Diagnostic and therapeutic applications of nuclear radiations Dr. Istvan Vos Radiopharmaceuticals Chemica agents or drugs having radioactivity. Preparations labeled with radioisotopes for dlagnostc ar terapeutic purposes. During their production the quality and purty requrements of medicines must be flied. Inthe pharmacopoeia one can find raciopharmaceutia'sin two roupe [AIC VO9 Radiopharmaceutals used in agnostics AATCVi0 Radhopharmaceutals used in therapy al, pharmaceutical applications of radioisotopes Sass of application: radilsotopes have Identical behavior nthe ctganism to corresponding stable atoms. Organ specie compounds canbe labeled with radloisotopes, (cadiopharmaceutca's) (George Hevesy 1923 frst biological tracing experiment Nobel pie enemistry 1983.) ls of application: diagnosis in vo, invite) therapy research {diagnosis + therapy = 100% from this 95 isthe diagnosis, In vivo diagnostics (the radioisotope is introduced into the patient’s body) Viewpoints for selection of isotopes f ‘gamma radiating (the longest effective range) + short hal-ife(but nt shorter, than the examined process) A=N/T >for the necessary activity lower amount is enough - photon energy should not be to low, and should nat be too high (higher energy ness asoration nthe issues, but the detection efficiency slower Pe sidesAt leastin 75% of the in vivo diagnostic apoliations "Tes used to label ifrent organ spectc compounds (eg. pyrophosphate — bones, colds liver and RE, albumin ceuation) Further gamme-radiating isotopes that are frequently used: 1, 4 (thoi gland and kdhey), Ga (inlammations an tumors}, 21 heart muscle}, Kr, 2 %e, Ke examination of ungs by Inbalaton) ‘The most frequent used poston rating sotopes for PET examination): Fc, 2M, $0 They have shor half. they are produced in cyclotron. ‘The most requentiy used pesteanradatngradopharmacon: Miso deoxy glucose (FOG) ~ bran aetvation @ The distribution of isotopes can be detected by diagnostic equipments based on scintillation. Gamma camera + Scintilation counter (see practice!) + Gamma camera (Anger camera) + SPECT (single photon emission computed tomography + PET (positron emission tomography)‘State examination fcntgram) ‘the distbution of otope inthe space can be examined Dynamic examination the change of activity in ‘the function of ima ina certain region can be examines OI~ region of interest)‘The sotope accumulation curve canbe obtained fom the measurement of actity in iflerent moments conan tne ee SPECTimages Silay to CAT scan cross sectional images are produced about the layers above each other From these sectional image of ny iecton or tnee dimensional image canbe reconstructes, SPECT (the detector of gamma cameras rotated around the body axis» three dimensional mage) PET examination positron radiating isotope - positron electron meeting -> annihilation > 2 gamma photons (S11 keV) these are detected coincidence: the gamma photons arrive ito the two detectors inthe same tie (ithina few ns, ————— >aion detectors. Combined equipments (for bath diagnostic and research purposes} a i pul mage fusion Combination of unctonal and morphological informat funcional: SPECT and PET ‘morphologial: CT and MR Invitro isotope diagnostics The patint does not get radisotope, butsome body fud'statenandlabeled with i) Usually the concentration of a component (eg hormone in body Mid 1004, rie) seme is determined In the selection of sotopes the measurement technologlcal Viewpoints ate important Negative beta, or soft gamma radiating isotopes ae used eH, 1, Halse can be also longer Working ith these preprations pn plates ae usd for radiation protectionRadioimmunoassay (RA) known amount of antibody and radioactive antigen + col” antigen in ferent amounts > calibration curve is made from ‘ere the unknown concentration can be rad (ey sentive mato Concentaten ol hormones nd dus inte aed Seumeantedtemined) ‘Therapy with radiation sources outside the body ‘Gamma radiating lotopes ae used (high senetation depth) Mali forking of tumors (2%, 0) Radiation sources of very high activity ate apples, because hgh dose Is necessary to kl he tumor cel Isotopes of long halite are useful to keep the activity fora long time, ‘he necessary amount of radiations ven Insmaller pants rom many aretion In order ‘avoid the injury ofthe surtounding healthy tissues. The exact lstributionn space and time |s planned by computer. Isotope therapy ‘The cling elect of ionizing radiation i used fr the treatment ‘of eg yerthyreoss (or tumors (=, 5m, Re boune to ‘mnoclonal antibody) Alpha, or beta-raditing lsotopes are gven to have local fect ‘The same objec beled wth aifferent Sotopes can be used for agnostic and therapeutic purposes (theranostes) ‘Gamma-knfe Used forthe treatment of intracranial tumors. Many (approx. 200) ce isotopes are putin ferent rections around the sll. Their radiations focused to 2 small volume,Radiation protectional viewpoints during work wth onizing radiation 4. Jostifieation =the application a ionizing radiation must be useful the risk of application shouldbe ower than the sk of not applying the radiation ~ tis must be considered frm te viewpoint ofthe patent 2. optiizaton~ the dose caused by the application should be ‘hs Low As Reasonasly Achievable (ALARA. principle). Tis must be considered both from the viewpoint of the patient and the personnel 3. Dose limits~the probable doses should not exced the individual ose limits that are safe. Tis must be considered from the viewpoint ofthe personnel Possibilities to decrease the exposure from radiation source outside the body + Increase the distance + Decrease the exposition time + Application of shielding * ‘The risk depends on the type of radiation Ifthe source is outside the body, gamma: or Xradiations the most dangerous [because of igh fective range) ifthe fotope is incorporate (by inhalation or by swallowing), alpha- Radiating isotopes are the most dangerous (Althe radiation f absorbed inthe body tissues)