The Bone Pathway: 223Ra-Dichloride

  • Laura EvangelistaEmail author
  • Alessandra Zorz


Several beta-emitting radiopharmaceuticals, including 89Sr-chloride, 186Re-hydroxyethylidene diphosphonate, and 153Sm-ethylene diamine tetramethylene phosphonate, have been developed for palliation of bone pain due to metastases. 223Ra dichloride is a novel bone-seeking alpha emitter used for treatment of CRPC in patients with bone metastases. It is a calcium-mimetic solution that selectively targets area of increased bone turnover in bone metastases. First clinical studies with 223Ra started in 2012. This chapter aims to describe the employment of 223Ra-dichloride in clinical setting, by analyzing the different clinical trials and future perspectives for this targeted nuclear medicine therapy.


223Ra-Dichloride Pharmacokinetic Biodistribution Phase I Phase II Phase III Prostate cancer Scintigraphy Radiation protection Bone metastases 











As low as reasonably achievable




ALpharadin in SYMPtomatic Prostate CAncer


Castrate-resistant prostate cancer


Computed tomography


External beam radiotherapy




Linear energy transfer




Methyl disphosphonate






National Institute of Standard and Technology


Positron emission tomography


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Nuclear Medicine UnitVeneto Institute of Oncology IOV—IRCCSPaduaItaly
  2. 2.Medical Physic UnitVeneto Institute of Oncology IOV—IRCCSPaduaItaly

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