Occupational skin dose from radionuclide contamination: one country's approach at standardising skin dose estimates using Varskin

The manipulation of unsealed radiopharmaceuticals by healthcare workers can cause accidental personal contamination leading to occupational radiation skin dose. The UK Ionising Radiations Regulations 2017 require that potential skin doses arising from reasonably foreseeable accident scenarios are included in risk assessments. Workers must be designated as classified if these dose estimates exceed 150 mSv equivalent dose averaged over 1 cm2. Updates from the UK Health and Safety Executive recently prompted many in the UK to review the classification of workers in Nuclear Medicine. Skin dose from contamination cannot be measured, it must be estimated. Varskin+ is a code that is widely recommended for estimating skin dose. The subjective choices made by users when defining modelled scenarios in Varskin+ lead to significant variation in the calculated skin doses. At the time of writing there is no definitive calculation method and all calculations rely on theoretical models. NHS Health Boards in Scotland have adopted a standardised framework for performing skin dose estimates for risk assessments. The parametric sensitivity of Varskin+ inputs were examined and the available evidence was reviewed. Generic, reasonably forseeable, worst-case accident scenarios were decided upon for: direct skin contamination, glove contamination and needlestick injury. Standardised inputs and assumptions for each scenario were compiled in a protocol that has been adopted by the Scottish Health Boards. The protocol allows for differences in practice between departments, but standardises most inputs. While significant uncertainty remains in the estimated skin doses, this approach reduces variation and enables the comparison of estimated skin doses between departments. The framework facilitates continuous improvement as more evidence is gathered to refine the standardised assumptions. Task by task skin dose estimates were made for workers in Nuclear Medicine in Scotland and many workers were designated classified as a result.

Radionuclide-Labeled Antisilencing Function 1a Inhibitory Peptides for Tumor Identification and Individualized Therapy

Immune checkpoint blockade (ICB) therapy is promising to revolutionize cancer regimens, but the low response rate and the lack of a suitable patient stratification method have impeded universal profit to cancer patients. Noninvasive positron emission tomography (PET) imaging in the whole body, upon coupling with specific biomarkers closely related to the immune response, could provide spatiotemporal information to prescribe cancer therapy. Herein, we demonstrate that antisilencing function 1a (ASF1a) could serve as a biomarker target to delineate tumor immune microenvironments by immune PET (iPET). The iPET radiotracer (68Ga-AP1) is designed to target ASF1a in tumors and predict immune response, and the signal intensity predicts anti-PD-1 (αPD-1) therapy response in a negative correlation manner. The ICB-resistant tumors with a high level of ASF1a as revealed by iPET (ASF1aHigh-iPET) are prescribed to be treated by either the combined 177Lu-labeled AP1 and αPD-1 or the standalone α particle-emitting 225Ac-labeled AP1, both achieving enhanced therapeutic efficacy and prolonged survival time. Our study not only replenishes the iPET arsenal for immune-related response evaluation by designing a reliable biomarker and a facile radiotracer but also provides optional therapeutic strategies for ICB-resistant tumors with versatile radionuclide-labeled AP1 peptides, which is promising for real-time clinical diagnosis and individualized therapy planning simultaneously.

The role of companion animal models in radiopharmaceutical development and translation

Advancements in molecular imaging and drug targeting have created a renaissance in the development of radiopharmaceuticals for therapy and theranostics. While some radiopharmaceuticals, such as Na[131 I]I, have been used clinically for decades, new agents are being approved using small-molecules, peptides, and antibodies for targeting. As these agents are being developed, the need to understand dosimetry and biologic effects of the systemically delivered radiotherapy becomes more important, particularly as highly potent radiopharmaceuticals using targeted alpha therapy become clinically utilized. As the processes being targeted become more complex, and the radiobiology of different particulate radiation becomes more diverse, models that better recapitulate human cancer and geometry are necessary. Companion animals develop many of the same types of cancer, carrying many of the same genetic drivers as those seen in people, and the scale and geometry of tumours in dogs more closely mimics those in humans than murine tumour models. Key translational challenges in oncology, such as alterations in tumour microenvironment, hypoxia, heterogeneity, and geometry are addressed by companion animal models. This review paper will provide background on radiopharmaceutical targeting techniques, review the use of radiopharmaceuticals in companion animal oncology, and explore the translational value of treating these patients in terms of dosimetry, treatment outcomes, and normal tissue complication rates.

Radioactivity and dose assessment of naturally occurring radionuclides in terrestrial environments and foodstuffs: a review of Bahi district, Tanzania

In this review, the online searchable research articles were scrutinized for the data presented in line with radioactivity and dose estimates from both terrestrial environments and foodstuffs from Bahi district and other parts of Tanzania. The data on natural gamma ray dose rates from Bahi localities were observed with variations among researchers. The observed ranges of radioactivity concentrations (Bq kg-1) in soil were 226Ra (28.5-57.4), 232Th (38.1-521.3), and 40K (562.9-665.0). Deep closed water wells with installed pumps from Ilindi and Bahi Mission reported radioactivity concentration of 238U 3.08 Bq L-1 and Ilindi swamps reported radioactivity concentrations of 226Ra 15.35 Bq L-1, whereas radioactivity concentrations of 238U in cereals were within the annual tolerable limits of 0.001-0.02 Bq kg-1. The quantity and accessibility of published studies, as well as the diversity of the data, point to the necessity for additional studies to be carried out in order to obtain comprehensive baseline data.

Radionuclide shuntography for cerebrospinal fluid shunt flow evaluation in adults

OBJECTIVE

Radionuclide shuntography (RS) performed using 99mTc-DTPA injected into the reservoir of CSF shunts enables evaluation of CSF flow for suspected shunt malfunctions. The goal of this study was to report the authors' institutional experience with RS and evaluate its utility and associated complications.

METHODS

The authors retrospectively reviewed all RS studies performed between November 2003 and June 2022. Patients with shunted hydrocephalus who were ≥ 18 years of age were included. Patients undergoing RS for evaluation of Ommaya reservoirs were excluded. Demographics, hydrocephalus etiology, presenting symptoms, study results, subsequent management, complications, and intraoperative diagnoses were recorded. Chi-square tests were reported for categorical variables and standard 2 × 2 contingency methods were used for sensitivity/specificity analysis.

RESULTS

The authors identified 211 RS procedures performed in 142 patients. The mean age at procedure was 55.6 ± 20.9 years (mean ± SD). Normal pressure hydrocephalus was the most common hydrocephalus etiology (37.0%), followed by congenital malformations (26.1%) and idiopathic intracranial hypertension (15.6%). Successful radionuclide injection was achieved in 207 studies (98.1%). Shunt patency was confirmed in 63.8% of successful injections, whereas malfunction was demonstrated in 27.1% and abnormally slow flow was seen in 9.2%. RS studies demonstrating shunt malfunction were more likely to result in subsequent revisions than were studies showing patency (86.6% vs 2.9%; p < 0.0001). The overall sensitivity and specificity of RS for detecting shunt malfunction was 92.3% and 96.2%, respectively. The median follow-up time was 29 months, with 151 cases having ≥ 6 months of follow-up. There were no complications or infections attributable to RS in this cohort.

CONCLUSIONS

RS is a useful and safe tool in the workup of shunt malfunction.

Reduction of renal activity retention of radiolabeled albumin binding domain‑derived affinity proteins using a non‑residualizing label strategy compared with a cleavable glycine‑leucine‑glycine‑lysine‑linker

The feasibility of targeted imaging and therapy using radiolabeled albumin‑binding domain‑derived affinity proteins (ADAPTs) has been demonstrated. However, high renal uptake of radioactivity limits the maximum tolerated dose. Successful reduction of renal retention of radiolabeled Fab fragments has been demonstrated by incorporating a cleavable linker between the targeting agent and the radiometal chelator. The present study investigated if the introduction of a glycine‑leucine‑glycine‑lysine (GLGK)‑linker would reduce the kidney uptake of radiolabeled ADAPT6 and also compared it with the non‑residualizing [125I]I‑[(4‑hydroxyphenyl)ethyl]maleimide ([125I]I‑HPEM) labeling strategy. GLGK was site‑specifically coupled to human epidermal growth factor receptor 2 (HER2)‑targeting ADAPT6. Conjugates without the cleavable linker were used as controls and all constructs were labeled with lutetium‑177 (177Lu). [125I]I‑HPEM was coupled to ADAPT6 at the C‑terminus. Biodistribution of all constructs was evaluated in NMRI mice 4 h after injection. Specific binding to HER2‑expressing cells in vitro was demonstrated for all constructs. No significant difference in kidney uptake was observed between the [177Lu]Lu‑2,2',2",2"'‑(1,4,7,10‑tetraazacyclododecane‑1,4,7,10‑tetrayl)tetraacetic acid‑GLGK‑conjugates and the controls. The renal activity of [125I]I‑HPEM‑ADAPT6 was significantly lower compared with all other constructs. In conclusion, the incorporation of the cleavable GLGK‑linker did not result in lower renal retention. Therefore, the present study emphasized that, in order to achieve a reduction of renal retention, alternative molecular design strategies may be required for different targeting agents.

Enhanced Iodine Capture Using a Postsynthetically Modified Thione-Silver Zeolitic Imidazole Framework

Efficient management of radionuclides that are released from various processes in the nuclear fuel cycle is of significant importance. Among these nuclides, radioactive iodine (mainly 129I and 131I) is a major concern due to the risk it poses to the environment and to human health; thus, the development of materials that can capture and safely store radioactive iodine is crucial. Herein, a novel silver-thione-functionalized zeolitic imidazole framework (ZIF) was synthesized via postsynthetic modification and assessed for its iodine uptake capabilities alongside the parent ZIF-8 and intermediate materials. A solvent-assisted ligand exchange procedure was used to replace the 2-methylimidazole linkers in ZIF-8 with 2-mercaptoimidazole, forming intermediate compound ZIF-8 = S, which was reacted with AgNO3 to yield the ZIF-8 = S-Ag+ composite for iodine uptake. Despite possessing the lowest BET surface area of the derivatives, the Ag-functionalized material demonstrated superior I2 adsorption in terms of both maximum capacity (550 g I2/mol) and rapid kinetics (50% loading achieved in 5 h, saturation in 50 h) compared to that of our pristine ZIF-8, which reached 450 g I2/mol after 150 h and 50% loading in 25 h. This improvement is attributed to the presence of the Ag+ ions, which provide a strong chemical driving force to form a stable Ag-I species. The results of this study contribute to a broader understanding of the strategies that can be employed to engineer adsorbents with robust iodine uptake behavior.

Precision strikes: PSMA-targeted radionuclide therapy in prostate cancer - a narrative review

Introduction

Radio-ligand targeted therapy is a new and promising concept of treatment Castration resistant prostate cancer (CRPC). Only a few radio-pharmaceutics were approved for usage in treating prostate cancer, among the multiple others tested. We aimed to review and summarize the literature on the therapeutic isotopes specific for PSMA.

Methods

We performed a scoping literature review of PubMed from January 1996 to December 2022.

Results

98 publications were selected for inclusion in this review. The studies contained in publications allowed to summarize the data on pharmacokinetics, therapeutic effects, side effects and the medical use of 225Ac and 177Lu radionuclides. The review also presents new research directions for specific PSMA radionuclides.

Conclusion

Radioligand targeted therapy is a new and promising concept where Lu-177-PSMA-617 have promising outcomes in treatment according to standard of care.

CD146-targeted nuclear medicine imaging in cancer: state of the art

The transmembrane glycoprotein adhesion molecule CD146 is overexpressed in a wide variety of cancers. Through molecular imaging, a specific biomarker's expression and distribution can be viewed in vivo non-invasively. Radionuclide-labeled monoclonal antibodies or relevant fragments that target CD146 may find potential applications in cancer imaging, thereby offering tremendous value in cancer diagnosis, staging, prognosis evaluation, and prediction of drug resistance. This review discusses the recent developments of CD146-targeted molecular imaging via nuclear medicine, especially in malignant melanoma, brain tumor, lung cancer, liver cancer, breast cancer, and pancreatic cancer. Many studies have proved that CD146 targeting may present a promising strategy for cancer theranostics.

Anthropogenic uranium signatures in turtles, tortoises, and sea turtles from nuclear sites

Chelonians (turtles, tortoises, and sea turtles) grow scute keratin in sequential layers over time. Once formed, scute keratin acts as an inert reservoir of environmental information. For chelonians inhabiting areas with legacy or modern nuclear activities, their scute has the potential to act as a time-stamped record of radionuclide contamination in the environment. Here, we measure bulk (i.e. homogenized scute) and sequential samples of chelonian scute from the Republic of the Marshall Islands and throughout the United States of America, including at the Barry M. Goldwater Air Force Range, southwestern Utah, the Savannah River Site, and the Oak Ridge Reservation. We identify legacy uranium (235U and 236U) contamination in bulk and sequential chelonian scute that matches known nuclear histories at these locations during the 20th century. Our results confirm that chelonians bioaccumulate uranium radionuclides and do so sequentially over time. This technique provides both a time series approach for reconstructing nuclear histories from significant past and present contexts throughout the world and the ability to use chelonians for long-term environmental monitoring programs (e.g. sea turtles at Enewetok and Bikini Atolls in the Republic of the Marshall Islands and in Japan near the Fukushima Daiichi reactors).

The potential role of biofilms in promoting fouling formation in radioactive discharge pipelines

Nuclear facility discharge pipelines accumulate inorganic and microbial fouling and radioactive contamination, however, research investigating the mechanisms that lead to their accumulation is limited. Using the Sellafield discharge pipeline as a model system, this study utilised modified Robbins devices to investigate the potential interplay between inorganic and biological processes in supporting fouling formation and radionuclide uptake. Initial experiments showed polyelectrolytes (present in pipeline effluents), had minimal effects on fouling formation. Biofilms were, however, found to be the key component promoting fouling, leading to increased uptake of inorganic particulates and metal contaminants (Cs, Sr, Co, Eu and Ru) compared to a non-biofilm control system. Biologically-mediated uptake mechanisms were implicated in Co and Ru accumulation, with a potential bioreduced Ru species identified on the biofilm system. This research emphasised the key role of biofilms in promoting fouling in discharge pipelines, advocating for the use of biocide treatments methods.

Positron Emission Tomography in Heart Failure: From Pathophysiology to Clinical Application

Imaging modalities are increasingly being used to evaluate the underlying pathophysiology of heart failure. Positron emission tomography (PET) is a non-invasive imaging technique that uses radioactive tracers to visualize and measure biological processes in vivo. PET imaging of the heart uses different radiopharmaceuticals to provide information on myocardial metabolism, perfusion, inflammation, fibrosis, and sympathetic nervous system activity, which are all important contributors to the development and progression of heart failure. This narrative review provides an overview of the use of PET imaging in heart failure, highlighting the different PET tracers and modalities, and discussing fields of present and future clinical application.

Synthesis and Application of a Novel Metal-Organic Frameworks-Based Ion-Imprinted Polymer for Effective Removal of Co(II) from Simulated Radioactive Wastewater

In this work, a novel metal-organic frameworks (MOFs)-based ion-imprinted polymer (MIIP) was prepared to remove Co(II) from simulated radioactive wastewater. The batch experiments indicated that the sorption was well described by the pseudo-second-order kinetic and Langmuir models, and it is monolayer chemisorption. The theoretical maximum sorption capacity was estimated to be 181.5 mg∙g^-1, which is by far the reported maximum value of Co(II) sorption by the imprinted materials. The MIIP presented an excellent selectivity for Co(II) in the presence of common monovalent and divalent metal ions, and the selectivity coefficients were 44.31, 33.19, 10.84, 27.71, 9.45, 16.25, and 7.60 to Li(I), K(I), Mg(II), Ca(II), Mn(II), Ba(II), and Cd(II), respectively. The sorption mechanism was explored by X-ray photoelectron spectroscopy (XPS) technology and density functional theory (DFT) calculations, suggesting that Co(II) was adsorbed by the MIIP via the chelation of 4-vinylpyridine (VP) ligands with Co(II), which was a spontaneous process, and the optimal coordination ratio of VP to Co(II) was 6. This work suggested that the MIIP has a high sorption capacity and excellent selectivity for Co(II), which is of great significance for the selective separation of Co-60 from radioactive wastewater.

Optimizing the Safety and Efficacy of Bio-Radiopharmaceuticals for Cancer Therapy

The precise delivery of cytotoxic radiation to cancer cells through the combination of a specific targeting vector with a radionuclide for targeted radionuclide therapy (TRT) has proven valuable for cancer care. TRT is increasingly being considered a relevant treatment method in fighting micro-metastases in the case of relapsed and disseminated disease. While antibodies were the first vectors applied in TRT, increasing research data has cited antibody fragments and peptides with superior properties and thus a growing interest in application. As further studies are completed and the need for novel radiopharmaceuticals nurtures, rigorous considerations in the design, laboratory analysis, pre-clinical evaluation, and clinical translation must be considered to ensure improved safety and effectiveness. Here, we assess the status and recent development of biological-based radiopharmaceuticals, with a focus on peptides and antibody fragments. Challenges in radiopharmaceutical design range from target selection, vector design, choice of radionuclides and associated radiochemistry. Dosimetry estimation, and the assessment of mechanisms to increase tumor uptake while reducing off-target exposure are discussed.

The Comparison of Low and High-Dose Scintigraphy Findings in Patients with Primary Parathyroid Lesions in which Intraoperative Gamma-Probe was Applied

OBJECTIVE

We aimed to evaluate the effectiveness of high-dose and low-dose use of radioactive material in intraoperative gamma probe application methods in patients diagnosed with primary hyperparathyroidism and planned for surgery.

METHODS

47 patients with primary hyperparathyroidism underwent minimally-invasive parathyroid surgery (MIS) after preoperative imaging studies consisting of ultrasonography (USG) and sestamibi parathyroid scintigraphy (SPS) showed a possible primary parathyroid lesion (PPL). All patients received Tc-99 sestamibi on day-of-surgery imaging (DOSI) to help with the localization of a primary parathyroid lesion (PPL) via both DOSI and intraoperative gamma probe (IGP). Patients in Group I were administered 20-25 mCi Tc-99m sestamibi (methoxy isobutyl isonitrile) and images were obtained at the 20th and 120th minutes. Patients in Group II were administered 8-10 mCi doses and images were obtained at the 20th and 40th minutes. Two nuclear medicine specialists independently evaluated the images. Lesions in the localizations determined by DOSI and IGP were compared with the histopathological results of these lesions.

RESULTS

47 patients, 35 females, and 12 males were included in the study. The mean age of 28 patients in the first group given the high dose was 54 (41-60), and the mean age was 48 (42-57) in the second group given the low dose (p=0.011). In the group given low-dose radioactive material during intraoperative gamma probe application, the observer's sensitivity, specificity, positive, and negative predictive values for finding pathology were 61.1, 100, 100, and 12.5, respectively. In the group given high-dose radioactive material, the same values were 90.9, 33.3, 50, and 83.3, respectively. While the success of MIS increases with the use of DOSI and IGP in large lesions, the success decreases with the prolongation of the accumulation time of the given dose.

CONCLUSIONS

In the intraoperative gamma probe technique used in primary hyperparathyroidism patients, the method used with low-dose radioactive material has lower sensitivity but higher specificity in estimating the post-operative pathology compared to the high-dose technique.

The radionuclides contamination in eggs as an environmental marker: a systematic review

Foods are contaminated with natural and man-made radionuclides. The aim of this systematic review was to determine the amount and type of radionuclides in eggs, as well as the biomarker capability of eggs. The research studies with keywords radionuclide, radioisotopes, contamination and egg were searched in PubMed, Scopus, and Science Direct databases, regardless of publication time. A number of 70 studies were obtained and only 13 articles were finally selected according to exclusion, inclusion criteria and quality assessment results. Studies which detected radionuclide in the hen eggs were selected. The highest frequency of radionuclides belonged to Ra-226 and Cs-137. The index of natural radionuclides is Ra-226 and the index of synthetic radionuclides is Cs-137. The local eggs, in addition to determining food contamination, can also be a good biomarker for identifying environmental contamination.

Adverse Clinical Events at the Injection Site Are Exceedingly Rare After Reported Radiopharmaceutical Extravasation in Patients Undergoing 99mTc-MDP Whole-Body Bone Scintigraphy: A 12-Year Experience

The deleterious effects of high-dose radiation on normal tissue are sometimes extrapolated to diagnostic (SPECT and PET) radiopharmaceutical extravasation (RPE). It has been hypothesized that diagnostic RPE can have gradually evolving local tissue injury and a potentially increased risk of local dermatologic or oncologic diseases over a longer period. However, data on clinical adverse events after diagnostic RPE are limited. Therefore, our primary aim was to study the occurrence of short-term and long-term clinical adverse events in patients who underwent ^99mTc-methylene diphosphonate (^99mTc-MDP) whole-body bone scintigraphy (WBBS) with reported RPE. Methods: The records of ^99mTc-MDP WBBS performed from June 2010 to January 2022 were retrospectively examined for RPE documented in the scan reports. The clinical records of patients with a documented RPE were extensively reviewed for any related short-term adverse events (within 2 wk of the WBBS: local symptoms and care sought for local dermatologic or musculoskeletal issues) and long-term adverse events (until the last follow-up: local deleterious effects and related consults for dermatology, plastic surgery, oncology, or orthopedics). Results: Retrospective review of the records of 31,679 ^99mTc-MDP WBBS studies showed RPE documented in 118 (0.37%). Medical records were not retrievable for 22 patients, yielding a final cohort of 96 patients with reported RPE. The median follow-up was 18.9 mo (interquartile range, 7.8-45.7 mo). Short-term events were noted in 4 patients, of whom one was asymptomatic. Of the 3 symptomatic patients, 2 experienced mild discomfort at the injection site, and 1 had tender swelling. Three of the 4 events were in patients who had a prior intravenous contrast extravasation for contrast-enhanced CT performed earlier during the day and a ^99mTc-MDP injection later at the same site, likely leading to RPE. None of the long-term local events had any plausible link with the RPE event. Conclusion: Reported RPE was rare, and 3 patients (0.009%) had short-term local symptoms, all of which were likely related to the prior higher-volume intravenous contrast extravasation. The smaller-volume diagnostic radiopharmaceutical injections for WBBS are highly unlikely to cause local symptoms on their own. No patient had any long-term adverse event with a plausible link to the RPE.

Astatine-211 based radionuclide therapy: Current clinical trial landscape

Astatine-211 (²¹¹At) has physical properties that make it one of the top candidates for use as a radiation source for alpha particle-based radionuclide therapy, also referred to as targeted alpha therapy (TAT). Here, we summarize the main results of the completed clinical trials, further describe ongoing trials, and discuss future prospects.

The mixed layer modified radionuclide atmospheric diffusion based on Gaussian model

Background

Atmospheric diffusion is often accompanied by complex meteorological conditions of inversion temperature.

Methods

In response to the emergency needs for rapid consequence assessment of nuclear accidents under these complex meteorological conditions, a Gaussian diffusion-based model of radionuclide is developed with mixed layer modification. The inhibition effect of the inversion temperature on the diffusion of radionuclides is modified in the vertical direction. The intensity of the radionuclide source is modified by the decay constant.

Results

The results indicate that the enhancement effect of the mixed layer on the concentration of radionuclides is reflected. The shorter the half-life of the radionuclide, the greater the effect of reducing the diffusion concentration. The Kincaid dataset validation in the Model Validation Kit (MVK) shows that, compared to the non-modified model, predictions of the modified model have an enhancement effect beyond 5 km, modulating the prediction values to be closer to the observation values.

Conclusions

This development is consistent with the modification effects of the mixed layer. The statistical indicators show that the criteria of the modified model meet the criteria of the recommended model.

Physical, Mechanical and Radiological Characteristics of a Fly Ash Geopolymer Incorporating Titanium Dioxide Waste as Passive Fire Insulating Material in Steel Structures

This research analyzes whether a titanium dioxide waste (TiO₂ waste) can be used as a source material for geopolymers with good fire resistance properties. Samples with different proportions were prepared, replacing fly ashes with titanium dioxide waste on geopolymers (0, 20, 30, 40 and 100% w/w). The activating solution has a Na₂O/SiO₂ molar ratio of 0.98. Physical (bulk density, moisture content and water absorption) and mechanical (superficial hardness and compressive strength) characteristics have been evaluated. In addition, their thermal behavior at high temperatures (fire resistance, compressive strength at elevated temperature and absorbed energy) has also been evaluated to see if they can be used as fire insulating materials. This work also studies the radiological activity of geopolymer materials. The replacement of FA with WTiO₂ increases the bulk density due to its higher specific bulk density. The highest compressive strength values were obtained with a TiO₂ waste content between 30 and 40% w/w. The compressive strength decreases at high temperatures, especially when more TiO₂ waste is added. When the amount of TiO₂ waste is increased, so is the plateau of evaporation, and this, in turn, increases the resistance to fire. Geopolymers containing FA and TiO₂ waste do not present radiological problems, although, when the TiO₂ waste is increased, the activity index of the geopolymer also rises.

Peptide-Based [68Ga]Ga Labeled PET Tracer for Tumor Imaging by Targeting Tumor-Associated Macrophages

Tumor-associated macrophages (TAMs) are known to promote cancer development and metastasis. In this study, a TAMs-targeting peptide named M2pep was selected to investigate the feasibility of [68Ga]Ga-labeled M2pep as a noninvasive probe in targeted TAMs imaging. The peptide M2pep was conjugated with 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) and radiolabeled with 68Ga. The cellular uptake and binding assay were assessed in M2 macrophages and in the B16F10 cell line. Micro-PET imaging and a biodistribution study were performed on B16F10 tumor-bearing mice. High radiochemical purity [68Ga]Ga-DOTA-M2pep (>95%) was prepared and was stabilized in saline and bovine serum at 37 °C for 2 h. In vitro studies demonstrated high uptake of [68Ga]Ga-DOTA-M2pep in M2 macrophages, which was effectively blocked by the “cold” M2pep (free peptide). The micro-PET imaging and biodistribution study revealed that [68Ga]Ga-DOTA-M2pep reached the tumor site rapidly and showed high accumulation in the tumor at 1 h post-injection. In addition, the probe was rapidly cleared from the blood and mainly excreted via the kidneys, resulting in a high tumor/background ratio. Preclinical studies have shown that [68Ga]Ga-DOTA-M2pep specifically targets TAMs and might be a promising molecular probe for the noninvasive visualization of TAMs expression.

Comparative Preclinical Evaluation of Peptide-Based Chelators for the Labeling of DARPin G3 with 99mTc for Radionuclide Imaging of HER2 Expression in Cancer

Non-invasive radionuclide imaging of human epidermal growth factor receptor type 2 (HER2) expression in breast, gastroesophageal, and ovarian cancers may stratify patients for treatment using HER2-targeted therapeutics. Designed ankyrin repeat proteins (DARPins) are a promising type of targeting probe for radionuclide imaging. In clinical studies, the DARPin [99mTc]Tc-(HE)3-G3 labeled using a peptide-based chelator His-Glu-His-Glu-His-Glu ((HE)3), provided clear imaging of HER2 expressing breast cancer 2-4 h after injection. The goal of this study was to evaluate if the use of cysteine-containing peptide-based chelators Glu-Glu-Glu-Cys (E3C), Gly-Gly-Gly-Cys (G3C), and Gly-Gly-Gly-Ser-Cys connected via a (Gly-Gly-Gly-Ser)3-linker (designated as G3-(G3S)3C) would further improve the contrast of imaging using 99mTc-labeled derivatives of G3. The labeling of the new variants of G3 provided a radiochemical yield of over 95%. Labeled G3 variants bound specifically to human HER2-expressing cancer cell lines with affinities in the range of 1.9-5 nM. Biodistribution of [99mTc]Tc-G3-G3C, [99mTc]Tc-G3-(G3S)3C, and [99mTc]Tc-G3-E3C in mice was compared with the biodistribution of [99mTc]Tc-(HE)3-G3. It was found that the novel variants provide specific accumulation in HER2-expressing human xenografts and enable discrimination between tumors with high and low HER2 expression. However, [99mTc]Tc-(HE)3-G3 provided better contrast between tumors and the most frequent metastatic sites of HER2-expressing cancers and is therefore more suitable for clinical applications.

Comparative Study of Plutonium and Radiocaesium Content in the Muscle of Fish of the Yenisey River

This work reports the first data on the content of plutonium (^239+240Pu) in the muscle tissues of the Northern pike (Esox lucius) and the Siberian dace (Leiciscus baicalensis) inhabiting the middle reaches of the Yenisey River in the vicinity of the radioactive discharge site. An increase in the content of ^239+240Pu and radiocaesium (¹³⁷Cs) in pike muscles followed an increase in the volume of controlled discharges of these radionuclides to the Yenisey in 2018. The content of ^239+240Pu in the muscles of pike (2-11 mBq/kg dry weight) and dace (1-4 mBq/kg dry weight) of the Yenisey fall within the range of values obtained by other authors for the ichthyofauna from water bodies contaminated with radioactive discharges from nuclear power plants and spent nuclear fuel processing plants. The ratio of the activity concentrations ^239+240Pu/¹³⁷Cs in fish muscles, compared with the similar ratios in other hydrobionts, indicates a significantly lower bioavailability of plutonium for fish. The obtained preliminary results make it possible to consider the Northern pike as a more prospective indicator of biologically available plutonium in the Yenisey than the dace.

A Hydrofluoric Acid-Free Green Synthesis of Magnetic M.Ti2CTx Nanostructures for the Sequestration of Cesium and Strontium Radionuclide

MAX phases are the parent materials used for the formation of MXenes, and are generally obtained by etching using the highly corrosive acid HF. To develop a more environmentally friendly approach for the synthesis of MXenes, in this work, titanium aluminum carbide MAX phase (Ti₂AlC) was fabricated and etched using NaOH. Further, magnetic properties were induced during the etching process in a single-step etching process that led to the formation of a magnetic composite. By carefully controlling etching conditions such as etching agent concentration and time, different structures could be produced (denoted as M.Ti₂CT_x). Magnetic nanostructures with unique physico-chemical characteristics, including a large number of binding sites, were utilized to adsorb radionuclide Sr²⁺ and Cs⁺ cations from different matrices, including deionized, tap, and seawater. The produced adsorbents were analyzed using X-ray diffraction (XRD), scanning electron microscopy (SEM), X-ray energy dispersive spectroscopy (EDS), and X-ray photoelectron spectroscopy (XPS). The synthesized materials were found to be very stable in the aqueous phase, compared with corrosive acid-etched MXenes, acquiring a distinctive structure with oxygen-containing functional moieties. Sr²⁺ and Cs⁺ removal efficiencies of M.Ti₂CT_x were assessed via conventional batch adsorption experiments. M.Ti₂CT_x-A_III showed the highest adsorption performance among other M.Ti₂CT_x phases, with maximum adsorption capacities of 376.05 and 142.88 mg/g for Sr²⁺ and Cs⁺, respectively, which are among the highest adsorption capacities reported for comparable adsorbents such as graphene oxide and MXenes. Moreover, in seawater, the removal efficiencies for Sr²⁺ and Cs⁺ were greater than 93% and 31%, respectively. Analysis of the removal mechanism validates the electrostatic interactions between M.Ti₂C-A_III and radionuclides.

MIRD Pamphlet No. 27: MIRDcell V3, a Revised Software Tool for Multicellular Dosimetry and Bioeffect Modeling

Radiopharmaceutical therapy is growing rapidly. However, yet to be addressed is the implementation of methods to plan treatments for circulating tumor cells, disseminated tumor cells, and micrometastases. Given the capacity of radiopharmaceuticals to specifically target and kill single cells and multicellular clusters, a quality not available in chemotherapy and external-beam radiation therapy, it is important to develop dosimetry and bioeffect modeling tools that can inform radiopharmaceutical design and predict their effect on microscopic disease. This pamphlet describes a new version of MIRDcell, a software tool that was initially released by the MIRD committee several years ago. Methods: Version 3 (V3) of MIRDcell uses a combination of analytic and Monte Carlo methods to conduct dosimetry and bioeffect modeling for radiolabeled cells within planar colonies and multicellular clusters. A worked example is provided to assist users to learn old and new features of MIRDcell and test its capacity to recapitulate published responses of tumor cell spheroids to radiopharmaceutical treatments. Prominent capabilities of the new version include radially dependent activity distributions, user-imported activity distributions, cold regions within the cluster, complex bioeffect modeling that accounts for radiation type and subcellular distribution, and a rich table of output data for subsequent analysis. Results: MIRDcell V3 effectively reproduces experimental responses of multicellular spheroids to uniform and nonuniform distributions of therapeutic radiopharmaceuticals. Conclusion: MIRDcell is a versatile software tool that can be used for educational purposes and design of radiopharmaceutical therapies.

Applications of Nano Hydroxyapatite as Adsorbents: A Review

Nano hydroxyapatite (Ca₁₀(PO₄)₆(OH)₂, HAp) has aroused widespread attention as a green and environmentally friendly adsorbent due to its outstanding ability in removing heavy metal ions, radio nuclides, organic pollutants and fluoride ions for wastewater treatment. The hexagonal crystal structure of HAp supports the adsorption mechanisms including ionic exchange reaction, surface complexation, the co-precipitation of new partially soluble phases and physical adsorption such as electrostatic interaction and hydrogen bonding. However, nano HAp has some drawbacks such as agglomeration and a significant pressure drop during filtration when used in powder form. Therefore, instead of using nano HAp alone, researchers have worked on modificationsand composites of nano HAp to overcome these issues and enhance the adsorption capacity. The modification of cationic doping and organic molecule grafting for nano HAp can promote the immobilization of ions and then increase adsorption capacity. Developing nano HAp composite with biopolymers such as gelatin, chitosan and chitin has proven to obtain a synergetic effect for improving the adsorption capacity of composites, in which nano HAp fixed and dispersed in polymers can playmuch more of a role for adsorption. This review summarizes the adsorption properties and adsorbent applications of nano HAp as well as the methods to enhance the adsorption capacity of nano HAp.

Determination of a reliable assessment for occupational eye lens dose in nuclear medicine

The most recent statement published by the International Commission on Radiological Protection describes a reduction in the maximum allowable occupational eye lens dose from 150 to 20 mSv/year (averaged over 5‐year periods). Exposing the eye lens to radiation is a concern for nuclear medicine staff who handle radionuclide tracers with various levels of photon energy. This study aimed to define the optimal dosimeter and means of measuring the amount of exposure to which the eye lens is exposed during a routine nuclear medicine practice. A RANDO human phantom attached to Glass Badge and Luminess Badge for body or neck, DOSIRIS and VISION for eyes, and nanoDot for body, neck, and eyes was exposed to ^99mTc, ¹²³I, and ¹⁸F radionuclides. Sealed syringe sources of each radionuclide were positioned 30 cm from the abdomen of the phantom. Estimated exposure based on measurement conditions (i.e., air kerma rate constants, conversion coefficient, distance, activity, and exposure time) was compared measured dose equivalent of each dosimeter. Differences in body, neck, and eye lens dosimeters were statistically analyzed. The 10‐mm dose equivalent significantly differed between the Glass Badge and Luminess Badge for the neck, but these were almost equivalent at the body. The 0.07‐mm dose equivalent for the nanoDot dosimeters was greatly overestimated compared to the estimated exposure of ^99mTc and ¹²³I radionuclides. Measured dose equivalents of exposure significantly differed between the body and eye lens dosimeters with respect to ¹⁸F. Although accurately measuring radiation exposure to the eye lenses of nuclear medicine staff is conventionally monitored using dosimeters worn on the chest or abdomen, eye lens dosimeters that provide a 3‐mm dose equivalent near the eye would be a more reliable means of assessing radiation doses in the mixed radiation environment of nuclear medicine.

Fluorine-18 Labelled Radioligands for PET Imaging of Cyclooxygenase-2

Molecular imaging probes enable the early and accurate detection of disease-specific biomarkers and facilitate personalized treatment of many chronic diseases, including cancer. Among current clinically used functional imaging modalities, positron emission tomography (PET) plays a significant role in cancer detection and in monitoring the response to therapeutic interventions. Several preclinical and clinical studies have demonstrated the crucial involvement of cyclooxygenase-2 (COX-2) isozyme in cancer development and progression, making COX-2 a promising cancer biomarker. A variety of COX-2-targeting PET radioligands has been developed based on anti-inflammatory drugs and selective COX-2 inhibitors. However, many of those suffer from non-specific binding and insufficient metabolic stability. This article highlights examples of COX-2-targeting PET radioligands labelled with the short-lived positron emitter ¹⁸F, including radiosynthesis and PET imaging studies published in the last decade (2012–2021).

The Chemical Scaffold of Theranostic Radiopharmaceuticals: Radionuclide, Bifunctional Chelator, and Pharmacokinetics Modifying Linker

Therapeutic radiopharmaceuticals have been researched extensively in the last decade as a result of the growing research interest in personalized medicine to improve diagnostic accuracy and intensify intensive therapy while limiting side effects. Radiometal-based drugs are of substantial interest because of their greater versatility for clinical translation compared to non-metal radionuclides. This paper comprehensively discusses various components commonly used as chemical scaffolds to build radiopharmaceutical agents, i.e., radionuclides, pharmacokinetic-modifying linkers, and chelators, whose characteristics are explained and can be used as a guide for the researcher.

Functionalization of Tailored Porous Carbon Monolith for Decontamination of Radioactive Substances

As the control over radioactive species becomes critical for the contemporary human life, the development of functional materials for decontamination of radioactive substances has also become important. In this work, a three-dimensional (3D) porous carbon monolith functionalized with Prussian blue particles was prepared through removal of colloidal silica particles from exfoliated graphene/silica composite precursors. The colloidal silica particles with a narrow size distribution were used to act a role of hard template and provide a sufficient surface area that could accommodate potentially hazardous radioactive substances by adsorption. The unique surface and pore structure of the functionalized porous carbon monolith was examined using electron microscopy and energy-dispersive X-ray analysis (EDS). The effective incorporation of PB nanoparticles was confirmed using diverse instrumentations such as X-ray diffraction (XRD), Fourier-transform infrared (FT-IR), and X-ray photoelectron spectroscopy (XPS). A nitrogen adsorption/desorption study showed that surface area and pore volume increased significantly compared with the starting precursor. Adsorption tests were performed with ¹³³Cs ions to examine adsorption isotherms using both Langmuir and Freundlich isotherms. In addition, adsorption kinetics were also investigated and parameters were calculated. The functionalized porous carbon monolith showed a relatively higher adsorption capacity than that of pristine porous carbon monolith and the bulk PB to most radioactive ions such as ¹³³Cs, ⁸⁵Rb, ¹³⁸Ba, ⁸⁸Sr, ¹⁴⁰Ce, and ²⁰⁵Tl. This material can be used for decontamination in expanded application fields.

Review of Knowledge of Uranium-Induced Kidney Toxicity for the Development of an Adverse Outcome Pathway to Renal Impairment

An adverse outcome pathway (AOP) is a conceptual construct of causally and sequentially linked events, which occur during exposure to stressors, with an adverse outcome relevant to risk assessment. The development of an AOP is a means of identifying knowledge gaps in order to prioritize research assessing the health risks associated with exposure to physical or chemical stressors. In this paper, a review of knowledge was proposed, examining experimental and epidemiological data, in order to identify relevant key events and potential key event relationships in an AOP for renal impairment, relevant to stressors such as uranium (U). Other stressors may promote similar pathways, and this review is a necessary step to compare and combine knowledge reported for nephrotoxicants. U metal ions are filtered through the glomerular membrane of the kidneys, then concentrate in the cortical and juxtaglomerular areas, and bind to the brush border membrane of the proximal convoluted tubules. U uptake by epithelial cells occurs through endocytosis and the sodium-dependent phosphate co-transporter (NaPi-IIa). The identified key events start with the inhibition of the mitochondria electron transfer chain and the collapse of mitochondrial membrane potential, due to cytochrome b5/cytochrome c disruption. In the nucleus, U directly interacts with negatively charged DNA phosphate, thereby inducing an adduct formation, and possibly DNA strand breaks or cross-links. U also compromises DNA repair by inhibiting zing finger proteins. Thereafter, U triggers the Nrf2, NF-κB, or endoplasmic reticulum stress pathways. The resulting cellular key events include oxidative stress, DNA strand breaks and chromosomal aberrations, apoptosis, and pro-inflammatory effects. Finally, the main adverse outcome is tubular damage of the S2 and S3 segments of the kidneys, leading to tubular cell death, and then kidney failure. The attribution of renal carcinogenesis due to U is controversial, and specific experimental or epidemiological studies must be conducted. A tentative construction of an AOP for uranium-induced kidney toxicity and failure was proposed.

CD93 in macrophages: A novel target for atherosclerotic plaque imaging?

Noninvasive imaging atherosclerotic (AS) plaque is of great importance for early diagnosis. Recently, CD93 in MΦ was linked to atherosclerosis development. Herein, we have investigated whether CD93 in MΦ is a potential novel target for atherosclerotic plaque imaging. CD93^hi and CD93^lo MΦ were prepared with or without LPS stimulation, before biological activity was evaluated. A rat AS model was produced with left carotid artery clamped. Whole‐body/ex vivo phosphor autoradiography of the artery and biodistribution were investigated after incorporation of ³H‐2‐DG into CD93^hi and CD93^lo MΦ or after ¹²⁵I‐α‐CD93 (¹²⁵I‐anti‐CD93mAb) injection. The plaque tissue was subjected to CD93/CD68 immunofluorescence/immunohistochemistry staining. CD93^hi and CD93^lo MΦ cells were successfully prepared without significant effect on bioactivity after incorporative labelled with ³H‐2‐DG. The AS model was successfully established. Biodistribution studies showed that adoptive transfer of ³H‐2‐DG‐CD93^hi MΦ or ¹²⁵I‐ α‐CD93 injection resulted in accumulation of radioactivity within the atherosclerotic plaque in the clamped left carotid artery. T/NT (target/non‐target, left/right carotid artery) ratio was higher in the ³H‐2‐DG‐CD93^hi MΦ adoptive transfer group than in the ³H‐2‐DG‐CD93^lo MΦ group (p < .05). Plaque radioactivity in the ¹²⁵I‐α‐CD93 injection group was significantly higher than in the ¹²⁵I‐IgG control group (p < .01). The higher radioactivity accumulated in the clamped left carotid artery was confirmed by phosphor autoradiography. More importantly, CD93/CD68 double‐positive MΦ accumulated at the atherosclerotic plaque in ³H‐2‐DG‐CD93^hi MΦ adoptive transfer group, which correlated with plaque radioactivity (r = .99, p < .01). In summary, both adoptive‐transferred ³H‐2‐DG‐labelled CD93^hi MΦ and ¹²⁵I‐α‐CD93 injection specifically targeted CD93 in atherosclerotic plaque. CD93 is a potential target in atherosclerotic plaque imaging.

Where do we stand with radioimmunotherapy for acute myeloid leukemia?

INTRODUCTION

Despite the approval of several new drugs, deaths from acute myeloid leukemia (AML) remain common. Because of well-defined cell surface antigens, easy accessibility, and radiosensitivity of leukemia cells, there is long-standing interest in radiolabeled antibodies (radioimmunotherapy [RIT]) to complement or replace existing treatments and improve outcomes in AML.

AREAS COVERED

Targeting primarily CD33, CD45, or CD66, early RIT efforts have focused on β-emitters, including iodine-131 (¹³¹I) and yttrium-90, mostly to intensify conditioning therapy before allogeneic hematopoietic cell transplantation (HCT). An ¹³¹I-labeled CD45 antibody (Iomab-B [apamistamab-I131]) is currently studied in the registration-type phase 3 SIERRA trial (NCT02665065) for this purpose. Of growing interest as therapeutic payloads are α-particle emitting radionuclides such as actinium-225 (²²⁵Ac) or astatine-211 (²¹¹At) since they deliver substantially higher decay energies over a much shorter distance than β-emitters, rendering them more suitable for precise, potent, and efficient target cell killing while minimizing toxicity to surrounding bystander cells, possibly allowing use outside of HCT. Clinical efforts with ²¹¹At-labeled CD45 antibodies and ²²⁵Ac-labeled CD33 antibodies (e.g. ²²⁵Ac-lintuzumab [Actimab-A]) are ongoing.

EXPERT OPINION

A first anti-AML RIT may soon become available. This might propel further work to develop RIT-based treatments for AML, with many such efforts already ongoing.

Sediment Sources and Sealed-Pavement Area Drive Polycyclic Aromatic Hydrocarbon and Metal Occurrence in Urban Streams

Metals and polycyclic aromatic hydrocarbons (PAHs) are common pollutants in urban streambed sediment, yet their occurrence is highly variable and difficult to predict. To investigate sources of PAHs and metals to streambed sediment, we sampled pavement dust, soil, and streambed sediment in 10 urban watersheds in three regions of the United States and applied a fallout-radionuclide-based sediment-source analysis to quantify the pavement dust contribution to stream sediment (%dust). We also mapped the area of sealcoated pavement in each watershed (%sealed) to investigate the role of coal-tar pavement sealant (CTS) as a PAH source. Median total and carbon-normalized total PAH concentrations were significantly higher in streambed sediment in the Northeast (54.3 mg/kg and 2.71 mg/gOC) and Southeast (5.37 mg/kg and 1.36 mg/gOC), where CTS is commonly used, than in the Northwest (2.11 mg/kg and 0.071 mg/gOC), where CTS is rarely used. Generalized additive models indicated that %sealed and in some cases %dust significantly affected total PAH concentrations in streambed sediments. The %dust was a significant variable for common urban metals: Cu, Pb, and Zn. These findings advance our quantitative understanding of the role of pavement dust as a source and a vector of contaminants to urban streams.

Treatment of Neuroendocrine Neoplasms with Radiolabeled Peptides-Where Are We Now

Peptide receptor radionuclide therapy (PRRT) has been one of the most successful and exciting examples of theranostics in nuclear medicine in recent decades and is now firmly embedded in many treatment algorithms for unresectable or metastatic neuroendocrine neoplasms (NENs) worldwide. It is widely considered to be an effective treatment for well- or moderately differentiated neoplasms, which express high levels of somatostatin receptors that can be selectively targeted. This review article outlines the scientific basis of PRRT in treatment of NENs and describes its discovery dating back to the early 1990s. Early treatments utilizing Indium-111, a γ-emitter, showed promise in reduction in tumor size and improvement in biochemistry, but were also met with high radiation doses and myelotoxic and nephrotoxic effects. Subsequently, stable conjugation of DOTA-peptides with β-emitting radionuclides, such as Yttrium-90 and Lutetium-177, served as a breakthrough for PRRT and studies highlighted their potential in eliciting progression-free survival and quality of life benefits. This article will also elaborate on the key trials which paved the way for its approval and will discuss therapeutic considerations, such as patient selection and administration technique, to optimize its use.

Computational dose evaluation on children exposed to natural radioactivity from granitic rocks used as architectural materials

Considering the higher radiosensitivity of children in comparison to adults, studies related to children's exposure to ionising radiation have been long considered of relevance. For this study, the MCNPX2.7.0 Monte Carlo code and four paediatric voxel computational anthropomorphic phantoms, of both genders and aged 5 and 10 years, were used to simulate scenarios, where children are exposed to natural radiation emitted by sources in the ground by radionuclides of⁴⁰K and of²³²Th and²³⁸U radioactive series. These elements are part of the composition of ten different types of ornamental rocks obtained from three regions of Brazil, and used as architectural material for flooring of houses. The virtual paediatric anthropomorphic phantoms were positioned in a room with dimensions of (4.0 × 5.0 × 2.8) m³filled with atmospheric air and a 3 cm thick granitic floor acting as a uniformly distributed planar gamma radiation source. The walls of the room were composed of 20 cm thick concrete. Gonads, bone marrow, bladder, colon, and skin were found to be the organs which receive the highest doses. The mean values of effective dose per air kerma at 1 m above the ground summed for all three radionuclides, were 0.96 and 0.68 Sv Gy^-1for the 5 and 10 year old phantoms, respectively. The obtained results showed that the granitic rocks considered implicate annual effective doses which are 69%-78% lower than the annual limits, recommended by ICRP Publication 103.

Biodistribution and image characteristics of 124 I-positron emission tomography in dogs with neuroendocrine neoplasia

Radioactive iodine is frequently used for staging of human thyroid carcinomas. Iodine-124 scans performed using position emission tomography (PET) allow for more precise dosimetry of therapeutic radioiodine. The distribution of I-124 has not previously been described in veterinary medicine. The purpose of this prospective, exporatory, descriptive study is to evaluate the whole-body distribution of I-124 in dogs with suspected thyroid carcinoma. Ten dogs with either a cytologic diagnosis of a neuroendocrine neoplasm or biochemical hyperthyroidism were enrolled in a prospective clinical study. Whole-body I-124 PET/CT scans were performed and were evaluated for physiologic and pathologic uptake of I-124. The maximum and mean standardized uptake values (SUVmean) were recorded for several normal and abnormal tissues. Varying degrees of uptake were found in thyroid tumors (SUVmean = 66.37), ectopic thyroid masses (21.44), presumed metastatic lesions in lymph nodes (32.14), and the pulmonary parenchyma (4.50). In most dogs, physiologic uptake above background, measured in maximum SUV, was identified in parotid and mandibular salivary glands (14.00 and 1.57) the urinary tract (1.83), the gastrointestinal tract (19.90 stomach, 6.15 colon), the liver (1.41), and the heart (1.88). Occasionally, uptake was identified in the nasolacrimal duct (3.42), salivary duct (2.73), gallbladder (2.68), and anal gland (2.22). Physiologic uptake was also identified in normal thyroid glands and ectopic thyroid tissue. This study provides a baseline of pathologic and physiologic uptake of I-124 in dogs with thyroid carcinoma, to guide interpretation of future studies.

New Radionuclides and Technological Advances in SPECT and PET Scanners

Simple Summary

Advances in nuclear medicine are made by technological and radionuclide improvements. Throughout nuclear medicine’s history, these advances were often intertwined and complementary based on different clinical questions, availability and need. This paper covers some of these developments in radionuclides and instrumentation.

Abstract

Developments throughout the history of nuclear medicine have involved improvements in both instrumentation and radionuclides, which have been intertwined. Instrumentation developments always occurred during the search to improving devices’ sensitivity and included advances in detector technology (with the introduction of cadmium zinc telluride and digital Positron Emission Tomography—PET-devices with silicon photomultipliers), design (total body PET) and configuration (ring-shaped, Single-Photon Emission Computed Tomography (SPECT), Compton camera). In the field of radionuclide development, we observed the continual changing of clinically used radionuclides, which is sometimes influenced by instrumentation technology but also driven by availability, patient safety and clinical questions. Some areas, such as tumour imaging, have faced challenges when changing radionuclides based on availability, when this produced undesirable clinical findings with the introduction of unclear focal uptakes and unspecific uptakes. On the other end of spectrum, further developments of PET technology have seen a resurgence in its use in nuclear cardiology, with rubidium-82 from strontium-82/rubidium-82 generators being the radionuclide of choice, moving away from SPECT nuclides thallium-201 and technetium-99m. These continuing improvements in both instrumentation and radionuclide development have helped the growth of nuclear medicine and its importance in the ever-evolving range of patient care options.

Molecular Targeted Positron Emission Tomography Imaging and Radionuclide Therapy of Pancreatic Ductal Adenocarcinoma

Simple Summary

Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis, mainly due to difficulty in early detection of the disease by current imaging modalities. In this review, we discuss the more specific diagnostic imaging modality that evaluates the presence of specific tumour tracers via positron emission tomography. In addition, we review the available therapeutic applications of these tumour-specific tracers.

Abstract

Pancreatic ductal adenocarcinoma (PDAC) has an inauspicious prognosis, mainly due to difficulty in early detection of the disease by the current imaging modalities. The upcoming development of tumour-specific tracers provides an alternative solution for more accurate diagnostic imaging techniques for staging and therapy response monitoring. The future goal to strive for, in a patient with PDAC, should definitely be first to receive a diagnostic dose of an antibody labelled with a radionuclide and to subsequently receive a therapeutic dose of the same labelled antibody with curative intent. In the first part of this paper, we summarise the available evidence on tumour-targeted diagnostic tracers for molecular positron emission tomography (PET) imaging that have been tested in humans, together with their clinical indications. Tracers such as radiolabelled prostate-specific membrane antigen (PSMA)—in particular, ¹⁸F-labelled PSMA—already validated and successfully implemented in clinical practice for prostate cancer, also seem promising for PDAC. In the second part, we discuss the theranostic applications of these tumour-specific tracers. Although targeted radionuclide therapy is still in its infancy, lessons can already be learned from early publications focusing on dose fractioning and adding a radiosensitiser, such as gemcitabine.

Dosimetry in Clinical Radiopharmaceutical Therapy of Cancer: Practicality Versus Perfection in Current Practice

The use of radiopharmaceutical therapies (RPTs) in the treatment of cancers is growing rapidly, with more agents becoming available for clinical use in last few years and many new RPTs being in development. Dosimetry assessment is critical for personalized RPT, insofar as administered activity should be assessed and optimized in order to maximize tumor-absorbed dose while keeping normal organs within defined safe dosages. However, many current clinical RPTs do not require patient-specific dosimetry based on current Food and Drug Administration-labeled approvals, and overall, dosimetry for RPT in clinical practice and trials is highly varied and underutilized. Several factors impede rigorous use of dosimetry, as compared with the more convenient and less resource-intensive practice of empiric dosing. We review various approaches to applying dosimetry for the assessment of activity in RPT and key clinical trials, the extent of dosimetry use, the relative pros and cons of dosimetry-based versus fixed activity, and practical limiting factors pertaining to current clinical practice.

Strippable Polymeric Nanocomposites Comprising "Green" Chelates, for the Removal of Heavy Metals and Radionuclides

The issue of heavy metal and radionuclide contamination is still causing a great deal of concern worldwide for environmental protection and industrial sites remediation. Various techniques have been developed for surface decontamination aiming for high decontamination factors (DF) and minimal environmental impact, but strippable polymeric nanocomposite coatings are some of the best candidates in this area. In this study, novel strippable coatings for heavy metal and radionuclides decontamination were developed based on the film-forming ability of polyvinyl alcohol, with the remarkable metal retention capacity of bentonite nanoclay, together with the chelating ability of sodium alginate and with "new-generation" "green" complexing agents: iminodisuccinic acid (IDS) and 2-phosphonobutane-1,2,4-tricarboxylic acid (PBTC). These environmentally friendly water-based decontamination solutions are capable of generating strippable polymeric films with optimized mechanical and thermal properties while exhibiting high decontamination efficiency (DF ≈ 95-98% for heavy metals tested on glass surface and DF ≈ 91-97% for radionuclides 241Am, 90Sr-Y and 137Cs on metal, painted metal, plastic, and glass surfaces).

Treatment of radiological contamination: a review

After nuclear accidents, people can be contaminated internally via ingestion, inhalation and via intact skin or wounds. The assessment of absorbed, committed doses after internal exposure is based on activity measurement byin vivoorin vitrobioassay. Estimation of dose following internal contamination is dependent on understanding the nature and form of the radionuclide. Direct counting methods that directly measureγ-rays coming from within the body or bioassay methods that measure the amount of radioactive materials in urine or feces are used to estimate the intake, which is required for calculating internal exposure doses. The interpretation of these data in terms of intake and the lifetime committed dose requires knowledge or making assumptions about a number of parameters (time, type of exposure, route of the exposure, physical, biological and chemical characteristics) and their biokinetics inside the body. Radioactive materials incorporated into the body emit radiation within the body. Accumulation in some specific organs may occur depending on the types of radioactive materials. Decorporation therapy is that acceleration of the natural rate of elimination of the contaminant will reduce the amount of radioactivity retained in the body. This article presents an overview of treatment of radiological contamination after internal contamination.

Case Report: Radioactive Holmium-166 Microspheres for the Intratumoral Treatment of a Canine Pituitary Tumor

Introduction: In this case study, a client-owned dog with a large pituitary tumor was experimentally treated by intratumoral injection of radioactive holmium-166 microspheres (166HoMS), named 166Ho microbrachytherapy. To our knowledge, this is the first intracranial intratumoral treatment through needle injection of radioactive microspheres. Materials and Methods: A 10-year-old Jack Russell Terrier was referred to the Clinic for Companion Animal Health (Faculty of Veterinary Medicine, Utrecht University, The Netherlands) with behavioral changes, restlessness, stiff gait, and compulsive circling. MRI and CT showed a pituitary tumor with basisphenoid bone invasion and marked mass effect. The tumor measured 8.8 cm3 with a pituitary height-to-brain area (P/B) ratio of 1.86 cm-1 [pituitary height (cm) ×10/brain area (cm2)]. To reduce tumor volume and neurological signs, 166HoMS were administered in the tumor center by transsphenoidal CT-guided needle injections. Results: Two manual CT-guided injections were performed containing 0.6 ml of 166HoMS suspension in total. A total of 1097 MBq was delivered, resulting in a calculated average tumor dose of 1866 Gy. At 138 days after treatment, the tumor volume measured 5.3 cm3 with a P/B ratio of 1.41 cm-1, revealing a total tumor volume reduction of 40%. Debulking surgery was performed five months after 166HoMS treatment due to recurrent neurological signs. The patient was euthanized two weeks later at request of the owners. Histopathological analysis indicated a pituitary adenoma at time of treatment, with more malignant characteristics during debulking surgery. Conclusion: The 40% tumor volume reduction without evident severe periprocedural side effects demonstrated the feasibility of intracranial intratumoral 166HoMS treatment in this single dog.

Radionuclide-Based Imaging of Breast Cancer: State of the Art

Simple Summary

Breast cancer is one of the most commonly diagnosed malignant tumors, possessing high incidence and mortality rates that threaten women’s health. Thus, early and effective breast cancer diagnosis is crucial for enhancing the survival rate. Radionuclide molecular imaging displays its advantages for detecting breast cancer from a functional perspective. Noninvasive visualization of biological processes with radionuclide-labeled small metabolic compounds helps elucidate the metabolic state of breast cancer, while radionuclide-labeled ligands/antibodies for receptor-targeted radionuclide molecular imaging is sensitive and specific for visualization of the overexpressed molecular markers in breast cancer. This review focuses on the most recent developments of novel radiotracers as promising tools for early breast cancer diagnosis.

Abstract

Breast cancer is a malignant tumor that can affect women worldwide and endanger their health and wellbeing. Early detection of breast cancer can significantly improve the prognosis and survival rate of patients, but with traditional anatomical imagine methods, it is difficult to detect lesions before morphological changes occur. Radionuclide-based molecular imaging based on positron emission tomography (PET) and single-photon emission computed tomography (SPECT) displays its advantages for detecting breast cancer from a functional perspective. Radionuclide labeling of small metabolic compounds can be used for imaging biological processes, while radionuclide labeling of ligands/antibodies can be used for imaging receptors. Noninvasive visualization of biological processes helps elucidate the metabolic state of breast cancer, while receptor-targeted radionuclide molecular imaging is sensitive and specific for visualization of the overexpressed molecular markers in breast cancer, contributing to early diagnosis and better management of cancer patients. The rapid development of radionuclide probes aids the diagnosis of breast cancer in various aspects. These probes target metabolism, amino acid transporters, cell proliferation, hypoxia, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), gastrin-releasing peptide receptor (GRPR) and so on. This article provides an overview of the development of radionuclide molecular imaging techniques present in preclinical or clinical studies, which are used as tools for early breast cancer diagnosis.

Modeling radionuclide transport in urban overland flow: a case study

This paper presents a case study demonstrating the process used to develop an overland flow model of radionuclide transport following an aerosol deposition from a hypothetical radiological dispersal device explosion. The process included the integration of digital elevation, building, and land cover information with hydrologic information from a calibrated Stormwater Management Model (SWMM) model. The overland flow model was used to explore the impact of washoff parameter selection and different storm events on radionuclide transport in surface flow. The range of washoff parameters used in the literature resulted in over a 7 times difference in radionuclide washoff, from a small surface removal to nearly full removal. The overland flow model illuminated the primary pathways of contaminant transport, a potentially useful tool that informs emergency response, planning, and remediation activities.

Recent Achievements about Targeted Alpha Therapy-Based Targeting Vectors and Chelating Agents

One of the most rapidly growing options in the management of cancer therapy is Targeted Alpha Therapy (TAT) through which lethal α-emitting radionuclides conjugated to tumor-targeting vectors selectively deliver high amount of radiation to cancer cells.²²⁵Ac, ²¹²Bi, ²¹¹At, ²¹³Bi, and ²²³Ra have been investigated by plenty of clinical trials and preclinical researches for the treatment of smaller tumor burdens, micro-metastatic disease, and post-surgery residual disease. In order to send maximum radiation to tumor cells while minimizing toxicity in normal cells, a high affinity of targeting vectors to cancer tissue is essential. Besides that, the stable and specific complex between chelating agent and α-emitters was found as a crucial parameter. The present review was planned to highlight recent achievements about TAT-based targeting vectors and chelating agents and provide further insight for future researches.

Synthesis of Silver-Impregnated Magnetite Mesoporous Silica Composites for Removing Iodide in Aqueous Solution

Mag@silica-Ag composite has a high sorption ability for I- in aqueous solution due to its high surface area and strong affinity for the studied anion. The material adsorbed I- rapidly during the initial contact time (in 45 min, η = 80%) and reached adsorption equilibrium after 2 h. Moreover, mag@silica-Ag proved to selectively remove I- from a mixture of Cl-, NO3- and I-. The adsorption behavior fitted the Langmuir isotherm perfectly and the pseudo-second-order kinetic model. Based on the Langmuir isotherm, the maximum adsorption capacity of mag@silica-Ag was 0.82 mmol/g, which is significantly higher than previously developed adsorbents. This study introduces a practical application of a high-capacity adsorbent in removing radioactive I- from wastewaters.

Nutraceuticals as Potential Radionuclide Decorporation Agents

Exposure of individuals to radioactive material as a result of ingestion of contaminated food and water is an increasing public health concern. Unfortunately, there are limited treatment modalities for dealing with these types of potentially toxic exposures. Recent research suggests that many plant-based nutraceuticals may possess metal-binding properties. This preliminary study investigated the ability of genistein, curcumin, quercetin, and lentinan to bind metals considered internal contamination risks, namely cesium, uranium, cobalt, and strontium, in a variety of matrices. The efficacy of these nutraceuticals in protecting cultured cells from metal-induced toxicity was also explored. Results showed that none of the compounds bound cesium or strontium. However, genistein, curcumin, and quercetin could bind uranium. Curcumin and quercetin also bound cobalt and could also protect cultured cells from metal-induced cytotoxicity. Lentinan did not bind any of the metals tested. Metal binding was also pH dependent, with no binding observed at lower pH values. This project showed that nutraceuticals could function as chelators for metals considered internal radionuclide contamination hazards. Further investigations are required in order to determine whether these compounds will become a new nontoxic arsenal of pharmaceutical compounds with which to treat radionuclide contamination.

Influence of the Position and Composition of Radiometals and Radioiodine Labels on Imaging of Epcam Expression in Prostate Cancer Model Using the DARPin Ec1

Simple Summary

Metastasis-targeting therapy might improve outcomes in oligometastatic prostate cancer. Epithelial cell adhesion molecule (EpCAM) is overexpressed in 40–60% of prostate cancer cases and might be used as a target for specific delivery of toxins and drugs. Radionuclide molecular imaging could enable non-invasive detection of EpCAM and stratification of patients for targeted therapy. Designed ankyrin repeat proteins (DARPins) are scaffold proteins, which can be selected for specific binding to different targets. The DARPin Ec1 binds strongly to EpCAM. To determine an optimal design of Ec1-based probes, we labeled Ec1 at two different positions with four different nuclides (⁶⁸Ga, ¹¹¹In, ⁵⁷Co and ¹²⁵I) and investigated the impact on Ec1 biodistribution. We found that the C-terminus is the best position for labeling and that ¹¹¹In and ¹²⁵I provide the best imaging contrast. This study might be helpful for scientists developing imaging probes based on scaffold proteins.

Abstract

The epithelial cell adhesion molecule (EpCAM) is intensively overexpressed in 40–60% of prostate cancer (PCa) cases and can be used as a target for the delivery of drugs and toxins. The designed ankyrin repeat protein (DARPin) Ec1 has a high affinity to EpCAM (68 pM) and a small size (18 kDa). Radiolabeled Ec1 might be used as a companion diagnostic for the selection of PCa patients for therapy. The study aimed to investigate the influence of radiolabel position (N- or C-terminal) and composition on the targeting and imaging properties of Ec1. Two variants, having an N- or C-terminal cysteine, were produced, site-specifically conjugated to a DOTA chelator and labeled with cobalt-57, gallium-68 or indium-111. Site-specific radioiodination was performed using ((4-hydroxyphenyl)-ethyl)maleimide (HPEM). Biodistribution of eight radiolabeled Ec1-probes was measured in nude mice bearing PCa DU145 xenografts. In all cases, positioning of a label at the C-terminus provided the best tumor-to-organ ratios. The non-residualizing [¹²⁵I]I-HPEM label provided the highest tumor-to-muscle and tumor-to-bone ratios and is more suitable for EpCAM imaging in early-stage PCa. Among the radiometals, indium-111 provided the highest tumor-to-blood, tumor-to-lung and tumor-to-liver ratios and could be used at late-stage PCa. In conclusion, label position and composition are important for the DARPin Ec1.

Development of the Functionalized Nanocomposite Materials for Adsorption/Decontamination of Radioactive Pollutants

A polymer-based nanofiber membrane with a high specific surface area, high porosity and abundant adsorption sites is demonstrated for selective trapping of radionuclides. The Prussian blue (PB)/poly(methyl methacrylate) (PMMA) nanofiber composites were successfully prepared through a one-step, single-nozzle electrospinning method. Various analytical techniques were used to examine the physical and chemical properties of PB nanoparticles and electrospun nanofibers. It is possible to enhance binding affinity and selectivity to radionuclide targets by incorporation of the PB nanoparticles into the polymer matrix. It is noteworthy that the maximum 133Cs adsorption capacity of hte PB/PMMA nanofiber filter is approximately 28 times higher than that of bulk PB, and the removal efficiency is measured to be 95% at 1 ppm of 133Cs. In addition, adsorption kinetics shows that the PB/PMMA nanofiber has a homogenous surface for adsorption, and all sites on the surface have equal adsorption energies in terms of ion-exchange between cyano groups of the introduced PB nanoparticles and radionuclides.