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Technetium-99m

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Technetium-99m

Technetium-99m (99mTc) is a metastable nuclear isomer of technetium-99 (itself an isotope of technetium), symbolized as 99mTc, that is used in tens of millions of medical diagnostic procedures annually, making it the most commonly used medical radioisotope in the world.

Technetium-99m is used as a radioactive tracer and can be detected in the body by medical equipment (gamma cameras). It is well suited to the role, because it emits readily detectable gamma rays with a photon energy of 140.5 keV (within the range emitted by conventional X-ray diagnostic equipment) and its half-life is 6.0066 hours (meaning 93.7% of it decays to 99Tc in 24 hours). The relatively "short" physical half-life of the isotope and its biological half-life of 1 day (in terms of human activity and metabolism) allows for scanning procedures which collect data rapidly but keep total patient radiation exposure low. The same characteristics make the isotope unsuitable for therapeutic use.[why?]

Technetium-99m was discovered as a product of cyclotron bombardment of molybdenum. This procedure produced molybdenum-99, a radionuclide with a longer half-life (2.75 days), which decays to 99mTc. This longer decay time allows for 99Mo to be shipped to medical facilities, where 99mTc is extracted from the sample as it is produced. In turn, the 99Mo is usually created by fission of highly enriched uranium in a small number of research and material testing nuclear reactors in several countries.

In 1938, Emilio Segrè and Glenn T. Seaborg isolated for the first time the metastable isotope technetium-99m, after bombarding natural molybdenum with 8 MeV deuterons in the 37-inch (940 mm) cyclotron of Ernest Orlando Lawrence's Radiation laboratory. In 1970 Seaborg explained that:

we discovered an isotope of great scientific interest, because it decayed by means of an isomeric transition with emission of a line spectrum of electrons coming from an almost completely internally converted gamma ray transition. [actually, only 12% of the decays are by internal conversion] (...) This was a form of radioactive decay which had never been observed before this time. Segrè and I were able to show that this radioactive isotope of the element with the atomic number 43 decayed with a half-life of 6.6 h [later updated to 6.0 h] and that it was the daughter of a 67-h [later updated to 66 h] molybdenum parent radioactivity. This chain of decay was later shown to have the mass number 99, and (...) the 6.6-h activity acquired the designation 'technetium-99m.

Later in 1940, Emilio Segrè and Chien-Shiung Wu published experimental results of an analysis of fission products of uranium-235, including molybdenum-99, and detected the presence of an isomer of element 43 with a 6-hour half-life, later labelled as technetium-99m.

99mTc remained a scientific curiosity until the 1950s when Powell Richards realized the potential of technetium-99m as a medical radiotracer and promoted its use among the medical community. While Richards was in charge of the radioisotope production at the Hot Lab Division of the Brookhaven National Laboratory, Walter Tucker and Margaret Greene were working on how to improve the separation process purity of the short-lived eluted daughter product iodine-132 from its parent, tellurium-132 (with a half-life of 3.2 days), produced in the Brookhaven Graphite Research Reactor. They detected a trace contaminant which proved to be 99mTc, which was coming from 99Mo and was following tellurium in the chemistry of the separation process for other fission products. Based on the similarities between the chemistry of the tellurium-iodine parent-daughter pair, Tucker and Greene developed the first technetium-99m generator in 1958. It was not until 1960 that Richards became the first to suggest the idea of using technetium as a medical tracer.

The first US publication to report on medical scanning of 99mTc appeared in August 1963. Sorensen and Archambault demonstrated that intravenously injected carrier-free 99Mo selectively and efficiently concentrated in the liver, becoming an internal generator of 99mTc. After build-up of 99mTc, they could visualize the liver using the 140 keV gamma ray emission.

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