Preparation of Rhenium-188-Lipiodol Using Freeze-Dried Kits for Transarterial Radioembolization: An Overview and Experience in a Hospital Radiopharmacy

Radhakrishnan, Edathurutykalarickal Ramakurup; Chirayil, Viju; Pandiyan, Arun; Subramanian, Suresh; Mallia, Madhava B.; Kamaleshwaran, Koramadai Karuppusamy; Shinto, Ajit

doi:10.1089/cbr.2021.0043

Cited by 3 publications

(4 citation statements)

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“…Also, the modified DEDC kits had advantage of less preparation time and any volume of perrhenate activity that can be added to the kit vial. 22 This study also showed comparable results with improved DEDC kits having mean % RCY and % RCP of 86.04 ± 2.35% and 90.83 ± 3.24%, respectively.…”

Section: Discussionsupporting

confidence: 71%

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188Re-N-DEDC Lipiodol for Treatment of Hepatocellular Carcinoma (HCC)—A Clinical and Prospective Study to Assess In-Vivo Distribution in Patients and Clinical Feasibility of Therapy

et al. 2023

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Objective The incidence of inoperable hepatocellular carcinoma (HCC) with/without malignant portal vein thrombosis (PVT) is increasing in India for the last decade; thus, Bhabha Atomic Research Centre (BARC), Mumbai, India, developed diethydithiocarbamate (DEDC), a new transarterial radionuclide therapy (TART) agent. 188Re-N-DEDC lipiodol is an emerging radiotherapeutic agent for inoperable HCC treatment due to its simple and onsite labeling procedure, cost-effectiveness, and least radiation-induced side effects. This study aimed to evaluate in-vivo biodistribution and clinical feasibility of 188Re-N-DEDC lipiodol TART in HCC and optimization of labeling procedure to assess post-labeling stability and radiochemical yield of labeled lipiodol with 188Re-N-DEDC complex. Materials and Methods DEDC kits were obtained as gift from BARC, Mumbai. Therapy was given to 31 HCC patients. Post-therapy planar and single-photon emission computed tomography/computed tomography (SPECT/CT) imaging were performed to see tumor uptake and biodistribution. Clinical feasibility and toxicity were decided by Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v 5.0). Statistical Analysis Descriptive statistics was done for data using SPSS v22. Values was expressed as mean ± standard deviation or median with range. Results Post-therapy planar and SPECT/CT imaging showed radiotracer localization in hepatic lesions. Few patients showed lungs uptake due to hepato-pulmonary shunt (lung shunt < 10%). Maximum clearance was observed through urinary tract with very less elimination through hepatobiliary route due to slow rate of leaching of tracer. No patient showed myelosuppression or any other long-term toxicity over median follow-up of 6 months. Mean overall % radiochemical yield of 188Re-N-DEDC lipiodol was 86.04 ± 2.35%. The complex 188Re-N-DEDC was found to be stable at 37°C under sterile condition over a period of 1 hour without any significant change on the % radiochemical purity (90.83 ± 3.24%, 89.78 ± 3.67%, 89.22 ± 3.77% at 0, 0.5, 1 hours, respectively). Conclusion Human biodistribution showed very high retention of radiotracer in hepatic lesions with no long-term toxicity with this therapy. The kit preparation procedure is ideally suited for a busy hospital radio-pharmacy. By this procedure, 188Re-N-DEDC lipiodol can be prepared in high radiochemical yield within a short time (∼45 minutes). Thus, 188Re-N-DEDC lipiodol can be considered for TART in advanced and/or intermediate HCC.

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Section: Discussionsupporting

confidence: 71%

“…The stability of complex was decided by %RCP at room temperature that was 89.78 AE 3.67, 89. 22 24 hours incubation of 188 Re-N-DEDC complex (8 samples) at room temperature. Mean %RCY in lipiodol phase with 188 Re-N-DEDC complex after 24 hours was 70.57 AE 3.69%.…”

Section: Radiochemistry and Standard Labeling Proceduresmentioning

confidence: 99%

188Re-N-DEDC Lipiodol for Treatment of Hepatocellular Carcinoma (HCC)—A Clinical and Prospective Study to Assess In-Vivo Distribution in Patients and Clinical Feasibility of Therapy

et al. 2023

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“…In the past decade, the development of 188 Re in nuclear medicine has been slow, with few innovative studies being reported [ 68 , 69 , 70 ]. However, the research on radioactive rhenium has not stopped.…”

Section: Study On Re In Cancer Therapymentioning

confidence: 99%

Recent Development of Rhenium-Based Materials in the Application of Diagnosis and Tumor Therapy

Wang

et al. 2023

Molecules

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Rhenium (Re) is widely used in the diagnosis and treatment of cancer due to its unique physical and chemical properties. Re has more valence electrons in its outer shell, allowing it to exist in a variety of oxidation states and to form different geometric configurations with many different ligands. The luminescence properties, lipophilicity, and cytotoxicity of complexes can be adjusted by changing the ligand of Re. This article mainly reviews the development of radionuclide 188Re in radiotherapy and some innovative applications of Re as well as the different therapeutic approaches and imaging techniques used in cancer therapy. In addition, the current application and future challenges and opportunities of Re are also discussed.

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“…The expansion of the coordination sphere around the Re(VII) ion impacts on the entropic factor of the free energy of the oxygen transfer reaction and leads to a sharp increase in the value of the standard reduction potential [ 17 ]. Recently, this reaction was greatly improved by replacing sodium oxalate and acetic acid with simple oxalic acid, thereby significantly reducing the number of steps in the radiopharmaceutical synthesis and the potential radiation exposure of the operator [ 23 , 24 ].…”

Section: The Expansion Of the Coordination Spherementioning

confidence: 99%

Fundamentals of Rhenium-188 Radiopharmaceutical Chemistry

2023

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The β− emitter, rhenium-188 (188Re), has long been recognized as an attractive candidate for targeted cancer radionuclide therapy (TRNT). This transition metal shares chemical similarities with its congener element technetium, whose nuclear isomer technetium-99m (99mTc) is the current workhorse of diagnostic nuclear medicine. The differences between these two elements have a significant impact on the radiolabelling methods and should always receive critical attention. This review aims to highlight what needs to be considered to design a successful radiopharmaceutical incorporating 118Re. Some of the most effective strategies for preparing therapeutic radiopharmaceuticals with 188Re are illustrated and rationalized using the concept of the inorganic functional group (core) and a simple ligand field theoretical model combined with a qualitative definition of frontiers orbitals. Of special interest are the Re(V) oxo and Re(V) nitrido functional groups. Suitable ligands for binding to these cores are discussed, successful clinical applications are summarized, and a prediction of viable future applications is presented. Rhenium-188 decays through the emission of a high energy beta particle (2.12 MeV max energy) and a half-life of 16.9 h. An ideal biological target would therefore be a high-capacity target site (transporters, potential gradients, tumour microenvironment) with less emphasis on saturable targets such as overexpressed receptors on smaller metastases.

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Preparation of Rhenium-188-Lipiodol Using Freeze-Dried Kits for Transarterial Radioembolization: An Overview and Experience in a Hospital Radiopharmacy

Cited by 3 publications

References 24 publications

188Re-N-DEDC Lipiodol for Treatment of Hepatocellular Carcinoma (HCC)—A Clinical and Prospective Study to Assess In-Vivo Distribution in Patients and Clinical Feasibility of Therapy

188Re-N-DEDC Lipiodol for Treatment of Hepatocellular Carcinoma (HCC)—A Clinical and Prospective Study to Assess In-Vivo Distribution in Patients and Clinical Feasibility of Therapy

Recent Development of Rhenium-Based Materials in the Application of Diagnosis and Tumor Therapy

Fundamentals of Rhenium-188 Radiopharmaceutical Chemistry

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