Radiopharmaceutics

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Radiopharmaceutical and regulators

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used for diagnostic and therapeutic purpose -- Food and drug administration (FDA) -- Nuclear Regulatory Commission (NRC)

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Diagnostics:

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Myocardial perfusion in cardiology - •Tumor imaging and localization in oncology •Cerbral perfusion in neurology •Kidney visualization in nephrology •Infection imaging

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Therapeutic:

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Thyroid cancer, Grave disease, hyperthyroidism, bone pain palliation (reducing), pheochromocytome (Andrenal cancer), or to treat neuroendocrine tumor

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An isotope - neutron

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the same atomic number as another atom but a different atomic mass. same number of protons and electrons but a different number of neutrons.

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nuclear chemistry -- Unstable

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from changes in the nucleus of an atom-- Unstable isotopes (or radioisotopes) undergo radioactive decay.

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Radioactive decay (*silver- 113 decays to cadmium-113 )

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nuclear reaction that emits radiation while changing the nuclide of one element into another. (the emission of a beta particle and gamma rays)

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major types of natural radioactive emission -- Gamma is strongest

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Alpha particle( the nucleus of a He atom) Beta particle (an electron from the nucleus) Gamma rays (energy similar to x-rays)

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Specific activity

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calculated by specific activity Ae, the equation for specific activity is Ae = A0 e-λt

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If the decay constant (λ) of a radiao-active material is 0.8 and initial activity is 25 Ci, what is the specific activity at 6 hours

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Ae = 25 * e -0.8*6 = 25 * e - 4.8 = 25 * 0.00822 = 0.205 Ci

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Half-Life : t1/2 = 0.69315/ λ

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the time/ frequently required for half of it to decay.

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If the half-life of a radio-active material is 21 hour, what is the decay constant for that material?

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21 = 0.693/ λ or λ= 0.693/21 = 0.033 per hour

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Units of Radioactivity Cari - BBQ

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is Curie (Ci) is 3.700 X 1010 nuclear transformation per second or disintegration per second (dps) A new unit is Becquerel (Bq).

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International radiation absorption unit by tissue is Gray - rad=ergs

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1 rad = 100 ergs of energy absorbed by 1 gm of tissue.

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Alzheimer disease imaging

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unsymmetry --

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Renogram - ortho-iodo-hippuric

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131I is labeled with orthoiodohippuric acid -- IV admin -- assesses the renal function in patients with transplanted kidney. -- •Limitation: The image is poor quality.

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•pyelogram. pelvic

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•The visualization of entire kidney anatomically is known as

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•99mTc-Mag-3 can provide Mag= Maximum quality

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high quality image.

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(MPI)

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myocardial perfusion imaging

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201 Tl Thallous chloride - old -- side effects

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Before Thallous Cl

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99m Tc-sestamibi, 99mTc-tetrafosmin compare to Thallous

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Sestamibi, - Tetrafosmin are now used.

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Therapeutic - cotreOTIDE - pentreOTIDE

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a synthetic analogue of the SOMAtostatin peptide hormone, with the 111In-labeled analogue PENTEtreotide

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perfusion definition

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process of delivery of blood to a capillary bed in the biological tissue

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99mTc exametazime (Ceretec) -- CereBral

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Cerebral perfusion, radiolebeling autologous leukocytes.

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99mTc mertiatide (Technescan MAG3)

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Renal imaging

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133Xe (Dupont Xenon) -- Pulmonary Mui` Son DUpon

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Pulmonary ventilation imaging

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90Y microspheres (TheraSphere) -- Liver sphere

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Therapy for biopsy-proven, unresectable hepatocellular carcinoma

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Positron emission tomography (PET)

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3D - detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide (tracer) -- mapping regional blood flow, oxygen metabolism, regional blood volume, rate of use of metabolic substrate, receptor –specific tracer binding, bone remodeling, tumor receptor density, and receptor gene expression.

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X-ray computed tomography, also Computed tomography (CT) or Computed axial tomography (CAT),

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tomography created by computer processing. 3D (use series 2D X-ray)

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Magnetic resonance imaging (MRI),

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nuclear magnetic resonance (NMR) to image nuclei of atoms inside the body. •Sometimes PET is combined with CT and MRI.

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Drug antidote for radiation exposure -- Prussian blue (Thallium)

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•137Cs (treat cancer) -- Thallium (imaging) .• Prussian blue (treat 137Cs and thallium side effect) --> trapping cesium and thallium ions (GI tract) and interrupts their re-absorption

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Interventional drugs --- Diamox-Capoten-Cimetidine

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to complement -- INC diagnosis information, specificity and sensitivity --- improves the information about the process under study. •Decrease the time

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Acetazolamide (diamox): - cerebral

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Used for increase of CEREBRAL blood flow in cerebral perfusion imaging.

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Captopril (Capoten): -- BP - kidney

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Used for preventing vasoCONSTRICtion of the efferent arterioles of the kidney in diagnosis of RENOvascular hypertension.

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Cimetidine: Diverticulum (gastric mucosa bleeding) -- red. vol

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Cimetidine REDuces the Vol - Conc stomach acid and allow continual 99mTc-pertechnetate

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Dipyridamole (Persantine) and Adenosine (Adenocard): -- Caridal imaging - treadmill

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Dipyradamole (Persantine) is used an alternative to treadmill stress and used for elderly patients. Whereas Adenosine can increase the blood flow up to four to five times than in normal value. (need for In cardial imaging)

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Furosemide (Lasix): scintigraphy -- a two-dimensional picture of internal body tissue

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Furosemide (Lasix), a loop diuretic, is administered to help confirm or rule out mechanical obstruction during renal scintigraphy when significant retention of radioactivity is noted in the renal pelvis.