Abstract
Simple SummaryAdvances in nuclear medicine are made by technological and radionuclide improvements. Throughout nuclear medicine’s history, these advances were often intertwined and complementary based on different clinical questions, availability and need. This paper covers some of these developments in radionuclides and instrumentation.Developments throughout the history of nuclear medicine have involved improvements in both instrumentation and radionuclides, which have been intertwined. Instrumentation developments always occurred during the search to improving devices’ sensitivity and included advances in detector technology (with the introduction of cadmium zinc telluride and digital Positron Emission Tomography—PET-devices with silicon photomultipliers), design (total body PET) and configuration (ring-shaped, Single-Photon Emission Computed Tomography (SPECT), Compton camera). In the field of radionuclide development, we observed the continual changing of clinically used radionuclides, which is sometimes influenced by instrumentation technology but also driven by availability, patient safety and clinical questions. Some areas, such as tumour imaging, have faced challenges when changing radionuclides based on availability, when this produced undesirable clinical findings with the introduction of unclear focal uptakes and unspecific uptakes. On the other end of spectrum, further developments of PET technology have seen a resurgence in its use in nuclear cardiology, with rubidium-82 from strontium-82/rubidium-82 generators being the radionuclide of choice, moving away from SPECT nuclides thallium-201 and technetium-99m. These continuing improvements in both instrumentation and radionuclide development have helped the growth of nuclear medicine and its importance in the ever-evolving range of patient care options.
Highlights
The world of nuclear medicine has been dynamic and fast-paced since the discovery of radioactivity by Marie and Pierre Curie in 1897 and the development of the Anger camera in the late 1950s
This study suggests that personalized dosimetry is likely to improve clinical practice outcomes and should be used in future trials of selective internal radiation therapy
Due to this indirect imaging, various disadvantages are observed, such as its low spatial resolution that depends on energy window width, collimator choice and image processing [36]; attenuation correction, since it depends on the density of the objects through which the photon passes, as well as the photon’s energy [37]; and overall quantification capability translating into an inaccurate dose-response analysis, despite the possible compensation techniques for attenuation, scatter and collimator detector response [38,39]
Summary
The world of nuclear medicine has been dynamic and fast-paced since the discovery of radioactivity by Marie and Pierre Curie in 1897 and the development of the Anger camera in the late 1950s. While conventional SPECT devices have detector heads attached to a rotating gantry, and their tomography image acquisition is obtained by positioning the heads at different angles, the ring-shaped SPECT (Figure 7) uses the same design as PET. One such proposed design (J-PET), in addition to benefitting from this multilayer detector, uses long plastic scintillators (across the entire axial field of view and an order of magnitude cheaper than crystals) coupled with photomultipliers and electronics at its ends, instead of having multiple detector rings (Figure 9) [31]. A different approach proposed by some groups is to use multiple layers of detectors, thereby generating images from both absorbed gamma as well as the interactions of a stack of detectors [30], as shown FiFgiugurere8.8R.iRenpeFrpeirsgeesunertnaettai9vt.ievOmenmaexaisxmuimcuhmumpinrotinepnteosnistseyidtpyrdopejresocijgteicnotni(oJ(n-MP(IEMPT,It)Po,,pitnoropawdr)odwaint)idoananxdtioaalxbPieaEnlTePifEmitTtaiignmegsagf(breoosmt(tbomothttirosomwm)ruoolwftia)- 5o7f-aye5a7r--yoeladr(ftbheolrmleeeulfdfPtaeelErf(meeebTmnwlauwcraieegtli,laehienamntlndhenyw)aoceoeairwtontrnPgrhr-doiEddswnnnTmet)eoahitrwacsaneeslnc-sillson-tedaamcotfdrtegrttoaliho,elmtlwelasl0a-ulacxewlstnegaionolagranldgl8suilc.efisut5sasu,eeneaSiltdgsxdcnUteei-oslcaVroota.l0.fencnP-fIahvtcigmroedeieeelarpsa8dwo.ge.lp-5PfaneoefrshtSfofre-trUarvisdocvei1Vtmeanh0isw.nrt-caIAe,gimnd4nfilomb-mat,areigc2ralrurele1-gtay,ls0feitt1srm-eiso,o-tptarfama4loaslgen-slr,e.(dA);dats2hElc0e-fbce,ur.ot5oeoer1rs-r.ucst-mttaJtssph.aonieelNntrdehtdsudaaraetirccal0nd.qlen;..wg5unEdaM-sitxiuamsitieri(rrhatFdid.einloJi.a.figapnMaxNxeushcilioaqrud(oaerlluc-lt.ioflgoi9fI.isfemhim)Mi-eltvtd[ial,uoe3id-gredn1oleiwto.nsf]di-.Mpfgva(mrlvic[oiei2qaegilwe7.rurhg]wIsit.mais,nciaartaq)ie.gnnoudFinddinsosmgirtoia[ron2ern7fgtes]hi.rnoee)nn.lecFtfehot,er
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