Options to meet the future global demand of radionuclides for radionuclide therapy

Nuclear medicine continues to represent one of the important modalities for cancer management. While diagnostic nuclear medicine for cancer management is fairly well established, therapeutic strategies using radionuclides are yet to be utilized to their full potential. Even if 1% of the patients undergoing diagnostic nuclear medicine procedures can benefit from subsequent nuclear therapeutic intervention, the radionuclide requirement for nuclear therapeutics would be expected to be in the multi-million Curie levels. Meeting the demand for such high levels of therapeutic radionuclides at an affordable price is an important task for the success of radionuclide therapy. Although different types of particle emitters (beta, alpha, Auger electron etc.) have been evaluated for treating a wide variety of diseases, the use of β⁻ emitting radionuclides is most feasible owing to their ease of production and availability. Several β⁻ emitting radionuclides have been successfully used to treat different kind of diseases. However, many of these radionuclides are not suitable to meet the projected demand owing to the non-availability with sufficiently high specific activity and adequate quantity because of high production costs, relatively short half-lives etc. This article describes the advantages and disadvantages for broader uses of some of the well known therapeutic radionuclides. In addition, radioisotopes which are expected to have the potential to meet the growing demand of therapeutic radionuclides are also discussed.