Bøger i Developments in Nuclear Medicine serien

During the past decade Positron Emission Tomography (PET) has turned from a highly sophisticated tool developed for basic research in neurology and cardiology into an advanced nuclear medicine imaging technique ready for routine use.

The application of 3D methodology has recently been receiving increasing attention at many PET centres, and this monograph is an attempt to provide a state-of-the-art review of this methodology, covering 3D reconstruction methods, quantitative procedures, current tomography performance, and clinical and research applications.

Radiochemical methodology constitutes the most important base for the successful functioning of a PET group in the routine production and development of radiopharmaceuticals.

Despite 50 years of antibiotics, infection remains a major source of both morbidity and mortality. Immunosuppression, either secondary to drugs in transplant recipients or secondary to HIV, has expanded the number of microorganisms that are known to be pathogenic in man. Imaging of infection has a vital role both in the initial diagnosis and in the continuing management of patients with infection or suspected infection. Functional imaging using nuclear medicine techniques has a unique role to play in identifying sites of infection in a wide range of patients with varying clinical conditions. This book, written by a series of experts not just in the fields of nuclear medicine but also infectious disease and radiology, discusses the role of nuclear medicine in three parts: a review of the pathophysiology of infection; a technical description of those nuclear medicine techniques which can be used in imaging infection; an extensive systematic review including thoracic, abdominal and orthopaedic infection as well as a special section on the acutely ill patient, the immunosuppressed patient and the patient with pyrexia of unknown origin. This book will be of interest to all clinicians looking after patients with infection and who need to use imaging techniques. It will also be of use to radiologists and nuclear medicine physicians who will be using these techniques clinically.

It was at Frankfurt/Mainin 1899 that Paul Ehrlich first expounded his famous "site-chain theory" -which described the basic immunological principal of antibody-antigen interactio- on the occasion of the opening of the Institute for Experimental Therapeutics (which was later named after him).

Parameters such as membrane transport, metabolism and protein incorporation govern the fate of amino acids in living tissue.

The book shows the fields in which PET offers new and unique information for the development of drugs (conception, toxicity, pharmacokinetics and metabolism, clinical research, and relations between clinical and biological effects) and evaluates fields in which PET may shorten the development time of drugs.

In the past nuclear medicine has tended to develop in cycles governed by the development of new radiopharmaceuticals followed or preceded by advances in instrumentation.

"More than half of the world's population is at risk of the tropical diseases malaria, leprosy, schistosomiasis, lymphatic filariasis, onchocerciasis, Chagas' disease, African trypanosomiasis and leishmaniasis and half a billion are infected with at least one of these diseases".

Among the readily available -emitting radionuclides, the nuclides of iodine have the greatest versatility in labeling both the hydrophilic and the lipophilic compounds that are used in biology and medicine. Although ~c is used more widely in diagnostic procedures, the radionuclides of iodine will always have a major role in biology and medicine.

The contents of this volume are based upon presentations made to the Second European Symposium on Radiopharmacy and Radiopharmaceuticals which was held in St. Catharine's College Cambridge in March 1985.

This publication contains a collection of 22 manuscripts by authors invited to write review articles. They are based on lectures presented on the First and Second Training Course in Radiopharmacy and Radiopharmacology. These courses were organized under the auspices of the "Joint Committee on Radiopharmaceuticals" of both European Societies of Nuclear Medicine (ENMS and SNME) and were sponsored by the European Society of Nuclear Medicine (ENMS). Recent developments in radiopharmacy and radiopharmacology have been very complex; they cannot be overlooked by the medical staff in nuclear medical departments. This book has been written to provide access to recent research and to practical daily routine in patients' investigations. It provides a wide-ranging and topical overview of radiopharmacology in­ cluding chapters on basic chemistry and physics, incorporation dosimetry, interference of drugs in radiopharmacokinetics, legal aspects and stable isotope-labelled pharmaceuticals. Style of presentation is not uniform. Par­ tial overlapping concerning the content of papers has not been avoided in order to ensure different views and aspects of the same subject. We hope that the interdisciplinary approach will be stimulating and thought-provok­ ing for the reader. Consequently, this book is designed for specialists work­ ing in nuclear medical centres which involve different disciplines such as pharmacists, radiochemists, physicists, biochemists, biologists, mathemati­ cians, electronic engineers, physicians with different specialities, and tech­ nicians.

Radiochemical methodology constitutes the most important base for the successful functioning of a PET group in the routine production and development of radiopharmaceuticals.

However, a major new direction of interest now lies in the development of receptor-binding radio-tracers which can be used to perform in-vivo characterisation of diseased tissues and it is likely that much of the future research in this field will follow this direction.

The work presented here is based upon contact with excellent scientists who did not measure their time sparingly to be of assistance. It has also benefited from the infrastructure some col­ leagues made available to me, and without which considerable delays and expenditure would have been unavoidable. In this respect, I am particularly indebted to a number of people. Dr. J. Abramovici, Professor S. Orloff and Professor R. Fridrich reviewed my data critically and gave me access to their Insti­ tutes, enabling me to collect the clinical evi­ dence required to complete this work. The latter benefited also from the efforts of Dr. K. Streule who supervised the cross-over study upon which the final conclusions have been based. Dr. R. Senekowitsch and her staff were of inva­ luable help with the animal experimental data and was, together with Professor H. Kriegel, kind enough to enable me to complete this particular part. Dr. H.L. Chia's laboratory data provided me with the possibility to widen the radiopharmaceu­ tical aspects of the theme under discussion. I am also indebted to Dr. K.J. Panek for personal com­ ments regarding the radiation dosimetry of lll- v vi SCINTIGRAPHY OF INFLAMMATION labelled leukocytes.

The application of 3D methodology has recently been receiving increasing attention at many PET centres, and this monograph is an attempt to provide a state-of-the-art review of this methodology, covering 3D reconstruction methods, quantitative procedures, current tomography performance, and clinical and research applications.