Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Biomedical MRI/MoSAIC, Department of Imaging and Pathology, Katholieke Universiteit Leuven, Herestraat 49, 3000, Leuven, Belgium.
ChemMedChem. 2021 Oct 6;16(19):2909-2941. doi: 10.1002/cmdc.202100135. Epub 2021 May 10.
Nuclear medicine is defined as the use of radionuclides for diagnostic and therapeutic applications. The imaging modalities positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are based on γ-emissions of specific energies. The therapeutic technologies are based on β -particle-, α-particle-, and Auger electron emitters. In oncology, PET and SPECT are used to detect cancer lesions, to determine dosimetry, and to monitor therapy effectiveness. In contrast, radiotherapy is designed to irreparably damage tumor cells in order to eradicate or control the disease's progression. Radiometals are being explored for the development of diagnostic and therapeutic radiopharmaceuticals. Strategies that combine both modalities (diagnostic and therapeutic), referred to as theranostics, are promising candidates for clinical applications. This review provides an overview of the basic concepts behind therapeutic and diagnostic radiopharmaceuticals and their significance in contemporary oncology. Select radiometals that significantly impact current and upcoming cancer treatment strategies are grouped as clinically suitable theranostics pairs. The most important physical and chemical properties are discussed. Standard production methods and current radionuclide availability are provided to indicate whether a cost-efficient use in a clinical routine is feasible. Recent preclinical and clinical developments and outline perspectives for the radiometals are highlighted in each section.
核医学被定义为使用放射性核素来进行诊断和治疗应用。正电子发射断层扫描（PET）和单光子发射计算机断层扫描（SPECT）这两种成像方式基于特定能量的γ射线发射。治疗技术则基于β粒子、α粒子和俄歇电子发射器。在肿瘤学中，PET 和 SPECT 用于检测癌症病灶、确定剂量学和监测治疗效果。相比之下，放射疗法旨在不可逆转地破坏肿瘤细胞，以消灭或控制疾病的进展。放射性金属正被探索用于开发诊断和治疗放射性药物。将这两种方式（诊断和治疗）相结合的策略，称为治疗学，是临床应用的有前途的候选者。本文综述了治疗性和诊断性放射性药物的基本概念及其在当代肿瘤学中的重要性。将对当前和即将出现的癌症治疗策略产生重大影响的选定放射性金属归类为临床适用的治疗学配对。讨论了最重要的物理和化学性质。提供了标准的生产方法和当前的放射性核素可用性，以表明在临床常规中是否可以进行具有成本效益的使用。在每个部分都强调了最近的临床前和临床发展，并概述了放射性金属的前景。
