Nuclear medicine in urological cancer

Abstract

Nuclear Medicine is the science and practice of using radionuclides for diagnosis or therapy. There is a long tradition of the use of nuclear medicine in urological cancers stretching back to the origin of the specialty 60 years ago. Imaging devises have been refined and more recently added to CT so that functional and morphological information can be obtained at the same time. This has introduced the idea of the “one stop imaging shop” which improves the accuracy of imaging and reduces costs and the time taken for the patient to be imaged. The types of nuclear medicine tests commonly performed in urological cancer setting include glomerular filtration rate (GFR) measurement and dynamic renography to assess renal function and bone scintigraphy to identify and quantify bone metastases. More recent work has concentrated on the use of positron emission tomography (PET) techniques which were generally less used which F-18 FDG (Fluorodeoxyglucose) was the only tracer available but now tracers which are much more avid for urological cancers such as F-18 and C-11 choline are becoming more widely available. In tandem radionuclide therapy has concentrated on palliation of bone pain but a recent trial has suggested that Ra-223 treatment can also have a survival benefit.