Radioisotopes are a powerful tool for treating and diagnosing diseases, especially cancers. In the realm of medical advancements, the radioisotope Rhenium-188 (Re-188) has emerged as a significant contributor to nuclear medicine. This radioisotope can be used for therapeutic nuclear medicine in cancer treatment, as its high beta emissions are able to penetrate and destroy targeted abnormal tissue. In addition, it also emits photon energy critical for medical imaging and dosimetry. The production if Re-188 involves a complex process reliant on nuclear reactors and the cyclical relationship between the isotope Tungsten-188 (W-188) and Re-188 decay. However, the availability of Re-188 is currently constrained due to its reliance on W-188, an isotope that is in short supply.
To address this concern, the IAEA convened a webinar, Production and Supply of W-188 and Re-188 Generators, in November 2023 with 145 participants following recommendations from the International Symposium on Trends in Radiopharmaceuticals (ISTR-2023).
The webinar highlighted the growing importance of therapeutic radiopharmaceuticals, the need for efficient theranostic radioisotopes, and the relevance of W-188 and Re-188 generators in clinical settings.
The importance of Re-188 stems from its role in therapeutic treatments within hospital settings, particularly its synergy with Technetium (Tc-99m). The discussions emphasized the industry's perspective on future demands, reviving interest in Re-188 radiopharmaceuticals, and proposing recommendations to the IAEA for enhanced preparation of therapeutic radiopharmaceuticals. Industry stakeholders offered their perspectives on future needs, enriching the conversation with valuable insights.
Bernard Ponsard, the expert panelist from SCK•CEN, Belgium, noted that “With a single Re-188 generator (lasting for 5-6 months), in principle, it is possible to prepare up to 20 000 therapeutic doses of high-specific- activity Re-188 radiopharmaceuticals at very low costs. This should be compared with the limited number of Lutetium-177 (Lu-177) doses that can be prepared with a single Lu-177 production, which makes Lu-177 radiopharmaceuticals prohibitively expensive.”
The IAEA, as a pivotal facilitator in global nuclear initiatives, spearheads efforts to ensure the safe and effective production and utilization of Re-188.
“The IAEA continues to raise awareness and re-introduce important radioisotopes for human disease treatment especially cancers through meetings, coordinated research projects and webinars that attract worldwide audiences, and ensure timely access to the latest information and updates on the therapeutic radiopharmaceuticals and future possibilities,” said Melissa Denecke, the Director of the Division of Physical and Chemical Sciences at the IAEA.
Looking ahead, the initiative is poised to sustain these dialogues, fostering stronger connections between producers and users, and ensuring an ample supply of Re-188 for medical needs. Additionally, efforts are underway to enhance Re-188's stability and develop comprehensive documentation to further refine its utilization in healthcare.
“I personally enjoyed the session and I now feel that Re-188 continues to be of interest to radiopharmaceutical professionals after listening to the discussions. All the talks were very informative, well presented and answered the possible questions,” said Meera Venkatesh, one of the attendees from India.
This gathering marked a significant stride toward augmenting the availability and efficacy of Re-188-based medical solutions as a safe, accessible, and potent tool in advancing medical therapies worldwide.
