TECHNETIUM-99m - THE WORKHORSE OF DIAGNOSTIC NUCLEAR MEDICINE

The appreciation of short-lived radionuclides in nuclear medicine has led to the development of radionuclide generators that serve as a convenient source of these radionuclides to prepare a wide range of radiopharmaceuticals. Of all the potentially useful generator systems, the 99mTc generator has found the most widespread use. Although originally chosen because of its excellent disintegration characteristics and its ready availability, 99mTc would not be so widely used today were it not for its ability to exhibit a versatile coordination chemistry.
During the first phase of research into the development of 99mTc based imaging agents in the 1970s the agents were relatively simple in nature (pertechnetate, colloids, particles, albumin, and complexes with DTPA, phosphonates). Then new complexes have been developed which provide images of flow and metabolism, e.g. kidney and liver functions as well as regional heart and brain perfusion. Antibodies, antibody fragments and numerous peptides have been successfully labelled with 99mTc.

Progress in technetium chemistry has led to an assortment of building blocks in the form of various cores and valuable combinations of donor groups in a number of chelating ligands. Research is still going on to extend and improve these tools. Using new concepts and methods, current research is being directed at an area of technetium chemistry well beyond perfusion tracers to open a window on biochemistry. There is considerable effort by many groups to develop agents that will target a variety of receptors, including CNS receptors. As for potential 99mTc based CNS receptor imaging agents, however, low brain uptake is a general problem.
The recent advances in the design of new technetium 99mTc imaging agents illustrate the continued expansion of the use of this class of radiopharmaceuticals.