Isotopic evaluation and therapy in patients with malignant endocrine disease

The contribution of nuclear medicine to the diagnosis and treatment of endo crine malignancy is increasing. Advances in molecular biology offer new opp ortunities for tumour targeting via surface receptor recognition and tumour -specific metabolic markers. Imaging the biodistribution of these markers a llows quantitative, in vivo characterization of tumour function. There is g rowing interest in the therapeutic potential of nuclear medicine targeting, substituting therapeutic beta-emitting radionuclides for the gamma-emitter s used in diagnostic imaging. Limited clinical experience supports the rati onale of this approach in patients with inoperable or disseminated disease and controlled trials are in progress. This chapter outlines the place of n uclear medicine techniques in the routine management of endocrine malignanc y and explores areas for further development.