Fundamentals of Nuclear Pharmacy - 7th Edition Annotated PDF Download
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Fundamentals of Nuclear
Pharmacy
Seventh Edition
Gopal B. Saha, PhD
Emeritus Staff
Cleveland Clinic
Cleveland, OH
USA
© Springer International Publishing AG 1979, 1984, 1992, 1998, 2004, 2010, 2018
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recita-
tion, broadcasting, reproduction on microfilms or in any other physical way, and transmission or infor-
mation storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar
methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publica-
tion does not imply, even in the absence of a specific statement, that such names are exempt from the
relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, express or implied, with respect to the material contained herein or for any errors
or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims
in published maps and institutional affiliations.
Since the sixth edition of this book in 2010, armamentariums in nuclear medicine
have changed with new additions and some deletions and hence the seventh edition.
Obsolete and outdated radiopharmaceuticals and techniques have been removed,
and new useful ones have been added. Like the previous editions, the book is aimed
to the nuclear medicine and radiology fellows, residents, and technologists in prepa-
ration for their respective professional board examinations. Also nuclear medicine
physicians and radiologists should find it a useful reference in their practice.
The organization of the book remains the same as the previous editions with a total of
16 chapters with the same titles. Chapters 1, 2, and 3 remain almost unchanged except the
addition of a section on Gaussian distribution in Chap. 2 and a small section on PET/MR
imaging in Chap. 3. A number of radionuclides have been added in Chap. 4, and the
227
Ac→227Th→223Ra generator has been added in Chap. 5. There is no change in Chaps. 6,
8, and 12. New US FDA-approved and some non-US FDA-approved radiopharmaceuti-
cals for clinical use are described in Chap. 7. Several radiopharmacyrelated accessories
have been added to Chap. 9, and radiation doses for new radiopharmaceuticals have been
included in Chap. 10. Revised and new regulations of the US FDA as well as a brief update
of European Union regulations have been cited in Chap. 11. Specific clinical uses of new
radiopharmaceuticals described in Chap. 7 have been presented in Chap. 13. Chapter 14
contains two new sections – theranostics and translational medicine. The use of Xofigo in
the treatment of castration-resistant prostate cancer has been added in Chap. 15. Chapter
16 has been revised with new information on adverse reactions from radiopharmaceutical
administration to humans. Appendix F is a new addition containing the decay factors of
18
F. Appropriate references and additional questions have been added in each chapter.
I would like to thank Dr. Guiyun Wu, staff of Nuclear Medicine at Cleveland Clinic,
for providing a few images on neuroimaging. Many thanks are due to Ms. Stephanie
Frost, developmental editor, for her skillful editing; Ms. Miranda Finch, editorial assis-
tant, Clinical Medicine; and Ms. Margaret Moore, editor, Clinical Medicine, of Springer,
for their sincere help and guidance during the production of the book. I thank Ms. Janet
Foltin, former senior editor of Clinical Medicine of Springer, for her help in the initial
phase of the book. Thanks and appreciation are due to Mr. Sivakumar Krishnamoorthy of
SPi Global for a job well done in the production of the book. Finally, I am ever grateful
to Springer Nature for its perpetual support through decades in my publication efforts.
vii
Contents
ix
x Contents
Index������������������������������������������������������������������������������������������������������������������ 415
The Atom
1
The Bohr atomic theory states that electrons in an atom rotate around the nucleus
in discrete energy orbits or shells. These energy shells, referred to as the K shell, L
shell, M shell, N shell, and so forth, are stationary and arranged in order of increas-
ing energy. When there is a transition of an electron from an upper orbit to a lower
orbit, the energy difference between the two orbits is released as the photon radia-
tion. If the electron is raised from a lower orbit to an upper orbit, the energy dif-
ference between the two orbits is absorbed and must be supplied for the transition
to occur.
According to the quantum theory, each shell is designated by a quantum number
n, called the principal quantum number, and denoted by integers, for example, 1 for
the K shell, 2 for the L shell, 3 for the M shell, 4 for the N shell, and 5 for the O shell
(Table 1.1). Each energy shell is subdivided into subshells or orbitals, which are
designated as s, p, d, f, and so forth. For a principal quantum number n, there are n
orbitals in the main shell. These orbitals are assigned azimuthal quantum numbers,
l, which designate the electron’s angular momentum and can assume numerical
values of l = 0, 1, 2,..., n − 1. Thus for the s orbital l = 0, the p orbital l = 1, the d
orbital l = 2, and so forth. According to the above description, the K shell has one
orbital, designated as 1s; the L shell has two orbitals, designated as 2s and 2p, and
so forth. The orientation of the electron’s magnetic moment in a magnetic field is
described by the magnetic quantum number, m. The values of m can be m = −l, −
(l − 1), …, ..., (l − 1), l. Another quantum number, the spin quantum number,
s(s = −1/2 or +1/2), is assigned to each electron in order to specify its rotation about
its own axis. Each orbital can accommodate a maximum of 2(2l + 1) electrons, and
the total number of electrons in a given shell is 2n2. Thus, the K shell can contain
only 2 electrons, the next L shell 8 electrons, the M shell 18 electrons, the N shell 32
electrons, and the O shell 50 electrons. In atoms, the orbitals are filled in order of
increasing energy; that is, the lowest energy orbital is filled in first. However, when
d orbitals start filling, there are some exceptions to this rule as seen in the examples
of the electron configurations of some elements given below:
11Na 1s22s22p63s1
18Ar 1s22s22p63s2 3p6
26Fe s22s22p63s2 3p63d64s2
43Tc 1s22s22p63s2 3p63d104s24p64d65s1
49In 1s22s22p63s2 3p63d104s24p64d105s25p1
The electronic structure of the atom of an element determines to a large degree the
chemical properties of the element. The periodic table has been devised to arrange
the groups of elements of similar chemical properties in order of increasing atomic
number. In the periodic table (Fig. 1.2), nine groups are presented vertically, and