Radiopharmaceutical is a drug contain radioactive material and used for medical purpose; diagnosing and to treat certain diseases. In the field of Nuclear Medicine, almost 95% is indicated for diagnosing diseases both cancer and non-cancer type. The dose given is small and drug administration is consider safe provided that patients adhered to the radiation protection principle as advised.
Radiopharmaceutical has two components; radionuclide and pharmaceutical. Radionuclide will emit radioactive ray that possesses different energy depending on the type of radioactive used whereas pharmaceutical serves as a carrier to transport radioactive to the targeted cell such as cancerous cells. Radiopharmaceutical could only be given to the patient by qualified medical staffs under supervision of nuclear medicine specialist and only available in the hospitals that offered this service.
Type of Radiofarmaseutical
Radiopharmaceuticals can be divided into 2 types depending on the intended use;
- Radiopharmaceuticals intended use for diagnostic disease.
- Radiopharmaceuticals intended use for treating disease.
Radiopharmaceuticals Intended Use for Diagnostic Disease
Radiopharmaceutical for this purpose contain radioactive material that will produce radiation emission, known as gamma rays. Gamma rays can be detected by using radiation detection equipment or devices such as camera scintillation imaging, Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography/Computed Tomography (PET/CT). If this radiopharmaceutical is injected into the patient, it will either pass through certain organs in the body or being take up by them. After that, the rays will be detected by gamma ray detector cameras and generate images. The information gathered will be used by the Nuclear Physicians to report the status of the patient assessment.
Examples of images for bone imaging procedure after radiopharmaceutical been administered for diagnostic purpose.
Radiopharmaceuticals Intended Use for Disease Treatment
Radiopharmaceuitical for this purpose have a radioactive material that willemit higher energy radiation emission of beta particles or alpha particles.This radiation could kill cancer cells or cancer stem cells. Drugs that injected into the patient’s body will travel andremain in the cancer tissue. Consequently, the cancer tissues will be damaged and died. The results of treatment could not be seen in near future because the damaged cells take for a while to decease. Patients may be quarantined after taking this medicine for radiation safety.
Listed below are some of the radiopharmaceuticals commonly used andit respective indication;
|1.||Technetium (99mTc) Medronate||Bone Imaging|
|2.||Technetium (99mTc) Tetrofosmin||Heart Perfusion Imaging|
|3.||Technetium (99mTc) Sestamibi
Sodium pertechnetate (99mTc)
|5.||Technetium (99mTc) succimer
Technetium (99mTc) pentetate
Technetium (99mTc) mertiatide
|6.||Sodium Iodide (131I)||Imaging and Treatment of Thyroid Cancer|
|7.||Yttrium (90Y) silicate||RadiosynovectomyTreatment|
When radiopharmaceutical is given?
Patient who are referred to Nuclear Medicine Department is eligible to use this medication. Sufficient explanation regarding the procedures to be performed will be given by a nuclear medicine physician. Radiopharmaceutical will only be given after the patient agree to continue with the prescribed procedure.
How to administered
Various form of pharmaceutical dosage available for pharmaceuticals. Usually patient will be administered intravenally or given orally; either in liquid form ( to drink) or capsule form (to swallow). There are also drugs in the form of gas to be inhaled by the patient.This radiopharmaceutical should only be given to patients in the hospital only or to be specified, in Nuclear Medicine Department. Patients are not supplied this medication to take home.
Unlike other pharmaceutical preparations, instead of using dose measurement in milligrams as quantity of intake given to patient, radiopharmaceuticals usually usemeasurement unit as Curie (Ci) (Non-SI unit) or Megabecquerel (MBq) (SI Units). The dose given to you will be determined by the nuclear medicine physician. There are variation in the dose administered to children and adults. Body weight also to be considered in determining the dose given to patient.
Matters of concern
Before and decided to use radiopharmaceuticals for diagnosis or treatment of disease, here are some things that need to be addressed;
- Make sure patient is not allergic to any ingredient content in the drugs used.
- Make sure patient are not pregnant.
- Patient are advised to stop breast-feeding for certain period of time.
- Consult your doctor if your child or your parents are to be given this medicine.
- Inform the doctor if patient on any medicine, traditional medicine, herbs and supplements (supplements).
- Inform your doctor if patient smoke or drink alcohol.
However, make sure you talk to your doctor about the benefits versus the risks posed by exposure to the radiation received from the use of radiopharmaceuticals.
Possible Side Effects of Sustained
- Breath Tickler
- Bronchospasm (acute narrowing of respiratory airways)
- Reduction of blood pressure
- Bradycardia( slow in heart beat)
If patient hasnot experience any of above signs and feelsuncomfortable, please inform the doctor or any medical practitioner. Side effects may occur after leaving the hospital.
- AgensiNuklear Malaysia. Warta Nuklear Malaysia. PerubatanNuklear (PDF). Jilid 4. Bilangan 3 Sept-Dis 2011.
- Gambar – http://www.who.int/diagnostic_imaging/imaging_modalities/dim_plain-radiography/en/index7.html
- http://www.whatisnuclearmedicine.com/Home 6. Saha G.P. (2010). Fundamental of Nuclear Pharmacy (6th ed.). New York: Springer Science+Business Media
- Video – http://www.snmmi.org/ClinicalPractice/content.aspx?ItemNumber=6539
|Last Reviewed||:||06 November 2014|
|Writer/Translator||:||Mohd Borhanuddin bin Md. Hassan|
|Accreditor||:||Suharzelim bin Abu Bakar|