We study the production of radioisotopes for nuclear medicine in (γ,xn+yp) photonuclear reactions or (γ,γ′) photoexcitation reactions with high-flux [(1013–1015)γ/s], small diameter ∼(100 μm)2 and small bandwidth (ΔE/E≈10−3–10−4) γ beams produced by Compton back-scattering of laser light from relativistic brilliant electron beams. We compare them to (ion,xn+yp) reactions with (ion = p,d,α) from particle accelerators like cyclotrons and (n,γ) or (n,f) reactions from nuclear reactors. For photonuclear reactions with a narrow γ-beam the energy deposition in the target can be managed by using a stack of thin target foils or wires, hence avoiding direct stopping of the Compton and pair electrons (positrons). However, for ions with a strong atomic stopping only a fraction of less than 10−2 leads to nuclear reactions resulting in a target heating, which is at least 105 times larger per produced radioactive ion and often limits the achievable activity. In photonuclear reactions the well defined initial excitation energy of the compound nucleus leads to a small number of reaction channels and enables new combinations of target isotope and final radioisotope. The narrow bandwidth γ excitation may make use of the fine structure of the Pygmy Dipole Resonance (PDR) or fluctuations in γ-width leading to increased cross sections. Within a rather short period compared to the isotopic half-life, a target area of the order of (100 μm)2 can be highly transmuted, resulting in a very high specific activity. (γ,γ′) isomer production via specially selected γ cascades allows to produce high specific activity in multiple excitations, where no back-pumping of the isomer to the ground state occurs. We discuss in detail many specific radioisotopes for diagnostics and therapy applications. Photonuclear reactions with γ-beams allow to produce certain radioisotopes, e.g. 47Sc, 44Ti, 67Cu, 103Pd, 117m Sn, 169Er, 195m Pt or 225Ac, with higher specific activity and/or more economically than with classical methods. This will open the door for completely new clinical applications of radioisotopes. For example 195m Pt could be used to verify the patient’s response to chemotherapy with platinum compounds before a complete treatment is performed. Also innovative isotopes like 47Sc, 67Cu and 225Ac could be produced for the first time in sufficient quantities for large-scale application in targeted radionuclide therapy.
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