NUCLEAR ONCOLOGY - CURRENT QUESTIONS AND FUTURE PROSPECTIVES

In spite of difficulties related to the imperfect specificity of its molecular vectors, nuclear medicine should widen its oncologic prospects. A functional approach adapted to the whole organism makes it original and specific when compared to other nuclear imaging methods. Nuclear medicine does not seem useful for the diagnosis of well localized and accessible tumors, for which histological sampling is easy and necessary. However, it is of interest for marking the more suspect zones situated inside a wide, altered or hardly accessible pathological area. With the appearance of new kinds of vectors, this method could soon comprise the metastatic extension evaluation and, probably, the precise local marking of satellite lymph nodes which are the most dependent of the tumour. New fields seem likely to open in relation to the evolution of therapeutic approaches of cancers headed by biology. Some of them include the definition of the evolutive potential of therapeutic sensitivity and in vivo detection of significant molecular anomalies that were observed until now only in vitro. The evaluation of therapeutic results and of the residual disease is also a major purpose, probably more useful in most cases than the detection of relapses. Therapeutic developments should primarily concern infraclinical residual lesions, but they remain dependent of a specific localization, which is a very limiting condition.