Many radioisotopes are made in nuclear reactors, some in cyclotrons (particle accelerators). Generally neutron-rich ones and those resulting from nuclear fission need to be made in reactors, neutron-depleted ones are made in cyclotrons. There are about 40 activation product radioisotopes and five fission product ones made in reactors.
- Molybdenum-99: Used as the ‘parent’ in a generator to produce technetium-99m, the most widely used isotope in nuclear medicine.
- Technetium-99m: Used in to image the skeleton and heart muscle in particular, but also for brain, thyroid, lungs (perfusion and ventilation), liver, spleen, kidney (structure and filtration rate), gall bladder, bone marrow, salivary and lachrymal glands, heart blood pool, infection and numerous specialized medical studies.
- Chromium-51: Used to label red blood cells and quantify gastro-intestinal protein loss.
- Cobalt-60: Used for external beam radiotherapy.
- Copper-64: Used to study genetic diseases affecting copper metabolism, such as Wilson and Menke’s diseases.
- Ytterbium-169: Used for cerebrospinal fluid studies in the brain.
- Iodine-125: Used to evaluate glomerular filtration rate of kidneys and to diagnose deep vein thrombosis in the leg. It is also widely used in radioimmunology assays and as an x-ray source for bone density measurements.
- Iodine-131: Widely used in functional imaging and therapeutic applications for the thyroid as in overactive and under active thyroid, carcinomas and their secondaries; also diagnosis of abnormal liver function, renal (kidney) blood flow and urinary tract obstruction.
- Iridium-192: Supplied in wire form for use as an internal radiotherapy source.
- Iron-59: Used in studies of iron metabolism in the spleen.
- Xenon-133, Xenon-127: Used for pulmonary (lung) ventilation studies.
- Phosphorus-32: Used in the treatment of polycythemia vera (excess red blood cells).
- Potassium-42: Used for the determination of exchangeable potassium in coronary blood flow.
- Samarium-153 (and Strontium-89): Used to relieve the pain of secondary cancers lodged in the bone, sold as Quadramet.
- Selenium-75: Used in the form of seleno-methionine to study the production of digestive enzymes.
- Sodium-24: Used for studies of electrolytes within the body.
- Yttrium-90: Used for cancer therapy and as silicate colloid for the treatment of arthritis in larger joints.
- Gallium-67: Used for tumor imaging and localization of inflammatory lesions (infections).
- Thallium-201: Used for myocardial perfusion imaging for diagnosis and location of myocardial infarction (heart muscle death) and low-grade lymphomas.
- Iodine 123: Used for diagnosis of thyroid function.
- Rubidium-81, Krypton-81m: Krypton-81m gas can yield functional images of pulmonary ventilation, e.g. in asthmatic patients, and for the early diagnosis of diseases and function of the lungs.
- Indium-111: Used for brain studies, infection and colon transit studies.
- Carbon-11, Nitrogen-13, Oxygen-15, Fluorine-18: These are used in PET for studying brain physiology and pathology, for localizing epileptic focus, and in dementia, psychiatry and neuropharmacology studies. They also have a useful role in cardiology. F-18 in FDG has become very important in detection of cancers and the monitoring of progress in their treatment, using PET.
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