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Characteristics and Comparison of RSO Isotopes i Characteristics and Comparison of RSO Isotopes i

Characteristics and Comparison of RSO Isotopes i - PowerPoint Presentation

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Characteristics and Comparison of RSO Isotopes i - PPT Presentation

ncluding Sn117m Nigel R Stevenson PhD SNMMI Denver CO CE98 Targeting Radionuclide Therapy in Various NonMalignant Arthritic Conditions Using Radiosynoviorthesis RSO June 14 2017 ID: 653920

colloid 117m 2017 denver 117m colloid denver 2017 rso snmmi size particle isotopes joints range 186 particles tissue potential treat colloids mid

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Slide1

Characteristics and Comparison of RSO Isotopes including Sn-117m

Nigel R. Stevenson, Ph.D

.

SNMMI (Denver, CO)

CE98

: Targeting Radionuclide Therapy in Various Non-Malignant Arthritic Conditions Using Radiosynoviorthesis (RSO

)

June 14, 2017Slide2

DisclosuresEmployment with Serene, LLC – manufacturers of Sn-117m colloid

6/14/2017

SNMMI (Denver, CO)

1Slide3

Radiosynoviorthesis (RSO)

A.k.a.

Radiosynovectomy (RSV)

Treatment for

arthritis (synovitis)

Used worldwide for over 60 years

Radioactive colloid injected directly into the synovial cavity

Intracavitary

radiotherapy to reduce pain, effusion, perfusion and inflammation (synovitis)Commercial isotopes are Y-90, Re-186, Er-169Y-90 for large joints (knee)Re-186 for mid-size joints (elbow, wrist, ankle)Er-169 for small joints (fingers)

SNMMI (Denver, CO)

6/14/2017

2Slide4

Radiosynoviorthesis IsotopesSNMMI (Denver, CO)

6/14/2017

3Slide5

Commercial RSO Isotopes

Isotope

Joint size

Colloidal

compounds

Half-life (days)

Imaging particle

Therapy

particle

Tissue

range (mm)

mean, max

Typical dose

(

mCi

)

Standard isotopes currently

in use globally (human dose)

Er-169SmallCitrate9.3Noneβ0.14, 1.11Re-186MediumSulfide3.7γ (lower quality)β1.1, 4.42.5Y-90LargeSilicate, citrate2.7Brem.β4.1, 114FutureSn-117mSmall/MedHydroxide14γ (high quality)CE0.27, 0.300.5-2.0

4

All

(except Sn-117m) – wide particle size range allows for potential leakage from the joint resulting in systemic distributionAll (except Sn-117m) – irradiate beyond the targeted tissue (i.e., the synovium)Y-90, Re-186 – shorter half-life causes some logistical problems outside of EuropeEr-169 – supply, reliability issues reported.

6/14/2017

SNMMI (Denver, CO)Slide6

Colloid Manufacturing

Centralized manufacturing – unit doses and bulk

Limited availability in some countries and regions

Local - “kit” produced

Re-188 using cold Sn

c

olloid base

(Courtesy of Prof. Jae Min Jeong, SNU)6/14/2017

SNMMI (Denver, CO)

5Slide7

Sn-117m

(CE)

Alpha

Particles

Beta

Particles

Characteristics of Sn-117m

Conversion

Electron

(

CE)

#

Energy

Penetrates up to a

set distance

(discrete energy)

Beta

Energy

#Avg.Produces a range of tissue penetration

Range in tissue (µm)30040-9050-5000

Shielding needed during administrationNoNoYes

Sn-117m was extensively developed at BNL starting in the 1980s

Reactor productionChemistry development

Oncology trials

SNMMI (Denver, CO)

6/14/2017

6Slide8

Sn-117m RSO Colloid

Time

7 days

2 weeks

6 weeks

Retention

>99.9%

>99.9%

99.8%

Retention of colloid in normal rat joint:

Stability studies – colloid size particle distribution at manufacture

Mean =6.28

μ

m SD=2.76

μ

m

Stability studies – colloid size particle distribution at 5 weeks in room temperature

Mean =6.43

μm SD=2.47 μmSNMMI (Denver, CO)6/14/20177Slide9

Sn-117m RSO Colloid is Unique6/14/2017

SNMMI (Denver, CO)

8

Tin forms an

ideal colloid

Used as the base for some existing RSO colloids

Very stable/long-lived

Biocompatible

ReproducibleOptimal size range

No particles smaller than 1 μ

m – i.e., no leakage

No particles above ~ 20

μ

m – i.e.,

complete phagocytosis

Suitable

half-life

Phagocytosed radioactive colloids migrate to deeper synovial tissues – i.e., potential to

treat larger jointsIrradiation of unintended tissues is avoidedSlide10

Summary6/14/2017

SNMMI (Denver, CO)

9

RSO is a well established procedure to treat

arthritis/synovitis

Commercially available isotopes are:

Y-90

for

large jointsRe-186 for mid-size jointsEr-169 for

small jointsSn-117m

is a new isotope that is proving useful for small and

mid-size

joints (possibly also large)

Existing colloids

leak

out to some degree resulting in systemic distribution

New

Sn-117m colloid is unique

in having no leakage or systemic problemsSn-117m has the potential to treat all sizes of joints