Application of radioisotopes in the field of nuclear medicine

A new evaluation of the decay data for 166Ho

The β--emitter 166Ho is of interest as a potential radiolabel for therapeutic medical applications. A new decay data evaluation for 166Ho has been performed using the Decay Data Evaluation Project (DDEP) methodology. New recommended values for the half-life, γ-ray emission probabilities, β-- branching ratios, and other relevant nuclear and atomic data are provided. This paper provides a summary of the evaluation; the complete set of recommended data tables and detailed evaluator comments are available at the DDEP website.

Radiolabeled nanomaterial for cancer diagnostics and therapeutics: principles and concepts

In the last three decades, radiopharmaceuticals have proven their effectiveness for cancer diagnosis and therapy. In parallel, the advances in nanotechnology have fueled a plethora of applications in biology and medicine. A convergence of these disciplines has emerged more recently with the advent of nanotechnology-aided radiopharmaceuticals. Capitalizing on the unique physical and functional properties of nanoparticles, radiolabeled nanomaterials or nano-radiopharmaceuticals have the potential to enhance imaging and therapy of human diseases. This article provides an overview of various radionuclides used in diagnostic, therapeutic, and theranostic applications, radionuclide production through different techniques, conventional radionuclide delivery systems, and advancements in the delivery systems for nanomaterials. The review also provides insights into fundamental concepts necessary to improve currently available radionuclide agents and formulate new nano-radiopharmaceuticals.

Production of 68Ge, 68Ga, 67Ga, 65Zn, and 64Cu important radionuclides for medical applications: theoretical model predictions for α-particles with 66Zn at ≈10–40 MeV

Theoretical predictions were made using TALYS-1.95(G) and EMPIRE 3.2 reaction-model codes for 69Ge, 67Ge, and medically used 68Ge, 67Ga, 68Ga, 65Zn, 64Cu radionuclides produced in the interaction of α-projectile with 66Zn-target at 10–40 MeV α-energies. Pearson’s statistical coefficients showed moderate to strong positive correlations between the theoretically predicted and experimentally measured production cross sections for radionuclides with practical medical applications. Furthermore, the present results indicated that a medium-sized cyclotron and a single α + 66Zn system (projectile + target system) might be an option for optimized production of 68Ge, 68Ga, 67Ga, 65Zn, and 64Cu radionuclides.

Production of neutron deficient rare earth radionuclides by heavy ion activation

The attempts to produce neutron deficient radioisotopes of rare Earth elements by heavy ion activation are discussed in this review. The heavy ion induced reaction products have large atomic number difference with that of the target; therefore, radiochemical separation of no-carrier-added radio-lanthanides from the target matrix becomes easier. Heavy ion induced reactions also allow the production of rare Earth radionuclides from non-rare Earth target by tailor-made target-projectile combinations, and in those cases, radiochemical separations become even more easier. In general, the cross sections of heavy ion induced reactions are less than those of light charged particle induced reactions. However, some of the heavy ion induced reactions have comparable cross sections with those of light ion induced reactions. The range of heavy ions is also much smaller in the target matrix than that of lighter charged particles. These points hinder application of heavy ion induced reactions to produce radionuclides for nuclear medicine.

Theranostic Terbium Radioisotopes: Challenges in Production for Clinical Application

Currently, research on terbium has gained a momentum owing to its four short-lived radioisotopes, ¹⁴⁹Tb, ¹⁵²Tb, ¹⁵⁵Tb, and ¹⁶¹Tb, all of which can be considered in one or another field of nuclear medicine. The members of this emerging quadruplet family have appealing nuclear characteristics and have the potential to do justice to the proposed theory of theranostics nuclear medicine, which amalgamates therapeutic and diagnostic radioisotopes together. The main challenge for in vivo use of these radioisotopes is to produce them in sufficient quantity. This review discusses that, at present, neither light charged particle nor the heavy ion (HI) activation are suitable for large-scale production of neutron deficient terbium nuclides. Three technological factors like (i) enrichment of stable isotopes to a considerable level, (ii) non-availability of higher energies in commercial cyclotrons, and (iii) non-availability of the isotope separation technique coupled with commercial accelerators limit the large scale production of terbium radionuclides by light charged particle activation. If in future, the technology can overcome these hurdles, then the light charged particle activation of enriched targets would produce a high amount of useful terbium radionuclides. On the other hand, to date, the spallation reaction coupled with an online isotope separator has been found suitable for such a requirement, which has been adopted by the CERN MEDICIS programme. The therapeutic ¹⁶¹Tb radionuclide can be produced in a reactor by neutron bombardment on enriched ¹⁶⁰Gd target to produce ¹⁶¹Gd which subsequently decays to ¹⁶¹Tb. The radiochemical separation is mandatory even if the ISOL technique is used to obtain high radioisotopic purity of the desired radioisotope.

A Step-by-Step Guide for the Novel Radiometal Production for Medical Applications: Case Studies with 68Ga, 44Sc, 177Lu and 161Tb

The production of novel radionuclides is the first step towards the development of new effective radiopharmaceuticals, and the quality thereof directly affects the preclinical and clinical phases. In this review, novel radiometal production for medical applications is briefly elucidated. The production status of the imaging nuclide 44Sc and the therapeutic β--emitter nuclide 161Tb are compared to their more established counterparts, 68Ga and 177Lu according to their targetry, irradiation process, radiochemistry, and quality control aspects. The detailed discussion of these significant issues will help towards the future introduction of these promising radionuclides into drug manufacture for clinical application under Good Manufacturing Practice (GMP).

The various therapeutic applications of the medical isotope holmium-166: a narrative review

Over the years, a broad spectrum of applications of the radionuclide holmium-166 as a medical isotope has been established. The isotope holmium-166 is attractive as it emits high-energy beta radiation which can be used for a therapeutic effect and gamma radiation which can be used for nuclear imaging purposes. Furthermore, holmium-165 can be visualized by MRI because of its paramagnetic properties and by CT because of its high density. Since holmium-165 has a natural abundance of 100%, the only by-product is metastable holmium-166 and no costly chemical purification steps are necessary for production of nuclear reactor derived holmium-166. Several compounds labelled with holmium-166 are now used in patients, such Ho¹⁶⁶-labelled microspheres for liver malignancies, Ho¹⁶⁶-labelled chitosan for hepatocellular carcinoma (HCC) and [¹⁶⁶Ho]Ho DOTMP for bone metastases. The outcomes in patients are very promising, making this isotope more and more interesting for applications in interventional oncology. Both drugs as well as medical devices labelled with radioactive holmium are used for internal radiotherapy. One of the treatment possibilities is direct intratumoural treatment, in which the radioactive compound is injected with a needle directly into the tumour. Numerous other applications have been developed, like patches for treatment of skin cancer and holmium labelled antibodies and peptides. The second major application that is currently clinically applied is selective internal radiation therapy (SIRT, also called radioembolization), a novel treatment option for liver malignancies. This review discusses medical drugs and medical devices based on the therapeutic radionuclide holmium-166.

Activation cross-sections of longer lived radioisotopes of proton induced nuclear reactions on terbium up to 65MeV

Experimental cross sections are presented for the ¹⁵⁹Tb(p,xn)^{153,155,157,159}Dy, ^{152,153,155,156m2,m1,g,158}Tb and ^153,151Gd nuclear reactions up to 65MeV. The experimental results are compared with the recently reported experimental data and with the results of the nuclear reaction codes ALICE-IPPE, EMPIRE and TALYS as reported in the TENDL-2015 on-line library. Integral thick-target yields are also derived for the reaction products used in practical applications and production routes are discussed.

Radiopharmaceuticals for bone metastasis therapy and beyond: a voyage from the past to the present and a look to the future

Bone cancer can be divided into primary and secondary (metastatic) bone cancer. Osteosarcoma is the most common type of primary bone cancer, but still is a rare cancer. The development of bone metastases is a common event for the cancer patient and the main cause of treatment failure and death, being chronic pain syndrome the most important complication. There are currently several therapeutic modalities for the treatment of metastatic bone disease, including radiation therapy. Treatment with radionuclides (β- and α-particle emitters and Auger electron cascades) is a safe and effective tool of medicine. There is a great deal of interest in diphosphonic acids in nuclear medicine as ligands for radiometals in bone-seeking diagnostic and therapeutic agents. Several radiopharmaceuticals have been designed with the phosphonates as ligands. A recent approach to develop an effective radiopharmaceutical for therapy of bone cancer was the design of a water-soluble polymer that would exploit the disrupted vasculature in tumors according to the enhanced permeability and retention effect. To enhance the effect of radionuclide therapy on the cancer cells, new strategies have recently been investigated, such as the combined radionuclide and chemotherapy, high-dose radionuclide therapy, and repeated radionuclide therapy.

Investigation on the production and isolation of 149,150,151Tb from 12C irradiated natural praseodymium target

Short lived α-emitting radionuclides have enormous potential to be used in the targeted therapy. 149Tb (4.118 h) is among the few α-emitting radionuclides which are projected for human clinical use. Therefore, direct production of 149Tb was aimed from the 12C induced reaction on natural praseodymium target of 15 mg∕cm2 thickness at 71.5 MeV incident beam energy. No-carrier-added (nca) 149,150,151Tb radionuclides were produced in the target matrix along with 149Gd, which is also the decay product of 149Tb, with relatively high yield of 149Tb. An efficient radiochemical separation method was developed to separate nca 149–151Tb from bulk praseodymium and coproduced Gd by liquid–liquid extraction (LLX) using aqueous HCl and liquid cation extracting agent di-(2-ethylhexyl)phosphoric acid (HDEHP) dissolved in cyclohexane. Quantitative extraction of nca 149–151Tb was achieved from bulk target with a high separation factor of 4.7×105.

177Lu labeling of Herceptin and preclinical validation as a new radiopharmaceutical for radioimmunotherapy of breast cancer

INTRODUCTION

In the present study, Herceptin was labeled with lutetium-177 via DOTA, and the necessary preclinical quality control tests (in vitro and in vivo) were performed to evaluate its use as a radioimmunotherapy agent.

MATERIAL AND METHODS

Herceptin was conjugated to DOTA as a chelator in three different conjugation buffers (ammonium acetate, carbonate and HEPES buffer); each of the resulting conjugates was compared with respect to in vitro characteristics such as number of chelates per antibody, incorporated activity, immunoreactivity and in vitro stability in PBS buffer and blood serum. The biodistribution study and gamma camera imaging were performed in mice bearing breast tumors. To assess the therapeutic effects of (177)Lu-Herceptin, cytotoxicity was investigated for 7 days in a SKBr3 breast cancer cell line.

RESULTS

Carbonate buffer was the best conjugation buffer (number of chelates per antibody: 6; incorporated activity: 81%; immunoreactivity: 87%; buffer stability: 86%; serum stability: 81%, after 4 days). The efficient tumor uptake observed in the biodistribution studies was consistent with the gamma camera image results. At a concentration of 4 μg ml(-1), (177)Lu-Herceptin (surviving cells: 5 ± 0.6% of the total cells) of the total cells corresponded to an approximately eightfold increase in cytotoxicity in comparison to unmodified Herceptin (surviving cells: 43 ± 3.9%).

CONCLUSION

The new complex described herein could be considered for further evaluation in animals and potentially in humans as a radiopharmaceutical for use in the radioimmunotherapy of breast cancer. These results may be important for patients who cannot tolerate the therapeutic dosage of Herceptin currently used because of heart problems.

Experimental study of the excitation functions of proton induced nuclear reactions on (167)Er for production of medically relevant (167)Tm

(167)Tm (T(1/2)=9.25d) is a candidate radioisotope for medical therapy and diagnostics due to its Auger-electron and low-energy X- and gamma-ray emission. Excitation functions of the (167)Er(p,n)(167)Tm reaction and (168)Er(p,n)(168)Tm, (167)Er(p,2n)(166)Tm, (166)Er(p,2n)(165)Tm disturbing reactions were measured up to 15MeV by using the stacked foil irradiation technique and gamma-ray spectroscopy. The measured excitation functions agree well with the results of ALICE-IPPE, EMPIRE-II and TALYS nuclear reaction model codes. The thick target yield of (167)Tm in the 15-8MeV energy range is 6.9MBq/microAh. A short comparison of charged particle production routes of (167)Tm is given.

Radiolabeling of trastuzumab with 177Lu via DOTA, a new radiopharmaceutical for radioimmunotherapy of breast cancer

AIM

Trastuzumab is a monoclonal antibody that is used in treating breast cancer. We labeled this monoclonal antibody with lutetium-177 and performed in vitro quality control tests as a first step in the production of a new radiopharmaceutical.

MATERIAL AND METHODS

Trastuzumab was labeled with lutetium-177 using DOTA as chelator. Radiochemical purity and stability in buffer and human blood serum were determined using thin layer chromatography. Immunoreactivity and toxicity of the complex were tested on MCF7 breast cancer cell line.

RESULTS

The radiochemical purity of the complex was 96+/-0.9%. The stabilities in phosphate buffer and in human blood serum at 96 h postpreparation were 93+/-1.2% and 85+/-3.5%, respectively. The immunoreactivity of the complex was 89+/-1.4%. At a concentration of 1 nM, the complex killed 70+/-3% of MCF7 cells. At 1.9 nM, 90+/-5% of the cells were killed.

CONCLUSIONS

The results showed that the new complex could be considered for further evaluation in animals and possibly in humans as a new radiopharmaceutical for use in radioimmunotherapy against breast cancer.

Production of 166Ho through 164Dy(n,γ)165Dy(n, γ)166Dy(β−)166Ho and separation of 166Ho

After irradiation with thermal neutrons 164Dy produces 166Ho through the nuclear reaction: 164Dy(n, gamma) 165Dy(n, gamma) 166Dy beta- --> 166Ho. 166Ho has been separated from the bulk dysprosium target with the help of HPLC using Aminex A7 ion exchanger resin and alpha-hydroxyisobutyric acid (alpha-HIBA) as the mobile phase. The separation was quantitative and without any contamination from the dysprosium target. Method has also been developed to produce holmium free of alpha-HIBA ligands. Attempts have been made to produce no-carrier-added recoiled 166Ho and 165Dy in water.

Enantioselective recognition between chiral alpha-hydroxy-carboxylates and macrocyclic heptadentate lanthanide(III) chelates

Three novel heptacoordinated Ln(III) complexes (Ln = Gd and Yb) have been synthesized and investigated by (1)H NMR spectroscopy. These complexes contain two stereogenic centers, one associated with a deltadeltadeltadelta or lambdalambdalambdalambda conformation of the ethylenediamine moieties in the tetraazamacrocycle and the latter arises from the orientation (Delta or Lambda) of the coordinating arms. Evidence has been gained for the occurrence of a fast exchange between all the possible conformers. Upon addition of several (S)-alpha-hydroxy-carboxylate substrates, the formation of stable ternary adducts has been obtained. Their (1)H NMR spectra are consistent with the presence of two diastereoisomers differing in the conformation adopted by the macrocyclic ligand wrapping the lanthanide(III) ion. The interaction leading to the formation of the ternary complexes is enantioselective depending on the hydrophilicity of the alpha-hydroxy-carboxylate.