Radiation Protection and Dosimetry Topics in the Novel Applications of Radiopharmaceuticals in Medicine

In recent years, novel applications of radionuclides and radiopharmaceuticals, for diagnostic and therapy applications in medicine have emerged, posing challenges from the radiation protection and dosimetry point of view. In addition to scientific, technological and technical issues, they also raise regulatory, policy, socioeconomic and financial concerns. In this review, promising emitters, α emitters (Targeted Alpha Therapy) and Auger electron emitters are identified. Production mechanisms, physical, biological and clinical characteristics and effectiveness are succinctly described. Supply and demand needs, routes and mechanisms are addressed. Radiation protection and dosimetry scientific, technological, technical, clinical, economic, financial and regulatory needs and issues to address the widespread clinical use of these radiopharmaceuticals are identified. Prospective views, informed by European and other international technical reports and data and peer reviewed scientific articles are provided. Potential hurdles and implementation issues are identified. The way to personalized and precision medicine and to the widespread implementation of theranostics in Nuclear Medicine Therapy 1 are discussed. It can be anticipated that in the coming years, the dissemination of the use of β-emitters and α-emitters in Nuclear Medicine Therapy will reach its mature phase, with significant and impactful clinical outcomes. However, radiation protection and dosimetry medical, occupational and public exposure issues need to be properly addressed in order to warrant radiation safety of these procedures.