Ever since the 1934 discovery of artificial radioactivity, doctors have been armed with a panoply of radioactive isotopes for use as markers or tracers. Thanks to these radioactive isotopes it is now possible to follow the path of a single atom or chemical element around the body without disturbing its physical, chemical or biological behaviour.
Medical tests of this kind involve administering a radioactive tracer, chosen carefully for its ability to follow a metabolism or provide information about the working of a given organ. The tracer can be an individual atom (for instance iodine 123), a marked molecule (such as a diphosphonate marked with technetium 99m), an hormone or even an antibody marked with an isotope. The isotope has to be chemically attached to the relevant molecule without altering its properties and metabolism. The bond must also be a solid one in order to follow the molecule and not an eventually shaken off radioactive atom.
So-called 'radiopharmaceutical' products (molecules containing radioactive isotopes) are generally inserted intravenously, though some can also be inhaled or even swallowed.
When it comes to internal body scans, the game is to localize the radiopharmaceutical product inside the body from an external detection while exposing the body to a minimal dose of radiation. Gamma emitters are therefore the ideal radioelements : gamma rays are relatively low ionisers and simultaneously penetrative enough to be detected outside of the body. Another important property of the radioelement is its half-life, which has to be long enough to follow the biological process in question and yet short enough to avoid any unnecessary exposure.
Technetium 99m is by far the most commonly used radioelement (as it is used in 80-90% of all scintigraphy scans), as it allows for the exploration of numerous body parts and emits only gamma rays whose energy (of 140 keV) is well adapted to the gamma-camera detectors. Beta-plus (positron) emitters are used in the field of 'positron emission tomography' (PET scans). In the field of metabolic therapy, beta-minus emitters are used to deliver a highly localized dose of radiation.
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