15. Metabolic radionuclide therapy. Main principles and application
Explains metabolic radionuclide therapy as targeted systemic radiotherapy, outlining how a carrier molecule and a therapeutic radionuclide work together, the mechanism from administration to cell death, and beta versus alpha emitters with examples. It then covers theranostic pairings in a table, the main applications including iodine-131, PRRT, PSMA and bone-seeking agents, yttrium-90 microspheres, patient selection, advantages, limitations and radiation safety. A closing section addresses radioimmunoassay, a laboratory method rather than therapy.
Topic 15 of 50 in the MU Sofia syllabus for Nuclear Medicine (Medicine, Year 4). The free AceMed note covers it in 10 sections, about 718 words (5 min of reading), with 16 flashcards.
In this note
Topic 15. Metabolic Radionuclide Therapy: Main Principles and Applications
Principle of Metabolic Radionuclide Therapy
Mechanism of Action
Types of Therapeutic Radiation
Theranostics
Main Applications
PSMA Radionuclide Therapy
Bone-Seeking Radionuclide Therapy
Yttrium-90 Therapy
Radio immunological assay - principles and application
Topic 15. Metabolic Radionuclide Therapy: Main Principles and Applications
Metabolic radionuclide therapy (MRT) is a form of systemic targeted radiotherapy in which a radioactive substance (radiopharmaceutical) is administered to the patient and selectively accumulates in diseased tissue. The radionuclide emits radiation that destroys tumor or diseased cells while minimizing damage to normal tissues.
Unlike external beam radiotherapy, where radiation comes from outside the body, MRT delivers radiation from inside the body after the radiopharmaceutical reaches the target tissue.
Principle of Metabolic Radionuclide Therapy
A therapeutic radiopharmaceutical consists of:
A targeting molecule (carrier) – directs the drug to a specific organ, receptor or tumor.
A therapeutic radionuclide – emits radiation that destroys the target cells.
Mechanism of Action
1. The radiopharmaceutical is administered (usually orally or intravenously).
2. It circulates in the bloodstream.
3. It accumulates selectively in the target tissue through physiological uptake or receptor binding.
4. The radionuclide emits radiation (mainly beta or alpha particles).
5. Radiation causes DNA damage, preventing cell division and leading to tumor cell death.
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