Immuno-SPET/CT and immuno-PET/CT: a step ahead to translational imaging

Malignant tumours have the remarkable property to express cell surface antigens. Pressman was first reporting that radiolabeled antibodies were capable of organ localization. It was a promising challenge but the expected success and the development of this imaging method was limited by a poor imaging resolution despite a rather good specificity of the antibodies used. Identification of key cell surface markers is opening a new era as potential molecular imaging biomarkers in oncologic applications. Antibodies production has been promoted by the development of engineered fragments with preserved immunological properties and pharmacokinetics optimized for molecular imaging. A good compromise has to be obtained between the biological properties of the antibody and the physical half-life of the radionuclide. Several positron emission tomography (PET) radionuclides such as iodine-124, copper-64, yttrium-86 or zirconium-89 have been the focus of recent immuno-PET studies with interesting informative images in preclinical and clinical studies. Thanks to the development of more sensitive new detectors and specific software, molecular imaging methods, particularly PET imaging, allow nowadays the detection of lesions smaller than 5 mm in human. Immuno-PET can potentially be used for tumour detection and identification at diagnosis, staging and restaging, for treatment selection and monitoring, and during follow-up. Moreover the availability of matched imaging or therapeutic radionuclide pairs, such as ¹²⁴I/¹³¹I, ⁶⁴Cu/⁶⁷Cu and ⁸⁶Y/⁹⁰Y, make easier the quantification of tissue uptake and dosimetry calculation for radioimmunotherapy.