Terbium-149 production: a focus on yield and quality improvement towards preclinical application.

Terbium-149 (T1/2 = 4.1 h, Eα = 3.98 MeV (16.7%), 28 µm range in tissue) is a radionuclide with potential for targeted alpha therapy. Due to the negligible emission of α-emitting daughter nuclides, toxicity to healthy tissue may be reduced in comparison with other α-particle emitters. In this study, terbium-149 was produced via 1.4 GeV proton irradiation of a tantalum target at the CERN-ISOLDE facility. The spallation products were mass separated and implanted on zinc-coated foils and, later, radiochemically processed. Terbium-149 was separated from the co-produced isobaric radioisotopes and the zinc coating from the implantation foil, using cation-exchange and extraction chromatographic techniques, respectively. At the end of separation, up to 260 MBq terbium-149 were obtained with > 99% radionuclidic purity. Radiolabeling experiments were performed with DOTATATE, achieving 50 MBq/nmol apparent molar activity with radiochemical purity > 99%. The chemical purity was determined by inductively coupled plasma-mass spectrometry measurements, which showed lead, copper, iron and zinc only at ppb level. The radiolabeling of the somatostatin analogue DOTATATE with [149Tb]TbCl3 and the subsequent in vivo PET/CT scans conducted in xenografted mice, showing good tumor uptake, further demonstrated product quality and its ability to be used in a preclinical setting.

First direct determination of the 93Mo half-life.

This work presents the first direct measurement of the 93Mo half-life. The measurement is a combination of high-resolution mass spectrometry for the determination of the 93Mo concentration and liquid scintillation counting for determining the specific activity. A 93Mo sample of high purity was obtained from proton irradiated niobium by chemical separation of molybdenum with a decontamination factor larger than 1.6 × 1014 with respect to Nb. The half-life of 93Mo was deduced to be 4839(63) years, which is more than 20% longer than the currently adopted value, whereas the relative uncertainty could be reduced by a factor of 15. The probability that the 93Mo decays to the metastable state 93mNb was determined to be 95.7(16)%. This value is a factor of 8 more precise than previous estimations. Due to the man-made production of 93Mo in nuclear facilities, the result leads to significantly increased precision for modelling the low-level nuclear waste composition. The presented work demonstrates the importance of chemical separations in combination with state-of-the-art analysis techniques, which are inevitable for precise and accurate determinations of nuclear decay data.

Strategies for reducing material costs through implementation of clinical guidelines.

This paper presents a case study where the efforts to improve clinical guidelines resulted in significant savings in material costs through the standardization of the supplies and negotiation of contracts with the suppliers. It also presents an approach that is now being used to standardize material and reduce supply costs in other areas of the health system.

Hydrogels and hydrocolloids: an objective product comparison.

It is difficult for providers to make selections from the vast array of currently available wound care products. There has been a paucity of objective data generated by a non-biased source comparing one product to another. In order for our Wound Care Team to recommend products for system-wide formulary purchase and patient use, we needed to develop a process for product comparison. A strategy for objective evaluation of hydrocolloid and amorphous hydrogel products was created, and these products were assessed clinically by experienced wound care providers. Laboratory testing included measurement of each product's ability to absorb water versus normal saline versus actual patient wound fluid. There were major differences in various products' abilities to absorb the fluids. These objective data from the laboratory, along with the subjective comparison of clinical performance, allowed our Wound Care Team to objectively rank the hydrocolloids and hydrogels and include those preferred products in our Wound Care Product Formulary.