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Aplicação de radiofármacos no diagnóstico de patologias cerebrais e doenças neurodegenerativas
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Resumo(s)
De acordo com um estudo publicado em 2021 cerca de 3,4 mil milhões de pessoas foram afetadas por uma patologia cerebral ou doença neurodegenerativa, principal causa de problemas de saúde, incapacidade e dependência a nível global.
Esta elevada incidência vem demonstrar a grande necessidade de desenvolvimento de meios de diagnóstico eficazes e seguros, de modo a combater a evolução deste tipo de patologias. Com esta revisão bibliográfica pretende-se abordar radiofármacos utilizados para este fim, em que o seu papel depende do radionuclídeo que o constitui. O facto de possuírem estes elementos radioativos obriga à sua utilização em baixas concentrações, a seguir uma legislação e regras de manipulação próprias, passando por um controlo de qualidade apertado e apropriado a cada radiofármaco para cada situação específica. No caso dos radiofármacos de perfusão a sua ação é feita com base na perfusão sanguínea cerebral, sendo que são distribuídos pela corrente sanguínea, ao contrário de outro tipo de radiofármacos que se têm de ligar a moléculas específicas para chegar ao local alvo. Estes elementos conseguem obter imagens tomográficas com grande especificidade e sensibilidade, a partir de dois métodos principais. A técnica PET (Tomografia de Emissão de Positrões), que utiliza radionuclídeos emissores de positrões por decaimento β+ (18F) e a técnica SPECT (Tomografia de Emissão de Fotão Único), que utiliza radionuclídeos emissores γ (99mTc). O desenvolvimento da medicina nuclear deve-se maioritariamente à elevada disponibilidade destes radiofármacos marcados com 99mTc, sendo que este é o radionuclídeo ideal, utilizado em mais de 85% dos casos.
Nesta abordagem geral sobre estes radiofármacos fundamentais para o futuro da clínica, o objetivo é demonstrar a sua importância para avaliar o fluxo sanguíneo cerebral, metabolismo da glicose e função dos neurotransmissores no cérebro, que permite aos profissionais de saúde obter informação para determinar a terapia de uma forma mais eficaz.
According to a study published in 2021, around 3.4 billion people were affected by a brain pathology or neurodegenerative disease, which is the main cause of health problems, disability and dependency worldwide. This high incidence demonstrates the great need to develop effective and safe means of diagnosis in order to combat the evolution of this type of pathology. The aim of this literature review is to look at radiopharmaceuticals used for this purpose, where their role depends on the radionuclide they contain. The fact that they contain these radioactive elements means that they have to be used in low concentrations, follow their own legislation and handling rules, and undergo strict quality control appropriate to each radiopharmaceutical for each specific situation. In the case of perfusion radiopharmaceuticals, their action is based on cerebral blood flow and they are distributed through the bloodstream, unlike other types of radiopharmaceuticals that have to bind to specific molecules to reach the target site. These elements can obtain tomographic images with great specificity and sensitivity, using two main methods. PET (Positron Emission Tomography), which uses positron-emitting radionuclides by β+ decay (18F) and SPECT (Single Photon Emission Tomography), which uses ℽ-emitting radionuclides (99mTc). The development of nuclear medicine is mainly due to the high availability of these radiopharmaceuticals labeled with 99mTc, which is the ideal radionuclide, used in more than 85% of cases. In this overview of these key radioactive compounds for the future of clinical practice, the aim is to demonstrate their importance for assessing cerebral blood flow, glucose metabolism and neurotransmitter function in the brain, which allows healthcare professionals to obtain information to determine therapy more effectively.
According to a study published in 2021, around 3.4 billion people were affected by a brain pathology or neurodegenerative disease, which is the main cause of health problems, disability and dependency worldwide. This high incidence demonstrates the great need to develop effective and safe means of diagnosis in order to combat the evolution of this type of pathology. The aim of this literature review is to look at radiopharmaceuticals used for this purpose, where their role depends on the radionuclide they contain. The fact that they contain these radioactive elements means that they have to be used in low concentrations, follow their own legislation and handling rules, and undergo strict quality control appropriate to each radiopharmaceutical for each specific situation. In the case of perfusion radiopharmaceuticals, their action is based on cerebral blood flow and they are distributed through the bloodstream, unlike other types of radiopharmaceuticals that have to bind to specific molecules to reach the target site. These elements can obtain tomographic images with great specificity and sensitivity, using two main methods. PET (Positron Emission Tomography), which uses positron-emitting radionuclides by β+ decay (18F) and SPECT (Single Photon Emission Tomography), which uses ℽ-emitting radionuclides (99mTc). The development of nuclear medicine is mainly due to the high availability of these radiopharmaceuticals labeled with 99mTc, which is the ideal radionuclide, used in more than 85% of cases. In this overview of these key radioactive compounds for the future of clinical practice, the aim is to demonstrate their importance for assessing cerebral blood flow, glucose metabolism and neurotransmitter function in the brain, which allows healthcare professionals to obtain information to determine therapy more effectively.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2024, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Radiofármaco PET SPECT Radionuclídeo Diagnóstico Mestrado Integrado - 2024