experiments and proposed with great potentials for human and clinical utility.
Problem was always that investigators could not reveal the distribution of these
nanomaterials repeatedly after systemic administration. Development of how to
measure silica or graphene was not an easy task and only the measurement of high
molecular weight metals was possible with inductively coupled plasma mass
spectrometry (ICP-MS) but with limited success to predict the whereabouts or
kinetics of the nanomaterials. The substance themselves can be toxic or does betray
the expectation that they will reach targets in vivo but we did not have very good
methods to trace or track the trails.
Trace amount use and tracer capability of nuclear medicine are the two beauties
of its fundamental advantage, which enabled its use for so many clinical situations.
Globally, for example in 2015, 20 million procedures (imaging and therapy) in
North America, 10 million in European Union and the vicinity and 5 million in Far
East Asia were performed. Globally up to 40 million procedures are taking
advantage of the trace amount of radionuclides and radiopharmaceuticals for use
and tracer capability for imaging and targeted delivery. We could now see the
chance of using the advantages of nuclear medicine to be refined for use with
nanomedicines. Here nanomedicines are the generic name for nanodrugs, collectively called as a group. If nanomedicines are radiolabeled, they are now radionanomedicines. In contrast, radionanomedicine is the combined nuclear and
nanomedicine. Radionanomedicine is using radionanomedicines for in vivo imaging, targeted delivery and hopefully therapy. Recently, combined therapy and
diagnostics came to be called as theranostics. And the ultimate feature of radionanomedicine is radionanomedical theranostics. The emphasis on theranostics
instead of diagnostic imaging is due to the realization that there are full of many
variations of too many imaging entries in clinical use and that the therapy is off the
point that it is not personalized nor individualized. Recent emphasis on precision
medicine is one example of this collective awareness. Useless and harmful biologics or small molecules are delivered to the patients carelessly, and post-hoc
decision is reached that the treatment regimen was not helpful to most of the
patients.
Radionanomedicine can rescue the dilemma of the novel therapeutic drugs
composed of nanomaterials, or nanomedicines. Regulations about biologics are
going to be applied similarly to the nanomedicines. The only difference is that we
do not know well but also cannot predict easily the perpetual fates of
nanomedicines in vivo after systemic administration in humans. By labeling
radionuclides to these nanomaterials or nanomedicines, we can trace the biodistribution in vivo after systemic administration and begin predicting the fates of
those radionanomedicines in vivo. This eventually will individualize the choice of
patients in whom we expect the biological or radiation effect upon the disease
of interest such as cancers. For cancers, so many tyrosine kinase (TK) inhibitors or
monoclonal antibodies had been developed and clinically in use, but shotgun type
of therapy is so prevalent to result in the patients’ agony and pharmaceutical
company’s profit. Elucidation methods of bodily fates of small chemicals and
biologics are well established and metabolomics are the newest name for that
1 Introduction
3
Problem was always that investigators could not reveal the distribution of these
nanomaterials repeatedly after systemic administration. Development of how to
measure silica or graphene was not an easy task and only the measurement of high
molecular weight metals was possible with inductively coupled plasma mass
spectrometry (ICP-MS) but with limited success to predict the whereabouts or
kinetics of the nanomaterials. The substance themselves can be toxic or does betray
the expectation that they will reach targets in vivo but we did not have very good
methods to trace or track the trails.
Trace amount use and tracer capability of nuclear medicine are the two beauties
of its fundamental advantage, which enabled its use for so many clinical situations.
Globally, for example in 2015, 20 million procedures (imaging and therapy) in
North America, 10 million in European Union and the vicinity and 5 million in Far
East Asia were performed. Globally up to 40 million procedures are taking
advantage of the trace amount of radionuclides and radiopharmaceuticals for use
and tracer capability for imaging and targeted delivery. We could now see the
chance of using the advantages of nuclear medicine to be refined for use with
nanomedicines. Here nanomedicines are the generic name for nanodrugs, collectively called as a group. If nanomedicines are radiolabeled, they are now radionanomedicines. In contrast, radionanomedicine is the combined nuclear and
nanomedicine. Radionanomedicine is using radionanomedicines for in vivo imaging, targeted delivery and hopefully therapy. Recently, combined therapy and
diagnostics came to be called as theranostics. And the ultimate feature of radionanomedicine is radionanomedical theranostics. The emphasis on theranostics
instead of diagnostic imaging is due to the realization that there are full of many
variations of too many imaging entries in clinical use and that the therapy is off the
point that it is not personalized nor individualized. Recent emphasis on precision
medicine is one example of this collective awareness. Useless and harmful biologics or small molecules are delivered to the patients carelessly, and post-hoc
decision is reached that the treatment regimen was not helpful to most of the
patients.
Radionanomedicine can rescue the dilemma of the novel therapeutic drugs
composed of nanomaterials, or nanomedicines. Regulations about biologics are
going to be applied similarly to the nanomedicines. The only difference is that we
do not know well but also cannot predict easily the perpetual fates of
nanomedicines in vivo after systemic administration in humans. By labeling
radionuclides to these nanomaterials or nanomedicines, we can trace the biodistribution in vivo after systemic administration and begin predicting the fates of
those radionanomedicines in vivo. This eventually will individualize the choice of
patients in whom we expect the biological or radiation effect upon the disease
of interest such as cancers. For cancers, so many tyrosine kinase (TK) inhibitors or
monoclonal antibodies had been developed and clinically in use, but shotgun type
of therapy is so prevalent to result in the patients’ agony and pharmaceutical
company’s profit. Elucidation methods of bodily fates of small chemicals and
biologics are well established and metabolomics are the newest name for that
1 Introduction
3