Radiopharmacology
Encyclopedia
Radiopharmacology is the study and preparation of radiopharmaceuticals, which are radioactive pharmaceuticals. Radiopharmaceuticals are used in the field of nuclear medicine
as tracers in the diagnosis and treatment of many disease
s. Many radiopharmaceuticals use technetium-99m
(Tc-99m) which has many useful properties as a gamma-emitting tracer nuclide. In the book Technetium a total of 31 different radiopharmaceuticals based on Tc-99m are listed for imaging and functional studies of the brain
, myocardium, thyroid
, lungs, liver
, gallbladder
, kidneys, skeleton
, blood
and tumor
s.
The term radioisotope has historically been used to refer to all radiopharmaceuticals, and this usage remains common. Technically, however, many radiopharmaceuticals incorporate a radioactive tracer
atom into a larger pharmaceutically-active molecule, which is localized in the body, after which the radionuclide tracer atom allows it to be easily detected with a gamma camera
or similar gamma imaging device. An example is fludeoxyglucose in which fluorine-18
is incorporated into deoxyglucose. Some radioisotopes (for example gallium-67, gallium-68, and radioiodine) are used directly as soluble ionic salts, without further modification. This use relies on the chemical and biological properties of the radioisotope itself, to localize it within the body.
Radionuclides used in radiopharmaceuticals are mostly radioactive isotopes of elements with atomic numbers less than that of bismuth
, that is, they are radioactive isotopes of elements that also have one or more stable isotopes. These may be roughly divided into two classes:
ic or inert
form without attachment to a pharmaceutical, these are also included. There is a section for each radioisotope with a table of radiopharmaceuticals using that radioisotope. The sections are ordered alphabetically by the English name of the radioisotope. Sections for the same element
are then ordered by atomic mass number.
is a beta
and gamma
emitter.
is a positron
emitter.
is a beta
emitter.
is a gamma
emitter.
is a gamma
emitter.
is a gamma
emitter.
is a beta
emitter.
is a positron
emitter with a half life of 109 minutes. It is produced in medical cyclotrons, usually from oxygen-18, and then chemically attached to a pharmaceutical. See PET scan.
is a gamma
emitter. See gallium scan
.
is a positron
emitter, with a 68 minute half life, produced by elution
from germanium-68 in a gallium-68 generator
. See also positron emission tomography
.
is a beta
emitter.
is a gamma
emitter.
is a gamma
emitter. It is used only diagnostically, as its radiation is penetrating and short-lived.
is a gamma
emitter with a long half-life of 59.4 days (the longest of all radioiodines used in medicine). Iodine-123 is preferred for imaging, so I-125 is used diagnostically only when the test requires a longer period to prepare the radiopharmaceutical and trace it, such as a fibrinogen scan to diagnose clotting. I-125's gamma radiation is of medium penetration, making it more useful as a therapeutic isotope for brachytherapy
implant of radioisotope capsules for local treatment of cancers.
is a beta
and gamma
emitter. It is used both to destroy thyroid and thyroid cancer tissues (via beta radiation, which is short-range), and also other neuroendocrine tissues when used in MIBG. It can also be seen by a gamma camera, and can serve as a diagnostic imaging tracer, when treatment is also being attempted at the same time. However iodine-123 is usually preferred when only imaging is desired.
is a beta
and gamma
emitter.
is a gamma
emitter.
is a positron
emitter.
is a positron
emitter.
is a beta
emitter.
is a positron
and gamma
emitter.
is a beta
and gamma
emitter.
is a gamma
emitter.
is a positron
and gamma
emitter.
is a beta
and gamma
emitter.
is a beta
emitter.
is a gamma
emitter. It is obtained on-site at the imaging center as the soluble pertechnetate which is eluted from a technetium-99m generator
, and then either used directly as this soluble salt, or else used to synthesize a number of technetium-99m
-based radiopharmaceuticals.
is a gamma
emitter.
is a gamma
emitter.
is a beta
emitter.
Nuclear medicine
In nuclear medicine procedures, elemental radionuclides are combined with other elements to form chemical compounds, or else combined with existing pharmaceutical compounds, to form radiopharmaceuticals. These radiopharmaceuticals, once administered to the patient, can localize to specific organs...
as tracers in the diagnosis and treatment of many disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
s. Many radiopharmaceuticals use technetium-99m
Technetium-99m
Technetium-99m is a metastable nuclear isomer of technetium-99, symbolized as 99mTc. The "m" indicates that this is a metastable nuclear isomer, i.e., that its half-life of 6 hours is considerably longer than most nuclear isomers that undergo gamma decay...
(Tc-99m) which has many useful properties as a gamma-emitting tracer nuclide. In the book Technetium a total of 31 different radiopharmaceuticals based on Tc-99m are listed for imaging and functional studies of the brain
Brain
The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...
, myocardium, thyroid
Thyroid
The thyroid gland or simply, the thyroid , in vertebrate anatomy, is one of the largest endocrine glands. The thyroid gland is found in the neck, below the thyroid cartilage...
, lungs, liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...
, gallbladder
Gallbladder
In vertebrates the gallbladder is a small organ that aids mainly in fat digestion and concentrates bile produced by the liver. In humans the loss of the gallbladder is usually easily tolerated....
, kidneys, skeleton
Skeleton
The skeleton is the body part that forms the supporting structure of an organism. There are two different skeletal types: the exoskeleton, which is the stable outer shell of an organism, and the endoskeleton, which forms the support structure inside the body.In a figurative sense, skeleton can...
, blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
and tumor
Tumor
A tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer...
s.
The term radioisotope has historically been used to refer to all radiopharmaceuticals, and this usage remains common. Technically, however, many radiopharmaceuticals incorporate a radioactive tracer
Radioactive tracer
A radioactive tracer, also called a radioactive label, is a substance containing a radioisotope that is used to measure the speed of chemical processes and to track the movement of a substance through a natural system such as a cell or tissue...
atom into a larger pharmaceutically-active molecule, which is localized in the body, after which the radionuclide tracer atom allows it to be easily detected with a gamma camera
Gamma camera
A gamma camera, also called a scintillation camera or Anger camera, is a device used to image gamma radiation emitting radioisotopes, a technique known as scintigraphy...
or similar gamma imaging device. An example is fludeoxyglucose in which fluorine-18
Fluorine-18
Fluorine-18 is a fluorine radioisotope which is an important source of positrons. It has a mass of 18.0009380 u and its half-life is 109.771 minutes....
is incorporated into deoxyglucose. Some radioisotopes (for example gallium-67, gallium-68, and radioiodine) are used directly as soluble ionic salts, without further modification. This use relies on the chemical and biological properties of the radioisotope itself, to localize it within the body.
Production
Production of a radiopharmaceutical involves two processes:- The production of the radionuclideRadionuclideA radionuclide is an atom with an unstable nucleus, which is a nucleus characterized by excess energy available to be imparted either to a newly created radiation particle within the nucleus or to an atomic electron. The radionuclide, in this process, undergoes radioactive decay, and emits gamma...
on which the pharmaceutical is based.
- The preparation and packaging of the complete radiopharmaceutical.
Radionuclides used in radiopharmaceuticals are mostly radioactive isotopes of elements with atomic numbers less than that of bismuth
Bismuth
Bismuth is a chemical element with symbol Bi and atomic number 83. Bismuth, a trivalent poor metal, chemically resembles arsenic and antimony. Elemental bismuth may occur naturally uncombined, although its sulfide and oxide form important commercial ores. The free element is 86% as dense as lead...
, that is, they are radioactive isotopes of elements that also have one or more stable isotopes. These may be roughly divided into two classes:
- Those with fewer neutrons in the nucleus to those required for stability are known as neutron-deficient, and tend to be most easily produced using a proton accelerator such as a medical cyclotronCyclotronIn technology, a cyclotron is a type of particle accelerator. In physics, the cyclotron frequency or gyrofrequency is the frequency of a charged particle moving perpendicularly to the direction of a uniform magnetic field, i.e. a magnetic field of constant magnitude and direction...
.
- Those with excess neutrons in the nucleus to those required for stability are known as proton-deficient, and tend to be most easily produced in a nuclear reactorNuclear reactorA nuclear reactor is a device to initiate and control a sustained nuclear chain reaction. Most commonly they are used for generating electricity and for the propulsion of ships. Usually heat from nuclear fission is passed to a working fluid , which runs through turbines that power either ship's...
.
Practical use
Because radiopharmeuticals require special licenses and handling techniques, they are often kept in local centers for medical radioisotope storage, often known as radiopharmacies. A radiopharmacist may dispense them from there, to local centers where they are handled at the practical medicine facility.Specific radiopharmaceuticals
A list of nuclear medicine radiopharmaceuticals follows. Some radioisotopes* are used in ionIon
An ion is an atom or molecule in which the total number of electrons is not equal to the total number of protons, giving it a net positive or negative electrical charge. The name was given by physicist Michael Faraday for the substances that allow a current to pass between electrodes in a...
ic or inert
Inert
-Chemistry:In chemistry, the term inert is used to describe a substance that is not chemically reactive.The noble gases were previously known as inert gases because of their perceived lack of participation in any chemical reactions...
form without attachment to a pharmaceutical, these are also included. There is a section for each radioisotope with a table of radiopharmaceuticals using that radioisotope. The sections are ordered alphabetically by the English name of the radioisotope. Sections for the same element
Chemical element
A chemical element is a pure chemical substance consisting of one type of atom distinguished by its atomic number, which is the number of protons in its nucleus. Familiar examples of elements include carbon, oxygen, aluminum, iron, copper, gold, mercury, and lead.As of November 2011, 118 elements...
are then ordered by atomic mass number.
Calcium-47
47CaCalcium
Calcium is the chemical element with the symbol Ca and atomic number 20. It has an atomic mass of 40.078 amu. Calcium is a soft gray alkaline earth metal, and is the fifth-most-abundant element by mass in the Earth's crust...
is a beta
Beta particle
Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay...
and gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Ca-47-Ca2+ | Bone metabolism | IV | In-vitro | Non-imaging |
Carbon-11
11CCarbon
Carbon is the chemical element with symbol C and atomic number 6. As a member of group 14 on the periodic table, it is nonmetallic and tetravalent—making four electrons available to form covalent chemical bonds...
is a positron
Positron
The positron or antielectron is the antiparticle or the antimatter counterpart of the electron. The positron has an electric charge of +1e, a spin of ½, and has the same mass as an electron...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| C11-L-methyl-methionine | Brain tumour imaging Parathyroid imaging |
IV | In-vivo | Imaging |
Carbon-14
14CCarbon-14
Carbon-14, 14C, or radiocarbon, is a radioactive isotope of carbon with a nucleus containing 6 protons and 8 neutrons. Its presence in organic materials is the basis of the radiocarbon dating method pioneered by Willard Libby and colleagues , to date archaeological, geological, and hydrogeological...
is a beta
Beta particle
Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| C14-Glycocholic acid Glycocholic acid Glycocholic acid, or cholylglycine, is a crystalline bile acid involved in the emulsification of fats. It occurs as a sodium salt in the bile of mammals. It is a conjugate of cholic acid with glycine. Its anion is called glycocholate.... |
Breath test for small intestine bacterial overgrowth | Oral | In-vitro | Non-imaging |
| C14-PABA (para-amino benzoic acid) | Pancreatic studies | Oral | In-vitro | Non-imaging |
| C14-Urea | Breath test to detect Helicobacter pylori | Oral | In-vitro | Non-imaging |
| C14-d-xylose | Breath test for small intestine bacterial overgrowth | Oral | In-vitro | Non-imaging |
Chromium-51
51CrChromium
Chromium is a chemical element which has the symbol Cr and atomic number 24. It is the first element in Group 6. It is a steely-gray, lustrous, hard metal that takes a high polish and has a high melting point. It is also odorless, tasteless, and malleable...
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Cr51-Red blood cell Red blood cell Red blood cells are the most common type of blood cell and the vertebrate organism's principal means of delivering oxygen to the body tissues via the blood flow through the circulatory system... s |
Red cell volume; sites of sequestration; gastrointestinal blood loss | IV | In-vitro | Non-imaging |
| Cr51-Cr3+ | Gastrointestinal protein loss | IV | In-vitro | Non-imaging |
| Cr51-EDTA EDTA Ethylenediaminetetraacetic acid, widely abbreviated as EDTA , is a polyamino carboxylic acid and a colourless, water-soluble solid. Its conjugate base is named ethylenediaminetetraacetate. It is widely used to dissolve limescale. Its usefulness arises because of its role as a hexadentate ligand... (ethylenediaminetetraacetic acid) |
Glomerular filtration rate measurement | IV | In-vitro | Non-imaging |
Cobalt-57
57CoCobalt
Cobalt is a chemical element with symbol Co and atomic number 27. It is found naturally only in chemically combined form. The free element, produced by reductive smelting, is a hard, lustrous, silver-gray metal....
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Co57-Cyanocobalamin Cyanocobalamin Cyanocobalamin is an especially common vitamer of the vitamin B12 family. It is the most famous vitamer of the family, because it is, in chemical terms, the most air-stable... (vitamin B12) |
Gastrointestinal absorption | Oral | In-vitro | Non-imaging |
Cobalt-58
58CoCobalt
Cobalt is a chemical element with symbol Co and atomic number 27. It is found naturally only in chemically combined form. The free element, produced by reductive smelting, is a hard, lustrous, silver-gray metal....
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Co58-Cyanocobalamin Cyanocobalamin Cyanocobalamin is an especially common vitamer of the vitamin B12 family. It is the most famous vitamer of the family, because it is, in chemical terms, the most air-stable... (vitamin B12) |
Gastrointestinal absorption | Oral | In-vitro | Non-imaging |
Erbium-169
169ErErbium
Erbium is a chemical element in the lanthanide series, with the symbol Er and atomic number 68. A silvery-white solid metal when artificially isolated, natural erbium is always found in chemical combination with other elements on Earth...
is a beta
Beta particle
Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay...
emitter.
| Name | Treatment of | Route of administration |
|---|---|---|
| Er169-Colloid | Arthritic conditions | Intra-articular |
Fluorine-18
18FFluorine-18
Fluorine-18 is a fluorine radioisotope which is an important source of positrons. It has a mass of 18.0009380 u and its half-life is 109.771 minutes....
is a positron
Positron
The positron or antielectron is the antiparticle or the antimatter counterpart of the electron. The positron has an electric charge of +1e, a spin of ½, and has the same mass as an electron...
emitter with a half life of 109 minutes. It is produced in medical cyclotrons, usually from oxygen-18, and then chemically attached to a pharmaceutical. See PET scan.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| F18-FDG (Fluorodeoxyglucose Fluorodeoxyglucose Fludeoxyglucose or fluorodeoxyglucose , commonly abbreviated 18F-FDG or FDG, is a radiopharmaceutical used in the medical imaging modality positron emission tomography... ) |
Tumor imaging Myocardial imaging |
IV | In-vivo | Imaging |
| F18-Fluoride | Bone imaging | IV | In-vivo | Imaging |
| F18-Fluorocholine | Prostate tumor imaging | IV | In-vivo | Imaging |
Gallium-67
67GaGallium
Gallium is a chemical element that has the symbol Ga and atomic number 31. Elemental gallium does not occur in nature, but as the gallium salt in trace amounts in bauxite and zinc ores. A soft silvery metallic poor metal, elemental gallium is a brittle solid at low temperatures. As it liquefies...
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter. See gallium scan
Gallium scan
A gallium scan or gallium 67 scan is a type of nuclear medicine study that uses a radioactive tracer to obtain images of a specific type of tissue, or disease state of tissue. Gallium salts like gallium citrate and gallium nitrate are used. The form of salt is not important, since it is the freely...
.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Ga67-Ga3+ | Tumor imaging | IV | In-vivo | Imaging |
| Ga67-Ga3+ | Infection/inflammation imaging | IV | In-vivo | Imaging |
Gallium-68
68GaGallium
Gallium is a chemical element that has the symbol Ga and atomic number 31. Elemental gallium does not occur in nature, but as the gallium salt in trace amounts in bauxite and zinc ores. A soft silvery metallic poor metal, elemental gallium is a brittle solid at low temperatures. As it liquefies...
is a positron
Positron
The positron or antielectron is the antiparticle or the antimatter counterpart of the electron. The positron has an electric charge of +1e, a spin of ½, and has the same mass as an electron...
emitter, with a 68 minute half life, produced by elution
Elution
Elution is a term used in analytical and organic chemistry to describe the process of extracting one material from another by washing with a solvent ....
from germanium-68 in a gallium-68 generator
Gallium-68 generator
A gallium-68 generator is a device used to extract the positron-emitting isotope 68Ga of gallium from a source of decaying germanium-68. The parent isotope 68Ge has a half-life of 271 days and can be easily sent to hospitals within the generator, where it is storable for almost a year...
. See also positron emission tomography
Positron emission tomography
Positron emission tomography is nuclear medicine imaging technique that produces a three-dimensional image or picture of functional processes in the body. The system detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide , which is introduced into the body on a...
.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Ga68-Dotatoc or Dotatate | Neuroendocrine tumor imaging | IV | In-vivo | Imaging |
Hydrogen-3
3H or tritiumTritium
Tritium is a radioactive isotope of hydrogen. The nucleus of tritium contains one proton and two neutrons, whereas the nucleus of protium contains one proton and no neutrons...
is a beta
Beta particle
Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| H3-water | Total body water | Oral or IV | In-vitro | Non-imaging |
Indium-111
111InIndium
Indium is a chemical element with the symbol In and atomic number 49. This rare, very soft, malleable and easily fusible post-transition metal is chemically similar to gallium and thallium, and shows the intermediate properties between these two...
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| In111-DTPA (diethylenetriaminepenta-acetic acid) | GI transit | Oral | In-vivo | Imaging |
| In111-DTPA (diethylenetriaminepenta-acetic acid) | Cisternography | Intra-cisternal | In-vivo | Imaging |
| In111-Leukocytes | Infection/inflammation imaging | IV | In-vivo | Imaging |
| In111-Platelet Platelet Platelets, or thrombocytes , are small,irregularly shaped clear cell fragments , 2–3 µm in diameter, which are derived from fragmentation of precursor megakaryocytes. The average lifespan of a platelet is normally just 5 to 9 days... s |
Thrombus imaging | IV | In-vivo | Imaging |
| In111-Pentetreotide | Somatostatin Somatostatin Somatostatin is a peptide hormone that regulates the endocrine system and affects neurotransmission and cell proliferation via interaction with G-protein-coupled somatostatin receptors and inhibition of the release of numerous secondary hormones.Somatostatin... receptor imaging |
IV | In-vivo | Imaging |
| In111-Octreotide | Somatostatin Somatostatin Somatostatin is a peptide hormone that regulates the endocrine system and affects neurotransmission and cell proliferation via interaction with G-protein-coupled somatostatin receptors and inhibition of the release of numerous secondary hormones.Somatostatin... receptor imaging (Octreoscan) |
IV | In-vivo | Imaging |
Iodine-123
123IIodine
Iodine is a chemical element with the symbol I and atomic number 53. The name is pronounced , , or . The name is from the , meaning violet or purple, due to the color of elemental iodine vapor....
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter. It is used only diagnostically, as its radiation is penetrating and short-lived.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| I123-Iodide | Thyroid Thyroid The thyroid gland or simply, the thyroid , in vertebrate anatomy, is one of the largest endocrine glands. The thyroid gland is found in the neck, below the thyroid cartilage... uptake |
Oral or IV | In-vivo | Non-imaging |
| I123-Iodide | Thyroid imaging Thyroid metastases Metastasis Metastasis, or metastatic disease , is the spread of a disease from one organ or part to another non-adjacent organ or part. It was previously thought that only malignant tumor cells and infections have the capacity to metastasize; however, this is being reconsidered due to new research... imaging |
Oral or IV | In-vivo | Imaging |
| I123-o-Iodohippurate | Renal imaging | IV | In-vivo | Imaging |
| I123-MIBG (m-iodobenzylguanidine) | Neuroectodermal tumour imaging | IV | In-vivo | Imaging |
| I123-FP-CIT | SPECT imaging of Parkinson's Disease | IV | In-vivo | Imaging |
Iodine-125
125IIodine
Iodine is a chemical element with the symbol I and atomic number 53. The name is pronounced , , or . The name is from the , meaning violet or purple, due to the color of elemental iodine vapor....
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter with a long half-life of 59.4 days (the longest of all radioiodines used in medicine). Iodine-123 is preferred for imaging, so I-125 is used diagnostically only when the test requires a longer period to prepare the radiopharmaceutical and trace it, such as a fibrinogen scan to diagnose clotting. I-125's gamma radiation is of medium penetration, making it more useful as a therapeutic isotope for brachytherapy
Brachytherapy
Brachytherapy , also known as internal radiotherapy, sealed source radiotherapy, curietherapy or endocurietherapy, is a form of radiotherapy where a radiation source is placed inside or next to the area requiring treatment...
implant of radioisotope capsules for local treatment of cancers.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| I125-fibrinogen | Clot imaging | IV | In-vivo | Imaging |
Iodine-131
131IIodine-131
Iodine-131 , also called radioiodine , is an important radioisotope of iodine. It has a radioactive decay half-life of about eight days. Its uses are mostly medical and pharmaceutical...
is a beta
Beta particle
Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay...
and gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter. It is used both to destroy thyroid and thyroid cancer tissues (via beta radiation, which is short-range), and also other neuroendocrine tissues when used in MIBG. It can also be seen by a gamma camera, and can serve as a diagnostic imaging tracer, when treatment is also being attempted at the same time. However iodine-123 is usually preferred when only imaging is desired.
Diagnostic
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| I131-Iodide | Thyroid Thyroid The thyroid gland or simply, the thyroid , in vertebrate anatomy, is one of the largest endocrine glands. The thyroid gland is found in the neck, below the thyroid cartilage... uptake |
Oral | In-vivo | Non-imaging |
| I131-Iodide | Thyroid metastases Metastasis Metastasis, or metastatic disease , is the spread of a disease from one organ or part to another non-adjacent organ or part. It was previously thought that only malignant tumor cells and infections have the capacity to metastasize; however, this is being reconsidered due to new research... imaging |
Oral or IV | In-vivo | Imaging |
| I131-MIBG (m-iodobenzylguanidine) | Neuroectodermal tumor imaging | IV | In-vivo | Imaging |
Therapeutic
| Name | Treatment of | Route of administration |
|---|---|---|
| I131-Iodide | Thyrotoxicosis | IV or Oral |
| I131-Iodide | Non-toxic goiter | IV or Oral |
| I131-Iodide | Thyroid carcinoma Thyroid cancer Thyroid neoplasm is a neoplasm or tumor of the thyroid. It can be a benign tumor such as thyroid adenoma, or it can be a malignant neoplasm , such as papillary, follicular, medullary or anaplastic thyroid cancer. Most patients are 25 to 65 years of age when first diagnosed; women are more affected... |
IV or Oral |
| I131-MIBG (m-iodobenzylguanidine) | Malignant disease | IV |
Iron-59
59FeIron
Iron is a chemical element with the symbol Fe and atomic number 26. It is a metal in the first transition series. It is the most common element forming the planet Earth as a whole, forming much of Earth's outer and inner core. It is the fourth most common element in the Earth's crust...
is a beta
Beta particle
Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay...
and gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Fe59-Fe2+ or Fe3+ | Iron metabolism | IV | In-vitro | Non-imaging |
Krypton-81m
81KrmKrypton
Krypton is a chemical element with the symbol Kr and atomic number 36. It is a member of Group 18 and Period 4 elements. A colorless, odorless, tasteless noble gas, krypton occurs in trace amounts in the atmosphere, is isolated by fractionally distilling liquified air, and is often used with other...
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Kr81m-Gas | Lung ventilation imaging | Inhalation | In-vivo | Imaging |
| Kr-81m-Aqueous solution | Lung perfusion imaging | IV | In-vivo | Imaging |
Nitrogen-13
13NNitrogen-13
Nitrogen-13 is a radioisotope of nitrogen used in positron emission tomography . It has a half life of a little under ten minutes, so it must be made at the PET site...
is a positron
Positron
The positron or antielectron is the antiparticle or the antimatter counterpart of the electron. The positron has an electric charge of +1e, a spin of ½, and has the same mass as an electron...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| N13-Ammonia Ammonia Ammonia is a compound of nitrogen and hydrogen with the formula . It is a colourless gas with a characteristic pungent odour. Ammonia contributes significantly to the nutritional needs of terrestrial organisms by serving as a precursor to food and fertilizers. Ammonia, either directly or... |
Myocardial blood flow imaging | IV | In-vivo | Imaging |
Oxygen-15
15OOxygen
Oxygen is the element with atomic number 8 and represented by the symbol O. Its name derives from the Greek roots ὀξύς and -γενής , because at the time of naming, it was mistakenly thought that all acids required oxygen in their composition...
is a positron
Positron
The positron or antielectron is the antiparticle or the antimatter counterpart of the electron. The positron has an electric charge of +1e, a spin of ½, and has the same mass as an electron...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| O15-Water | Cerebral blood flow imaging Myocardial blood flow imaging |
IV bolus | In-vivo | Imaging |
Phosphorus-32
32PPhosphorus
Phosphorus is the chemical element that has the symbol P and atomic number 15. A multivalent nonmetal of the nitrogen group, phosphorus as a mineral is almost always present in its maximally oxidized state, as inorganic phosphate rocks...
is a beta
Beta particle
Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay...
emitter.
| Name | Treatment of | Route of administration |
|---|---|---|
| P32-Phosphate | Polycythemia Polycythemia Polycythemia is a disease state in which the proportion of blood volume that is occupied by red blood cells increases... and related disorders |
IV or Oral |
Rubidium-82
82RbRubidium
Rubidium is a chemical element with the symbol Rb and atomic number 37. Rubidium is a soft, silvery-white metallic element of the alkali metal group. Its atomic mass is 85.4678. Elemental rubidium is highly reactive, with properties similar to those of other elements in group 1, such as very rapid...
is a positron
Positron
The positron or antielectron is the antiparticle or the antimatter counterpart of the electron. The positron has an electric charge of +1e, a spin of ½, and has the same mass as an electron...
and gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Treatment of | Route of administration |
|---|---|---|
| Rb-82 Chloride | Myocardial Imaging | IV |
Samarium-153
153SmSamarium
Samarium is a chemical element with the symbol Sm, atomic number 62 and atomic weight 150.36. It is a moderately hard silvery metal which readily oxidizes in air. Being a typical member of the lanthanide series, samarium usually assumes the oxidation state +3...
is a beta
Beta particle
Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay...
and gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Treatment of | Route of administration |
|---|---|---|
| Sm153-EDTMP Samarium-153-ethylene diamine tetramethylene phosphonate Samarium lexidronam is a complex of a radioisotope of the lanthanide element samarium with the chelator EDTMP. It is used to treat pain when cancer has spread to the bone.It is injected into a vein and distributes throughout the body... (Ethylenediaminotetramethylenephosphoric acid) |
Bone metastases | IV |
Selenium-75
75SeSelenium
Selenium is a chemical element with atomic number 34, chemical symbol Se, and an atomic mass of 78.96. It is a nonmetal, whose properties are intermediate between those of adjacent chalcogen elements sulfur and tellurium...
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Se75-Selenorcholesterol | Adrenal gland Adrenal gland In mammals, the adrenal glands are endocrine glands that sit atop the kidneys; in humans, the right suprarenal gland is triangular shaped, while the left suprarenal gland is semilunar shaped... imaging |
IV | In-vivo | Imaging |
| Se75-SeHCAT SeHCAT SeHCAT is the usual name for 23-seleno-25-homo-tauro-cholic acid . It is used in a clinical test to diagnose bile acid malabsorption.-Development:... (23-Seleno-25-homo-tauro-cholate) |
Bile salt absorption | Oral | In-vivo | Imaging |
Sodium-22
22NaSodium
Sodium is a chemical element with the symbol Na and atomic number 11. It is a soft, silvery-white, highly reactive metal and is a member of the alkali metals; its only stable isotope is 23Na. It is an abundant element that exists in numerous minerals, most commonly as sodium chloride...
is a positron
Positron
The positron or antielectron is the antiparticle or the antimatter counterpart of the electron. The positron has an electric charge of +1e, a spin of ½, and has the same mass as an electron...
and gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Na22-Na+ | Electrolyte studies | Oral or IV | In-vitro | Non-imaging |
Sodium-24
24NaSodium
Sodium is a chemical element with the symbol Na and atomic number 11. It is a soft, silvery-white, highly reactive metal and is a member of the alkali metals; its only stable isotope is 23Na. It is an abundant element that exists in numerous minerals, most commonly as sodium chloride...
is a beta
Beta particle
Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay...
and gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Na24-Na+ | Electrolyte studies | Oral or IV | In-vitro | Non-imaging |
Strontium-89
89SrStrontium
Strontium is a chemical element with the symbol Sr and the atomic number 38. An alkaline earth metal, strontium is a soft silver-white or yellowish metallic element that is highly reactive chemically. The metal turns yellow when exposed to air. It occurs naturally in the minerals celestine and...
is a beta
Beta particle
Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay...
emitter.
| Name | Treatment of | Route of administration |
|---|---|---|
| Sr89-Chloride | Bone metastases | IV |
Technetium-99m
99mTcTechnetium
Technetium is the chemical element with atomic number 43 and symbol Tc. It is the lowest atomic number element without any stable isotopes; every form of it is radioactive. Nearly all technetium is produced synthetically and only minute amounts are found in nature...
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter. It is obtained on-site at the imaging center as the soluble pertechnetate which is eluted from a technetium-99m generator
Technetium-99m generator
A technetium-99m generator, or colloquially a technetium cow or moly cow, is a device used to extract the metastable isotope 99mTc of technetium from a source of decaying molybdenum-99...
, and then either used directly as this soluble salt, or else used to synthesize a number of technetium-99m
Technetium-99m
Technetium-99m is a metastable nuclear isomer of technetium-99, symbolized as 99mTc. The "m" indicates that this is a metastable nuclear isomer, i.e., that its half-life of 6 hours is considerably longer than most nuclear isomers that undergo gamma decay...
-based radiopharmaceuticals.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Tc99m-pertechnetate Pertechnetate The pertechnetate ion is an oxoanion with the chemical formula TcO4−. It is often used as a convenient water-soluble source of isotopes of the radioactive element technetium... |
Thyroid Thyroid The thyroid gland or simply, the thyroid , in vertebrate anatomy, is one of the largest endocrine glands. The thyroid gland is found in the neck, below the thyroid cartilage... uptake and thyroid imaging Stomach and salivary gland imaging Meckel's diverticulum Meckel's diverticulum A Meckel's diverticulum, a true congenital diverticulum, is a small bulge in the small intestine present at birth. It is a vestigial remnant of the omphalomesenteric duct , and is the most frequent malformation of the gastrointestinal tract... imaging Brain imaging Micturating cystogram First pass blood flow imaging First pass peripheral vascular imaging |
IV | In-vivo | Imaging |
| Tc99m-pertechnetate | Lacrimal imaging | Eye drops | In-vivo | Imaging |
| Tc99m-Human albumin Human serum albumin Human serum albumin is the most abundant protein in human blood plasma. It is produced in the liver. Albumin constitutes about half of the blood serum protein... |
Cardiac blood pool imaging | IV | In-vivo | Imaging |
| Tc99m-Human albumin | Peripheral vascular imaging | IV | In-vivo | Imaging |
| Tc99m-Human albumin macroaggregates or microspheres | Lung perfusion imaging | IV | In-vivo | Imaging |
| Tc99m-Human albumin macroaggregates or microspheres | Lung perfusion imaging with venography | IV | In-vivo | Imaging |
| Tc99m-Phosphonates and phosphates | Bone imaging | IV | In-vivo | Imaging |
| Tc99m-Phosphonates and phosphates | Myocardial imaging | IV | In-vivo | Imaging |
| Tc99m-DTPA (diethylenetriaminepenta-acetic acid) | Renal imaging First pass blood flow studies Brain imaging |
IV | In-vivo | Imaging |
| Tc99m-DTPA (diethylenetriaminepenta-acetic acid) | Lung ventilation imaging | Aerosol inhalation | In-vivo | Imaging |
| Tc99m-DMSA(V) (dimercaptosuccinic acid Dimercaptosuccinic acid Dimercaptosuccinic acid , is the organosulfur compound with the formula HO2CCHCHCO2H. This colorless solid contains two carboxylic acid and two thiol groups, the latter being responsible for its mildly unpleasant odour. It occurs in two diastereomers, meso and the chiral dl forms... ) |
Tumor imaging | IV | In-vivo | Imaging |
| Tc99m-DMSA(III) (dimercaptosuccinic acid Dimercaptosuccinic acid Dimercaptosuccinic acid , is the organosulfur compound with the formula HO2CCHCHCO2H. This colorless solid contains two carboxylic acid and two thiol groups, the latter being responsible for its mildly unpleasant odour. It occurs in two diastereomers, meso and the chiral dl forms... ) |
Renal imaging | IV | In-vivo | Imaging |
| Tc99m-Colloid | Bone marrow imaging GI Bleeding |
IV | In-vivo | Imaging |
| Tc99m-Colloid | Lymph node imaging | Interstitial | In-vivo | Imaging |
| Tc99m-Colloid | Esophageal transit and reflux imaging | Oral | In-vivo | Imaging |
| Tc99m-Colloid | Lacrimal imaging | Eye drops | In-vivo | Imaging |
| Tc99m-HIDA (Hepatic iminodiacetic acid) | Functional biliary system imaging | IV | In-vivo | Imaging |
| Tc99m-Denatured red bood cells | Red cell volume | IV | In-vitro | Non-imaging |
| Tc99m-Red blood cells | GI bleeding Cardiac blood pool imaging MUGA scan A MUGA scan is a time-proven yet dated nuclear medicine test designed to evaluate the function of the right and left ventricles of the heart, thus allowing informed diagnostic intervention in heart failure. It is also called radionuclide angiography, as well as gated blood pool imaging... Peripheral vascular imaging |
IV | In-vivo | Imaging |
| Tc99m-MAG3 (mercaptoacetyltriglycine) | Renal imaging First pass blood flow imaging |
IV | In-vivo | Imaging |
| Tc99m-Exametazime | Cerebral blood flow imaging | IV | In-vivo | Imaging |
| Tc99m-Exametazime labelled leucocytes | Infection/inflammation imaging | IV | In-vivo | Imaging |
| Tc99m-Sestamibi Sestamibi Technetium sestamibi is a pharmaceutical agent used in nuclear medicine imaging. The drug is a coordination complex of the radioisotope technetium-99m with the ligand methoxyisobutylisonitrile . The generic drug became available late September 2008... (MIBI - methoxy isobutyl isonitrile) |
Parathyroid imaging Non-specific tumor imaging Thyroid tumor imaging Breast imaging Myocardial imaging |
IV | In-vivo | Imaging |
| Tc99m-Sulesomab (IMMU-MN3 murine Fab'-SH antigranulocyte monoclonal antibody fragments) | Infection/inflammation imaging | IV | In-vivo | Imaging |
| Tc99m-Technegas | Lung ventilation imaging | Inhalation | In-vivo | Imaging |
| Tc99m-Human immunoglobulin | Infection/inflammation imaging | IV | In-vivo | Imaging |
| Tc99m-Tetrofosmin | Parathyroid imaging Myocardial imaging |
IV | In-vivo | Imaging |
| Tc99m-ECD (ethyl cysteinate dimer) | Brain imaging | IV | In-vivo | Imaging |
Thallium-201
201TlThallium
Thallium is a chemical element with the symbol Tl and atomic number 81. This soft gray poor metal resembles tin but discolors when exposed to air. The two chemists William Crookes and Claude-Auguste Lamy discovered thallium independently in 1861 by the newly developed method of flame spectroscopy...
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Tl201-Tl+ | Non-specific tumor imaging Thyroid tumor imaging Myocardial imaging Parathyroid imaging |
IV | In-vivo | Imaging |
Xenon-133
133XeXenon
Xenon is a chemical element with the symbol Xe and atomic number 54. The element name is pronounced or . A colorless, heavy, odorless noble gas, xenon occurs in the Earth's atmosphere in trace amounts...
is a gamma
Gamma ray
Gamma radiation, also known as gamma rays or hyphenated as gamma-rays and denoted as γ, is electromagnetic radiation of high frequency . Gamma rays are usually naturally produced on Earth by decay of high energy states in atomic nuclei...
emitter.
| Name | Investigation | Route of administration | In-vitro / in-vivo | Imaging / non-imaging |
|---|---|---|---|---|
| Xe133-gas | Lung ventilation studies | Inhalation | In-vivo | Imaging |
| Xe133 in isotonic sodium chloride solution | Cerebral blood flow | IV | In-vivo | Imaging |
Yttrium-90
90YYttrium
Yttrium is a chemical element with symbol Y and atomic number 39. It is a silvery-metallic transition metal chemically similar to the lanthanides and it has often been classified as a "rare earth element". Yttrium is almost always found combined with the lanthanides in rare earth minerals and is...
is a beta
Beta particle
Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay...
emitter.
| Name | Treatment of | Route of administration |
|---|---|---|
| Y90-Silicate | Arthritic conditions | Intra-articular |
| Y90-Silicate | Malignant disease | Intracavitary |
Reading
- Notes for guidance on the clinical administration of radiopharmaceuticals and use of sealed radioactive sources. Administration of radioactive substances advisory committee. March 2006. Produced by the Health Protection Agency.
- Malabsorption. In: The Merck Manual of Geriatrics, chapter 111.
- Leukoscan summary of product characteristics (Tc99m-Sulesomab).
- Schwochau, Klaus. Technetium. Wiley-VCH (2000). ISBN 3-527-29496-1
External links
- National Isotope Development Center U.S. Government resources for isotopes - production, distribution, and information
- Isotope Development & Production for Research and Applications (IDPRA) U.S. Department of Energy program sponsoring isotope production and production research and development