Nuklearmedizinische Therapie von Nebennierentumoren

Zusammenfassung

In der Nebenniere liegen 2 distinkt unterschiedliche Gewebe, das Nebennierenmark und die Nebennierenrinde vor. Beide Gewebearten sezernieren unterschiedliche Hormone und besitzen eigene molekulare Charakteristika, die für eine spezifische Bildgebung mit Radiotracern genutzt werden können. Für das Nebennierenmark sind dies der Noradrenalin-Re-Uptake-Transporter und, beschränkt, auch der Somatostatinrezeptor. Für die Nebennierenrinde ist eine spezifische Darstellung von Enzymen der Cortisol- und Aldosteronbiosynthese möglich. In theranostischen Ansätzen wurden alle Zielstrukturen bisher bereits für gezielte Radionuklidtherapien genutzt, jedoch ist bisher lediglich die Noradrenalin-Re-Uptake-Transporter-gezielte ¹³¹I-metaIodBenzylGuanidin (mIBG)-Behandlung klinisch etabliert.

Abstract

In the adrenal glands, 2 distinctly different types of tissue may be found, adrenal medulla and the cortex. Both tissues produce different hormones and have their own molecular characteristics, which may be targeted for a specific imaging using radiotracers. For the adrenal medulla, these are the norepinephrine reuptake transporter and, with limitations, also the somatostatin receptor. For the adrenal cortex, a specific visualisation may be achieved by imaging enzymes involved in the cortisol and aldosterone biosynthesis. In a theranostic setting, all target structures have so far been addressed in the context of radionuclide therapies, but only the treatment with ¹³¹I-metaIodBenzylGuanidin (mIBG) targeting the noradrenalin reuptake transporter has found its way into clinical routine.

Schlüsselwörter

Radionuklidtherapie - Nebenniere - Theranostik, gezielte

Keywords

radionuclide therapy - adrenal - theranostic, targeted

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