• Nuclear Medicine and Molecular Imaging
• /
• 제40권2호
• /
• pp.82-89
• /
• 2006

Bone metastasis is a common sequelae of solid malignant tumors such as prostate, breast, lung, and renal cancers, which can lead to various complications, including fractures, hypercalcemia, and bone pain, as well as reduced performance status and quality of life it occurs as a result of a complex pathophysiologic process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. Several sequelae occur as a result of osseous metastases and resulting bone pain can lead to significant debilitation. A multidisciplinary approach is usually required not only to address the etiology of the pain and its complicating factors but also to treat the patient appropriately. Pharmaceutical therapy of bone pain, includes non-steroidal analgesics, opiates, steroids, hormones, bisphosphonates, and chemotherapy. While external beam radiation therapy remains the mainstay of pain palliation of a solitary lesions, bone seeking radiopharmaceuticals have entered the therapeutic armamentarium for the treatment of multiple painful osseous lesions. $^{32}P,\;^{89}SrCl,\;^{153}Sm-EDTMP,\;^{188}Re/^{186}Re-HEDP,\;and\;^{177}Lu-EDTMP$ can be used to treat painful osseous metastases. These various radiopharmaceuticals have shown good efficacy in relieving bone pain secondary to bone metastasis. This systemic form of metabolic radiotherapy is simple to administer and complements other treatment options. This has been associated with improved mobility in many patients, reduced dependence on narcotic and non-narcotic analgesics, improved performance status and quality of life, and, in some studios, improved survival. All of these agents, although comprising different physical and chemical characteristics, offer certain advantages in that they are simple to administer, are well tolerated by the patient if used appropriately, and can be used alone or in combination with the other forms of treatment. This article illustrates the salient features of these radiopharmaceuticals, including the usual therapuetic dose, method of administration, and indications for use and also describe about the pre-management checklists, and jndication/contraindication and follow-up protocol.

• Nuclear Engineering and Technology
• /
• 제55권2호
• /
• pp.669-673
• /
• 2023

Introduction: The crucial step in preclinical process of radiopharmaceutical production is internal dosimetry evaluation by different ways to realize radiobiological dose-response relationships and to extract the results for clinical use. Till now several bone-seeking radiopharmaceuticals have been developed for bone metastasis. Interesting features of bisphosphonates attracted attentions to them in the field of radiopharmaceutical therapy and studies on new generation of them have been doing too. Materials and methods: In this study, we used ZNA as representative of the third generation. The radiopharmaceutical ¹⁸⁸Re-ZNA was produced and its radiochemical purity was investigated. Then, the biological distribution of the produced radiopharmaceutical at 1, 2, 4 and 24 h after injection on different organs of mice were investigated. Finally, the absorbed dose of organs in the human body was assessed using the RADAR method. Results: The results show 96% radiochemical purity of the ¹⁸⁸Re-ZNA radiopharmaceutical. The amount of %ID/g in bone is 1.131% after 1 h and in 24 h it has a significant amount compared to other organs, that is 0.516%. Also dosimetric results show that the highest absorption dose is related to bone and the amount of this dose is 0.050 mGy/MBq. Conclusion: Considering the possibility of producing the ¹⁸⁸Re-ZNA radiopharmaceutical, as well as the proper distribution of this radiopharmaceutical in target and non-target organs and increasing the absorbed dose in bone, it can be concluded that this radiopharmaceutical can be useful in the "radiopharmaceutical therapy" in metastases.

• Nuclear Medicine and Molecular Imaging
• /
• 제43권4호
• /
• pp.253-258
• /
• 2009

Bone scintigraphy using $^{99m}$Tc-labeled phosphate agents has long been the standard evaluation method for whole skeletal system. However, recent shortage of $^{99m}$Tc supply and advanced positron emission tomography (PET) technology evoked the attention to surrogate radiopharmaceuticals and imaging modalities for bone. Actually, fluorine-18 ($^{18}$F) was the first bone seeking radiotracer before the introduction of $^{99m}$Tc-labeled agents even though its clinical application failed to become pervasive anymore after the rapid spread of Anger type gamma camera systems in early 1970s. However, rapidly developed PET technology made us refocus on the usefulness of $^{18}$F as a PET tracer. Early study comparing $^{18}$F-Na PET scan and planar bone scintigraphy reported that PET has higher sensitivity and specificity in the diagnosis of metastatic bone lesions than planar bone scan. Subsequent reports comparing between PET and both planar and SPECT bone image also revealed better results of PET scan in similar study groups. Rapid clinical application of PET/CT also accumulated considerable amount of experiences in skeletal evaluation and this modality is known to have better diagnostic power than stand alone PET system as well as bone scan. Furthermore $^{18}$F-Na PET/CT revealed better or at least equal results in detection of primary and metastatic bone lesions compared with CT and MRI. Therefore, it is obvious that $^{18}$F-Na PET/CT has potential to become new imaging modality for practical skeletal evaluation so continuous and careful evaluation of this modality and radiopharmaceutical must be required.

• 대한핵의학회지
• /
• 제39권1호
• /
• pp.44-48
• /
• 2005

목적: Ethylenediamine-tetramethylenephosphonic acid (EDTMP)는 방사성 금속과 안정된 착화물을 형성하여 골친화성 방사성의약품으로 사용되고 있다. $^{153}Sm$은 원자력연구소의 하나로에서 생산가능하며, 물리적 반감기가 46.7시간이고 베타 최대에너지=0.81 MeV (20%), 0.71 MeV(49%), 0.64 MeV (30%)와 감마방출=103 KeV (30%)하여 치료와 영상이 동시에 가능한 방사성동위원소이다. $^{153}Sm$-EDTMP의 표지 조건과 정상 래트에서의 영상을 확인하고자 하였다. 방법: EDTMP 20 mg을 2 M NaOH 0.1 mL로 녹이고 $^{153}SmCl_3$를 넣어 pH 8 과 pH 12에서의 표지 수율과 안정성을 관찰하였다. 방사화학적 순도는 ITLC와 paper chromatography법으로 확인하였다. 반응 후, pH 7.4로 중화하고 실온 방치하며 안정성을 관찰하였다. 정상 래트에 $^{153}Sm$-EDTMP 37 MBq을 주사하여 평면영상을 얻었다. 결과: 표지 수율은 실온 반응 1시간에 99%를 나타내었다. pH 중화 후 안정성은 pH 8 반응물이 60시간 99%, 96시간 95%, 120시간 89%이였고 pH 12 반응물은 36시간 99%, 60시간 95%, 96시간 88%, 120시간 66%를 나타내었다. 정상래트에서의 평면영상은 주사 후 2시간, 24시간, 48시간에서 동일하게 뼈에 흡수 된 것을 관찰하였다. 결론: $^{153}Sm$-EDTMP는 pH 8에서 표지된 것이 pH 12 조건보다 안정하게 유지되었으며, 2시간, 24시간, 48시간 평면영상에서 골섭취되는 것을 관찰하여 생체 내에서 안정하게 유지됨을 확인할 수 있었다.