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A molecule that homes to the tumour carries a radioactive atom. The same molecule with a different atom lets you see the tumour first.
Radiopharmaceuticals and theranostics pair a molecule that homes to the tumour with a radioactive atom, using one isotope to see the tumour and another to treat it. The section covers theranostic pairs such as 68Ga or 18F for PET imaging, 177Lu for beta therapy and 225Ac or 212Pb for alpha therapy, directed at PSMA, SSTR, FAP and other targets. Pluvicto and Lutathera are approved, alpha emitters and new targets are in late-stage trials, and isotope supply is the bottleneck. Linked technologies include PSMA PET, somatostatin receptor PET, radioligand therapy with beta emitters, targeted alpha therapy, PRRT, radioiodine therapy, MIBG theranostics and radioembolisation, and the companies Curium, Blue Earth Diagnostics, Sirtex Medical and Y-mAbs Therapeutics point here.
Actinium-225 is the alpha-emitting atom behind the most promising next wave of radioligand therapies, and there is not enough of it. Almost all of it used to come from one decaying stock of thorium in a US national laboratory. New routes use accelerators and old radium.
Actinium-225 releases four alpha particles as it decays, but the daughters escape and irradiate the kidneys and salivary glands. Nanocarriers try to hold them in place.
A rare alpha-emitting halogen that can be attached to antibodies and small molecules like iodine, tested in leukaemia conditioning and brain and ovarian cancer.
Auger-electron therapy uses radioactive atoms such as iodine-125 or terbium-161 that release cascades of low-energy electrons travelling only nanometres to micrometres, so they kill a cell only if the atom sits on or inside its DNA and spare the neighbours. Terbium-161 can replace lutetium-177 in existing PSMA ligands; true nuclear delivery remains preclinical.
Proton-rich isotopes for PET scans and some therapies are made by hitting a target with a beam from a cyclotron. Fluorine-18 is made every morning within driving distance of the scanner; gallium-68 comes from either a generator or a cyclotron; copper-64 and zirconium-89 last long enough to ship across a country.
The small radiation detectors that make nuclear medicine and sentinel node surgery work: a pen-sized probe that clicks when the surgeon nears the radioactive lymph node, and the well counter in the hot lab that checks every dose before it is injected.
Cancer-seeking molecules carrying the radioactive metal lutetium-177, which delivers short-range radiation to tumours it binds; approved for neuroendocrine tumours and prostate cancer.
The particle accelerators and shielded robotic chemistry boxes that make PET tracers in hospital basements and commercial pharmacies.
A noradrenaline look-alike that neuroblastoma cells swallow: labelled with a small amount of radioactivity it shows the tumour on a scan; with a large amount it treats it.
A radioactive version of the hormone mimic used for the scan; it homes to neuroendocrine tumour cells and irradiates them from inside.
Making PSMA, FDG, and new tracers under drug-manufacturing rules and delivering them daily.
A prostate-cancer-specific PET scan that finds spread far earlier than CT or bone scan, and tells you whether a matched radioactive drug will work.
Attaching a radioactive atom to an antibody, so an ADC's targeting is used to deliver radiation instead of chemotherapy.
Millions of tiny radioactive glass or resin beads are injected into the liver artery, lodging in the tumour and irradiating it from within.
Using the thyroid's natural appetite for iodine to image and treat thyroid cancer with a radioactive form of it. The oldest theranostic, and now used more selectively than it was.
Measuring, from scans taken after each dose, how much radiation a radioligand actually delivers to the tumour and to kidneys and marrow, so treatment can be personalised.
Adding a PARP or ATR inhibitor to a radioactive drug so the tumour cannot repair the damage the radiation causes.
A drug that finds tumour cells and carries a radioactive atom that irradiates them from inside the body.
Bench-top devices that 'milk' a short-lived isotope from a long-lived parent, plus vials of ready-to-label ligand. How most hospitals make PSMA and somatostatin PET tracers without a cyclotron.
A radioactive medicine loses activity every hour, so it is made to order, tested in hours and often injected before the sterility test has finished. The rules for that are different from ordinary drugs, and the handful of plants that make lutetium therapies have had their own shortages.
The factories and courier routes that make and deliver short-lived radioactive tracers to hospitals within hours.
Most of the world's therapeutic and scanning isotopes are made by putting targets into about half a dozen ageing research reactors and flying the product out within days. When two reactors were down at once in 2009 and 2010, hospitals worldwide ran short of the most used scan isotope.
A PET scan using a radioactive hormone mimic that lights up neuroendocrine tumours and shows whether the matching radioactive treatment will work.
A gamma camera with a CT scanner bolted on, so a hot spot on a bone scan or a sentinel-node scan is pinned to the exact bone or lymph node, and the dose from a radioactive drug can be measured after treatment.
Like radioligand therapy but with alpha particles: far more destructive over a much shorter range, so single cells can be killed with less collateral damage.
Where the radioactive atoms for imaging and therapy actually come from: ageing reactors, new accelerators, and a scramble for actinium.
Open-source software, hardware and data projects catalogued by a third party, the Open Medical Registry, that bear on this front. Listing is not endorsement; check each project's own licence and validation before clinical use.
This data-centric AI repository implements a robust deep learning method (LFBNet) for fully automated tumor segmentation in whole-body [18]F-FDG PET/CT images.
Tiny library for calculating Standardized Uptake Value for Nuclear Medicine (i.e.
Official public repository of Gate
LinaQA (pronounced Linakwa) is a medical physics toolkit for radiotherapy, diagnostic radiology and nuclear medicine based on pylinac and pydicom.
A 3D lesion segmentation method on whole-body PET images including automated quality control.
From the Open Medical Registry (openmedical.sh), an MIT-licensed catalogue of open-source medicine. Blurbs are one line from each registry record; every project keeps its own licence.