nuclear Medicine: TesticularCancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 925Abedallatif AlSharif, Serena Chiacchio, and GiampieroGiovacchini

33 Diagnostic Applications of Nuclear Medicine: PenileCancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 943Serena Chiacchio, Abedallatif AlSharif, Zia Saad,Giampiero Giovacchini, and Jamshed Bomanji

34 Diagnostic Applications of Nuclear Medicine:Vulvar Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 959Sonia Mahajan, Weining Ma, and Neeta Pandit-Taskar

35 Diagnostic Applications of Nuclear Medicine:Uterine Cancers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 979Neeta Pandit-Taskar, Sonia Mahajan, and Weining Ma

36 Diagnostic Applications of Nuclear Medicine: OvarianCancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1021Neeta Pandit-Taskar, Sonia Mahajan, and Weining Ma

37 Diagnostic Applications of Nuclear Medicine: Sarcomas . . . 1047Janet F. Eary

38 Diagnostic Applications of Nuclear Medicine: MalignantMelanoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1065Andrew M. Scott, Marika Ciprotti, and Sze-Ting Lee

39 Diagnostic Applications of Nuclear Medicine: PediatricCancers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1103Thomas Pfluger, Andrea Ciarmiello, Giampiero Giovacchini,Françoise Montravers, Hubert Ducou Le Pointe, JudithLandman-Parker, Martina Meniconi, and Christiane Franzius

Part III Radionuclide Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1139

40 Radionuclide Therapy of Lymphomas . . . . . . . . . . . . . . . . . . 1141Heather A. Jacene, Sree Harsha Tirumani, and Richard L.Wahl

41 Radionuclide Therapy of Leukemias and MultipleMyeloma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1157Martina Sollini, Sara Galimberti, Roberto Boni, and PaolaAnna Erba

42 Radionuclide Therapy of Thyroid Tumors . . . . . . . . . . . . . . 1197Rossella Elisei, Laura Agate, Sara Mazzarri, Valeria Bottici,Federica Guidoccio, Eleonora Molinaro, Giuseppe Boni,Marco Ferdeghini, and Giuliano Mariani

xvi Contents

43 Neuroendocrine Tumors: Therapy with RadiolabeledPeptides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1243Lisa Bodei, Laura Gilardi, Duccio Volterrani, GiovanniPaganelli, Chiara M. Grana, Mark Kidd, and Irvin M. Modlin

44 Neuroendocrine Tumors: Therapy with 131I-MIBG . . . . . . . 1269Jorge A. Carrasquillo and Clara C. Chen

45 Targeted Radionuclide Therapy for Bone Metastasis . . . . . . 1307Neeta Pandit-Taskar and Chaitanya R. Divgi

46 Radionuclide Therapy of Tumors of the Liver andBiliary Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1337Giuseppe Boni, Federica Guidoccio, Duccio Volterrani, andGiuliano Mariani

Volume 3

Part IV Radioguided Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1361

47 Radioguided Surgery for Breast Cancer . . . . . . . . . . . . . . . . 1363Francesco Giammarile, Federica Orsini, Renato A. ValdésOlmos, Sergi Vidal-Sicart, Armando E. Giuliano, andGiuliano Mariani

48 Radioguided Surgery for Malignant Melanoma . . . . . . . . . . 1401Sergi Vidal-Sicart, Federica Orsini, Francesco Giammarile,Giuliano Mariani, and Renato A. Valdés Olmos

49 Radioguided Surgery for Head and Neck Cancer . . . . . . . . . 1433Federica Orsini, Erinda Puta, Renato A. Valdés Olmos,Sergi Vidal-Sicart, Francesco Giammarile, and GiulianoMariani

50 Radioguided Surgery: Novel Applications . . . . . . . . . . . . . . . 1451Renato A. Valdés Olmos, Federica Orsini, FrancescoGiammarile, Sergi Vidal-Sicart, and Giuliano Mariani

Part V Heart Disease in the Cancer Patient . . . . . . . . . . . . . . . . . . 1481

51 Imaging the Heart in the Cancer Patient . . . . . . . . . . . . . . . . 1483H. William Strauss and Josef J. Fox

Part VI Adverse Effects of Cancer Therapy . . . . . . . . . . . . . . . . . . 1511

52 Nuclear Medicine in the Assessment of Adverse Effectsof Cancer Therapy in the Lung, Kidney, andGastrointestinal Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1513Diego Alfonso López Mora and Ignasi Carrió

Contents xvii

Part VII Teaching Cases in Nuclear Oncology(with Contributions from Various Authors) . . . . . . . . . . . . . . . . . . . 1529

53 Teaching Cases in Nuclear Oncology: Lymphomas . . . . . . . . 1531Kimiteru Ito, Somali Gavane, and Heiko Schöder

54 Teaching Cases in Nuclear Oncology: Multiple Myeloma . . . 1545Kimiteru Ito, Somali Gavane, and Heiko Schöder

55 Teaching Cases in Nuclear Oncology: Brain Tumors . . . . . . 1557Alice Lorenzoni, Alessandra Alessi, and Flavio Crippa

56 Teaching Cases in Nuclear Oncology: Head andNeck Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1569Kimiteru Ito, Somali Gavane, and Heiko Schöder

57 Teaching Cases in Nuclear Oncology: Thyroid Tumors . . . . 1585Kimiteru Ito, Somali Gavane, and Heiko Schöder

58 Teaching Cases in Nuclear Oncology: ParathyroidTumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1607Kimiteru Ito, Somali Gavane, and Heiko Schöder

59 Teaching Cases in Nuclear Oncology: Breast Cancer . . . . . . 1613Alice Lorenzoni, Alessandra Alessi, and Flavio Crippa

60 Teaching Cases in Nuclear Oncology: Lung andMediastinal Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1627Alice Lorenzoni, Alessandra Alessi, and Flavio Crippa

61 Teaching Cases in Nuclear Oncology: EsophagealCancers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1643Duccio Volterrani, Giulia Puccini, Sara Mazzarri, and FedericaGuidoccio

62 Teaching Cases in Nuclear Oncology: Gastric Cancers . . . . 1655Duccio Volterrani, Giulia Puccini, Sara Mazzarri, and FedericaGuidoccio

63 Teaching Cases in Nuclear Oncology: Small BowelCancers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1667Duccio Volterrani, Giulia Puccini, Sara Mazzarri, and FedericaGuidoccio

64 Teaching Cases in Nuclear Oncology: Tumors of theLiver and Biliary Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1681Duccio Volterrani, Giulia Puccini, Sara Mazzarri, and FedericaGuidoccio

65 Teaching Cases in Nuclear Oncology: Pancreatic Cancer . . . 1699Alice Lorenzoni, Alessandra Alessi, and Flavio Crippa

66 Teaching Cases in Nuclear Oncology: Colorectal Cancer . . . 1715Alice Lorenzoni, Alessandra Alessi, and Flavio Crippa

xviii Contents

67 Teaching Cases in Nuclear Oncology: NeuroendocrineTumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1729Alice Lorenzoni, Alessandra Alessi, and Flavio Crippa

68 Teaching Cases in Nuclear Oncology: Kidney and BladderCancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1749Duccio Volterrani, Giulia Puccini, Sara Mazzarri, and FedericaGuidoccio

69 Teaching Cases in Nuclear Oncology: Prostatic Cancer . . . . 1771Duccio Volterrani, Giulia Puccini, Sara Mazzarri, and FedericaGuidoccio

70 Teaching Cases in Nuclear Oncology: Testicular Cancer . . . 1799Kimiteru Ito, Somali Gavane, and Heiko Schöder

71 Teaching Cases in Nuclear Oncology: Penile Cancer . . . . . . 1805Kimiteru Ito, Somali Gavane, and Heiko Schöder

72 Teaching Cases in Nuclear Oncology: Vulvar Cancer . . . . . . 1813Alice Lorenzoni, Alessandra Alessi, and Flavio Crippa

73 Teaching Cases in Nuclear Oncology: Uterine Cancers . . . . 1823Alice Lorenzoni, Alessandra Alessi, and Flavio Crippa

74 Teaching Cases in Nuclear Oncology: Ovarian Cancer . . . . 1841Alice Lorenzoni, Alessandra Alessi, and Flavio Crippa

75 Teaching Cases in Nuclear Oncology: Sarcomas . . . . . . . . . . 1849Alice Lorenzoni, Alessandra Alessi, and Flavio Crippa

76 Teaching Cases in Nuclear Oncology: MalignantMelanoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1865Alice Lorenzoni, Alessandra Alessi, and Flavio Crippa

77 Teaching Cases in Nuclear Oncology: Pediatric Cancers . . . 1881Duccio Volterrani, Giulia Puccini, Sara Mazzarri, FedericaGuidoccio, and Lorenzo Biassoni

78 Teaching Cases in Nuclear Oncology: Investigating theHeart in Cancer Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1917Josef J. Fox and H. William Strauss

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1929

Contents xix

About the Editors

H. William Strauss, M.D., is Professor of Medicine at Icahn School ofMedicine, Mount Sinai Hospital, and Attending Physician Emeritus of Molec-ular Imaging and Therapy Service at Memorial Sloan Kettering Cancer Center.He additionally serves as Professor of Radiology in the Department of NuclearMedicine at Cornell University, Weill School of Medicine. He is a prolificwriter with over 550 original articles, over 70 book chapters, and nine books inhis portfolio. He has additionally served on the editorial board of several peer-reviewed journals, including Journal of Nuclear Medicine, European Journalof Nuclear Medicine and Molecular Imaging, Journal of Nuclear Cardiology,Quarterly Journal of Nuclear Medicine, and Annals of Nuclear Medicine.

xxi

Giuliano Mariani From 2001 to 2014, Giuliano Mariani has been FullProfessor of Nuclear Medicine, Director of the Regional Center of NuclearMedicine, and Director of the Specialty School of Nuclear Medicine at theUniversity of Pisa (Pisa, Italy). From 1994 to 2001, he was Associate Professorof Nuclear Medicine, Director of the Nuclear Medicine Service, and Directorof the Specialty School of Nuclear Medicine at the University of Genoa(Genoa, Italy).

He obtained his medical degree in 1968 at the Catholic University of Rome(Italy). For the next decade, his postgraduate training prepared him as aspecialist in internal medicine, nuclear medicine, medical nephrology, andradiology. He has been a Visiting Scientist at the National Cancer Institute inBethesda (Maryland, USA) from 1975 to 1977 and a Visiting Professor at theHarvard Medical School in Boston (Massachusetts, USA) from 1986 to 1990.

Initial investigations carried out at the CNR Institute of Clinical Physiologyand at the University of Pisa (Pisa, Italy) dealt with the pharmacokinetics ofradiolabeled tracers for metabolic studies of endogenous proteins and hor-mones in various clinical conditions. In the subsequent studies, the interests ofGiuliano Mariani have broadened to encompass virtually all fields of NuclearMedicine for both diagnostic and therapeutic applications. Nevertheless, hismain research interests have focused on tumor targeting for diagnosis ortherapy with radiopharmaceuticals; he has been the Senior or Principal Inves-tigator on many research projects, several of which were international collab-orations. Thanks to his important contributions to the whole field of NuclearMedicine, in 2014 GiulianoMariani has been granted honorary membership inthe European Association of Nuclear Medicine (EANM), while the ItalianAssociation of Nuclear Medicine (AIMN) bestowed to him the same recogni-tion in 2017. He is a member of the Society of Nuclear Medicine andMolecular Imaging (SNMMI).

Giuliano Mariani serves or has served on the Editorial Board of severaljournals including, among others devoted to Nuclear Medicine and diagnosticimaging in general, The Journal of Nuclear Medicine (currently as an Asso-ciate Editor – International), the European Journal of Nuclear Medicine andMolecular Imaging, the American Journal of Roentgenology, the Journal ofNuclear Biology and Medicine, the Journal of Nuclear Medicine and AlliedSciences, and the Quarterly Journal of Nuclear Medicine. He is also an activereferee for many international journals and has been Author/Editor of 16 booksand over 80 chapters in books. In addition, he has authored/coauthored over315 papers in international peer-reviewed journals.

xxii About the Editors

Over the past decade, Giuliano Mariani has served on several occasions asand Expert Consultant for the International Atomic Energy Agency (IAEA,Vienna, Austria), both for in-the-field training missions mostly in low- andmiddle-income countries to initiate specific Nuclear Medicine applications andfor hosting at the Regional Center of Nuclear Medicine in Pisa IAEA Fellowsfor training in the practice of Nuclear Medicine. These activities have beenconducted in collaboration with countries with such diverse levels of devel-opment as Albania, Algeria, Chile, Colombia, Cuba, Egypt, Estonia, India,Japan, Lithuania, Lybia, Malaysia, Pakistan, People’s Republic of China,South Africa, Sudan, Sultanate of Oman, and Thailand.

Duccio Volterrani is currently Full Professor of Nuclear Medicine, Directorof the Regional Center of Nuclear Medicine, and Director of the Post-graduateSpecialty School in Nuclear Medicine of the University of Pisa (Pisa, Italy). In2014, he became Associate Professor of Nuclear Medicine at the University ofPisa, after serving as Assistant Professor at the same University since 1998.Before joining the University of Pisa in 1998, Duccio Volterrani had served asAttending Physician at the Nuclear Medicine Service of the University Hos-pital of Siena (Siena, Italy) between 1993 and 1998.

After obtaining his medical degree in 1987 at the University of Pisa (Pisa,Italy), Dr. Volterrani was granted Research Fellowships (up until 1993) at theCNR Institute of Clinical Physiology for the analysis of data from theEuropean multicenter study on the diagnostic efficacy of captopril renographyin renovascular hypertension and for the investigations on the pathophysio-logic changes of systolic and diastolic parameters, assessed by means ofradionuclide techniques, in hypertensive cardiomyopathy.

Dr. Volterrani currently holds official courses on diagnostic imaging andnuclear medicine at the University of Pisa, including courses for the MedicalSchool and for the School of Technologists in Diagnostic Imaging and Radi-ation Oncology, as well as courses for the Post-graduate Specialty Schools inNuclear Medicine, in Diagnostic Radiology, and in Medical Oncology of theUniversity of Pisa (Pisa, Italy). In 2003, he has been a Visiting Professor at theNuclear Medicine Service of the Memorial Sloan-Kettering Cancer Center(New York, NY, USA).

About the Editors xxiii

Dr. Volterrani’s current interests in clinical investigations span virtually thewhole spectrum of applications of nuclear medicine (both for diagnosis and fortherapy with radionuclides), with a major focus on radionuclide evaluation ofdementias and parkinsonisms (through regional blood flow, receptor analysis,and amyloid imaging), PET/CT in oncology, radionuclide therapy of tumors,diagnostic imaging of coronary artery disease, and new tracers for tumortargeting.

Dr. Volterrani is a member of the Italian Association of Nuclear Medicine(AIMN, for which he has served several terms in the Board of Directors and asresponsible for quality management for the continuing medical educationprogram), of the European Association of Nuclear Medicine (EANM), andof the Society of Nuclear Medicine and Molecular Imaging (SNMMI). Heserves in the Editorial Board of theQuarterly Journal of Nuclear Medicine andis also an active referee for many international journals in the field of NuclearMedicine. He has authored/coauthored over 80 papers in international peer-reviewed journals, and in addition has been Coeditor of 3 books and over40 chapters in books.

Steven M. Larson M.D., FACNM, FACR is the Donna and BenjaminM. Rosen Chair and Attending in the Molecular Imaging and Therapy Servicewithin the Department of Radiology, as well as the Coleader of the Imagingand Radiation Sciences Program, a component of the Cancer Center SupportGrant, at Memorial Sloan Kettering Cancer Center. He serves as Director of theCenter for Radioimmunotherapy and Theranostics at the Ludwig Center andmember and Lab Head of the Molecular Pharmacology Program at SloanKettering Cancer Institute. He is also a Professor of Radiology at CornellUniversity Medical Center in New York, NY.

Larson’s primary expertise is in molecular imaging, targeted radio-diagnosis, and therapy using small molecules and monoclonal antibodies.Dual-boarded in nuclear medicine and internal medicine, Larson has clinicalskills in oncology, cancer immunology, and clinical thyroid cancer. He hasbeen responsible for directing and developing successful nuclear medicine andPET programs at several major institutions in the USA, including the VeteranAdministration Hospitals in Portland and Vancouver; University of Oregon,Portland; Seattle Veterans Administration Hospital; Clinical Center, NationalInstitutes of Health (NIH); and Memorial Sloan Kettering Cancer Center. Hehas extensive experience as an Advisor to public and private institutions,having served, among other appointments, as a member of what is now the

xxiv About the Editors

MEDI grant review committee of NIH, the Department of Energy Office ofScience’s Advisory Committee, and the American Board of Nuclear Medicine,and as Chair of the Radiopharmaceutical Advisory Committee of the USFDA,Cochair of the National Research Council of the NAS Committee onMolybdenum-99 production with nonenriched Uranium 235, and Chair ofthe Molecular Imaging Committee of RSNA. He is now Chair of the ClinicalImaging Steering Committee of the National Cancer Institute and Chair of theClinical “Impact” Study Section of NIH, as well as a member of the NationalAcademy of Medicine. He has received numerous awards for excellenceincluding the Wylie Prize of the USFDA, the Hevesy Award, and CassenPrize of the Society of Nuclear Medicine, USA. He is an inventor on sevenpatents. He has published over 600 peer-reviewed publications in prestigiousjournals, and his current H-factor is approximately 100. He has trained morethan 50 residents in nuclear medicine who are now ABNM-certified.

About the Editors xxv

Contributors

Laura Agate Endocrine Unit, Department of Clinical and ExperimentalMedicine, University of Pisa, Pisa, Italy

Alessandra Alessi Nuclear Medicine Division, IRCCCS National CancerInstitute, Milan, Italy

Abedallatif AlSharif Department of Radiology and Nuclear Medicine, Uni-versity of Jordan, Jordan University Hospital, Amman, Jordan

Elite Arnon Department of Nuclear Medicine, Rambam Health Care Cam-pus, Haifa, Israel

Dale L. Bailey Faculty of Health Sciences, The University of Sydney,Camperdown, NSW, Australia

Simona Ben-Haim University College London and UCL Hospitals, NHSTrust, London, UK

Department of Nuclear Medicine, The Chaim Sheba Medical Center, Tel-Hashomer, Israel

Lorenzo Biassoni Nuclear Medicine Service, Great Ormond Street Hospital,London, UK

Lisa Bodei Molecular Imaging and Therapy Service, Department of Radiol-ogy, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Jamshed Bomanji Institute of Nuclear Medicine, University College Lon-don Hospitals, NHS Foundation Trust, University College Hospital, London,UK

Emilio Bombardieri Department of Nucleare Medicine, HumanitasGavazzeni Hospital, Bergamo, Italy

Nuclear Medicine Unit, “Humanitas Gavazzeni” Hospital, Bergamo, Italy

Giuseppe Boni Regional Center of Nuclear Medicine, University Hospital ofPisa, Pisa, Italy

xxvii

Roberto Boni Regional Center of Nuclear Medicine, Department of Trans-lational Research and New Technology in Medicine, University of Pisa, Pisa,Italy

Irene Bossert Nuclear Medicine Unit, “S. Orsola-Malpighi”University Hos-pital, Bologna, Italy

Nuclear Medicine Service, “Fondazione Salvatore Maugeri” IRCCS, Pavia,Italy

Valeria Bottici Endocrine Unit, Department of Clinical and ExperimentalMedicine, University of Pisa, Pisa, Italy

Kirsten Bouchelouche Department of Nuclear Medicine and PET Centre,Aarhus University Hospital, Aarhus, Denmark

Marie Boyd Strathclyde Institute of Pharmacy and Biomedical Sciences,Strathclyde University, Glasgow, UK

Jorge A. Carrasquillo Molecular Imaging and Therapy Service, MemorialSloan-Kettering Cancer Center, New York, NY, USA

Ignasi Carrió Department of Nuclear Medicine, Hospital Sant Pau, Auton-omous University of Barcelona, Barcelona, Spain

Laura Cassalia Nuclear Medicine Unit, Department of Biomedical Sciencesand of Morphologic and Functional Images, University of Messina, Messina,Italy

Clara C. Chen Division of Nuclear Medicine, Department of Radiology andImaging Sciences, Clinical Center, National Institutes of Health, Bethesda,MD, USA

Serena Chiacchio Regional Center of Nuclear Medicine, University Hospi-tal of Pisa, Pisa, Italy

Marco Chianelli Department of Endocrinology, Ospedale ReginaApostolorum, Albano, Rome, Italy

Carlo Chiesa Nuclear Medicine Department, National Cancer Institute,Milan, Italy

AndreaCiarmiello NuclearMedicine Department, Institute of Nuclear Med-icine, S. Andrea Hospital, La Spezia, Italy

Gianluigi Ciocia Nuclear Medicine Unit, “Humanitas Gavazzeni” Hospital,Bergamo, Italy

Radiotherapy Unit, “Humanitas Gavazzeni” Hospital, Bergamo, Italy

Marika Ciprotti Global Clinical Research Oncology, Bristol-Myers Squibb,London, UK

xxviii Contributors

Brendon E. Cook Department of Radiology, Memorial Sloan KetteringCancer Center, New York, NY, USA

Department of Chemistry, Hunter College of the City University of New York,New York, NY, USA

Ph.D. Program in Chemistry, Graduate Center of the City University of NewYork, New York, NY, USA

Marta Cremonesi Department of Medical Physics, European Institute ofOncology, Milan, Italy

Flavio Crippa Nuclear Medicine Division, IRCCCS National Cancer Insti-tute, Milan, Italy

Désirée Deandreis Department of Medical Sciences Nuclear Medicine, Uni-versity of Torino, Torino, Italy

Dustin W. Demoin Department of Radiology, Memorial Sloan KetteringCancer Center, New York, NY, USA

Chaitanya R. Divgi Jenkintown, PA, USA

Janet F. Eary Cancer Imaging Program, National Cancer Institute, NationalInstitutes of Health, Bethesda, MD, USA

William C. Eckelman Molecular Tracer, Bethesda, MD, USA

Rossella Elisei Endocrine Unit, Department of Clinical and ExperimentalMedicine, University of Pisa, Pisa, Italy

Paola Anna Erba Regional Center of Nuclear Medicine, Department ofTranslational Research and Advanced Technologies in Medicine, Universityof Pisa, Pisa, Italy

Laura Evangelista Nuclear Medicine and Molecular Imaging Unit, VenetoInstitute of Oncology IOV - IRCCS, Padua, Italy

Stefano Fanti Nuclear Medicine Unit, “S. Orsola-Malpighi”University Hos-pital, Bologna, Italy

Marco Ferdeghini Nuclear Medicine Unit, Department of Diagnostics andPublic Health, University of Verona, Verona, Italy

Yuman Fong Department of Surgery, City of Hope National Medical Center,Duarte, CA, USA

Josef J. Fox Department of Radiology, Memorial Sloan Kettering CancerCenter, New York, NY, USA

Christiane Franzius Nuclear Medicine and PET/CT Centre Bremen,Bremen, Germany

Centre of Modern Diagnostics (ZEMODI), MRI and MR/PET, Bremen,Germany

Contributors xxix

Sara Galimberti Hematology Unit, University of Pisa, Pisa, Italy

Somali Gavane Division of Nuclear Medicine, Department of Radiology,Mount Sinai Hospital, New York, NY, USA

Francesco Giammarile Nuclear Medicine and Diagnostic Imaging Section,Division of Human Health, Department of Nuclear Sciences and Applications,International Atomic Energy Agency, Vienna, Austria

Laura Gilardi Division of Nuclear Medicine, European Institute of Oncol-ogy, Milan, Italy

Giampiero Giovacchini Nuclear Medicine Department, S. Andrea Hospital,La Spezia, Italy

Elisabetta Giovannini Nuclear Medicine Department, Institute of NuclearMedicine, S. Andrea Hospital, La Spezia, Italy

Armando E. Giuliano Surgical Oncology, Samuel Oschin ComprehensiveCancer Institute, Cedars-Sinai, Los Angeles, CA, USA

Chiara M. Grana Division of Nuclear Medicine, European Institute ofOncology, Milan, Italy

Federica Guidoccio Regional Center of Nuclear Medicine, Department ofTranslational Research and Advanced Technologies in Medicine and Surgery,University of Pisa, Pisa, Italy

Ludmila Guralnik The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

Department of Radiolody, Rambam Health Care Campus, Haifa, Israel

John L. Humm Department of Medical Physics, Memorial Sloan KetteringCancer Center, New York, NY, USA

Luca Indovina Department of Medical Physics - Policlinico UniversitarioA. Gemelli, Rome, Italy

Ora Israel Department of Nuclear Medicine, Rambam Health Care Campus,Haifa, Israel

The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Tech-nology, Haifa, Israel

Kimiteru Ito Department of Radiology, Molecular Imaging and Therapyservice, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Heather A. Jacene Nuclear Medicine/PET-CT, Department of Imaging,Dana-Farber Cancer Institute and Department of Radiology, Brigham andWomen’s Hospital, Harvard Medical School, Boston, MA, USA

Mark Kidd Wren Laboratories, Branford, CT, USA

Judith Landman-Parker Department of Pediatric Oncology, Armand-Trousseau Hospital, Assistance Publique Hôpitaux de Paris, Pierre et MarieCurie University, Paris, France

xxx Contributors

StevenM. Larson Molecular Imaging and Therapy Service, Memorial SloanKettering Cancer Center, New York, NY, USA

Hubert Ducou Le Pointe Department of Radiology, Armand-TrousseauHospital, Assistance Publique Hôpitaux de Paris, Pierre et Marie Curie Uni-versity, Paris, France

Jean H. Lee Department of Radiology, University of Washington, Seattle,WA, USA

Seattle Cancer Care Alliance, Seattle, WA, USA

Sze-Ting Lee Olivia Newton-John Cancer Research Institute and La TrobeUniversity, Melbourne, VIC, Australia

Department of Molecular Imaging and Therapy, Austin Health, Melbourne,VIC, Australia

Jason S. Lewis Radiochemistry and Imaging Sciences Service, Departmentof Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Cen-ter, New York, NY, USA

Department of Radiology, Weill Cornell Medical College, New York, NY,USA

Department of Pharmacology, Weill Cornell Medical College, New York, NY,USA

Diego Alfonso López Mora Department of Nuclear Medicine, Hospital SantPau, Autonomous University of Barcelona, Barcelona, Spain

Alice Lorenzoni Nuclear Medicine Division, IRCCCS National CancerInstitute, Milan, Italy

Marsha Camilla Lynch Division of Nuclear Medicine, Department of Radi-ology, University of Pennsylvania, Philadelphia, PA, USA

Division of Nuclear Medicine and Clinical Molecular Imaging, University ofPennsylvania Health System, Philadelphia, PA, USA

Weining Ma Department of Radiology, Memorial Sloan Kettering CancerCenter, New York, NY, USA

Anna Margherita Maffione Nuclear Medicine Unit, Ospedale Santa Mariadella Misericordia, Rovigo, Italy

SoniaMahajan Department of Radiology, Memorial Sloan Kettering CancerCenter, New York, NY, USA

Robert J. Mairs Institute of Cancer Sciences, University of Glasgow, Glas-gow, UK

David A. Mankoff Division of Nuclear Medicine, Department of Radiology,University of Pennsylvania, Philadelphia, PA, USA

Division of Nuclear Medicine and Clinical Molecular Imaging, University ofPennsylvania Health System, Philadelphia, PA, USA

Contributors xxxi

Giuliano Mariani Regional Center of Nuclear Medicine, Department ofTranslational Research and Advanced Technologies in Medicine and Surgery,University of Pisa, Pisa, Italy

Sara Mazzarri Regional Center of Nuclear Medicine, Department of Trans-lational Research and Advanced Technologies in Medicine and Surgery,University of Pisa, Pisa, Italy

Salvatore Mazzeo Department of Diagnostic and Interventional Radiology,University of Pisa, Pisa, Italy

MartinaMeniconi Regional Center of Nuclear Medicine, University of Pisa,Pisa, Italy

Roberta Meroni Radiology Unit, “Humanitas Gavazzeni” Hospital,Bergamo, Italy

Irvin M. Modlin Wren Laboratories, Branford, CT, USA

Department of Surgery, Yale School of Medicine, New Haven, CT, USA

Eleonora Molinaro Endocrine Unit, Department of Clinical and Experimen-tal Medicine, University of Pisa, Pisa, Italy

Françoise Montravers Department of Nuclear Medicine, Tenon Hospital,Assistance Publique Hôpitaux de Paris, Pierre et Marie Curie University, Paris,France

Cristina Nanni Nuclear Medicine Unit, “S. Orsola-Malpighi” UniversityHospital, Bologna, Italy

Federica Orsini Nuclear Medicine Unit, “Maggiore della Carità” UniversityHospital, Novara, Italy

Massimiliano Pacilio Department of Medical Physics, Azienda OspedalieraSan Camillo Forlanini, Rome, Italy

Giovanni Paganelli Nuclear Medicine and Radiometabolic Units, IstitutoScientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS,Meldola, Italy

Neeta Pandit-Taskar Department of Radiology, Memorial Sloan KetteringCancer Center, New York, NY, USA

Department of Radiology, Weill Cornell Medical College, New York, NY,USA

Ettore Pelosi PET Center, Affidea IRMET, Torino, Italy

Daniele Penna PET Center, Affidea IRMET, Torino, Italy

Thomas Pfluger Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany

xxxii Contributors

Giulia Puccini Regional Center of Nuclear Medicine, University of Pisa,Pisa, Italy

Erinda Puta Nuclear Medicine Unit, “Maggiore della Carità” UniversityHospital, Novara, Italy

Mustafa Raoof Department of Surgery, City of Hope National MedicalCenter, Duarte, CA, USA

Mattia Riondato Nuclear Medicine Department, Institute of Nuclear Medi-cine, S. Andrea Hospital, La Spezia, Italy

Zia Saad Institute of Nuclear Medicine, University College London Hospi-tals, NHS Foundation Trust, University College Hospital, London, UK

Christopher G. Sakellis Department of Imaging, Dana-Farber Cancer Insti-tute, Boston, MA, USA

Department of Radiology, Brigham andWomen’s Hospital, Boston, MA, USA

Harvard Medical School, Boston, MA, USA

Center for Biomedical Imaging in Oncology, Dana-Farber Cancer Institute,Boston, MA, USA

Tumor Imaging Metrics Core, Dana-Farber/Harvard Cancer Center, Boston,MA, USA

Massimo Salvatori Nuclear Medicine Institute, Catholic University of theSacred Heart – Policlinico A. Gemelli, Rome, Italy

Mirkka Sarparanta Department of Radiology, Memorial Sloan KetteringCancer Center, New York, NY, USA

Laboratory of Radiochemistry, Department of Chemistry, University of Hel-sinki, Helsinki, Finland

Maria Grazia Sauta Oncology Unit, “Humanitas Gavazzeni” Hospital,Bergamo, Italy

Heiko Schöder Department of Radiology, Molecular Imaging and TherapyService, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Andrew M. Scott Olivia Newton-John Cancer Research Institute and LaTrobe University, Melbourne, VIC, Australia

Department of Molecular Imaging and Therapy, Austin Health, Melbourne,VIC, Australia

Lucia Setti Nuclear Medicine Unit, “Humanitas Gavazzeni” Hospital,Bergamo, Italy

Martina Sollini Department of Biomedical Sciences, Humanitas University,Rozzano, Milan, Italy

H. William Strauss Molecular Imaging and Therapy Service, MemorialSloan Kettering Cancer Center, New York, NY, USA

Contributors xxxiii

Elena Tabacchi Nuclear Medicine Unit, “S. Orsola-Malpighi” UniversityHospital, Bologna, Italy

Sree Harsha Tirumani Nuclear Medicine/PET-CT, Department of Imaging,Dana-Farber Cancer Institute and Department of Radiology, Brigham andWomen’s Hospital, Harvard Medical School, Boston, MA, USA

Renato A. Valdés Olmos Nuclear Medicine Section and InterventionalMolecular Imaging Laboratory, Department of Radiology, Leiden UniversityMedical Centre, Leiden, The Netherlands

Diagnostic Oncology Division, Nuclear Medicine Department, NetherlandsCancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam, CX,The Netherlands

Annick D. Van den Abbeele Department of Imaging, Dana-Farber CancerInstitute, Boston, MA, USA

Department of Radiology, Brigham andWomen’s Hospital, Boston, MA, USA

Harvard Medical School, Boston, MA, USA

Center for Biomedical Imaging in Oncology, Dana-Farber Cancer Institute,Boston, MA, USA

Tumor Imaging Metrics Core, Dana-Farber/Harvard Cancer Center, Boston,MA, USA

Sergi Vidal-Sicart Nuclear Medicine Department, Hospital Clínic Barce-lona, Barcelona, Catalonia, Spain

Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona,Spain

Duccio Volterrani Regional Center of Nuclear Medicine, Department ofTranslational Research and Advanced Technologies in Medicine and Surgery,University of Pisa, Pisa, Italy

Richard L.Wahl Mallinkrodt Institute of Radiology, Washington UniversitySchool of Medicine, St. Louis, MO, USA

Thida Win University College London, London, UK

University of Buckingham, Buckingham, UK

E&N Heartfordshire NHS Trust, Lister Hospital, Stevenage, UK

Pat Zanzonico Memorial Hospital Research Laboratories, Department ofMedical Physics, Memorial Sloan Kettering Cancer Center, New York, NY,USA

Brian M. Zeglis Radiochemistry and Imaging Sciences Service, Departmentof Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Department of Chemistry, Hunter College of the City University of New York,New York, NY, USA

Graduate Center of the City University of New York, New York, NY, USA

Department of Radiology, Weill Cornell Medical College, New York, NY,USA

xxxiv Contributors