1&2.unsealed Sources - Thursday16thMay - S Jeans PDF

RCR 2013
UNSEALED SOURCES
Steve Jeans
Nuclear Medicine Group
Christie Medical Physics and Engineering
The Christie NHS Foundation Trust
steve.jeans@christie.nhs.uk

Syllabus
Basic principles of radioactivity

Stability, shelf life
Physical v biological half life
Radiopharmaceuticals
Use in therapy
Clinical applications and dose calculations
(from www.rcr.ac.uk)

Lecture Structure
Part 1
Radioisotopes and radionuclides
Legislation
Part 2
Diagnostic and clinical uses
Dosimetry

Radioisotopes and Radionuclides
Atomic structure
Elements, nuclides and isotopes
Physical half-life
Radionuclide production

Atomic structure
Nucleus
Z = number of protons
= Atomic number
N = number of neutrons
A = Z + N = Mass number
Orbital Electrons
Number of electrons = Z

Element
All atoms of an element have the
Same number of protons Z
Same number of electrons Z
Number of neutrons may vary N
Therefore A may vary

Nomenclature
A e.g 14
6C
ZX
Should write
Normally don’t use the Z number, as this is

identified by the chemical symbol
Alternative forms are.....

14C C-14 or Carbon-14

Nuclides and isotopes (1)
“Nuclide” = general collective term
for atoms or nuclei
eg. C-12, C-14, O-16, O-18 are
nuclides
“Radionuclide” = radioactive nuclide

eg. C-14, O-18 are
radionuclides

Nuclides and Isotopes (2)
“Isotopes” = nuclides with same Z but different A

eg. Cl-35 , Cl-37 are
isotopes of chlorine
“Radioisotopes” = radioactive isotopes

eg. C-13, C-14 are
radioisotopes of carbon

Example: iodine
I-127 is a stable nuclide
A= 127, Z = 53, N=75
But
If A = 131, Z= 53, N = 78
I-131 - unstable nuclide
If A = 123, Z= 53, N = 70
I-123 - unstable nuclide
I-131 and I-123 are isotopes of I-127.

They are unstable, radioactive and are
radioisotopes.
They are radioisotopes (not radionuclides) of
iodine

Stability of nuclei (1)
For stability, N  Z at low Z,

N  1.5xZ at higher Z
Further away from stable band -> more unstable
Decay to move to more stable configuration

S N=Z
Too few
protons
“neutron rich” U U S=stable
U=unstable
S
Neutrons Too few
(N) neutrons
“proton rich”
Protons (Z)
Neutron rich nuclei decay by  emission
Proton rich nuclei decay by positron

emission or electron capture
Heavy nuclei decay by  emission or

spontaneous fission

Daughter nuclides
“Daughter” nucleus may be stable, ie. in ground state.
Parent -----> stable daughter
..or may be unstable, so undergo further decay

Parent -----> excited daughter -----> stable daughter
..or may be “metastable”, allowing them to exist for up

to a few hours before transforming to ground state e.g
Tc-99m
Parent -----> metastable daughter -----> stable daughter

e.g. I-123 Decay
127I
is a stable nuclide
A= 127, Z = 53, N=75
123I
is an unstable nuclide
A= 123, Z = 53, N=70
I-123 has fewer neutrons than stable iodine (i.e.

it is proton rich)
Undergoes radioactive decay by EC:
• increase neutron number N to 71
• decrease proton number Z to 52
I-123 decay: Daughter nuclide
Tellerium-123
Also radioactive: decays to

Antimony-123 (stable nuclide)

But…..
Not all isotopes are radioactive
Some elements have more than 1 stable
isotope e.g. hydrogen (1H and 2H)
Heavier (Z > 83) elements have no stable
isotopes e.g. radium (Ra-222, Ra-223, Ra-
224, Ra-225,Ra-226, Ra–227,Ra-228)

Physical Half–life: Tp
The time taken for an amount
of radioactivity to reduce to half by
radioactive decay.
Sample has a particular activity only at a

stated time point, called reference time or
date
Before reference time, sample has higher
activity
After that time, will have lower activity

Physical Half–life: Tp
N
Tp = time taken for half of the nuclei
N0 present (N) to decay.
N0/2
N0/4
N0/8
0 Tp 2Tp 3Tp Time
Tp examples
Krypton-81m TP = 13 seconds
Technetium-99m TP = 6.02 hours
Rhenium-186 TP = 90.6 hours
Iodine-131 TP = 8.04 days
Strontium-90 TP = 29.1 years

Production of medical radionuclides
All have short half lives, so all artificially

produced
Neutron-rich radionuclides from nuclear

reactors
Proton-rich from cyclotrons
For convenience, some radionuclides

produced from secondary sources called
generators

Reactors
Specialised nuclear reactors are used to

produce clinically useful radionuclides from
uranium-235 fission products.
Alternatively the neutrons produced by uranium
fission can be used to create radionuclides by
bombarding stable target materials placed in
the reactor core.
Of particular relevance is Mo-99, the parent
radionuclide of Tc-99m.

Cyclotrons
Positively charged particle accelerators

Bombardment of stable nuclei with high energy
charged particles
Most cyclotron produced radionuclides are neutron
poor and decay by positron emission or electron
capture.
E.g. Ga-67, In-111, I-123, Tl-201
Specialised hospital based cyclotrons produce positron
emitters for PET studies. e.g. F-18, C-11.

Radionuclide Generators
Extremely important for Tc-99m production
Tc-99m is the most important radionuclide used in nuclear
medicine.
Short half-life (6hrs) makes it impractical to store even a
weekly supply
Supply problem is overcome by obtaining parent Mo-99
(half life 67hrs) which continually produces Tc-99m
A system for holding the parent in such a way that the
daughter can easily be separated for clinical use is called
a radionuclide generator.

Radionuclide Generator

Radionuclide Generators
Need :-
Long-lived parent radionuclide to keep,
preferably, for days
Clinically useful daughter decay product,
of short half-life
Means of separating daughter from
parent, to provide pure samples of the
daughter radionuclide...usually ion
exchange...chemical separation is called
elution
Tc-99m Production
99
42 Mo 9943
m
Tc 99
43Tc
Thalf 67 hours Thalf 6 hours

Schematic Tc-99m generator
“Eluant” = “Eluate” =
isotonic Tc-99m sodium
saline pertechnetate
solution
(TcO4- ion)
Mo-99 adsorbed
Lead or DU
onto alumina
shielding
in ion exchange
column

Tc-99m generator elution pattern
Mo-99 decays with 67 hour
T1/2 99Mo
Tc-99m produced, and 99mTc (no elution)
reaches max after ~ 24 hours
(i.e. transient equilibrium
99mTc elution every 24 hours
reached) 100%
If no elution, Tc-99m
available decreases with half-
life of Mo-99
Eluted at this point to
separate Tc-99m from Mo-99
Daily availability of supply of 0%
Tc-99m
0 24 48 72
hours
Tc-99m Production
Generator delivered weekly to radiopharmacy

Elute daily for a supply of Tc-99m as TcO4-
solution
(More than 1850 TBq (50,000Ci) of Mo-99 are

required daily to meet worldwide requirements for
NM procedures)

World Production of Medical
Radioisotopes

Molybdenum production
Mo-99/Tc-99m
Total Worldwide annual production

468,000Ci =17,316,000GBq
Canada 38%
Netherlands 26%
South Africa 16%
Belgium 16%
Rest of world 4%

Shut that reactor !!!!!
Petten Routine maintenance Dug up and temporary fix on Aug 2008- Mar 2009
Bubbles from pipe in piping.
cooling system
Fleurus Iodine -131 leak and Restricted the consumption of Aug 2008-Nov 2008
contamination vegetables and milk produced
within five km
Safari Planned maintenance Aug 2008
Chalk River Electrical storm Aug 2008
Mol Planned maintenance Aug 2008-Sep 2008
Osiris Planned maintenance Aug 2008-Sept 2008
Chalk River Heavy Water Leak Dec 2008
Chalk River Planned maintenance Rod lifting mechanism failed May 2009 to September
2010
Petten Planned maintenance February to August 2010

The Future??

Possible Solutions
Create new reactor capacities
- Maria reactor in Poland to begin Mo-99
production spring 2010
- PALLAS reactor to replace HFR in 2016
Find new methodology for Tc-99m production
- University of Alberta looking into cyclotron
produced Tc-99m
Use alternative isotopes
- Thyroid – I-123
- Cardiac – Tl-201
- Bone - F-18 PET
(however higher radiation dose and greater
cost!) The Christie NHS Foundation Trust
Up to date review:
A Review of the Supply of Molybdenum-99, the

Impact of Recent Shortages and the
Implications for Nuclear Medicine Services in
the UK
www.arsac.org.uk/newsletter/newsletters.htm

Krypton generator
81
37 Rb 8136
m
Kr 36
81
Kr
TP 4.7 hours TP 13 secs
The generator contains Rb-81 which decays

to Kr-81m
Kr-81m is a gas used for lung ventilation
imaging
Air is passed through the generator which
carries the Kr-81m to the patients lungs.
RADIOPHARMACEUTICALS

Definition
Radiopharmaceutical properties
Stability and shelf life
Examples

Radiopharmaceutical
The radionuclide to be used for the

investigation or treatment
The pharmaceutical or chemical form used

to carry the radionuclide to the right part of
the body
Together, they make a radiopharmaceutical

Properties of the radionuclide
Physical properties
Type of radiation
Energy of radiation
Physical half-life

Types of radiation
Radiations emitted during radioactive decay may be:
Penetrating e.g. gamma radiation
Non-penetrating e.g. alpha or beta particles

Auger electrons

Energy of the radiation
For a particular type of radiation, the energy

determines the range in tissue
e.g. Iodine-131, beta decay
Mean energy = 192 keV mean range = 0.4mm
Max. energy = 610 keV max. range = 2.9 mm

Range in tissue – Beta particles
3
2.5
Mean energy (MeV)
2
Cu-67
I-131
1.5
Re-186
Y-90
1
0.5
0
0 200 400 600 800 1000
Mean range in tissue (um)
But …..
The range is also determined by the type of

radiation
Isotope Decay Energy Range

At-211  5870 keV 0.08 mm
I-131  610 keV 2.9 mm

A practical implication …
The very short range of  particles means that they
constitute a negligible radiation hazard (other than
to skin) as an external radiation source
BUT
a very potent radiation hazard when ingested
because of their densely ionising nature.
IMPLICATIONS FOR USE IN THERAPY

(Remember Litvinenko!)

Properties of the pharmaceutical
Biological handling of the material by the body
What is the rate of biological clearance?

• Biological and effective half life
How is the pharmaceutical taken up by the target

tissue?
• Is there good uptake in the target tissue?
• Is there no/low uptake in normal tissue?

Biological half life
The time for the amount of a substance in the body

to reduce to half by biological processes alone
e.g. iodine TB = 80 days

Effective half-life
Physical half-life = T(P)

Biological half-life = T(B)
Effective half-life = T(E)
1 = 1 + 1
T(E) T(P) T(B)
Effective half life gives the net rate of clearance of

a radiopharmaceutical, from both radioactive
decay and biological clearance

Effective half life
e.g. iodine-131
TP = 8.04 days
TB = 80 days
1/TE= 1/8.04 +1/80
= 1/0.136
= 7.3 DAYS

Organ or tissue uptake
Target : non-target uptake ratio determined by

mechanism of localisation

Mechanisms of localisation (1)
Compartmental localisation
Cell sequestration
Phagocytosis
Passive diffusion
Metabolism
Active transport

Mechanisms of localisation (2)
Capillary blockade
Perfusion
Chemotaxis
Antibody-antigen interaction
Receptor binding
Physiochemical adsorption

Properties of the ideal
radiopharmaceutical
Low toxicity, sterile, pyrogen free
Radionuclidically and radiochemically pure
Stable in vivo and in vitro
Effective half life appropriate to study
Efficacious for use in diagnosis or therapy
Good availability

Stability and shelf-life
Stability - labelling of a suitable
pharmaceutical
• The nature and durability of the
association (bonding) between
radionuclide and pharmaceutical
Shelf-life
• stability of labelling
• amount of radioactivity and half-life
• preservatives
Stability
Ionic: I-131 or I-123 sodium iodide
Particulate: Tc-99m MAA

Y-90 colloid
Chelate: Tc-99m DTPA Complex:

Tc-99m Anti-CEA
Compound: I-131 or I-123 m-IBG

LEGISLATION

REGULATIONS
MARS (ARSAC)
IRMER, see radiation protection lecture

MARS REGULATIONS (1978)
Irrespective of the degree of danger involved

to the subject, they prohibit the
administration to human beings of
radioactive medicinal products except by a
doctor or dentist holding a certificate issued
by the Health Ministers, or by a person
acting under the direction of such a doctor
or dentist.

ARSAC
Administration of Radioactive Substances

Advisory Committee
Advise on
The Medicines (Administration of Radioactive
Substances) Regulations 1978 (MARS 1978)
also the Amendment Regulations 1995
(www.arsac.org.uk)

ARSAC Certificate
An ARSAC Certificate is required for any

radionuclide administration for diagnosis,
therapy or research

ARSAC Certificate
Certificates
Must be held for each type of administration
are specific to a person, a site, and the purpose (eg
diagnosis)
list the types of investigation/treatment which have been
authorised
Must be renewed every 5 years

Research Implications
Every research study or clinical trial that requires:

Diagnostic imaging
Functional imaging
In vitro tests for organ function
Therapeutic administrations
Any other possible study that involves administration of
radioisotopes.
MUST have its own ARSAC certificate.

TIME FOR A BREAK!

LECTURE STRUCTURE
Part 1
Radioisotopes and radionuclides
Legislation
Part 2
Diagnostic and clinical uses
Dosimetry

Nuclear Medicine
Includes diagnostic & therapeutic applications
Internal radionuclide therapy - aka

• Targeted radiotherapy
• Radionuclide therapy
• Unsealed source therapy
• Systemic radionuclide therapy

Suitable Emissions
Diagnostics Therapy
 X ?
 X √
 √ X

DIAGNOSTIC IMAGING

DIAGNOSTIC IMAGING
Investigations
Ideal radiopharmaceutical
Tc-99m radiopharmaceuticals
PET

Investigations
Functional imaging
• Cardiac scan (LVEF)
• Lung perfusion scan
• Renogram
Diagnostic imaging
• Bone scan for metastasis
• Thyroid scan and uptake
In vitro tests
• GFR
The ideal diagnostic
radiopharmaceutical
For imaging using a gamma camera
pure  emitter
 energy between 100 & 300 keV
appropriate effective half-life (say 1.5x the
duration of the study)
Good availability ££
High target to background ratio– i.e. good
uptake in relevant organ/tissue
Should function as a tracer……
Tracer
Substance that traces a physiological process

Does not affect the system under investigation
Nanogram amounts
If the tracer is chemically identical to the chemical being
traced, then the behaviour of the tracer shows how the
chemical is handled (e.g. iodine)
Most radiopharmaceuticals are not identical to naturally
occurring compounds in the system under investigation,
but are handled in a similar manner

Tracers
Isotopes of naturally occurring elements.

e.g. 131I, 123I to image thyroid
(But no single photon isotopes of
C,N,O,S)
Isotopes of elements with similar

chemistry
e.g. 201Tl similar to K – myocardial perfusion

Other Diagnostic
‘Designer’ radiopharmaceuticals
e.g.HMPAO, MIBI, MAG3
Antibodies/fragments
e.g. radioimmunoscintigraphy
Biochemical analogues
e.g.99mTc-MAA for lung scans.
Autologous products
e.g radiolabelled wbc

Technetium-99m pharmaceuticals
Majority of diagnostic Nuclear Medicine procedures
• >90% of tests, ~98% of MBq administered
Relatively low radiation dose (mSv per MBq)

6 hour half life
140 keV gamma (+some Auger electrons)
Many different radiopharmaceuticals

Generator and ‘cold kits’ available commercially
Good availability as kits have good shelf life, isotope
available daily

99mTc Radiopharmaceuticals
Chemical form Investigation MBq

MAA Lung perfusion 100
Phosphonates Bone imaging 600
Erythrocytes Cardiac (LVEF) 600
DMSA(V) Tumour imaging 400
MAG3 Renal imaging 50

Tc-99m HDP
Bone scan
Hydroxymethyl disphosphanate
Administer i.v
Rapid renal excretion gives high bone to soft
tissue ratio.
Thus by 2-3 hrs post injection 50-60% of
injected dose localises in bone.
Bone uptake determined by blood supply and
rate of turnover

Bone scan

Tc-99m MAG3
Renal imaging
“Cold kit” supplied as a freeze dried powder
Add sodium pertechnetate [99Tcm] solution
Shake to reconstitute, then boil for 10 minutes
Administer IV in front of gamma camera
Excreted via tubular secretion and glomerular
filtration
Dynamic sequence of images show renal perfusion
and function, urine outflow and reflux.

Tc-99m MAG3 normal renogram

Tc-99m MAG3 abnormal renogram

PET (1) : positron emission
Nucleus
decays Positron
slows 0.51 MeV
photon
Positron
0.51 MeV annihilates
photon
0.51 MeV is mc2 for positrons (or electrons)

Photon pairs detected for PET (positron emission tomography)

PET (2) : PET scanner

PET radiopharmaceuticals in current use
Radionuclide Half-life Radiopharmaceutical Application
C-11 20 min Methionine Protein/DNA synthesis
N-13 10 min NH3 Myocardial perfusion
O-15 2 min CO, O2, H2O Blood volume, blood flow,

oxygen consumption
F-18 110 min Fluoro-2-deoxy-D-glucose Tumour / myocardial
(FDG) glucose metabolism
F-18 110 min Sodium fluoride Bone imaging
F-18 110 min Fluorine-labelled- Tumour proliferation

thymidine (FLT)
18F-FDG
Most commonly used PET tracer
Cyclotron produced
• Half life 110 min
Glucose analogue ………almost

• Taken up by cells that are metabolically active
• Doesn’t enter glycolytic pathway
• Gets trapped in intracellular space.
• Filtered by glomeruli but not resorbed by
tubules. Therefore appears in urine

Normal 18F-FDG PET scan

18F-FDG in Lymphoma

RADIONUCLIDE THERAPY

RADIONUCLIDE THERAPY
Aim
Source and target
Ideal radiopharmaceutical
Iodine-131
Other therapies
Methods of localisation

Radiotherapy
External beam
Brachytherapy
(Sealed source)
Internal radionuclide therapy

(Unsealed source)

Aim of radiotherapy
Maximise the tumour : normal tissue ratio

• Maximise the radiation dose to the target
tissue
• Spare the normal tissue
Internal radionuclide therapy achieves this by the

selective delivery of radioactive material to
abnormal cells

Aim of Radionuclide Therapy
Achieved by:
High uptake in the target organ/tumour
Low uptake elsewhere
And ideally use emitter of non-penetrating

radiation, which will be absorbed in the
target and not be penetrating enough to
irradiate other organs
Source and target
Tissue containing the radioactivity is the source
Tissue receiving the radiation dose is the target
For radioiodine in the thyroid gland, the thyroid is the

source and the target
However, irradiation of non-target (normal) tissue by

radioactivity must also be considered

Source and target separated.....
Target Source

Source touching target....
Source
Target

Source surrounded by target....
Source
Target

.... or source and target identical
Source
Target

Which is the best scenario for
radionuclide therapy?
a) Source and target separated
b) Source and target touching
c) Source surrounded by target
d) Source and target identical
Answer d)
Why? Because a higher proportion of the radiation
will be absorbed within the target tissue, so
providing maximum dose to the target and
minimal dose to non-target tissues.

The ideal radiopharmaceutical
for therapy
Pure  emitter
Moderately long effective half-life
(few days-weeks)
High target to non-target ratio
Minimal internal radiation dose to any part of
the body other than the target organ or tumour

Example: Iodine-131
Most commonly used therapeutic radionuclide
,  and X-ray emissions
Average  energy: 191 keV
Decays to Xe-131 (stable)
Range of  particles in tissue = 2-4mm
 radiation: 364 keV (can be imaged)
Half-life = 8.04 days

Physiological targeting
Sodium iodide [131I] administered
Iodine [131I] concentrates in the thyroid
Radiation dose is delivered to the thyroid
But dose to whole body due to gamma

emissions and circulating radioiodinated
hormones
Iodine-131Therapies
Form Disease Activity (MBq)
Na-I Hypothyroidism 400-800

Na-I Ca Thyroid 3,500-7,000
I-mIBG NET 3,000-11,000
I-mAb NHL 1,000-2,000

Therapies at The Christie
131I for thyrotoxicosis 325

131I thyroid ablation 158
32P for polycythaemia vera 8
89Sr or 153Sm for bone pain palliation 25
131I mIBG therapy for NET 5
90Y ibritumomab tiuxetan (Zevalin®) 3
for NHL
223Ra Alpharadin for prostate 23
90Y SIRT microspheres 24
177Lu Dotatate therapy for
TheNET 5
Christie NHS Foundation Trust
Other Therapies
Radioimmunotherapy
• anti-CEA monoclonal antibody labelled with I-131 for
solid tumours
• iodine-131-labeled antitenascin monoclonal antibody
81C6 in malignant glioma
188Re-HEDP
• Bone pain palliation

90Y-somatostatinanalogues
• Receptor targeted therapy for NET, lymphoma
• Ca breast and lung
See also www.eanm.org/scientific_info/guidelines

DOSIMETRY

DOSIMETRY
Radiation dose
What do we need to know?
MIRD/OLINDA

Radiation Dose
Biological effect of radiation is due to the absorption

of energy
Radiation dose is the energy absorbed per unit
mass (at the site of interest)
SI unit is the Gy : 1 Gy = 1 joule/kg
If the energy absorbed in a known mass can be
calculated, this can be extrapolated to the dose/kg,
provided the activity is uniformly distributed

What do we need to know?
Type and energy of radiation(s)

• Range, fraction absorbed by target
• Energy deposited in tissue
Half-life (rate of clearance)

• Biological & physical
Activity administered
Percentage of administered activity deposited in

tissue

Radiation Dose Calculation (1)
Dose to target organ from source organ depends upon:
Ã - the cumulated activity

= the number of disintegrations that take place in the
source organ
∆ - the mean energy emitted per decay ….

Radiation Dose calculation (2)
 - the absorbed fraction

= the fraction of energy emitted from the source that is
absorbed by the target
m – the mass of the target organ
(don’t forget that route of administration can affect kinetics

and organ uptake)

The equation!
D(rk) = AohS(rk rh)
Gives the absorbed dose (D) in target organ k from

activity in the source organ h per unit activity
administered to the patient.

However…… Don’t Panic
Be grateful for MIRD

(Medical Internal Radiation Dose
Committee of the Society of Nuclear Medicine)
Provides a schema to calculate the absorbed

dose in any target organ per radioactive decay
in any source organ

Estimation of dose to the patient
MIRD
Ascertain
• which organs accumulate the radiopharmaceutical
(source organs) and
• the variation in time
Determine which organs are irradiated (target
organs)
• depends on nature and energy of radiation emitted
REMEMBER
Organs can be a source and a target
Some radionuclides have more than one radioactive emission
OLINDA software
(replaced MIRDose)
Organ Level INternal Dose Assessment
User must provide biokinetic data in the form of

residence times for each source organ
The programme then generates tables of organ

doses per unit administered activity

Alternatively:
Ask a physicist!!!

Syllabus
Isotopes
Stability, shelf life
Physical v biological half life
Use in imaging and therapy
Clinical applications and dose calculations
(from www.rcr.ac.uk)


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RCR 2013

The Christie NHS Foundation Trust

Basic principles of radioactivity

The Christie NHS Foundation Trust

The Christie NHS Foundation Trust

Elements, nuclides and isotopes

The Christie NHS Foundation Trust

The Christie NHS Foundation Trust

The Christie NHS Foundation Trust

Normally don’t use the Z number, as this is

Alternative forms are.....

The Christie NHS Foundation Trust

“Radionuclide” = radioactive nuclide

The Christie NHS Foundation Trust

“Isotopes” = nuclides with same Z but different A

“Radioisotopes” = radioactive isotopes

The Christie NHS Foundation Trust

I-131 and I-123 are isotopes of I-127.

The Christie NHS Foundation Trust

For stability, N  Z at low Z,

Further away from stable band -> more unstable

Decay to move to more stable configuration

The Christie NHS Foundation Trust

Neutron rich nuclei decay by  emission

Proton rich nuclei decay by positron

Heavy nuclei decay by  emission or

The Christie NHS Foundation Trust

..or may be unstable, so undergo further decay

..or may be “metastable”, allowing them to exist for up

The Christie NHS Foundation Trust

I-123 has fewer neutrons than stable iodine (i.e.

Also radioactive: decays to

The Christie NHS Foundation Trust

The Christie NHS Foundation Trust

Sample has a particular activity only at a

The Christie NHS Foundation Trust

Technetium-99m TP = 6.02 hours

Rhenium-186 TP = 90.6 hours

Iodine-131 TP = 8.04 days

Strontium-90 TP = 29.1 years

The Christie NHS Foundation Trust

All have short half lives, so all artificially

Neutron-rich radionuclides from nuclear

For convenience, some radionuclides

The Christie NHS Foundation Trust

Specialised nuclear reactors are used to

The Christie NHS Foundation Trust

Positively charged particle accelerators

The Christie NHS Foundation Trust

The Christie NHS Foundation Trust

The Christie NHS Foundation Trust

Thalf 67 hours Thalf 6 hours

The Christie NHS Foundation Trust

The Christie NHS Foundation Trust

Generator delivered weekly to radiopharmacy

(More than 1850 TBq (50,000Ci) of Mo-99 are

The Christie NHS Foundation Trust

The Christie NHS Foundation Trust

Total Worldwide annual production

The Christie NHS Foundation Trust

Chalk River Electrical storm Aug 2008

Mol Planned maintenance Aug 2008-Sep 2008

Osiris Planned maintenance Aug 2008-Sept 2008