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EANM Procedure Guidelines for Other Radionuclide Therapies

• EANM Procedure Guidelines for I-131- Ethiodised Oil (Lipiodol) Therapy (2002)
  
  
• The purpose of this guideline is to assist nuclear medicine practitioners in evaluating patients who might be candidates for treatment using ¹³¹I lipiodol for primary hepatocellular carcinoma, providing information for performing this treatment and understanding and evaluating the sequelae of therapy. Ethiodised oil, also known as Lipiodol is a naturally iodinated fatty acid ethyl ester of poppy seed oil. After hepatic intra-arterial injection, ¹³¹I-Lipiodol follows arterial flow towards the tumour and is trapped in tumour microvessels.
  
  
• EANM procedure guidelines for I-131-meta-iodobenzylguanidine (¹³¹I-mIBG) therapy (2008)
  
  The purpose of this guideline is to assist nuclear medicine practitioners to 1. Evaluate patients who might be candidates for ¹³¹I-metaiodobenzylguanidine (mIBG) to treat neuro-ectodermal tumours, 2. Provide information for performing this treatment and 3. Understand and evaluate the consequences of therapy.
  Meta-iodobenzylguanidine, or Iobenguane, is an aralkylguanidine resulting from the combination of the benzyl group of bretylium and the guanidine group of guanethidine (an adrenergic neurone blocker). It is a noradrenaline (norepinephrine) analogue and so-called “false” neurotransmitter. This radiopharmaceutical, labeled with ¹³¹I, could be used as a radiotherapeutic metabolic agent in neuroectodermal tumours, that are derived from the primitive neural crest which develops to form the sympathetic nervous system.
  
  
• EANM procedure guideline for P-32 phosphate treatment of myeloproliferative diseases (2007)
  
  The purpose of this guideline is to assist the nuclear medicine physician in treating and managing patients who may be candidates for ³²P phosphate therapy. It is used for patients with Polycythaemia Vera and Essential thrombocythaemia. ³²P is actively incorporated into
  the nucleic acids of rapidly proliferating cells. The radiopharmaceutical is used to suppress hyperproliferative cell lines rather than to eradicate them.
  
  
• EANM procedure guideline of radio-immunotherapy for B-cell lymphoma with 90Y-radiolabeled ibritumomab tiuxetan (Zevalin®) (2006)
  
  The purpose of this guideline is to assist the nuclear medicine physician in treating and managing patients who may be candidates for radioimmunotherapy. EMEA has approved 90Y-radiolabelled ibritumomab tiuxetan, Zevalin®, in Europe for the treatment of adult patients with rituximab-relapsed or -refractory CD20+ follicular B-cell non-Hodgkin´s lymphoma (NHL) in January 2004. Being a pure beta-emitter with a pathlength of 100-200 cell diameters, ⁹⁰Y has a broad crossfire effect when it is conjugated to monoclonal antibody such as ibritumomab.