Newer radionuclide therapies

Author(s): Dr Francis Sundram, Dr Eleonora Manca

Hospital: University Hospital Southampton NHS Foundation Trust

Reference: RAD Magazine, 42, 495, 23-24

Excerpt: 

Radionuclide therapy (RNT), also known as molecular radiotherapy (MRT), utilises unsealed ionising radiation to target particular tissues. RNT depends on the properties of the radionuclides and tracer conjugates that selectively binds to cell receptors. The majority of radionuclides used in RNT are beta (β)-particles, although there is an established role and also emerging applications using alpha (α)-particles. RNT is considered as low dose rate irradiation because the rate of energy deposited in targeted cells is prolonged, whereas external beam irradiation delivers a high dose over a very short time.

β-particles are high energy ionising electrons, causing single strand DNA breaks and subsequent cell damage. The range for high energy β-emitters surpasses multiple cell diameters. Some β-emitting radionuclides also emit gamma (γ)-rays, allowing radionuclide distribution imaging. The short path length and high linear energy transfer of α-particles, which cause unrepairable double strand DNA breaks, results in more specific tumour cell kill, with less damage to surrounding normal tissues.

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