Rhenium-188 Production in Hospitals, by W-188/Re-188 Generator, for Easy Use in Radionuclide Therapy

Abstract

Rhenium-188 (Re-188) is a high energy β-emitting radioisotope obtained from the tungsten-188/rhenium-188 (W-188/Re-188) generator, which has shown utility for a variety of therapeutic applications in nuclear medicine, oncology, and interventional radiology/cardiology. Re-188 decay is accompanied by a 155 keV predominant energy γ-emission, which could be detected by γ-cameras, for imaging, biodistribution, or absorbed radiation dose studies. Its attractive physical properties and its potential low cost associated with a long-lived parent make it an interesting option for clinical use. The setup and daily use of W-188/Re-188 generator in hospital nuclear medicine departments are discussed in detail. The clinical efficacy, for several therapeutic applications, of a variety of Re-188-labeled agents is demonstrated. The high energy of the β-emission of Re-188 is particularly well suited for effective penetration in solid tumours. Its total radiation dose delivered to tissues is comparable to other radionuclides used in therapy. Furthermore, radiation safety and shielding requirements are an important subject of matter. In the case of bone metastases treatment, therapeutic ratios are presented in order to describe the efficacy of Re-188 usage.

PMPA for Nephroprotection in PSMA-Targeted Radionuclide Therapy of Prostate Cancer

“…186 Re (half-life, 3.7 d; maximum energy of b emission, 1.07 MeV; 11% coemission of 137-keV g emission for imaging) presents an attractive "matched pair" for therapy. 188 Re (half-life, 17 h; maximum energy of b emission, 2.12 MeV; 15% coemission of 155 keV g emission for imaging) can be obtained from a 188 W/ 188 Re generator (Oak Ridge National Laboratory) that was Food and Drug Administration-approved and would be suitable for clinical application (18). MIP1095 can be tagged with different isotopes of iodine.…”

Palliative treatment of metastatic bone pain with radiopharmaceuticals: A perspective beyond Strontium-89 and Samarium-153

“…The availability of no carrier added 188 Re from the 188 W/ 188 Re generators makes the use of 188 Re convenient. However, currently, there are only a few reactors in the world capable of production of sufficiently high specific activity 188 W needed for the preparation of alumina-based commercial 188 W/ 188 Re generator (Argyrou et al, 2013a;Das and Pillai, 2013). The short physical half-life and high dose rate are predicted to lead to rapid symptom response post therapy administration (Lewington, 2005;Knut Liepe et al, 2003).…”

“…31 P(n,γ) 32 P (None) 32 S(n,p) 32 P ( 33 P, 35 S) 34 S(d,α) 32 P (None) High Cost-effective High (Bé et al, 2008;Lewington, 2005;Vimalnath et al, 2013;Volkert and Hoffman, 1999) (Argyrou et al, 2013a(Argyrou et al, , 2013cBé et al, 2008;Lewington, 2005) (Bé et al, 2008;Henriksen et al, 2003;Lewington, 2005) Legend: T1/2 (days) -radioisotope half-life in days; E (MeV) (%) -particle energy and respective decay abundance shown in parentheses; Eγ (keV) (%) -gamma ray energy and respective abundance in total energy emission shown in parentheses; Tissue penetration range (mm) -maximum tissue penetration in soft tissue shown in millimeters. …”

“…For example, the decay of 125 I has been shown to lead to the deposition of a very high dose (≈10 9 cGy/decaying atom) in the immediate vicinity (≈2 nm 3 ) of the decay site and a sharp and significant drop in the energy deposited (from ≈10 9 to ≈10 6 cGy) as a function of increasing distance (few nanometres) from the decaying 125 I atom (Kassis, 2011). For example, when 125 I is localized within the cytoplasm, the survival curve is of the low LET type and the number of decays needed to reduce survival is ≈80 times that of DNA-incorporated 125 I (Kassis, 2011 (Abbasi, 2012(Abbasi, , 2011Argyrou et al, 2013a;Bączyk, 2011;Bryan et al, 2009;Chakraborty et al, 2008;Daha et al, 2010;Das et al, 2009;Harrison et al, 2013;Lewington, 2005;Máthé et al, 2010;Neves et al, 2005;Nilsson et al, 2013bNilsson et al, , 2007Nilsson et al, , 2005aNilsson et al, , 2005bPandit-Taskar et al, 2014;Ramdahl et al, 2013;Sartor, 2004;Simón et al, 2012;Sivaprasad and Rajagopal, 2012;Tomblyn, 2012;Vigna et al, 2011;Volkert and Hoffman, 1999;Wang et al, 2011). Despite the growing number of radionuclides investigated for treatment of bone metastases, the use of 89 Sr and 153 Sm still accounts for the bulk of radiopharmaceutical bonetargeted therapeutics in the clinical context and the majority of the review articles available in the literature focus on those two radionuclides.…”

Comparative analysis of 11 different radioisotopes for palliative treatment of bone metastases by computational methods

“…Radioisotopes investigated for this application included phosphorus-32 ( 32 P), strontium-89 ( 89 Sr), yttrium-90 ( 90 Y), tin-117m ( 117m Sn), samarium-153 ( 153 Sm), holmium-166 ( 166 Ho), thulium-170 ( 170 Tm), lutetium-177 ( 177 Lu), rhenium-186 ( 186 Re), rhenium-188 ( 188 Re), and radium-223 ( 223 Ra). 2,5,6,[9][10][11][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] The main physical characteristics of these radionuclides are presented in Table I. The 32 P was the first radioisotope to be evaluated for palliative treatment of bone metastases and its first clinical use dates back to 1941.…”