Radionuclide generators - a new renaissance in the development of technologies to provide diagnostic and therapeutic radioisotopes for clinical applications

Developing a Chromatographic 99mTc Generator Based on Mesoporous Alumina for Industrial Radiotracer Applications: A Potential New Generation Sorbent for Using Low-Specific-Activity 99Mo

The commercial low-pressure column chromatographic ⁹⁹Mo/^99mTc generator represents a reliable source of onsite, ready-to-use ^99mTc for industrial applications. These generators use fission-produced ⁹⁹Mo of high specific activity, posing serious production challenges and raising proliferation concerns. Therefore, many concepts are aimed at using low-specific-activity (LSA) ⁹⁹Mo. Nonetheless, the main roadblock is the low sorption capacity of the used alumina (Al₂O₃). This study investigates the feasibility of using commercial alumina incorporated with LSA ⁹⁹Mo to develop a useful ⁹⁹Mo/^99mTc generator for industrial radiotracer applications. First, the adsorption profiles of some commercial alumina sorbents for LSA ⁹⁹Mo were tested under different experimental conditions. Then, the potential materials to develop a ⁹⁹Mo/^99mTc generator were selected and evaluated regarding elution yield of ^99mTc and purity. Among the sorbents investigated in this study, mesoporous alumina (SA-517747) presented a unique sorption-elution profile. It demonstrated a high equilibrium and dynamic sorption capacity of 148 ± 8 and 108 ± 6 mg Mo/g. Furthermore, ^99mTc was eluted with high yield and adequate chemical, radiochemical, and radionuclidic purity. Therefore, this approach provides an efficient and cost-effective way to supply onsite ^99mTc for radiotracer applications independent of fission-produced ⁹⁹Mo technology.

New strategies for a sustainable 99mTc supply to meet increasing medical demands: Promising solutions for current problems

The continuing rapid expansion of ^99mTc diagnostic agents always calls for scaling up ^99mTc production to cover increasing clinical demand. Nevertheless, ^99mTc availability depends mainly on the fission-produced ⁹⁹Mo supply. This supply is seriously influenced during renewed emergency periods, such as the past ⁹⁹Mo production crisis or the current COVID-19 pandemic. Consequently, these interruptions have promoted the need for ^99mTc production through alternative strategies capable of providing clinical-grade ^99mTc with high purity. In the light of this context, this review illustrates diverse production routes that either have commercially been used or new strategies that offer potential solutions to promote a rapid production growth of ^99mTc. These techniques have been selected, highlighted, and evaluated to imply their impact on developing ^99mTc production. Furthermore, their advantages and limitations, current situation, and long-term perspective were also discussed. It appears that, on the one hand, careful attention needs to be devoted to enhancing the ⁹⁹Mo economy. It can be achieved by utilizing ⁹⁸Mo neutron activation in commercial nuclear power reactors and using accelerator-based ⁹⁹Mo production, especially the photonuclear transmutation strategy. On the other hand, more research efforts should be devoted to widening the utility of ⁹⁹Mo/^99mTc generators, which incorporate nanomaterial-based sorbents and promote their development, validation, and full automization in the near future. These strategies are expected to play a vital role in providing sufficient clinical-grade ^99mTc, resulting in a reasonable cost per patient dose.

Sorption Profile of Low Specific Activity 99Mo on Nanoceria-Based Sorbents for the Development of 99mTc Generators: Kinetics, Equilibrium, and Thermodynamic Studies

⁹⁹Mo/^99mTc generators play a significant role in supplying ^99mTc for diagnostic interventions in nuclear medicine. However, the applicability of using low specific activity (LSA) ⁹⁹Mo asks for sorbents with high sorption capacity. Herein, this study aims to evaluate the sorption behavior of LSA ⁹⁹Mo towards several CeO₂ nano-sorbents developed in our laboratory. These nanomaterials were prepared by wet chemical precipitation (CP) and hydrothermal (HT) approaches. Then, they were characterized using XRD, BET, FE-SEM, and zeta potential measurements. Additionally, we evaluated the sorption profile of carrier-added (CA) ⁹⁹Mo onto each material under different experimental parameters. These parameters include pH, initial concentration of molybdate solution, contact time, and temperature. Furthermore, the maximum sorption capacities were evaluated. The results reveal that out of the synthesized CeO₂ nanoparticles (NPs) materials, the sorption capacity of HT-1 and CP-2 reach 192 ± 10 and 184 ± 12 mg Mo·g^–1, respectively. For both materials, the sorption kinetics and isotherm data agree with the Elovich and Freundlich models, respectively. Moreover, the diffusion study demonstrates that the sorption processes can be described by pore diffusion (for HT-synthesis route 1) and film diffusion (for CP-synthesis route 2). Furthermore, the thermodynamic parameters indicate that the Mo sorption onto both materials is a spontaneous and endothermic process. Consequently, it appears that HT-1 and CP-2 have favorable sorption profiles and high sorption capacities for CA-⁹⁹Mo. Therefore, they are potential candidates for producing a ⁹⁹Mo/^99mTc radionuclide generator by using LSA ⁹⁹Mo.

Radionuclide generator-based production of therapeutic 177Lu from its long-lived isomer 177mLu

Background

In this work, a lutetium-177 (¹⁷⁷Lu) production method based on the separation of nuclear isomers, ^177mLu & ¹⁷⁷Lu, is reported. The ^177mLu-¹⁷⁷Lu separation is performed by combining the use of DOTA & DOTA-labelled peptide (DOTATATE) and liquid-liquid extraction.

Methods

The ^177mLu cations were complexed with DOTA & DOTATATE and kept at 77 K for periods of time to allow ¹⁷⁷Lu production. The freed ¹⁷⁷Lu ions produced via internal conversion of ^177mLu were then extracted in dihexyl ether using 0.01 M di-(2-ethylhexyl) phosphoric acid (DEHPA) at room temperature. The liquid-liquid extractions were performed periodically for a period up to 35 days.

Results

A maximum ¹⁷⁷Lu/^177mLu activity ratio of 3500 ± 500 was achieved with [^177mLu]Lu-DOTA complex, in comparison to ¹⁷⁷Lu/^177mLu activity ratios of 1086 ± 40 realized using [^177mLu]Lu-DOTATATE complex. The ¹⁷⁷Lu-^177mLu separation was found to be affected by the molar ratio of lutetium and DOTA. A ¹⁷⁷Lu/^177mLu activity ratio up to 3500 ± 500 was achieved with excess DOTA in comparison to ¹⁷⁷Lu/^177mLu activity ratio 1500 ± 600 obtained when lutetium and DOTA were present in molar ratio of 1:1. Further, the ¹⁷⁷Lu ion extraction efficiency, decreases from 95 ± 4% to 58 ± 2% in the presence of excess DOTA.

Conclusion

The reported method resulted in a ¹⁷⁷Lu/ ^177mLu activity ratio up to 3500 after the separation. This ratio is close to the lower end of ¹⁷⁷Lu/^177mLu activity ratios, attained currently during the direct route ¹⁷⁷Lu production for clinical applications (i.e. 4000–10,000). This study forms the basis for further extending the liquid-liquid extraction based ^177mLu-¹⁷⁷Lu separation in order to lead to a commercial ^177mLu/¹⁷⁷Lu radionuclide generator.

Electronic supplementary material

The online version of this article (10.1186/s41181-019-0064-5) contains supplementary material, which is available to authorized users.

An overview of radioisotope separation technologies for development of 188W/188Re radionuclide generators providing 188Re to meet future research and clinical demands

Separation technologies for ¹⁸⁸W/¹⁸⁸Re radionuclide generators.

Radiotracers for positron emission tomography imaging

The use of positron emission tomography for clinical diagnostics has grown rapidly over the past 2 decades. This growth has mainly been due to advances in scanner technology, and particularly the introduction of the combined PET/CT scanner, and has been based almost exclusively on one PET radiopharmaceutical ([(18)F]fluorodeoxyglucose), which is broadly applicable to cancer patients. The availability of radiopharmaceuticals and the clinical diagnostic potential of PET has also supported the continued development of the scanner technology. Due to the efforts of many researchers worldwide in the field of radiopharmaceutical sciences, we are now seeing an increasing number of radiopharmaceuticals used for routine clinical diagnostic imaging. This article is intended as a short educational review, giving a brief overview of the design, preparation and use of PET radiopharmaceuticals, with some examples of highly clinically relevant PET tracers.