NUCLEAR MEDICINE
Diagnosing and Treating Disease

Doctor prepares a radioisotope.

Transforming ORNL-produced radioisotopes into agents that can help restore human health has long been the goal of nuclear medicine researchers at ORNL. Led by Russ Knapp since the mid-1970s, they have developed a radioactive imaging agent for medical scanning diagnosis of heart disease. This agent, which has been tested in more than 350,000 patient studies worldwide, is commercially produced in Japan and Russia and used on numerous heart patients. The ORNL agent is a fatty acid labeled with radioactive iodine-123. It can be used to detect how much heart muscle is alive after a heart attack and to predict whether bypass surgery or balloon angioplasty will restore full blood flow.

In 1993 the ORNL group developed the tungsten-188/rhenium-188 isotope generator, tested the radioactive agents at ORNL, and established clinical trials in the United States and abroad. The trials showed that rhenium-188 (formed from the decay of tungsten-188) can reduce cancer-induced bone and liver pain and inflammation in arthritis patients. It also can prevent the buildup of smooth muscle cells in coronary arteries (restenosis) after balloon angioplasty, reducing the need to repeat the procedure.

Because ORNL's radioisotope delivery system offers low-cost therapy, it's being used to treat restenosis and cancer-induced pain in patients in developing countries (thanks to support from the International Atomic Energy Agency) as well as nations such as Germany and the United States.

A radioisotope generator developed by ORNL's Saed Mirzadeh and colleagues is providing a successful treatment for advanced leukemia patients. ORNL has a stockpile of uranium-233. The isotope decays to form actinium-225, which is shipped in ORNL generators to research sites around the world. At Memorial Sloan-Kettering Cancer Center, patients with acute myeloid leukemia are injected with antibodies labeled with bismuth-213, obtained from the decay of actinium-225. The bismuth isotope destroys the blood cells that make these patients dangerously ill.

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