Rhenium-188 (
188
Re) is a high energy beta-emitting radioisotope with a short 16.9 h physical half-life, which has been shown to be a very attractive candidate for use in therapeutic nuclear medicine. The high beta emission has an average energy of 784 keV and a maximum energy of 2.12 MeV, sufficient to penetrate and destroy targeted abnormal tissues. In addition, the low-abundant gamma emission of 155 keV (15%) is efficient for imaging and for dosimetric calculations. These key characteristics identify
188
Re as an important therapeutic radioisotope for routine clinical use. Moreover, the highly reproducible on-demand availability of
188
Re from the
188
W/
188
Re generator system is an important feature and permits installation in hospital-based or central radiopharmacies for cost-effective availability of no-carrier-added (NCA)
188
Re. Rhenium-188 and technetium-99 m exhibit similar chemical properties and represent a “theranostic pair.” Thus, preparation and targeting of
188
Re agents for therapy is similar to imaging agents prepared with
99m
Tc, the most commonly used diagnostic radionuclide. Over the last three decades, radiopharmaceuticals based on
188
Re-labeled small molecules, including peptides, antibodies, Lipiodol and particulates have been reported. The successful application of these
188
Re-labeled therapeutic radiopharmaceuticals has been reported in multiple early phase clinical trials for the management of various primary tumors, bone metastasis, rheumatoid arthritis, and endocoronary interventions. This article reviews the use of
188
Re-radiopharmaceuticals which have been investigated in patients for cancer treatment, demonstrating that
188
Re represents a cost effective alternative for routine clinical use in comparison to more expensive and/or less readily available therapeutic radioisotopes.
These findings show that CED of (188)Re-loaded LNC is a safe and potent anti-tumour system for treating malignant gliomas. Our data are the first to show the in vivo efficacy of (188)Re internal radiotherapy for the treatment of brain malignancy.
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