Medical Radioisotopes

One of the most important and compelling utilization of radioisotopes is for medical procedures, both for diagnostics and treatment. While the NIDC is not directly involved in this work, many of the radioisotopes that we manage are primarily used in these critical applications.

The presentations below give overall background information on medical uses as well as some more specific information on Tc-99m and on isotopes for Positron Emission Tomography (PET) procedures.

Technetium-99m is used in roughly 30 million medical imaging procedures a year -- roughly one per second -- making it the most extensively used radioisotope for medical diagnostics. It can be used for imaging a variety of ailments such as impeded blood flow to the heart and the spread of cancer to bones. Because of the demand and because the half-life is only 6 hours, fresh batches of the parent isotope Molybdenum-99 must be continually produced to satisfy worldwide demand.

Tc-99m for Medical Uses [Suzanne Lapi, Washington Univ., 2010]

PET Medical Isotopes [Suzanne Lapi, Washington Univ., 2010]

Medical Isotope Production and Use [Darrell Fisher, Washington State Univ., 2009]

Medical Isotopes Production and Availability [Nuclear Energy Institute, 2009 - 2010]

Reports

Our Reports page lists numerous reports on the topic of Medical Isotopes, including:

Improvements in Charged-Particle Monitor Reactions and Nuclear Data for Medical Isotope Production [International Nuclear Data Committee, October 2011]

Nuclear Data for the Production of Therapeutic Radionicludes (draft) [International Atomic Energy Agency, 2010]

Timothy J. R. Harris, Joseph D. Kalen, Jennifer Hall, Report of Meeting Held to Discuss Existing and Future Radionuclide Requirements for the National Cancer Institute [April 2008]

Making Medical Isotopes [TRIUMF, 2008]

Advancing Nuclear Medicine Through Innovation [National Academies, 2007]

New Frontiers of Science: DOE Fueling the Future of Nuclear Medicine, DOE, Office of Biological and Environmental Research [September 2007]

Radiopharmaceutical Development and the Office of Science, Prepared by a Subcommittee of the Biological and Environmental Research Advisory Committee [April 2004]

Expert Panel: Forecast Future Demand for Medical Isotopes [March 1999]

Nuclear Data


Our Learn More page lists some valuable resources for nuclear information on medical radioisotopes, including:

Medical Applications at the Nuclear Data Section - Nuclear Data Section, International Atomic Energy Agency

Charged-particle cross section database for medical radioisotope production - Nuclear Data Section, International Atomic Energy Agency

Cross section database for medical radioisotope production: Production of Therapeutic Radionuclides - Nuclear Data Section, International Atomic Energy Agency

Cross Sections for Emerging Isotopes - Nuclear Data Section, International Atomic Energy Agency

Recommended Charged-Particle Beam Monitor Cross Sections - Nuclear Data Section, International Atomic Energy Agency

External Sites


There are a number of external sites with information on medical isotpes, including:

Radioisotopes in Medicine

American College of Radiology

American Nuclear Society

American Chemical Society - Division of Nuclear Chemistry and Technology

Food and Drug Administration - Radiation Emitting Products

International Isotopes Society

National Cancer Institute

Nuclear Regulatory Commission (NRC) - Advisory Committee on the Medical Uses of Isotopes

Radiochemical Society

Radiological Society of North America

Society of Nuclear Medicine [SNM]

List of Nuclear Medicine Radioisotopes


Below we give a summary of the most prevalent nuclear medicine radioisotopes and their specific applications. Please see the bottom for references and acronyms.

Ac-225 10.0d Monoclonal antibody attachment used for cancer treatment (RIT), also parent of Bi-213.
Ac-227 21.8y Parent of Ra-223 (Monoclonal antibody attachment used for cancer treatment (RIT).
Am-241 432y Osteoporosis detection, heart imaging.
As-72 26.0h Planar imaging, SPECT or PET.
As-74 17.8d Positron-emitting isotope with biomedical applications.
At-211 7.21h Monoclonal antibody attachment (alpha emitter) used for cancer treatment (RIT), used with F-18 for in vivo studies.
Au-198 2.69d Cancer treatment using mini-gun (B), treating ovarian, prostate, and brain cancer.
B-11 Stable Melanoma and brain tumor treatment.
Be-7 53.2d Used in berylliosis studies.
Bi-212 1.10h Monoclonal antibody attachment (alpha emitter) used for cancer treatment (RIT), cellular dosimetry studies.
Bi-213 45.6m Monoclonal antibody attachment (alpha emitter) used for cancer treatment (RIT).
Br-75 98m Planar imaging, SPECT or PET (C).
Br-77 57h Label radiosentizers for Te quantization of hypoxia in tumors, and monoclonal antibody labeling.
C-11 20.3m Radiotracer in PET scans to study normal/abnormal brain functions.
C-14 5730y Radiolabeling for detection of tumors (breast, et al.).
Ca-48 Stable
Cd-109 462d Cancer detection (C), pediatric imaging (C).
Ce-139 138d Calibrates high-purity germanium gamma detectors.
Ce-141 32.5d Gastrointestinal tract diagnosis, measuring regional myocardial blood flow.
Cf-252 2.64y Cervical, melanoma, brain cancer treatment.
Co-55 17.5h Planar imaging, SPECT or PET (B). Used in PET imaging of damaged brain tissue after stroke.
Co-57 272d Gamma camera calibration, should be given high priority, radiotracer in research and a source for X-ray fluorescence spectroscopy.
Co-60 5.27y Teletherapy (destroy cancer cells), disinfect surgical equipment and medicines, external radiation cancer therapy (E).
Cr-51 27.7d Medical, cell labeling and dosimetry.
Cs-130 29.2m Myocardial localizing agent.
Cs-131 9.69d Intracavity implants for radiotherapy.
Cs-137 30.2y Blood irradiators, PET imaging, tumor treatment.
Cu-61 3.35h Planar imaging, SPECT or PET (B).
Cu-62 4.7m Positron emitting radionuclide (B), cerebral and myocardial blood flow used As-a tracer in conjunction with Cu 64 (B).
Cu-64 12.7h PET scanning (C), planar imaging (C), SPECT imaging (C) dosimetry studies (C), cerebral and myocardial blood flow (C), used with Cu-62 (C), treating of colorectal cancer.
Cu-67 61.9h Cancer treatment/diagnostics, monoclonal antibodies, radioimmunotherapy, planar imaging, SPECT or PET.
Dy-165 2.33h Radiation synovectomy, rheumatoid arthritis treatment.
Eu-152 13.4y Medical.
Eu-155 4.73y Osteoporosis detection.
F-18 110m Radiotracer for brain studies (C), PET imaging (C).
Fe-55 2.73y Heat source.
Fe-59 44.5d Medical.
Ga-64 2.63m Treatment of pulmonary diseases ending in fibrosis of lungs.
Ga-67 78.3h Imaging of abdominal infections (C), detect Hodgkins/non-Hodgkins lymphoma (C), used with In-111 for soft tissue infections and osteomyelitis detection (C), evaluate sarcoidiodis and other granulomaous diseases, particularly in lungs and mediastiusim (C).
Ga-68 68.1m Study thrombosis and atherosclerosis, PET imaging, detection of pancreatic cancer, attenuation correction.
Gd-153 242d Dual photon source, osteoporosis detection, SPECT imaging.
Ge-68 271d PET imaging.
H-3 12.3y Labeling, PET imaging.
I-122 3.6m Brain blood flow studies.
I-123 13.1h Brain, thyroid, kidney, and myocardial imaging (C), cerebral blood flow (ideal for imaging) (C), neurological disease (Alzheimer's) (C).
I-124 4.17d Radiotracer used to create images of human thyroid, PET imaging.
I-125 59.9d Osteoporosis detection, diagnostic imaging, tracer for drugs, monoclonal antibodies, brain cancer treatment (I-131 replacement), SPECT imaging, radiolabeling, tumor imaging, mapping of receptors in the brain (A), interstitial radiation therapy (brachytherapy) for treatment of prostate cancer (E).
I-131 8.04d Lymphoid tissue tumor/hyperthyroidism treatment (C), antibody labeling (C), brain biochemistry in mental illness (C), kidney agent (C), thyroid problems (C), alternative to Tl-201 for radioimmunotherapy (C), imaging, cellular dosimetry, scintigraphy, treatment of graves disease, treatment of goiters, SPECT imaging, treatment of prostate cancer, treatment of hepatocellular carcinoma, treatment of melanoma (A), locate osteomyelitis infections (A), radiolabeling (A), localize tumors for removal (A), treatment of spinal tumor (A), locate metastatic lesions (A), treAt-neuroblastoma (A), internal (systemic) radiation therapy (E), treatment of carcinoma of the thyroid (E).
I-132 2.28h Mapping precise area of brain tumor before operating.
In-111 2.81d Detection of heart transplant rejection (C), imaging of abdominal infections (C), antibody labeling (C) cellular immunology (C), used with Ga-67 for soft tissue infection detection and ostemyelitis detection (C), concentrates in liver, kidneys (C), high specific activity (C), white blood cell imaging, cellular dosimetry, myocardial scans, treatment of leukemia, imaging tumors.
In-115m 4.49h Label blood elements for evaluating inflammatory bowel disease.
Ir-191m 6s Cardiovascular angiography.
Ir-192 73.8d Implants or "seeds" for treatment of cancers of the prostate, brain, breast, gynecological cancers.
Kr-81m 13.3s Lung imaging.
Lu-177 6.68d Heart disease treatment (restenosis therapy), cancer therapy.
Mn-51 46.2m Myocardial localizing agent.
Mn-52 5.59d PET scanning.
Mo-99 65.9h Parent for Tc-99m generator used for brain, liver, lungs, heart imaging.
N-13 9.97m PET imaging, myocardial perfusion.
Nb-95 35d Study effects of radioactivity on pregnant women and fetus, myocardial tracer, PET imaging.
O-15 122s Water used for tomographic measuring of cerebral blood flow (C), PET imaging (C), SPECT imaging.
Os-191 15.4d Parent for Ir-191m generator used for cardiovascular angiography.
Os-194 6.00y Monoclonal antibody attachment used for cancer treatment (RIT).
P-32 14.3d Polycythaemia Rubra Vera (blood cell disease) and leukemia treatment, bone disease diagnosis/treatment, SPECT imaging of tumors (A), pancreatic cancer treatment (A), radiolabeling (A).
P-33 25d Labeling.
Pb-203 2.16d Planar imaging, SPECT or PET (used with Bi-212) (B), monoclonal antibody immunotherapy (B), cellular dosimetry.
Pb-212 10.6h Radioactive label for therapy using antibodies, cellular dosimetry.
Pd-103 17d Prostate cancer treatment.
Pd-109 13.4h Potential radiotherapeutic agent.
Pu-238 2.3y Pacemaker (no Pu-236 contaminants).
Ra-223 11.4d Monoclonal antibody attachment (alpha emitter) used for cancer treatment (RIT).
Ra-226 1.60e3y Target isotope to make Ac-227, Th-228, Th-229 (Parents of alpha emitters used for RIT).
Rb-82 1.27m Myocardial imaging agent, early detection of coronary artery disease, PET imaging, blood flow tracers.
Re-186 3.9d Cancer treatment/diagnostics, monoclonal antibodies, bone cancer pain relief, treatment of rheumatoid arthritis, treatment of prostate cancer, treating bone pain.
Re-188 17h Monoclonal antibodies, cancer treatment.
Rh-105 35.4h Potential therapeutic applications: target neoplastic cells (e.g., small cell lung cancer) (A), labeling of molecules and monoclonal antibodies (A).
Ru-97 2.89d Monoclonal antibodies label (C), planar imaging (C), SPECT or PET techniques (C), gamma-camera imaging.
Ru-103 39d Myocardial blood flow, radiolabeling mircospheres, PET imaging.
S-35 87.2d Nucleic acid labeling, P-32 replacement, cellular dosimetry.
Sc-46 84d Regional blood flow studies, PET imaging.
Sc-47 3.34d Cancer treatment/diagnostics (F), monoclonal antibodies (F), radioimmunotherapy (F).
Se-72 8.4d Brain imaging, generator system with As-72, monoclonal antibody immunotherapy.
Se-75 120d Radiotracer used in brain studies, scintigraphy scanning.
Si-28 Stable Radiation therapy of cancer.
Sm-145 340d Brain cancer treatment using I-127 (D).
Sm-153 2.00d Cancer treatment/diagnostics (C), monoclonal antibodies (C), bone cancer pain relief (C), higher uptake in diseased bone than Re-186 (C), treatment of leukemia.
Sn-117m 13.6d Bone cancer pain relief.
Sr-85 65.0d Detection of focal bone lesions, brain scans.
Sr-89 50d Bone cancer pain palliation (improves the quality of life), cellular dosimetry, treatment of prostate cancer, treatment of multiple myeloma, osteoblastic therapy, potential agent for treatment of bone metastases from prostate and breast cancer (E).
Sr-90 29.1y Generator system with Y-90 (B), monoclonal antibody immunotherapy (B).
Ta-178 9.3m Radionuclide injected into patients to allow viewing of heart and blood vessels.
Ta-179 1.8y X-ray fluorescence source and in thickness gauging (might be a good substitute for Am-241).
Ta-182 115d Bladder cancer treatment, internal implants.
Tb-149 4.13h Monoclonal antibody attachment used for cancer treatment (RIT).
Tc-96 4.3d Animal studies with Tc-99m.
Tc-99m 6.01h Brain, heart, liver (gastoenterology), lungs, bones, thyroid, and kidney imaging (C), regional cerebral blood flow (C), equine nuclear imaging (C), antibodies (C), red blood cells (C), replacement for Tl-201 (C).
Th-228 720d Cancer treatment, monoclonal antibodies, parent of Bi-212.
Th-229 7300y Grandparent for alpha emitter (Bi-213) used for cancer treatment (RIT), parent of Ac-225.
Tl-201 73.1h Clinical cardiology (C), heart imaging (C), less desirable nuclear characteristics than Tc-99m for planar and SPECT imaging (C), myocardial perfusion, cellular dosimetry.
Tm-170 129d Portable blood irradiations for leukemia, lymphoma treatment, power source.
Tm-171 1.9y Medical.
W-188 69.4d Cancer treatment, monoclonal antibodies, parent for Re-188 generator.
Xe-127 36.4d Neuroimaging for brain disorders, research for variety of neuropsychiatric disorders, especially schizophrenia and dementia, higher resolution SPECT studies with lower patient dose, lung imaging (some experts believe it is superior to Xe-133 in inhalation lung studies).
Xe-133 5.25d Lung imaging (C), regional cerebral blood flow (C), liver imaging (gas inhalation) (C), SPECT imaging of brain, lung scanning, lesion detection.
Y-88 107d Substituted for Y-90 in development of cancer tumor therapy.
Y-90 64h Internal radiation therapy of liver cancer (C), monoclonal antibodies (C), Hodgkins disease, and hepatoma (C), cellular dosimetry, treating rheumatoid arthritis, treating breast cancer, treatment of gastrointestinal adenocarcinomas (A).
Y-91 58.5d Cancer treatment (RIT), cellular dosimetry.
Yb-169 32d Gastrointestinal tract diagnosis.
Zn-62 9.22h Parent of Cu-62, a positron-emitter, used for the study of cerebral and myocardial blood flow.
Zn-65 244d Medical.
Zr-95 64.0d Medical.

References:

A = June 1996 Society of Nuclear Medicine (SNM) Abstracts
B = Holmes, R. A. 1991. National Biomedical Tracer Facility Planning and Feasibility Study. New York, N.Y.: Society of Nuclear Medicine.
C = McAfee, J. G. 1989. Nuclear Medicine. Report for the U.S. Department of Energy Office of Energy and Environmental Research Advisory Committee (HERAC). Washington, D.C.: U.S. Department of Energy.
D = Fairchild 87
E = Everyone's Guide to Cancer Therapy (Dollinger, Rosenbaum, Cable), 1991
F = SNM (Society of Nuclear Medicine) http://www.snm.org
RIT = Radioimmunotherapy