MASTER nlky introductionRecently, there has been a resurgence of interest in nuclear medicine therapeutic procedures (1-4). Using unsealed sources for therapy is not a new concept; it has been around since the beginnings of nuclear medicine. Treatment of thyroid disorders with radioiodine is a classic example. The availability of radionuclides with suitable therapeutic properties for specific applications, as well as methods for their selective targeting to diseased tissue have, however, remained the main obstacles for therapy t o assume a more widespread role in nuclear medicine (4,5). Nonetheless, a number of new techniques that have recently emerged, (e.g., tumor therapy with radiolabeled monoclonal antibodies, treatment of metastatic bone pain, etc.) appear t o have provided a substantial impetus t o research on production of new therapeutic radionuclides (4-7). Table 1 lists the various categories of therapeutic procedures involving the use of internally administered radionuclides. Although there are a number of new therapeutic approaches requiring specific radionuclides, only selected broad areas will be used as examples in this article.
Selection CriteriaThe selection criteria for therapeutic radionuclides have t o include the physical and chemical characteristics of the radionuclide, feasibility of large-scale production, and the biological factors governing its in-vivo distribution (4,7).
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DISCLAIMERPortions of this document may be illegible in electronic image products. Images are produced from the best available original document . * Physical properties that are important to consider include half-life, and the type, energy, branching ratio and abundances of particulate and gamma-ray emissions.Ideally, the physical half-life should be matched with the in-vivo pharmacokinetics of the radiolabeled compound. If the half-life is too short, most decay will have occurred before the compound has reached maximum target/background ratio.Conversely, too long a lifetime would cause unnecessary radiation dose t o normal tissues following the processing of the labeled compound. The nature of the particulate emission is also important to maximize therapeutic effectiveness. The potent lethality of high-LET (linear energy transfer) Auger and low-energy conversion electrons is well documented (8). This effect, however, can best be achieved with intranuclear localization of the labeled compound. Beta particles on the other hand are less densely ionizing and thus have a longer range but much lower LET. Their distribution requirements are, therefore, less restrictive for effective radiotherapy. The gamma-ray energies and abundances are also important since the presence of gamma rays allows low dose biodistribution studies by external imaging for determining biodistribution and dosimetry. Biodistribution data combined with the physical properties of the radionuclide, and with assumptions about tumor size, etc., can be used to calculate radiation atsorbed dose at the cellular level (7,9-1 1).The important chemical criteria...