Radiopharmaceutical cellular uptake mechanisms

Cellular radiopharmaceutical specificity depends mainly of the uptake mechanisms. Usually, this can be one of the classical membrane transport type (a passive or active transport, a receptor mediated one or a combination of them). It can also be an electrochemical gradient dependent membrane transport in relation with Nernst equation, as in case of 99m Tc MIBI, the representative molecule of a widely studied family tracers, with applications in cardiac and oncological scintigraphy. Another mechanism can be an ATP dependent active transport, that results in the most important 201 Tl inflow. 201 Tl inflow is also an example of multiple mechanisms involved in cellular ionic inflow. Over 30% of 201 Tl transport imply other ways, like Na+ - K+ - Cl- co-transport. For a given tracer, the mechanism may depend also on the cell type. In conclusion, knowledge of the radiotracer uptake mechanisms allows finding the 'ideal' radiotracer with high specificity for the tissue to be visualized. (authors)