Emerging ionizing and non-ionizing radiation treatment for musculoskeletal disorders and malignancies

Document Type: Review article


1 The Persian Gulf Nuclear Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr, Iran

2 Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran

3 Department of Diagnostic Radiology, Keck Faculty of Medicine, University of Southern California (USC), Los Angeles, USA

4 Department of Interventional Radiology, Faculty of Medicine, Mercer University, Savannah, GA, USA

5 Department of Molecular Imaging and Radionuclide Therapy (MIRT), The Persian Gulf Nuclear Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran


The musculoskeletal (MSK) system includes bone, cartilage, fat, muscles, blood vessels, neural tissue, and other connective tissues. As aging occurs, the incidence of musculoskeletal disorders increases. Benign bone and soft tissue pathologies are more common than malignant ones. Although some MSK abnormalities can be self-limited, in the cases of severe defects or impairment of the potential restoration, intervention by novel methods such as radiation therapy may be required along with the main treatment, which is surgery in most cases. Radiation is categorized as non-ionizing and ionizing. Non-ionizing radiation is longer wavelength, lower frequency, and lower energy, while ionizing radiation is short wavelength, high frequency, and higher energy that able to destroy the cells. Utilizing these methods can have both symptom-relieving and curative effects.
One of the non-ionizing radiation types comes in the form of Low Level Laser Therapy (LLLT), which is a non-aggressive, non-ionizing, monochromatic and electromagnetic high-concentrated beam. LLLT has an essential role in ATP production, reducing inflammation, pain relief, wound healing, and muscle function. The development of ionization radiation therapy by radionuclides as a targeted therapy in nuclear medicine, boron capture neutron therapy and proton therapy as external radiation therapy can play a critical role in treating bone and soft tissue malignancies, especially in pediatric oncology. The purpose of this paper is to review the efficiency of LLLT, bone-seeking radiopharmaceuticals, proton, and boron capture neutron therapy for the treatment of bone and soft tissue pathologies and malignancies.