NRC ADVISORY COMMITTEE ON MEDICAL USES OF ISOTOPES

iprimap · Veteran Member

NRC ADVISORY COMMITTEE ON MEDICAL USES OF ISOTOPES

10kBq Jaro · Senior Member

Here's another another one along similar lines....

International Symposium on Trends in Radiopharmaceuticals
14 - 18 November 2005
Vienna, Austria
Announcement and Call for Papers

1. INTRODUCTION
Radiopharmaceuticals, along with imaging instrumentation, are the
pillars that support the edifice of clinical nuclear medicine and the
former is the major driver enabling investigations of molecular
phenomena for better understanding of human disease and developing
effective treatments. The growth of nuclear medicine has been intimately
linked to availability of new radioisotopes and the discovery of new
radiopharmaceuticals. The field of radiopharmaceuticals has witnessed
continuous evolution thanks to the immense contributions of scientists
from diverse disciplines such as radiochemistry, inorganic chemistry,
organic chemistry, biochemistry, physiology and pharmacology.
Several milestones can be cited in the trajectory of this growth, which include
continuing development of a plethora of 99mTc radiopharmaceuticals,
automated synthesis of 18F labelled compounds, labelled peptides for
accurate mapping of metastasis and the advances in radionuclide therapy.
The International Symposium on Trends in Radiopharmaceuticals,
ISTR-2005, under the auspices of International Atomic Energy Agency,
will provide scientists and professionals working in the field of
radiopharmaceuticals and related sciences an opportunity to review the
exciting developments in the field. The International Atomic Energy
Agency has been organizing such Symposia on Radiopharmaceuticals since
1973 and the last one was held in Lisbon, Portugal, in 1998.

[ PS.: I posted an interesting diagram of the automated synthesis of 18F labelled compounds on the CNS-Quebec web site, at http://www.cns-snc.ca/branches/quebec/slowpoke/F-18_FDG_synthesis_process_diagram.JPG ....along with a chemical process schematic illustrating the speed with which this must be accomplished, at http://www.cns-snc.ca/branches/quebec/slowpoke/F-18_FDG_synthesis_process_chronology.jpg ]

2. BACKGROUND
The field of technetium radiopharmaceutical chemistry has grown at an
accelerated pace in the last decade thanks to new chemistries such as
the nitrido, carbonyl and hynic together with the synthesis of several
novel ligands fitting to these chemistries. These pioneering studies are
making the anthropogenic element technetium the most explored metal ion
for its complexation behaviour. Several new 99mTc radiopharmaceuticals
continue to be developed, aiming for greater efficacy in exploring
biochemistry in vivo and introducing accuracy of diagnosis of metastatic
cancer to lead to greater objectivity in medical decisions.
The cyclotron, originally developed for nuclear physics research, has
been simplified for the benefit of increasing medical applications,
being the ideal source for many short-lived, neutron-deficient
radioisotopes, and is today a versatile tool in the hands of the
radiopharmaceutical scientists. There is a significant growth in the
installation of new cyclotrons to cater to the production of
radionuclides for medical applications and interesting developments are
taking place through the development of better cyclotron targetry,
radiochemical processing methods and automated chemistry modules. The
short half-life of most of these radioisotopes makes it essential that
the process be automated, starting from irradiation all the way to the
final dispensing stage, such that the final radiopharmaceutical
formulation is compliant with the codes of Good Manufacturing Practices
(cGMP). There is a continuing need to evolve appropriate guidelines of
cGMP for radiopharmaceuticals, due to the conflicting requirements for
handling radioactivity and formulating products for intravenous administration.
The most spectacular development is undoubtedly the advances in the
synthesis of 18F labelled fluoro deoxy glucose (FDG), opening a new
avenue in nuclear medicine, namely the regular clinical use of positron
emission tomography (PET). Initially developed for studying glucose
metabolism in vivo, especially to map the regional cerebral functions
under various conditions, today 18FDG is the most useful clinical PET
tracer for the detection, staging, treatment planning and management of
cancer. Research into other 18F labelled molecules, including peptides
and agents for tracking gene therapy, has resulted in several new
radiopharmaceuticals. The quest for newer and more specific 18F labelled
radiopharmaceuticals keeps PET chemists busy the world over. The work on
other short-lived PET radionuclides, mainly 11C and to a lesser extent
15O, is also continuing, despite the logistical problems due to their short half-lives.
The radiohalogens play a pivotal role in the growth of nuclear medicine
by the continued use of iodine isotopes such as 131I, 123I, 124I for
diagnosis and therapy. Strategies to increase the availability of 123I
products are important for clinical nuclear medicine practices.
The bromine and astatine isotopes are being vigorously explored for
establishing their utility in clinical nuclear medicine. The use of the
short-lived SPECT isotopes such as 201Tl, 111In and 67Ga is continuing
to grow for diagnostic imaging starting from myocardial studies to
tumour and infection imaging.
One of the challenges in the coming years will be to take advantage of
the potentials of radiolabelled peptides to formulate clinically useful
radiopharmaceuticals. Peptide receptors have been found to represent
excellent targets for in vivo cancer diagnosis and therapy.
Recent in vitro studies have shown that many cancers can over-express
not just one but several peptide receptors concomitantly. This presents
a basis for starting and/or optimizing the in vivo targeting of tumours
by selecting suitable radiopeptides initially for tumour diagnosis and
later with appropriate radionuclides for therapy as well.
In addition, nuclear medicine is being transformed from a non-invasive
diagnostic methodology to a powerful therapeutic modality. There
continues to be growth in the use of 131I for cost effective treatment
of hyperthyroidism and metastatic thyroid cancer. Radiopharmaceuticals
such as 89SrCl2, 153Sm-EDTMP and 186Re-HEDP are increasingly used in
many centres as cost effective bone pain palliative agents. The use of
131I-mIBG and 131I/188Re labelled lipiodol continues to attract
attention, with growing medical interest in neuro-endocrine tumours and
extensive difficulties with liver cancer, respectively. There is great
excitement in the prospect of very specific therapeutic targeting with
radiolabelled peptides with radionuclides such as 90Y, 186/188Re and
177Lu. Generator produced radionuclides offer a new dimension to
availability of therapeutic radiopharmaceuticals. Non-conventional
applications include synoviorthesis using radiopharmaceuticals labelled
with beta particle emitting radioisotopes to improve the quality of life
of patients suffering from rheumatoid arthritis. Intravascular
radionuclide therapy (IVRNT) for prevention of arterial restenosis
post-percutaneous transluminal coronary angioplasty (PTCA) is an
attractive alternative to drug eluting stents.
While surgery remains the most effective method for managing cancer,
radiopharmaceuticals play a useful role there too, being the preferred
markers for identifying metastatic lymph nodes and helping surgeons to
achieve better precision in tumour mass excision. Accordingly, a new
modality, radioguided surgery (RIGS), is emerging for use in the operating theatre.
The major constituent of a radiopharmaceutical is the radionuclide and
the search for new radionuclides to improve the availability of
diagnostic and therapeutic radiopharmaceuticals is continuing.
Several metallic isotopes such as 60/61/62Cu, 68Ga, 86Y and 94Tc are emerging
for PET studies. In view of the promising advances in targeted therapy
for cancer management, the need for therapeutic radioisotopes is
expected to grow manifold.
Internalized targeted therapy can be highly
specific in its ability to deliver radiation dose to the tumour and
hence, when the potential of targeted therapy is fully realized, the
demand for radioisotopes for this modality will be huge. Keeping this in
mind, radionuclides that can be produced in abundant quantity are being
explored. 90Y, the daughter of the long-lived fission product 90Sr, and
177Lu, which can be produced by (n,ã) activation of 176Lu, are the two
isotopes which can meet such large demands. Efforts are being made to
develop new production routes and radiochemical processing methods, as
well as radionuclide generator technologies, to effectively bridge the
gap between demand and supply.
A review of the radiopharmaceuticals field would be incomplete without a
discussion about centralized radiopharmacy practices. There is a
continuing need to formulate radiopharmaceuticals cost effectively and
to a high standard of consistent quality. There is need for improvements
in the systems for dispensing of PET and therapeutic
radiopharmaceuticals. This symposium will focus on practices and
facilities for greater pharmaceutical safety and better radiation hygiene.
The exciting developments in all the above areas in the
radiopharmaceuticals field are contributing to transforming nuclear
medicine to a preferred modality for diagnosis and therapy of many
diseases not only in developed countries but also in most developing nations.
3. TOPICS
The symposium will cover developments in the entire spectrum of
radiopharmaceuticals chemistry, including radionuclide production,
radiochemical processing, manufacturing and quality control of
radiopharmaceuticals, latest advances in radiopharmaceuticals research,
GMP and regulatory aspects, etc.
The IAEA welcomes high quality contributions on the following topics.
Radionuclide production and synthesis of radiopharmaceuticals
Novel technetium chemistry and radiopharmaceuticals
Flourine-18 and iodine-123 based radiopharmaceuticals and automation of synthesis
Other radiohalogens and metallic nuclides for PET
Carbon-11 radiopharmaceuticals and other short-lived PET tracers
Therapeutic radiopharmaceuticals
Molecular biology based radiopharmaceuticals
Pharmacology and dosimetry of radiopharmaceuticals
Codes of GMP for radiopharmaceuticals
Centralized radiopharmacies
Regulatory aspects
Indigenous capacity building in radiopharmaceuticals
It is expected that the symposium will stimulate international exchange
of information and ideas that will contribute to further enhancing the
growth of developmental opportunities in nuclear medicine in general and
in radiopharmaceutical chemistry in particular.
<SNIP>

13. SYMPOSIUM WEB PAGE
Please visit the IAEA symposium web page regularly for new information regarding this symposium:
http://www-pub.iaea.org/MTCD/Meetings/Announcements.asp?ConfID=130.
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