Imaging biomarker development and optimization of 195mPt-cisplatin and 68Ga-DOTATATE

Cancer affects people worldwide, causing approximately 9.6 million deaths in 2018 globally. Although cancer remains a deadly disease, the survival rate for all cancers has significantly increased over time. This increase in survival is due to both early detection and improved treatment strategies, in which new anti-cancer drugs play a pivotal role. Molecular imaging can play an important role in the selection of the right treatment for each individual patient by imaging at the cellular or molecular level (with a gamma camera or PET/CT scanner). Nuclear medicine employs these techniques for imaging of tumors, studying the distribution of pharmaceuticals throughout the body, visualization of specific proteins and receptors, or determining organ function. Since cancer is different from healthy tissue at a molecular and cellular level, molecular imaging is especially suitable for imaging and characterization of cancer prior to-, during-, and after treatment. Before molecular imaging can be used for outcome prediction, the technique should be validated both technically and clinically, which is described in this thesis.
In this thesis two types for molecular imaging are investigated, that are designed to select the most appropriate treatment for individual patients. The first part describes the development of radioactive cisplatin, which might be used to predict patient outcome of cisplatin-based chemotherapy. The second part describes developments of molecular imaging for patients with neuroendocrine tumors. Furthermore, external factors that may (unintentionally) influence molecular imaging results are investigated.