NEWSLINE and for 2005

he breakneck rate of change to which we have diagnosis of appendicitis in patients age 5 and over with become accustomed in the scientific world has not equivocal symptoms and signs. T been reflected in the number of changes in avail- Although PET agents such as 11C-carbon monoxide, able radionuclides and radiopharmaceuticals between my 11C-flumenazil, 11C-mespiperone, 11C-, 11C- last compilation in 2003 (J Nucl Med. 2003;44[6]:27N– , 11C-, 18F-fluorodopa, 13N-ammonia, and 31N) and the current lists. Economic and regulatory issues 15O-water are now being compounded under the state- have not kept pace with science. regulated practice of medicine and pharmacy, these are Gone is radiolabeled hippuran (labeled with 123Ior not widely available outside of certain research institu- 131I), a stalwart of renal diagnosis since 1961, because of tions and so do not appear on the list. the excellent physical and biologic properties of 99mTc- I have added 2 radiopharmaceuticals classified as “de- mertiatide (MAG3). 99mTc-lidofenin has disappeared as a vices” for by the FDA: 90Y-microspheres hepatobiliary agent, leaving 99mTc-labeled disofenin and (for unresectable hepatocellular carcinoma) and 125I-3- mebrofenin on the market. iodo-4-hydroxybenzenesulfonate (for recurrent malignant 131I- finally passed U.S. Food and Drug glioma). Administration (FDA) review as another labeled antibody A number of new radionuclides appear on this list, against lymphocyte antigen CD20 (as is 90Y-ibritumomab such as 7Be, 32Si, and 44Ti, produced by the U.S. Depart- tiuxetan) for the therapy of lymphoma. 99mTc- ment of Energy (DOE), as well as the radioisotopes of fanolesomab, an antibody directed against granulocyte plutonium, uranium, and thorium available from the antigen CD15, has been approved by the FDA for the (Continued on page 14N)

TABLE 1 Commercially Available Radiopharmaceuticals, 2005

14C-urea 89Sr-strontium chloride 57Co-cyanocobalamin 99mTc-apcitide (GPIIa/IIIb)† 51Cr-sodium chromate 99mTc-arcitumomab (CEA)† 18F-sodium fluoride 99mTc-bicisate dihydrochloride (ECD)* 18F-fluorodeoxyglucose (FDG)* 99mTc-disofenin (DISIDA)* 67Ga-gallium citrate 99mTc-exametazime (HMPAO)* 111In-capromab pendetide (PMSA)† 99mTc-fanolesomab (CD15)† 111In- (CD20)† 99mTc-gluceptate 111In-indium chloride 99mTc-macroaggregated albumin (MAA)* 111In-indium oxyquinoline (oxine)* 99mTc-mebrofenin 111In-pentetate (DTPA)* 99mTc-medronate (MDP)* 111In-pentetreotide (SRS)† 99mTc-mertiatide (MAG3)* 123I- (MIBG)* 99mTc-oxidronate (HDP)* 123I-sodium iodide 99mTc-pentetate (DTPA)* 125I-iodinated albumin (HSA)* 99mTc-sodium pertechnetate 125I-3-iodo-4-hydroxybenzenesulfonate** 99mTc-pyrophosphate (PYP)* 125I-sodium iothalamate 99mTc-red blood cells§ 131I-iobenguane 99mTc-sestamibi 131I-iodinated albumin 99mTc-succimer (DMSA)* 131I-sodium iodide 99mTc-sulfur colloid 131I-6-␤-iodomethyl-19-norcholesterol†† 99mTc-tetrofosmin 131I-tositumomab 201Tl-thallous chloride 32P-chromic phosphate (suspension) 133Xe-xenon gas 32P-sodium phosphate 90Y-ibritumomab tiuxetan (CD20)† 82Rb-rubidium chloride 90Y-microspheres** 153Sm-samarium lexidronam (EDTMP)*

*Common chemical abbreviation. †Antigen or receptor with which interaction occurs. ††Investigational new drug (IND) approval with the University of Michigan required. §Red cells labeled with commercially available kit. **Classified as a medical device for brachytherapy by the U.S. Food and Drug Administration.

Newsline 13N TABLE 2 Radionuclides Available in the United States, 2005

Radioisotopes Source Radioisotopes Source

225Ac/213Bi Alp, DOE 103Pd MURR, Nor, TCI, CNL 26Al CNL 109Pd MURR 241 NEWSLINE Am Aur, CNL 147Pm Aur, CNL 243Am DOE 149Pm MURR 41Ar TX, OR 210Po CNL 73As DOE 191Pt MURR 198Au MURR, OSU, TX 195mPt MURR, DOE-carrier free 133Ba DOE, INIS, Aur, CNL 240Pu DOE 7Be DOE, CNL 241Pu DOE 207Bi DOE, CNL 242Pu DOE 212Bi Alp 224Ra/212Pb/212Bi Alp 213Bi Alp 226Ra CNL 76Br WU 86Rb PE 77Br WU 186Re DOE, MURR, NOR 14C PE, Nor, CNL 188Re DOE, MURR 45Ca PE 105Rh MURR 109Cd DOE, PE, Aur, CNL 106Ru PE, CNL 139Ce CNL 33S CNL 141Ce PE 35S MURR, PE, CNL 252Cf DOE, Aur, CNL 122Sb MURR 36Cl PE 46Sc MURR, PE, TX 244Cm DOE, CNL 47Sc Alp 248Cm DOE 74Se CNL 57Co INIS, Nor, PE, Aur, CNL 75Se Aur, DOE, MURR 58Co CNL 76Se CNL 60Co DOE, INIS, PE, Nor, Aur, CNL 77Se CNL 51Cr MURR, PE, Nor 78Se CNL 137Cs INIS, Aur, CNL 80Se CNL 60Cu INIS, WU 82Se CNL 61Cu WU 32Si DOE 64Cu WU, Nor 153Sm MURR 67Cu Alp, DOE 113Sn PE 166Dy/166Ho MURR 117mSn DOE 55Fe Aur, DOE, PE, CNL 82Sr DOE, Nor, CNL 59Fe PE, CNL 85Sr DOE, PE, CNL 66Ga WU 89Sr DOE, CNL 67Ga BMS, Mal, Nor, CNL 90Sr DOE, Aur, CNL 68Ga CNL, TCI (from 68Ge generator) 160Tb MURR 153Gd PE, CNL, Aur 94mTc WU 68Ge DOE, INIS, PE, TCI, CNL 99Tc DOE, PE 3H PE, CNL 99mTc Mal 166Ho MURR 123mTe MURR, DOE 123I Alp, Am, Mal, Nor 125mTe MURR 124I WU 129mTe MURR 125I CAL-D, Nor, PE, TX, TCI, CNL 228Th Aur, CNL 129I PE, CNL 229Th DOE 131I Drax, INIS, Nor, PE, TCI, Mal, CNL 230Th DOE 111In Alp, Am, Mal, Nor, PE, CNL 44Ti DOE, CNL 114In PE 201Tl Am, BMS, Mal, Nor 192Ir Aur, DOE, MURR, Nor, WSU, CNL 234U DOE 42K MURR 235U DOE 85Kr Aur 236U CNL 177Lu Aur, DOE, INIS, MURR, Nor, PE 238U DOE 54Mn PE, Aur, CNL 188W/188Re DOE, CNL 99Mo Mal, Nor, TCI 133Xe Nor, Mal 22Na DOE, INIS, PE, Aur, CNL 86Y WU 24Na TX 88Y DOE, CNL 95Nb PE 90Y Aur, MURR, Nor, PE, CNL 63Ni Aur, DOE, PE 169Yb MURR, Aur 237Np CNL 65Zn DOE, MURR, PE, CNL 191Os MURR 68Zn CNL 32P MURR, Nor, PE, TCI, Mal, Aur, CNL 88Zr DOE 33P MURR, PE, CNL

Alp ϭ AlphaMed (Acton, MA); Am ϭ Amersham Health (Princeton, NJ); Aur ϭ Auriga Medical of AEA Technology QSA, Inc. (Burlington, MA); BMS ϭ Bristol Myers Squibb (Princeton, NJ); CAL-D ϭ University of California-Davis (Davis, CA); CNL ϭ CNL Scientific Resources, Isotope Products Laboratories (Valencia, San Francisco, CA); DOE ϭ U.S. Department of Energy (Washington, DC); Drax ϭ Draximage Inc. (Quebec, Canada); INIS ϭ International Isotopes, Inc. (Idaho Falls, ID); Mal ϭ Mallinckrodt Corporation (St. Louis, MO); MURR ϭ University of Missouri Research Reactor (Columbia, MO); Nor ϭ MDS Nordion Corporation (Ottawa, ON, Canada); OR ϭ Oregon State University (Corvallis, OR); OSU ϭ Ohio State University (Columbus, OH); PE ϭ PerkinElmer Life and Analytical Sciences (Boston, MA); TCI ϭ TCI Medical, Inc. (Albuquerque, NM); TX ϭ Texas A&M University (College Station, TX); WSU ϭ Washington State University (Pullman, WA); WU ϭ Washington University (St. Louis, MO). (Continued on page 26N)

14N THE JOURNAL OF • Vol. 46 • No. 5 • May 2005