Physics & Pharmacy · Radiopharmacy
Radiopharmaceuticals
Snapshot
How the tracers are made and kept safe: radionuclides from reactors, cyclotrons and generators; ⁹⁹ᵐTc chemistry with cold kits (about 80% of nuclear-medicine work); PET tracers such as FDG, ⁶⁸Ga and ⁸²Rb; and the quality control and aseptic radiopharmacy practice behind every dose.
Reactor/cyclotron/generatorProduction
⁹⁹ᵐTc kitsWorkhorse chemistry
QCPurity & sterility
Clinical topics
Mechanisms of Action
Every tracer grouped by the step that traps it — 16 mechanisms, 56 animated agents.
Radionuclide Atlas
Interactive board of 29 clinical nuclides — decay, energies, uses.
Radionuclide production
Reactors, cyclotrons and generators.
⁹⁹Mo/⁹⁹ᵐTc generator
Elution, equilibrium and breakthrough.
⁹⁹ᵐTc chemistry & cold kits
Stannous reduction; labelling; impurities.
PET radiopharmaceuticals
FDG synthesis, ¹⁸F, ⁶⁸Ga, ⁸²Rb.
Radiopharmaceutical QC
Radiochemical purity, sterility, pyrogens.
Radiopharmacy & adverse reactions
Aseptic practice, safety, reactions.
Sources
Key guidelines and evidence behind this chapter.
- Saha GB. Fundamentals of Nuclear Pharmacy. 7th ed. Cham: Springer; 2018.
- European Pharmacopoeia. Radiopharmaceutical monographs, including Sodium pertechnetate (⁹⁹ᵐTc) injection (fission) and Technetium (⁹⁹ᵐTc) macrosalb injection. Strasbourg: EDQM (current edition).
- United States Pharmacopeia. Sodium Pertechnetate Tc 99m Injection monograph; US Nuclear Regulatory Commission 10 CFR 35.204.
- Gillings N, Hjelstuen O, Ballinger J, et al. Guideline on current good radiopharmacy practice (cGRPP) for the small-scale preparation of radiopharmaceuticals. EJNMMI Radiopharm Chem. 2021;6:8.
- Gillings N, Todde S, Behe M, et al. EANM guideline on the validation of analytical methods for radiopharmaceuticals. EJNMMI Radiopharm Chem. 2020;5:7.
- Gillings N, Hjelstuen O, Behe M, et al. EANM guideline on quality risk management for radiopharmaceuticals. Eur J Nucl Med Mol Imaging. 2022;49:3353–64.
- Yu S. Review of ¹⁸F-FDG synthesis and quality control. Biomed Imaging Interv J. 2006;2:e57.
- Silberstein EB, Ryan J. Prevalence of adverse reactions in nuclear medicine. J Nucl Med. 1996;37:185–92.
- Schreuder N, Koopman D, Jager PL, et al. Adverse events of diagnostic radiopharmaceuticals: a systematic review. Semin Nucl Med. 2019;49:382–410.
- International Atomic Energy Agency. Cyclotron Produced Radionuclides: Physical Characteristics and Production Methods. Technical Reports Series No. 468. Vienna: IAEA; 2009.