European Nuclear Medicine Guide
As the main clinical modality for molecular imaging purposes, nuclear medicine (NM) has become of paramount importance for several aspects surrounding current day patient care. The most evident example is the early identification and staging of disease using diagnostic imaging. Current examples are the widespread use of 2-[18F]FDG and [18F]F-PSMA PET in e.g., breast cancer, melanoma, colorectal cancer and prostate cancer [1-4]. These examples further solidify the role of nuclear medicine in healthcare.
Next to diagnosis and staging, nuclear medicine also increasingly aids the treating physicians (e.g., oncologists, radiotherapists and surgeons) with tailored molecular imaging strategies that assist their procedural planning and decision-making processes. The recent advances in theranostic approaches that combine imaging and therapy have resulted in European Nuclear Medicine departments running their own out-patient clinics. In parallel with these efforts, the widespread pursuit of precision medicine has led to an increase in demand for image guidance during e.g., biopsy and surgery. This type of guidance comes under the sub-field of interventional nuclear medicine (iNM) [5, 6].
This burgeoning field is closely aligned with interventional radiology, cardiology and surgery. iNM includes – but also goes beyond – radioguided surgery (RGS), which is one of the most established forms of image-guided surgery. RGS exploits (molecularly targeted) radiopharmaceutical accumulation to support personalized precision intervention. In this chapter, we aim to provide an update on exciting developments within iNM while placing these efforts in perspective to other interventional molecular imaging strategies.