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Potential of Technetium and Rhenium Theranostics.

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Technetium-99m (99mTc) for imaging and Rhenium-188 (188Re) for therapy offer a promising theranostic pair. This approach can improve global access to precision medicine, overcoming limitations of current PET/CT-based methods.

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Area of Science:

  • Nuclear Medicine
  • Radiochemistry
  • Precision Medicine
  • Theranostics

Background:

  • Theranostics has advanced precision medicine, but true diagnostic and therapeutic pairs with negligible differences are limited.
  • Current theranostic reliance on PET/CT (Positron Emission Tomography/Computed Tomography) creates access inequities due to cost and availability.
  • Global demand for radionuclides like Gallium-68 (68Ga) and Lutetium-177 (177Lu) strains production capacity.

Purpose of the Study:

  • To explore the potential of technetium-99m (99mTc) for imaging and rhenium-188 (188Re) for therapy as a novel theranostic pair.
  • To address health inequities in theranostics access by utilizing widely available generator-produced isotopes.
  • To leverage advances in SPECT/CT (Single Photon Emission Computed Tomography/Computed Tomography) instrumentation for broader theranostic application.

Main Methods:

  • Investigated the near-identical radiochemistry of 99mTc and 188Re.
  • Considered the advantages of daily generator elution for 99mTc and 188Re, offering convenience and flexibility.
  • Evaluated the suitability of 188Re's low-abundance gamma emissions for serial imaging and dosimetry.

Main Results:

  • 99mTc/188Re theranostics utilize readily available generator systems, ensuring consistent supply.
  • The pair's favorable radiochemistry supports delayed biomolecule imaging and flexible application.
  • SPECT/CT instrumentation, combined with 99mTc/188Re, can extend theranostics to underserved populations.

Conclusions:

  • The 99mTc/188Re theranostic pair presents a viable alternative to PET/CT-based approaches.
  • This radionuclide combination has the potential to significantly improve global access to theranostics.
  • Implementing 99mTc/188Re theranostics can help bridge health equity gaps in precision medicine.