Radiopharmaceuticals in the Management of Leptomeningeal Metastasis

This book reviews the current clinical practice of leptomeningeal metastasis (LM) diagnosis and treatment, which is predominately by intrathecal chemotherapy and/or in combination with external beam radiotherapy. LM is a refractory lethal complication of many human malignancies when neoplastic cells grow in the meninges. The use of penetrating emissions from radionuclides has the advantages of visualizing cerebrospinal fluid (CSF) flow and ablating meninges at shallow depths and has been used to diagnose CSF flow anomalies and to treat LM. The scientific bases of using radionuclides inside human CSF and ablating LM will be discussed within the text, with results from established and completed clinical trials to explore optimal use of radionuclides to diagnose and treat LM. Many limitations of current practices of treating LM are also discussed, as well as potential avenues of overcoming these limitations. This book is an ideal guide for clinical researchers in the practice of treating leptomeningeal metastasis including radiologists, neurologists, oncologists and radiotherapists as well as their associates.

Human Leptomeningeal Metastasis (LM)- Epidemiology and Challenges. - State of Art of LM Radiographic Diagnosis Anatomic and Functional Imaging. - State of Art of LM Therapies: Intrathecal and Systemic approaches. - Current Practice of Radiation Therapy of LM. - Radionuclides in the Diagnosis and Therapy in Neuro-Oncology. - Radionuclide LM Therapy - Published Clinical Trial Findings. - Intrathecal LM Dosimetry Models- Radionuclides in CSF Spaces. - Human Radiation Dosimetry from Imaging- Guidance for Therapy. - Radiographic Assessment for Monitoring of LM Treatment. - Clinical Assessment for Monitoring of LM Treatment. - Logistic and Regulatory Aspects of Locoregional Radionuclide Therapy. - Radionuclides in the Management of LM Challenges and Opportunities.