Adam J, Kadeřávek J, Kužel F, Vašina J, Rehák Z
Klin Onkol. 2014;27 Suppl 1:S137-42. doi: 10.14735/amko20141s137.
Nuclear medicine is an important field of nuclear medicine, especially thanks to its role in in vivo imaging of important processes in human organism. An overwhelming majority of nuclear medicine examinations comprises of planar scintigraphy and single photon emission computed tomography, for decades relying on the labeling by metastable technetium nuclide (99mTc), used with a great diversity of ligands for various applications. Nuclear medicine departments utilize commercially available molybdenum technetium generators, being able to elute the nuclide at any time and prepare the radiopharmaceutical. The mother nuclide, molybdenum-99 (99Mo), is produced in just a handful of places around the world. The production places are without exception research nuclear reactors working far past their life expectancy. A concurrent temporary shutdown of two of them in the year 2009 caused a critical worldwide shortage of 99mTc. An unavoidable permanent shutdown of part of these capacities in the second decade of the 21st century will cause the second, and this time rather permanent "technetium crisis". The article focuses on history, present, potential future and possible solutions in regard to SPECT diagnostics.
核医学是核医学的一个重要领域,特别是由于其在人体重要生理过程的体内成像方面所发挥的作用。绝大多数核医学检查包括平面闪烁显像和单光子发射计算机断层扫描,几十年来一直依赖于亚稳态锝核素(99mTc)标记,它与各种各样的配体一起用于各种应用。核医学科室使用市售的钼锝发生器,能够随时洗脱核素并制备放射性药物。母核素钼-99(99Mo)仅在世界上少数几个地方生产。生产地无一例外都是运行时间远超其预期寿命的研究用核反应堆。2009年其中两座反应堆同时临时关闭,导致全球范围内99mTc严重短缺。21世纪第二个十年部分产能不可避免的永久关闭将引发第二次,而且这次可能是永久性的“锝危机”。本文重点探讨单光子发射计算机断层扫描(SPECT)诊断的历史、现状、潜在的未来以及可能的解决方案。