Theranostic radionuclides: recent advances in production methodologies

Direct radiolabeling of methotrexate and methotrexate micelles with Tc-99m using QbD approach

The aim of the work presented in this manuscript was to radiolabel methotrexate and prepare radiolabeled methotrexate micelles, an antifolate drug with Tc-99m using QbD approach. The radiolabeling was executed using the experimental design and the radiolabeled drug was further encapsulated in micelles. The authors are of the view that the radiolabeled MTX could be used to target the folate receptor overexpressing cancers such as the kidney, colorectal, breast, brain etc thereby opening newer possibilities to the theranostic applications of the formed conjugate.

Exploring the Potential of Nanogels: From Drug Carriers to Radiopharmaceutical Agents

Nanogels open up access to a wide range of applications and offer among others hopeful approaches for use in the field of biomedicine. This review provides a brief overview of current developments of nanogels in general, particularly in the fields of drug delivery, therapeutic applications, tissue engineering, and sensor systems. Specifically, cyclodextrin (CD)-based nanogels are important because they have exceptional complexation properties and are highly biocompatible. Nanogels as a whole and CD-based nanogels in particular can be customized in a wide range of sizes and equipped with a desired surface charge as well as containing additional molecules inside and outside, such as dyes, solubility-mediating groups or even biological vector molecules for pharmaceutical targeting. Currently, biological investigations are mainly carried out in vitro, but more and more in vivo applications are gaining importance. Modern molecular imaging methods are increasingly being used for the latter. Due to an extremely high sensitivity and the possibility of obtaining quantitative data on pharmacokinetic and pharmacodynamic properties, nuclear methods such as single photon emission computed tomography (SPECT) and positron emission tomography (PET) using radiolabeled compounds are particularly suitable here. The use of radiolabeled nanogels for imaging, but also for therapy, is being discussed.

Nuclear Cross-Section of Proton-Induced Reactions on Enriched 48Ti Targets for the Production of Theranostic 47Sc Radionuclide, 46cSc, 44mSc, 44gSc, 43Sc, and 48V

The cross-sections of the 48Ti(p,x)47Sc, 46cSc, 44mSc, 44gSc, 43Sc, and 48V nuclear reactions were measured from 18 to 70 MeV, with particular attention to 47Sc production. Enriched 48Ti powder was deposited on an aluminum backing and the obtained targets were characterized via elastic backscattering spectroscopy at the INFN-LNL. Targets were exposed to low-intensity proton irradiation using the stacked-foils technique at the ARRONAX facility. Activated samples were measured using γ-spectrometry; the results were compared with the data int he literature and the theoretical TALYS-based values. A regular trend in the new values obtained from the different irradiation runs was noted, as well as a good agreement with the literature data, for all the radionuclides of interest: 47Sc, 46cSc, 44mSc, 44gSc, 43Sc, and 48V. 47Sc production was also discussed, considering yield and radionuclidic purity, for different 47Sc production scenarios.

Copper radionuclides for theranostic applications: towards standardisation of their nuclear data. A mini-review

Copper has several clinically relevant radioisotopes and versatile coordination chemistry, allowing attachment of its radionuclides to biological molecules. This characteristic makes it suitable for applications in molecular imaging or radionuclide targeted therapy. Of particular interest in nuclear medicine today is the theranostic approach. This brief review considers five radionuclides of copper. These are Cu-60, Cu-61, Cu-62, Cu-64, and Cu-67. The first four are positron emitters for imaging, and the last one Cu-67 is a β--emitting radionuclide suitable for targeted therapy. The emphasis here is on theory-aided evaluation of available experimental data with a view to establishing standardised cross-section database for production of the relevant radionuclide in high purity. Evaluated cross section data of the positron emitters have been already extensively reported; so here they are only briefly reviewed. More attention is given to the data of the 68Zn(p,2p)67Cu intermediate energy reaction which is rather commonly used for production of 67Cu.

A study on the cross-section data of 43,44m,46,47Sc isotopes via (d,x) reactions on natural abundance targets under the effects of deuteron optical models

Many studies have investigated the influence of theoretical models and factors involved in the acquisition of cross-section data of a nuclear reaction. The implications of different models of various variables such as level density, gamma strength function, and optical potentials on cross-section calculations whether used solo or jointly are investigated in a significant portion of the works conducted in this perspective. The aim of this particular study is to investigate the influence of different optical models on the cross-section calculations in production of several scandium isotopes, known for various medical uses, from several targets with natural abundances by (d,x) reactions. For this purpose, the cross-section calculations using five available deuteron optical models of TALYS code in ^natTi(d,x)⁴³Sc, ^natTi(d,x)^44mSc, ^natTi(d,x)⁴⁶Sc, ^natTi(d,x)⁴⁷Sc, ^natV(d,x)⁴⁷Sc and ^natCr(d,x)⁴⁷Sc reactions were performed and the obtained calculation results were compared with the experimental cross-section data gathered from the literature. To understand whether there is a significant and consistent relationship between the experimental data and the calculation results, both have been plotted together and analyzed with the naked-eye. In addition, the calculations of the mean standardized deviation, the mean relative deviation, the mean ratio and the mean square logarithmic deviation were performed in order to evaluate the results numerically.

An Overview of In Vitro Assays of 64Cu-, 68Ga-, 125I-, and 99mTc-Labelled Radiopharmaceuticals Using Radiometric Counters in the Era of Radiotheranostics

Radionuclides are unstable isotopes that mainly emit alpha (α), beta (β) or gamma (γ) radiation through radiation decay. Therefore, they are used in the biomedical field to label biomolecules or drugs for diagnostic imaging applications, such as positron emission tomography (PET) and/or single-photon emission computed tomography (SPECT). A growing field of research is the development of new radiopharmaceuticals for use in cancer treatments. Preclinical studies are the gold standard for translational research. Specifically, in vitro radiopharmaceutical studies are based on the use of radiopharmaceuticals directly on cells. To date, radiometric β- and γ-counters are the only tools able to assess a preclinical in vitro assay with the aim of estimating uptake, retention, and release parameters, including time- and dose-dependent cytotoxicity and kinetic parameters. This review has been designed for researchers, such as biologists and biotechnologists, who would like to approach the radiobiology field and conduct in vitro assays for cellular radioactivity evaluations using radiometric counters. To demonstrate the importance of in vitro radiopharmaceutical assays using radiometric counters with a view to radiogenomics, many studies based on ⁶⁴Cu-, ⁶⁸Ga-, ¹²⁵I-, and ^99mTc-labeled radiopharmaceuticals have been revised and summarized in this manuscript.

Development of purification of no-carrier-added 47Sc of theranostic interest: selective separation study from the natTi(n,p) process

Scandium-47 is one of the most promising medical radioisotopes, and its production and trace separation make it an attractive candidate for theranostic application. In this study, the production of no-carrier-added (NCA) 47Sc through the natTi(n,p) reaction and subsequent purification using liquid–liquid extraction was done for the theranostic application. The comparative separation of NCA 47Sc after the dissolution of an activated Ti target using Di-2-Ethylhexyl Phosphoric Acid (HDEHP) in kerosene was evaluated. The extraction process was optimized in terms of the concentration of extractant, extraction time, pH, and reaction temperature to achieve the maximum possible separation. HDEHP is efficient and promising for rapid extraction and separation of NCA 47Sc from Ti ions at low acidity (pH 0.85) with high extraction percent (>99%), contaminated with 22.3% of Ti ions after 5 min of extraction time. Different stripping reagents were used to separate loaded 47Sc and Ti ions. Firstly, 5 M HCl was enough for stripping the loaded Ti ions. Then the loaded 47Sc was separated with a purity of 100% using 0.05 M NaOH. The obtained results find the HDEHP a promising extractant for efficient separation of 47Sc from irradiated Ti target for preparing the 47Sc radiopharmaceuticals for theranostics applications.

Cyclotron Production of Gallium-68 Radiopharmaceuticals Using the 68Zn(p,n)68Ga Reaction and Their Regulatory Aspects

Designing and implementing various radionuclide production methods guarantees a sustainable supply, which is important for medical use. The use of medical cyclotrons for radiometal production can increase the availability of gallium-68 (⁶⁸Ga) radiopharmaceuticals. Although generators have greatly influenced the demand for ⁶⁸Ga radiopharmaceuticals, the use of medical cyclotrons is currently being explored. The resulting ⁶⁸Ga production is several times higher than obtained from a generator. Moreover, the use of solid targets yields end of purification and end of synthesis (EOS) of up to 194 GBq and 72 GBq, respectively. Furthermore, experiments employing liquid targets have provided promising results, with an EOS of 3 GBq for [⁶⁸Ga]Ga-PSMA-11. However, some processes can be further optimized, specifically purification, to achieve high ⁶⁸Ga recovery and apparent molar activity. In the future, ⁶⁸Ga will probably remain one of the most in-demand radionuclides; however, careful consideration is needed regarding how to reduce the production costs. Thus, this review aimed to discuss the production of ⁶⁸Ga radiopharmaceuticals using Advanced Cyclotron Systems, Inc. (ACSI, Richmond, BC, Canada) Richmond, Canada and GE Healthcare, Wisconsin, USA cyclotrons, its related factors, and regulatory concerns.

Development of radiopharmaceuticals for targeted alpha therapy: Where do we stand?

Targeted alpha therapy is an oncological treatment, where cytotoxic doses of alpha radiation are locally delivered to tumor cells, while the surrounding healthy tissue is minimally affected. This therapeutic strategy relies on radiopharmaceuticals made of medically relevant radionuclides chelated by ligands, and conjugated to targeting vectors, which promote the drug accumulation in tumor sites. This review discusses the state-of-the-art in the development of radiopharmaceuticals for targeted alpha therapy, breaking down their key structural components, such as radioisotope, targeting vector, and delivery formulation, and analyzing their pros and cons. Moreover, we discuss current drawbacks that are holding back targeted alpha therapy in the clinic, and identify ongoing strategies in field to overcome those issues, including radioisotope encapsulation in nanoformulations to prevent the release of the daughters. Lastly, we critically discuss potential opportunities the field holds, which may contribute to targeted alpha therapy becoming a gold standard treatment in oncology in the future.

Study of activation cross sections of proton induced reactions on natBa and natCe near their threshold energy regions

Activation cross-sections of the nuclear reactions natBa(p,x)135,132gLa, 135mBa and natCe(p,x)142,139,138mPr, 141,139,137mCe have been measured experimentally at the MGC-20 cyclotron, Cairo, Egypt, from their respective threshold energies up to about 14.7 MeV. Stacked foil irradiation technique and high-resolution gamma-ray spectroscopy were used. A comparison between the experimental and theoretical data derived from the nuclear model codes EMPIRE and TALYS (in the form of the TENDL library) was performed. The agreement in the low-energy region is fairly good. Integral yields of the produced radioisotopes were estimated from the present cross-section data and the results are discussed in terms of their production possibilities.

New strategies for a sustainable 99mTc supply to meet increasing medical demands: Promising solutions for current problems

The continuing rapid expansion of ^99mTc diagnostic agents always calls for scaling up ^99mTc production to cover increasing clinical demand. Nevertheless, ^99mTc availability depends mainly on the fission-produced ⁹⁹Mo supply. This supply is seriously influenced during renewed emergency periods, such as the past ⁹⁹Mo production crisis or the current COVID-19 pandemic. Consequently, these interruptions have promoted the need for ^99mTc production through alternative strategies capable of providing clinical-grade ^99mTc with high purity. In the light of this context, this review illustrates diverse production routes that either have commercially been used or new strategies that offer potential solutions to promote a rapid production growth of ^99mTc. These techniques have been selected, highlighted, and evaluated to imply their impact on developing ^99mTc production. Furthermore, their advantages and limitations, current situation, and long-term perspective were also discussed. It appears that, on the one hand, careful attention needs to be devoted to enhancing the ⁹⁹Mo economy. It can be achieved by utilizing ⁹⁸Mo neutron activation in commercial nuclear power reactors and using accelerator-based ⁹⁹Mo production, especially the photonuclear transmutation strategy. On the other hand, more research efforts should be devoted to widening the utility of ⁹⁹Mo/^99mTc generators, which incorporate nanomaterial-based sorbents and promote their development, validation, and full automization in the near future. These strategies are expected to play a vital role in providing sufficient clinical-grade ^99mTc, resulting in a reasonable cost per patient dose.

Status of the decay data for medical radionuclides: existing and potential diagnostic γ emitters, diagnostic β+ emitters and therapeutic radioisotopes

Recommended half-lives and specific well-defined emission energies and absolute emission probabilities are important input parameters that should be well-defined to assist in ensuring the diagnostic and therapeutic efficacy of individual radionuclides when applied in the field of nuclear medicine. Bearing in mind the nature of these requirements, approximately one hundred radionuclides have been considered and re-assessed as to whether their decay data are either adequately quantified, or require further in-depth measurements to improve their existing status and merit full re-evaluations of their decay schemes. The primary aim of such a review is to provide sufficient information on the existing and future requirements for such atomic and nuclear data.

Nuclear data for light charged particle induced production of emerging medical radionuclides

Whatever the radionuclide to be used in nuclear medicine, it is essential to know the expected yield during the production process, but also of all the possible radionuclidic impurities coproduced, that can have an impact on the product final quality, as well as in the related waste management. The availability of the majority of emerging radioisotopes, including the theranostic ones or pairs, is mainly limited by the fact that, for most of them, the optimal production route still needs to be strengthened if not defined in some cases. The aim of this work is to present a review on the charged particle induced nuclear cross sections to produce some emerging radionuclides for medical applications to show that all types of projectiles should be considered in the quest of producing medical radionuclides. An accurate analysis of the production routes is presented for some radionuclides (67Cu, 47Sc, 89Zr, 103Pd, 186gRe, 97Ru, 211At) chosen as examples to highlight (i) how the quality of the final product strongly depends on the chosen target/projectile/energy parameters set, (ii) how deuteron production routes may sometimes be more effective than the proton ones or lead to a different impurity profile and (iii) how α-particle beams may allow to bypass the limitations occurring when using Z = 1 beams. An overview of possible advantages and drawbacks of the cited production routes and of potential cross sections that still need to be measured, is also reported.

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.

The role of chemistry in accelerator-based production and separation of radionuclides as basis for radiolabelled compounds for medical applications

Radiochemical separations used in large scale routine production of diagnostic and therapeutic radionuclides at a particle accelerator for patient care are briefly outlined. The role of chemistry at various stages of development of a production route of a novel radionuclide, namely nuclear data measurement, high-current targetry, chemical processing and quality control of the product, is discussed in detail. Special attention is paid to production of non-standard positron emitters (e.g. 44gSc, 64Cu, 68Ga, etc.) at a cyclotron and novel therapeutic radionuclides (e.g. 67Cu, 225Ac, etc.) at an accelerator. Some typical examples of radiochemical methods involved are presented.

Nuclear reaction data for medical and industrial applications: recent contributions by Egyptian cyclotron group

Measurement and evaluation of nuclear data of radioisotopes used as tracers are continuously underway in many laboratories to reach high accuracy for their use in production. We briefly mention some of the radionuclides useful for medical diagnostics and other industrial applications. The research group at the Egyptian cyclotron facility (EGCF) performed in collaboration with nuclear research centres and universities in many countries (Germany, Hungary, Finland, USA, Japan and Saudi Arabia) some measurements and evaluations of interesting nuclear reaction data. Nuclear reactions induced by p, d and α-particles on a wide variety of targets were extensively studied from threshold energy up to 50 MeV. Nuclear model code calculations, mainly using EMPIRE and TALYS, were performed for nuclear data validation. Proton and neutron activation of some industrially interesting samples were also studied as technological application of nuclear analytical techniques. Since the cyclotron facility is dedicated to development of the production routes of medical radioisotopes, this overview presents examples of optimization experiments to establish good production conditions.

An overview of nuclear data standardisation work for accelerator-based production of medical radionuclides in Pakistan

The standardisation of nuclear reaction cross section data is an integral part of optimisation of production routes of medical radionuclides. The production cross sections are available for the reactor and cyclotron produced radionuclides to be used for diagnostics or therapeutic procedures. The types of nuclear data needed, and the sources of their availability are summarized. The method of standardisation of charged-particle data is briefly described. A historical overview of research work in Pakistan in this direction is given. Examples of a few medically important radionuclides, such as 64Cu, 86Y, 89Zr, 103Pd, 186Re, etc., whose data were standardised and evaluated are highlighted. Calculated thick target yields from the recommended data are given. Some new directions in the nuclear data research are outlined.

Dual-Labelling Strategies for Nuclear and Fluorescence Molecular Imaging: Current Status and Future Perspectives

Molecular imaging offers the possibility to investigate biological and biochemical processes non-invasively and to obtain information on both anatomy and dysfunctions. Based on the data obtained, a fundamental understanding of various disease processes can be derived and treatment strategies can be planned. In this context, methods that combine several modalities in one probe are increasingly being used. Due to the comparably high sensitivity and provided complementary information, the combination of nuclear and optical probes has taken on a special significance. In this review article, dual-labelled systems for bimodal nuclear and optical imaging based on both modular ligands and nanomaterials are discussed. Particular attention is paid to radiometal-labelled molecules for single-photon emission computed tomography (SPECT) and positron emission tomography (PET) and metal complexes combined with fluorescent dyes for optical imaging. The clinical potential of such probes, especially for fluorescence-guided surgery, is assessed.

Synthesis of 68Ga-radiopharmaceuticals using both generator-derived and cyclotron-produced 68Ga as exemplified by [68Ga]Ga-PSMA-11 for prostate cancer PET imaging

[⁶⁸Ga]Ga-PSMA-11, a urea-based peptidomimetic, is a diagnostic radiopharmaceutical for positron emission tomography (PET) imaging that targets the prostate-specific membrane antigen (PSMA). The recent Food and Drug Administration approval of [⁶⁸Ga]Ga-PSMA-11 for PET imaging of patients with prostate cancer, expected follow-up approval of companion radiotherapeutics (e.g., [¹⁷⁷Lu]Lu-PSMA-617, [²²⁵Ac]Ac-PSMA-617) and large prostate cancer patient volumes requiring access are poised to create an unprecedented demand for [⁶⁸Ga]Ga-PSMA-11 in nuclear medicine clinics around the world. Meeting this global demand is going to require a variety of synthesis methods compatible with ⁶⁸Ga eluted from a generator or produced on a cyclotron. To address this urgent need in the PET radiochemistry community, herein we report detailed protocols for the synthesis of [⁶⁸Ga]Ga-PSMA-11, (also known as HBED-CC, Glu-urea-Lys(Ahx)-HBED-CC and PSMA-HBED-CC) using both generator-eluted and cyclotron-produced ⁶⁸Ga and contrast the pros and cons of each method. The radiosyntheses are automated and have been validated for human use at two sites (University of Michigan (UM), United States; Royal Prince Alfred Hospital (RPA), Australia) and used to produce [⁶⁸Ga]Ga-PSMA-11 for patient use in good activity yields (single generator, 0.52 GBq (14 mCi); dual generators, 1.04-1.57 GBq (28-42 mCi); cyclotron method (single target), 1.47-1.89 GBq (40-51 mCi); cyclotron method (dual target), 3.63 GBq (98 mCi)) and high radiochemical purity (99%) (UM, n = 645; RPA, n > 600). Both methods are appropriate for clinical production but, in the long term, the method employing cyclotron-produced ⁶⁸Ga is the most promising for meeting high patient volumes. Quality control testing (visual inspection, pH, radiochemical purity and identity, radionuclidic purity and identity, sterile filter integrity, bacterial endotoxin content, sterility, stability) confirmed doses are suitable for clinical use, and there is no difference in clinical prostate cancer PET imaging using [⁶⁸Ga]Ga-PSMA-11 prepared using the two production methods.

Prospects for the production of radioisotopes and radiobioconjugates for theranostics

The development of diagnostic methods in medicine as well as the progress in the synthesis of biologically active compounds allows the use of selected radioisotopes for the simultaneous diagnosis and treatment of diseases, especially cancerous ones, in patients. This approach is called theranostic. This review article includes chemical and physical characterization of chosen theranostic radioisotopes and their compounds that are or could be useful in nuclear medicine.

Electrochemical deposition of nickel from aqueous electrolytic baths prepared by dissolution of metallic powder

A new method of preparation of aqueous electrolyte baths for electrochemical deposition of nickel targets for medical accelerators is presented. It starts with fast dissolution of metallic Ni powder in a HNO3-free solvent. Such obtained raw solution does not require additional treatment aimed to removal nitrates, such as the acid evaporation and Ni salt precipitation-dissolution. It is used directly for preparation of the nickel plating baths after dilution with water, setting up pH value and after possible addition of H3BO3. The pH of the baths ranges from alkaline to acidic. Deposition of 95% of ca. 50 mg of Ni dissolved in the bath takes ca. 3.5 h for the alkaline electrolyte while for the acidic solution it requires ca. 7 h. The Ni deposits obtained from the acidic bath are physically and chemically more stable and possess smoother and crack-free surfaces as compared to the coatings deposited from the alkaline bath. A method of estimation of concentration of H2O2 in the electrolytic bath is also proposed.

High purity 47Sc production using high-energy photons and natural vanadium targets

Scandium-47 (⁴⁷Sc) is of high value for targeted radiotherapy and theranostics; we report a novel, cost-effective approach to produce high-purity ⁴⁷Sc via photonuclear reactions with natural vanadium. Irradiation at 20 MeV photon end-point energy produces >99.998% pure ⁴⁷Sc, while irradiation at 38 MeV produces 98.8 ± 1.6% pure ⁴⁷Sc. Experimental data suggest producing greater than 100 mCi (3700 MBq) of ⁴⁷Sc using this approach may be feasible. Future research into refinement and scale-up to support pre-clinical research is recommended.

The radio-europium impurities in [153Sm]-EDTMP production: a review of isolation methods

Many human cancers predominantly metastasize to the bone which causes bone pain and other symptoms. However, the management of bone metastases is challenging. Radionuclide therapy using low-energy beta-emitting radionuclides has yielded encouraging results. The aim of this therapy is to deliver the maximum dose to the metastatic sites but a minimal dose to the normal tissue. Samarium-153 [153Sm]Sm-Ethylenediamine tetramethylene phosphonate (EDTMP) is an FDA and European Medicine Agency approved (Quadramet) radionuclide and is widely used for bone pain palliation. 153Sm is reactor produced, and the presence of europium impurities is thus unavoidable. This in turn causes an increase in the hospital radioactive waste burden and in radiation absorbed doses to the patients, and therefore it is a concern. The effective removal of these impurities is thus highly desirable before its administration to the patients. In this article, we present a detailed review of the various methods described in the literature for separation of 153Sm and Eu, that is solvent extraction, ion-exchange chromatography, electrochromatography, electrochemical separation and supported ionic liquid phase.

Production of a broad palette of positron emitting radioisotopes using a low-energy cyclotron: Towards a new success story in cancer imaging?

Over the last several years, positron emission tomography (PET) has matured as an indispensable component of cancer diagnostics. Owing to the large variability observed among the cancer patients and the need to personalize individual patient's diagnosis and treatment, the need for new positron emitting radioisotopes has continued to grow. This mini review opens with a brief introduction to the criteria for radioisotope selection for PET imaging. Subsequently, positron emitting radioisotopes are categorized as: established, emerging and futuristic, based on the stages of their advancement. The production methodologies and the radiochemical separation procedures for obtaining the important radioisotopes in a form suitable for preparation of radiopharmaceuticals for PET imaging are briefly discussed.

Production of scandium radionuclides for theranostic applications: towards standardization of quality requirements

In the frame of "precision medicine", the scandium radionuclides have recently received considerable interest, providing personalised adjustment of radiation characteristics to optimize the efficiency of medical care or therapeutic benefit for particular groups of patients. Radionuclides of scandium, namely scandium-43 and scandium-44 (43/44Sc) as positron emitters and scandium-47 (47Sc), beta-radiation emitter, seem to fit ideally into the concept of theranostic pair. This paper aims to review the work on scandium isotopes production, coordination chemistry, radiolabeling, preclinical studies and the very first clinical studies. Finally, standardized procedures for scandium-based radiopharmaceuticals have been proposed as a basis to pave the way for elaboration of the Ph.Eur. monographs for perspective scandium radionuclides.

Electrochemical deposition of nickel targets from aqueous electrolytes for medical radioisotope production in accelerators: a review

This paper reviews reported methods of the electrochemical deposition of nickel layers which are used as target materials for accelerator production of medical radioisotopes. The review focuses on the electrodeposition carried out from aqueous electrolytes. It describes the main challenges related to the preparation of suitable Ni target layers, such as work with limited amounts of expensive isotopically enriched nickel; electrodeposition of sufficiently thick, smooth and free of cracks layers; and recovery of unreacted Ni isotopes from the irradiated targets and from used electrolytic baths.

Bismuth-213 for Targeted Radionuclide Therapy: From Atom to Bedside

In contrast to external high energy photon or proton therapy, targeted radionuclide therapy (TRNT) is a systemic cancer treatment allowing targeted irradiation of a primary tumor and all its metastases, resulting in less collateral damage to normal tissues. The α-emitting radionuclide bismuth-213 (213Bi) has interesting properties and can be considered as a magic bullet for TRNT. The benefits and drawbacks of targeted alpha therapy with 213Bi are discussed in this review, covering the entire chain from radionuclide production to bedside. First, the radionuclide properties and production of 225Ac and its daughter 213Bi are discussed, followed by the fundamental chemical properties of bismuth. Next, an overview of available acyclic and macrocyclic bifunctional chelators for bismuth and general considerations for designing a 213Bi-radiopharmaceutical are provided. Finally, we provide an overview of preclinical and clinical studies involving 213Bi-radiopharmaceuticals, as well as the future perspectives of this promising cancer treatment option.

Evaluation of production cross-sections for theranostic 67Cu radionuclide via proton-induced nuclear reaction on 68Zn target

Copper-67 (T_1/2 = 61.83 h, E_β-^mean=141 keV, I_β-^total=100%; E_γ = 184.577 keV, I_γ = 48.7%) is a promising radionuclide for theranostic applications especially in radio immunotherapy. However, one of the main drawbacks for its application is related to its limited availability. Various nuclear reaction routes investigated in the last years can result in ⁶⁷Cu production, although the use of proton beams is the method of choice taken into account in this work. The goal of this work is a revision of the cross-sections aimed at ⁶⁷Cu yield, which were evaluated for the ⁶⁸Zn(p,2p)⁶⁷Cu reaction route up to 80 MeV proton energy. A well-defined statistical procedure, i.e., the Simultaneous Evaluation on KALMAN (SOK), combined with the least-squares concept, was used to obtain the evaluated data together with the covariance matrix. The obtained evaluated data were also compared to predictions provided by the nuclear reaction model codes TALYS and EMPIRE, and a partial agreement among them has been found. These data may be useful for both existing and potential applications in nuclear medicine, to achieve an improvement and validation of the various nuclear reaction models, and may also find applications in other fields (e.g., activation analysis and thin layer activation).

Efficient trace-scale extraction method of reactor produced 199Au adequate for nuclear medicine applications

Production of no carrier-added (NCA) 199Au through natPt(n, γ) reaction and subsequent purification using liquid-liquid extraction from other radioisotopes is studied in the context of theranostic application. Comparative separation of NCA 199Au after dissolution of activated Pt target using three Cyanex compounds (Cyanex-272, Cyanex-302 and Cyanex-923) is evaluated. The extraction process is optimized in terms of the type of extractant, the concentration of extractant, extraction time and aqueous media (HNO3, NH4OH). Among these extractants, the Cynaex-923 is efficient and promising for rapid separation and production of NCA 199Au from HNO3 by high extraction %. Selective extraction of 199Au from other Pt and Ir radioisotopes is observed. High recovery of 199Au was obtained in the case of Cyanex-923 using 0.05 M thiourea dissolved in HCl or 2 M NaOH. Our results find the Cyanex-923 as a promising extractant for efficient separation of 199Au from irradiated Pt target with high yield (99%).

Radiolabeled Peptides and Antibodies in Medicine

Radiolabeled peptides are a relatively new, very specific radiotracer group, which is still expanding. This group is very diverse in terms of peptide size. It contains very small structures containing several amino acids and whole antibodies. Moreover, radiolabeled peptides are diverse in terms of the binding aim and therapeutic or diagnostic applications. The majority of this class of radiotracers is utilized in oncology, where the same structure can be used in therapy and diagnostic imaging by varying the radionuclide. In this study, we collected new reports of radiolabeled peptide applications in diagnosis and therapy in oncology and other fields of medicine. Radiolabeled peptides are also increasingly being used in rheumatology, cardiac imaging, or neurology. The studies collected in this review concern new therapeutic and diagnostic procedures in humans and new structures tested on animals. We also performed an analysis of clinical trials, which concerns application of radiolabeled peptides and antibodies that were reported in the clinicaltrials.gov database between 2008 and 2018.

Cyclotron production of no carrier added 186gRe radionuclide for theranostic applications

^186gRe (T_1/2 = 3.7183 d, E_(β^-_)mean = 346.7 keV, I_(β^-_)mean = 92.59%), a mixed beta and γ-emitter shows great potential for use in theranostic applications. The dominant ¹⁸⁵Re(n,γ) route, via use of a nuclear reactor, provides ^186gRe in carrier added form with low specific activity, while cyclotrons offer no carrier-added (NCA) high specific activity production of ^186gRe. However, to be able to select the best possible nuclear reaction and to optimize the production route via the use of a cyclotron, information on the excitation function for the reaction of interest as well as for the competing reactions is necessary. Accordingly, we have conducted a detailed study of the excitation functions for ^natW(d, x) reactions in seeking optimized parameters for the NCA production of ^186gRe. Noting a discrepancy among the experimental data, we made an evaluation of the available literature, finally selecting optimum parameters for the production of ^186gRe via the ¹⁸⁶W(d,2n)¹⁸⁶Re reaction. These beam parameters were then used for batch production of ^186gRe by irradiating an enriched ¹⁸⁶W metallic powder target, followed by a subsequent automated chemical separation process. The preliminary results show 98.1% radionuclidic purity of ^186gRe at 8 h subsequent to the End of Bombardment (EOB), offering the potential for use in clinical applications.

Expanding PET-applications in life sciences with positron-emitters beyond fluorine-18

Positron-emission-tomography (PET) has become an indispensable diagnostic tool in modern nuclear medicine. Its outstanding molecular imaging features allow repetitive studies on one individual and with high sensitivity, though no interference. Rather few positron-emitters with near favourable physical properties, i.e. carbon-11 and fluorine-18, furnished most studies in the beginning, preferably if covalently bound as isotopic label of small molecules. With the advancement of PET-devices the scope of in vivo research in life sciences and especially that of medical applications expanded, and other than "standard" PET-nuclides received increasing significance, like the radiometals copper-64 and gallium-68. Especially during the last decades, positron-emitters of other chemical elements have gotten into the focus of interest, concomitant with the technical advancements in imaging and radionuclide production. With known nuclear imaging properties and main production methods of emerging positron-emitters their usefulness for medical application is promising and even proven for several ones already. Unfortunate decay properties could be corrected for, and β⁺-emitters, especially with a longer half-life, provided new possibilities for application where slower processes are of importance. Further on, (bio)chemical features of positron-emitters of other elements, among there many metals, not only expanded the field of classical clinical investigations, but also opened up new fields of application. Appropriately labelled peptides, proteins and nanoparticles lend itself as newer probes for PET-imaging, e.g. in theragnostic or PET/MR hybrid imaging. Furthermore, the potential of non-destructive in-vivo imaging with positron-emission-tomography directs the view on further areas of life sciences. Thus, exploiting the excellent methodology for basic research on molecular biochemical functions and processes is increasingly encouraged as well in areas outside of health, such as plant and environmental sciences.

Accurate determination of production data of the non-standard positron emitter 86Y via the 86Sr(p,n)-reaction

In view of several significant discrepancies in the excitation function of the 86Sr(p,n)86g+xmY reaction which is the method of choice for the production of the non-standard positron emitter 86Y for theranostic application, we carried out a careful measurement of the cross sections of this reaction from its threshold up to 16.2 MeV at Forschungszentrum Jülich (FZJ) and from 14.3 to 24.5 MeV at LBNL. Thin samples of 96.4% enriched 86SrCO3 were prepared by sedimentation and, after irradiation with protons in a stacked-form, the induced radioactivity was measured by high-resolution γ-ray spectrometry. The projectile flux was determined by using the monitor reactions natCu(p,xn)62,63,65Zn and natTi(p,x)48V, and the calculated proton energy for each sample was verified by considering the ratios of two reaction products of different thresholds. The experimental cross section data obtained agreed well with the results of a nuclear model calculation based on the code TALYS. From the cross section data, the integral yield of 86Y was calculated. Over the optimum production energy range Ep = 14 → 7 MeV the yield of 86Y amounts to 291 MBq/μA for 1 h irradiation time. This value is appreciably lower than the previous literature values calculated from measured and evaluated excitation functions. It is, however, more compatible with the experimental yields of 86Y obtained in clinical scale production runs. The levels of the isotopic impurities 87mY, 87gY, and 88Y were also estimated and found to be <2% in sum.

Production of radiometals in liquid targets

Over the last several years, the use of radiometals has gained increasing relevance in supporting the continuous development of new, complementary and more specific biological targeting agents. Radiopharmaceuticals labelled with radiometals from elements such as Tc, Zr, Y, Ga and Cu received increasing attention as they find application in both diagnostic SPECT and PET imaging techniques and radiotherapeutic purposes. Such interest stems from the wide variety of radionuclides available with distinct and complementary nuclear decay characteristics to choose from with unequalled specificity, but can also be explained by growing demand in targeted radionuclide therapy. As a result, as routine supply of these radiometals becomes mandatory, studies describing their production processes have expanded rapidly. Although most radiometals are traditionally provided by the irradiation of solid targets in specialized cyclotrons, recently developed techniques for producing radiometals through the irradiation of liquid targets have received growing attention due to compatibility with commonly available small medical cyclotrons, promising characteristics and encouraging results. Irradiating liquid targets to produce radiometals appears as a fast, reliable, convenient and cost-efficient alternative to the conventional solid target techniques, characterized by complex and time-consuming pre- and post-irradiation target handling. Production of radiometals in liquid targets incorporated to complete manufacturing processes for daily routine is already recognized as a viable alternative and complementary supply methodology to existing solid target based infrastructures to satisfy growing clinical demands. For instance, several sites already use the approach to produce ⁶⁸Ga-radiopharmaceuticals for clinical use. This review article covers the production of common radiometals with clinical potential through the irradiation liquid targets. A comparison with the traditional solid target irradiation methods is presented when relevant.