Fig. 8.

Preclinical and clinical examples where nuclear imaging has been used to answer specific liposomal therapy questions. (A) Introduction of a single chain antibody (scFv) tumour-targeting group into liposomes (immunoliposomes – ILs) improves tumour uptake. (Top) SPECT/CT images of ¹¹¹In-ILs 24 h after injection showing uptake of in both epithelioid (M28) and sarcomatoid (VAMT-1) mesothelioma tumours. (Bottom) ILs show higher tumour uptake compared to non-targeted liposomes (CLs). Adapted with permission from Iyer et al. [59], Copyright 2011 Elsevier. (B) Glucocorticoid-loaded PEGylated liposomes radiolabelled with ¹¹¹In demonstrate high-EPR mediated uptake over time in inflamed joints in a model of rheumatoid arthritis. Adapted with permission from Metselaar et al. [129], Copyright 2003 John Wiley and Sons. (C) PEGylated liposomes radiolabelled with ⁸⁹Zr allow non-invasive quantification of therapeutic liposome (e.g. Doxil®) tumour uptake using PET (top) and allow therapeutic efficacy prediction based on PET signal concentration at the tumour (bottom). Adapted from Pérez-Medina et al. [79] under CC-BY license [275]. (D) (Top) Maximum intensity projection PET images of a patient with HER2-positive breast cancer injected with ⁶⁴Cu-MM-302. As expected from long circulating liposomes at 0.6 h post injection most activity is in circulation, and only from day 2 is significant uptake in RES organs and tumour lesions evident. (Bottom) A correlation between ⁶⁴Cu-MM-302 tumour uptake levels (high or low) and patient progression-free survival (PFS) is seen, although not statistically significant due to low numbers. Adapted by permission from the American Association for Cancer Research: Lee et al. [163].