Radioactive

Isotopes in
Medicine

Group 2
 Radioactive Isotopes in Medicine
The radioactive isotopes were first
used in medicine for diagnostic
procedures during the early 1930s.
This eventually laid the foundation for
nuclear medicine. This article will
cover all the information regarding
the procedures and uses of
radioactive isotopes in medicine.
 What is Nuclear Medicine

 Nuclear medicine is the branch of science

under medicine, that uses radiation to give
information regarding the functioning of a
specific organ in the human body or to treat
a disease. This collected information gives
accurate and immediate diagnosis of the
patient's illness. Radioactive isotopes in
medicine are used to form images of the
thyroid, bones, heart, liver and many other
organs. Radioactive isotopes used in
medicine have also helped in treating
diseased organs and tumors.
What is Nuclear Medicine
 Nuclear medicine uses radiation to
provide diagnostic information about the
functioning of a person's specific
organs, or to treat them. Diagnostic
procedures are now routine.
 Diagnostic techniques in nuclear
medicine
 Medical diagnosis refers to the process of
attempting to determine and/or identify a
possible disease or disorder and the opinion
reached by this process.
 Diagnostic techniques in nuclear medicine
use radioactive tracers which emit gamma
rays from within the body. These tracers are
generally short-lived isotopes linked to
chemical compounds which permit specific
physiological processes to be scrutinized. They
can be given by injection, inhalation or orally.
Diagnostic techniques in nuclear
medicine
 Positron Emission Tomography (PET)- a more
precise and sophisticated technique using
isotopes produced in a cyclotron. A positron-
emitting radionuclide is introduced, usually by
injection, and accumulates in the target
tissue. As it decays it emits a positron, which
promptly combines with a nearby electron
resulting in the simultaneous emission of two
identifiable gamma rays in opposite directions
 These are detected by a PET camera and
give very precise indication of their origin
 Diagnostic techniques in nuclear
medicine
 The Positron Emission Tomography or the PET scan
was the first diagnostic tool invented by Peter
Alfred Wolf that used radioactive isotopes in
medicine.
 New procedures combine PET with Computed X-
ray tomography (CT) scans to give co-registration
of the two images (PETCT), enabling 30% better
diagnosis than with traditional gamma camera
alone. It is a very powerful and significant tool
which provides unique information on a wide
variety of diseases from dementia to
cardiovascular disease and cancer (oncology).
 Radionuclide therapy (RNT)
 Rapidly dividing cells are particularly sensitive to
damage by radiation. For this reason, some
cancerous growths can be controlled or eliminated
by irradiating the area containing the growth.
 Internal radionuclide therapy is by administering or
planting a small radiation source, usually a gamma
or beta emitter, in the target area. Short-range
radiotherapy is known as brachytherapy, and this is
becoming the main means of treatment.
 Radionuclide therapy (RNT)
 Externalirradiation (sometimes called
teletherapy) can be carried out using a
gamma beam from a radioactive cobalt-
60 source, though in developed countries
the much more versatile linear
accelerators are now being utilized as a
high-energy x-ray source (gamma and x-
rays are much the same)
 Biochemical Analysis
 Itis very easy to detect the presence or absence of
some radioactive materials even when they exist in
very low concentrations. Radioisotopes can
therefore be used to label molecules of biological
samples in vitro (out of the body). Pathologists have
devised hundreds of tests to determine the
constituents of blood, serum, urine, hormones,
antigens and many drugs by means of associated
radioisotopes. These procedures are known as
radioimmuno-assays and, although the
biochemistry is complex, kits manufactured for
laboratory use are very easy to use and give
accurate results.
 Diagnostic Radiopharmaceuticals
 Diagnostic radiopharmaceuticals can be used
to examine blood flow to the brain, functioning
of the liver, lungs, heart or kidneys, to assess
bone growth, and to confirm other diagnostic
procedures. Another important use is to predict
the effects of surgery and assess changes since
treatment.
 A radioisotope used for diagnosis must emit
gamma rays of sufficient energy to escape
from the body and it must have a half-life short
enough for it to decay away soon after
imaging is completed.
 Therapeutic Radiopharmaceuticals
 Forsome medical conditions, it is useful to destroy
or weaken malfunctioning cells using radiation.
The radioisotope that generates the radiation
can be localized in the required organ in the
same way it is used for diagnosis - through a
radioactive element following its usual biological
path, or through the element being attached to
a suitable biological compound. In most cases, it
is beta radiation which causes the destruction of
the damaged cells. This is radionuclide therapy
(RNT) or radiotherapy.
 SOME Isotopes used in Medicine
 Many radioisotopes are made in nuclear reactors, some
in cyclotrons. Generally neutron-rich ones and those
resulting from nuclear fission need to be made in
reactors, neutron-depleted ones are made in
cyclotrons. There are about 40 activation product
radioisotopes and five fission product ones made in
reactors.
 Reactor Radioisotopes (half-life indicated)
 Bismuth-213 (46 min): Used for targeted alpha therapy
(TAT), especially cancers, as it has a high energy (8.4
MeV).
 Chromium-51 (28 d): Used to label red blood cells and
quantify gastro-intestinal protein loss.
 Isotopes used in Medicine
 Cobalt-60 (5.27 yr): Formerly used for external
beam radiotherapy, now used more for sterilizing
 Erbium-169 (9.4 d): Use for relieving arthritis pain in
synovial joints.
 Holmium-166 (26 h): Being developed for
diagnosis and treatment of liver tumours.
 Iodine-125 (60 d): Used in cancer brachytherapy
(prostate and brain), also diagnostically to
evaluate the filtration rate of kidneys and to
diagnose deep vein thrombosis in the leg. It is
also widely used in radioimmuno-assays to show
the presence of hormones in tiny quantities.
 Isotopes used in Medicine
 Iodine-131 (8 d)*: Widely used in treating thyroid
cancer and in imaging the thyroid; also in
diagnosis of abnormal liver function, renal
(kidney) blood flow and urinary tract obstruction.
A strong gamma emitter, but used for beta
therapy.
 Iron-59 (46 d): Used in studies of iron metabolism
in the spleen.
 Potassium-42 (12 h): Used for the determination of
exchangeable potassium in coronary blood flow.
 Isotopes used in Medicine
 Rhenium-186 (3.8 d): Used for pain relief in bone
cancer. Beta emitter with weak gamma for
imaging.
 Rhenium-188 (17 h): Used to beta irradiate
coronary arteries from an angioplasty balloon.
 Samarium-153 (47 h): Sm-153 is very effective in
relieving the pain of secondary cancers lodged in
the bone, sold as Quadramet. Also very effective
for prostate and breast cancer. Beta emitter.
 Technetium-99m (6 h): Used in to image the
skeleton and heart muscle in particular, but also
for brain, thyroid, lungs (perfusion and ventilation
 Isotopes used in Medicine
 Xenon-133 (5 d)*: Used for pulmonary (lung)
ventilation studies.
 Carbon-11, Nitrogen-13, Oxygen-15, Fluorine-18:
These are positron emitters used in PET for
studying brain physiology and pathology, in
particular for localising epileptic focus, and in
dementia, psychiatry and neuropharmacology
studies. They also have a significant role in
cardiology. F-18 in FDG (fluorodeoxyglucose) has
become very important in detection of cancers
and the monitoring of progress in their
treatment, using PET.
 Isotopes used in Medicine
 Copper-64 (13 h): Used to study genetic
diseases affecting copper metabolism, such as
Wilson's and Menke's diseases, and for PET
imaging of tumours, and therapy.
 Indium-111 (2.8 d): Used for specialist diagnostic
studies, eg brain studies, infection and colon
transit studies.
 Iodine-123 (13 h): Increasingly used for diagnosis
of thyroid function, it is a gamma emitter
without the beta radiation of I-131.
 Isotopes used in Medicine
 Palladium-103 (17 d): Used to make
brachytherapy permanent implant seeds
for early stage prostate cancer.
 Phosphorus-32 (14 d): Used in the
treatment of polycythemia vera (excess
red blood cells). Beta emitter.
 Potassium-42 (12 h): Used for the
determination of exchangeable
potassium in coronary blood flow.