**5. Recent advances of skeletal radionuclide imaging and therapy**

It's well-known that the skeletal radionuclide imaging and therapy will have a prospective development in novel radiopharmaceuticals of skeletal imaging (18F-NaF) (Figure 14) and therapy (heavy ion Carbon-11 and boron neutron capture therapy (BNCT)) and advanced nuclear medicine equipments such as SPECT/CT, PET/CT and PET/MR. In routine clinical practice, a variety of new radiopharmaceuticals have been introduced in recent years. There are three commercial radiopharmaceuticals of Samarium-153-ethylenediaminetetramethylene phosphonic acid (153Sm-EDTMP), Rehnium-188-(Sn)-hydroxyethylene diphosphonate (188Re-HEDP) and Strontium-89 chloride (89SrCl2). 89SrCl2 is still the most widely used agent due to a longer physical half life (T½ = 50.5 days) and a pure beta-emitter playing an important role in radionuclide internal radiation therapy. 188Re-HEDP (T½ = 16.9 hr) obtained from 188W-188Re generator is cheap and convenient in clinical practice routine, with scintigraphic imaging of gamma rays in order to perform individual dosimetric studies, but 188W-188Re generator must be imported from other countries. 153Sm-EDTMP developed by our country is one of the radiopharmaceutical therapeutic agents and has relatively ideal physical, chemical and biological properties similar to 188Re except of slightly longer have-life (T½ = 40.4 hr). The 0.103-Mev gamma ray is suitable for imaging in vivo distribution. The benefit of the favourable clinical experience with 153Sm-EDTMP has been reported in several multicenter trials.

response is 1-12 months. The main toxicity of these radiotherapeutics is mild transient bone

Radionuclide seed such as 125I、103Pd、198Au implantation has been used in lots of clinical departments. Mostly 125I seeds (Figure 13) have been chosen as the proper one. Iodine-125 delivers a higher radiation dose to the patient due to the half life of 60 days and 125I seeds

marrow suppression.

multicenter trials.

**4.2 Radionuclide seed implantation** 

planted have been used in the therapy of solid tumors.

Fig. 13. 125I seed is used in the therapy of solid tumor by implantation.

**5. Recent advances of skeletal radionuclide imaging and therapy** 

It's well-known that the skeletal radionuclide imaging and therapy will have a prospective development in novel radiopharmaceuticals of skeletal imaging (18F-NaF) (Figure 14) and therapy (heavy ion Carbon-11 and boron neutron capture therapy (BNCT)) and advanced nuclear medicine equipments such as SPECT/CT, PET/CT and PET/MR. In routine clinical practice, a variety of new radiopharmaceuticals have been introduced in recent years. There are three commercial radiopharmaceuticals of Samarium-153-ethylenediaminetetramethylene phosphonic acid (153Sm-EDTMP), Rehnium-188-(Sn)-hydroxyethylene diphosphonate (188Re-HEDP) and Strontium-89 chloride (89SrCl2). 89SrCl2 is still the most widely used agent due to a longer physical half life (T½ = 50.5 days) and a pure beta-emitter playing an important role in radionuclide internal radiation therapy. 188Re-HEDP (T½ = 16.9 hr) obtained from 188W-188Re generator is cheap and convenient in clinical practice routine, with scintigraphic imaging of gamma rays in order to perform individual dosimetric studies, but 188W-188Re generator must be imported from other countries. 153Sm-EDTMP developed by our country is one of the radiopharmaceutical therapeutic agents and has relatively ideal physical, chemical and biological properties similar to 188Re except of slightly longer have-life (T½ = 40.4 hr). The 0.103-Mev gamma ray is suitable for imaging in vivo distribution. The benefit of the favourable clinical experience with 153Sm-EDTMP has been reported in several

 a b c Fig. 14 Normal image of 18F- Fluoride PET(a: 3D projection imaging b: coronal slice iamging: c: sagittal slice imaging)
