Positron emitting radionuclides for South Africa

Full text: In South Africa there are currently two projects underway to supply and utilise positron emitting radionuclides for imaging in clinical nuclear medicine facilities. The advantages and applications of such radio nuclides are numerous and well known. However the premier initial application will be to employ 1BF, at first in the compound fluorine-18 fluorodeoxyglucose (18F)-FDG, for patients with cancers and neoplasms. The two projects are sited at iThemba LABS, where production of a generator supplying 66Ga and the provision of (18F]-FDG, are in an advanced state of planning; the former already fully financed by the Innovation Fund of the National Research Foundation. The two positron emitting radionuclides, 18F and 68Ge, will be produced using a cyclotron induced reaction on 1802 and Ga, respectively, at iThemba LABS. The 68Ge/68Ga generator consists of an anion exchanger loaded with 68Ge, which decays to 68Ga. The resulting radiopharmaceuticals, (18F]-FDG and 68Ga citrate, will be produced by the Radionuclide Production Group of iThemba LABS, using well described methods. However the structures and processes to be used in the generator to provide 68Ga are novel and will be explained. Initially provision of the CBF]-FDG will be to selected clinical medicine facilities in the Western Cape and Gauteng. It should be noted that the logistical problems of providing this radiopharmaceutical (which are much complicated by its short half life of 109.7 min) to Gauteng, were shown to be surmountable in the 1970s, by a regular delivery of 18F between Gauteng and Cape Town, after the advent of a commercial service using jet aircraft. The obvious requirement that there should be appropriate nuclear medicine facilities to image patients, at the sites to which the positron emitting radiopharmaceuticals will be supplied, has been addressed. Proposed solutions will be outlined, in terms of a dedicated positron emission tomography (PET) camera and a gamma camera with a facility to detect coincident 511 kev radiation from positron-electron annihilation. The relevance of PET to nuclear medicine in Southern Africa and the application of PET within the proposed Major Radiation Medicine Centre (MRMC) of iThemba LABS will also be outlined, as will the questions of costs, frequency of supply and future PET facilities in South Africa. (author)