Srivastava S C
Brookhaven National Laboratory, Medical Department, Upton, NY 11973-5000, USA.
Semin Nucl Med. 1996 Apr;26(2):119-31. doi: 10.1016/s0001-2998(96)80033-x.
The use of radionuclides for medical and for a multitude of other basic research applications has continued to grow at a very rapid pace. Procedures, based on their use as radiotracers for nuclear medicine imaging and for radiotherapy of cancer and other pathology, have become firmly established as important clinical modalities. It is estimated that on an annual basis in the United States alone, radionuclides are used medically in over 13 million imaging procedures, in over 100 million laboratory tests, and in an ever increasing number (> 100,000) for therapeutic administrations. One out of every four hospital patients undergoes a procedure that involves the use of radionuclides. Diagnostic imaging methods using planar/single-photon emission computed tomography and positron-emission tomography (PET) imaging, as well as the measurement of in vivo organ function, physiology, or biochemistry, have become indispensable tools in patient workup and management. More than 80% of all imaging studies (mostly anatomic) currently use technetium-99m (99mTc), because it has turned out to be the ideal isotope from various considerations. However, over the past few years, nuclear medicine has experienced a slow but steady evolution towards functional studies, quantitative PET imaging, and novel therapeutic approaches. New radionuclides are required for these applications, and their development has attracted considerable interest. This article reviews the current status and future prospects for the development of many new potential isotopes. Practical issues, such as the feasibility of large-scale production and wide-spread availability in a continuous reliable fashion, are addressed. To date, the data are not sufficient to answer the question as to whether any of these radionuclides (or their applications, for that matter) will eventually assume as broad-based a role as that of 99mTc. Nonetheless, there are a number of promising radionuclides that could assume an important place in the future practice of nuclear medicine.
放射性核素在医学及众多其他基础研究领域的应用一直在快速增长。基于其作为核医学成像及癌症和其他病症放射治疗的放射性示踪剂的程序，已牢固确立为重要的临床手段。据估计，仅在美国，每年就有超过130万次医学成像程序、超过1亿次实验室检测以及越来越多（超过10万次）的治疗给药使用放射性核素。每四名住院患者中就有一人接受涉及使用放射性核素的程序。使用平面/单光子发射计算机断层扫描和正电子发射断层扫描（PET）成像的诊断成像方法，以及体内器官功能、生理学或生物化学的测量，已成为患者检查和管理中不可或缺的工具。目前，超过80%的所有成像研究（大多为解剖学研究）使用锝-99m（99mTc），因为从各种考虑因素来看，它已被证明是理想的同位素。然而，在过去几年中，核医学已朝着功能研究、定量PET成像和新型治疗方法缓慢但稳步地发展。这些应用需要新的放射性核素，其开发已引起相当大的关注。本文综述了许多新的潜在同位素的开发现状和未来前景。还讨论了实际问题，如大规模生产的可行性以及以持续可靠的方式广泛供应的问题。迄今为止，数据尚不足以回答这些放射性核素（或其应用）是否最终会像99mTc那样发挥广泛作用的问题。尽管如此，有一些有前景的放射性核素可能在未来的核医学实践中占据重要地位。
