Development Of Nuclear Medicine Research Articles

Future of nuclear medicine- an overview

The development of nuclear medicine has led to an entire subset of extremely effective strategies in diagnosis and disease therapy. The emerging advancements in nuclear medicine are vast and diverse. Nuclear medicine tests and treatments involve the use of small amounts of radioactive material in order to diagnose and determine the severity of a variety of conditions and diseases. Basically, nuclear medicine involves the use of the latest imaging facilities such as magnetic resonance imaging, computed tomography scans and positron emission tomography which will find in many modern medical institutions today. One significant advantage of using nuclear medicine is the ability to make complex medical procedures simpler and safer for patients. With this technology, physicians and medical professionals are able to examine in great detail the most sensitive areas. All examinations can happen without subjecting patients to possibly dangerous and invasive procedures and surgeries. This medical technology has enabled the development of treatment options for patients suffering from serious illnesses, such as cancer either through radiation or chemotherapy. Health care professionals now face many challenges in their profession such as new rules and the latest practices that enable them to learn new skills and new ways of practicing their daily tasks in nuclear medicine areas. As a result, they are confronted with new skills and new ways of practicing in nuclear medicine area every day.

Efforts in the Formation and Development of Nuclear Medicine in Vietnam.

The foundations of nuclear medicine in Vietnam were established from 1970. Until now, after 48years of development, in Vietnam, we have some basic equipment including 31 SPECT, 4 SPECT/CT machines, 11 PET/CT scanners, five cyclotrons, and one nuclear reactor. Many nuclear medicine techniques in diagnosis and treatment have been routinely performed at provincial and central level health facilities such as tumor scintigraphy, thyroid scintigraphy, bone scintigraphy, kidney scintigraphy, cardiac scintigraphy, and radio-isotope therapy with I-131 and P-32. Selective internal radiation therapy with Y-90 microsphere and I-125 radioactive seed implantation has been also successfully applied in some big hospitals. However, there are still many difficulties for Vietnam as the lack of new widely used radioisotopes such as Ga-67, Cu-64, Samarium-153, and Lutetium-177 and the lack of nuclear medicine specialists. In the future, we are putting our efforts on the applications of new isotopes in diagnosis and treatment of cancers (theranostic) like Ga-68-DOTATATE, Lutetium-177-DOTATATE, Ga-68-PSMA, and Lutetium-177-PSMA, equipping modern nuclear medicine diagnostic tools, strengthening the human resources training in nuclear medicine. At the same time, we are trying our best to strengthen the cooperation with international nuclear medicine societies in over the world.

Ensuring effective and sustainable radionuclide delivery and its impact on the development of nuclear medicine in the developing world with special reference to Nigeria.

Recent activities of Boko Haram, a local extremist group in Nigeria, raise concerns about a nuclear terrorist attack. Whereas nuclear medicine (NM) relies on the timely delivery of radioactive sources, a robust security structure that assures public safety is the backbone for its beneficial use. NM radionuclides have short half-lives and carry an insignificant risk for acts of terrorism. Yet, their importation and delivery in Nigeria receive undue scrutiny in a bid to implement a strict nuclear security regime. These actions prevent timely delivery of radionuclides with direct consequences on quality and economic viability of nuclear medicine. There have been no accounts of terrorist acts accomplished with NM radionuclides. Thus, it is important the NM community question the current approach that has contributed to the loss of NM services in Nigeria and proposes a more logical strategy for securing their supply. We also highlight the need for developing local pragmatic solutions when implementing global recommendations in developing countries.

Imaging in Diagnostic Nuclear Medicine

Single-photon emission computed tomography (SPECT) and positron emission tomography (PET) are modern methods for visualization in diagnostic nuclear medicine. SPECT is known as a workhorse in cardiology, and PET is the gold standard in oncology. The development of nuclear medicine is provided by cooperation of physicists, mathematicians, biologists, medical doctors, and radio-chemists. In spite of extensive clinical applications, several problems may lead to false diagnoses. In particular, the correction of attenuation of gamma radiation in human organs must be taken into account. For interpretation and evaluation of such an effect on the clinical results, we perform physico-mathematical simulation of the SPECT diagnostics in cardiology in the absence and presence of the correction of attenuation. A brief review of the state-of-the art is presented. The simulation employs the first Russian anthropomorphic mathematical phantom that describes the distribution of radio-pharmacological agent (99m Tc-methoxyisobutylisonitrile) in chest organs of a typical male patient. A model for calculation of raw images is developed with allowance for attenuation of radiation in biological tissues and the effect of collimator and detector. The results of the proposed models and calculated images are compared with clinical images obtained at the Meshalkin Institute of Circulation Pathology (Novosibirsk) and Myasnikov Institute of Clinical Cardiology (Moscow). Statistical algorithms are developed for the solution of the inverse problem of image reconstruction based on the entropy principle. The clinical and physico-mathematical approaches are compared in the evaluation of the effect of correction on the quality of reconstructed images of the left ventricle of myocardium.

Current possibilities for developing nuclear medicine in Russia

Focus in this article is placed on the areas of application of nuclear medicine methods, the existing structure of the nuclear medicine market in the world and the scope of implementation of these methods into practice of the Russian health care. Some criteria for selecting the regions and medical institutions to be taking part in the implementation of the national program on the development of nuclear medicine are determined. The existing experience is pooled and the conclusions drawn by experts on the challenges and opportunities of training highly qualified non-medical specialists for nuclear medicine are given.

Characterization of Sn-Apatites and 99mTcO4 – anions removal from aqueous solutions

Abstract Apatite is a natural mineral from the group of phosphate minerals. It originates primarily in rocks and converted limestones. It is also one of the few minerals produced and used by microeconomic systems. Due to its low solubility in water and high sorption capacity, apatite is a suitable sorbent for heavy metals and radionuclides removal from aqueous radioactive waste. Increasing amount of radioactive waste (RAW) has a negative impact on human health as well as on the environment. Production of RAW is constantly increasing because of the use of nuclear energy as well as by the development of nuclear medicine. The aim of this work was to study the effect of pH and various anions on the sorption of pertechnetate anions from aqueous solution to Sn-Apatite. Sn-Apatite samples used in the experiment were prepared by the wet precipitation method and adsorption of 99mTc was monitored by the radioisotope indication method. Sorption experiments were performed using the batch method. It was found that the sorption percentage was higher than 90 % in all Sn-Apatite samples and the dissociation constant, KD, indicated high affinity of pertechnetate anions to the solid Sn-Apatite particles. The presence of competing anions did not significantly influence the ability of Sn-Apatite materials to adsorb 99mTcO4 - from aqueous solutions.

INTERNATIONAL ISOTOPES MARKETS

The paper studies world markets of stable and radioactive isotopes. Isotopes have found various applications in science, industry, agriculture and other sectors of the economy, but especially - in medicine. Nuclear medicine is developing intensively all over the world thanks to the success in the treatment of various diseases with the help of radioactive pharmaceuticals (radiopharmaceuticals). The article uses empirical data from a forecast study of the global radiopharmaceuticals market made in 2015 by a research company «Markets and Markets» for the European, North American and global markets. The paper also analyzes the statistical data on the global export and import of natural uranium, enriched and depleted uranium, plutonium, thorium and some stable isotopes of non-medical purposes, presented by a company «Trend economy» in 2014. Despite a unique industrial base for the production of isotopes created in the Soviet Union Russia occupies a modest position on the world market of nuclear medicine except for certain areas. More than 80% of isotopes, produced in USSR were consumed domestically, the export of the stable and radioactive isotopes was in equal proportions. Now the country's domestic radiopharmaceuticals market is poorly developed. To radically change the situation, it is necessary to carry out reforms that stimulate the development of nuclear medicine.

Radionuclide imaging and treatment of thyroid cancer.

Over the past decades, the diagnostic methods and therapeutic tools for thyroid cancer (TC) have been greatly improved. In addition to the classical method of ingestion of radioactive iodine-131 (I131) and subsequent I123 and I124 positron emission tomography (PET) in therapy and examination, I124 PET-based 3-dimensional imaging, Ga68-labeled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI(3)-octreotide (DOTANOC) PET/computed tomography (CT), Tc99m tetrofosmin, pre-targeted radioimmunotherapy, and peptide receptor radionuclide therapy have all been used clinically. These novel methods are useful in diagnosis and therapy of TC, but also have unavoidable adverse effects. In this review, we will discuss the development of nuclear medicine in TC examination and treatment.

Radiologic Imaging Techniques for the Diagnosis and Management of Invasive Fungal Disease

Invasive fungal diseases (IFDs) are an important cause of morbidity and mortality, especially in immunocompromised patients. Prompt antifungal therapy is essential for favorable outcomes, but clinical signs and symptoms are nonspecific and mycologic confirmation is often not possible. Radiographic testing is an important adjunct to the diagnosis and management of IFDs. Early imaging has been associated with improved survival, particularly in neutropenic patients with fungal pneumonia or acute invasive fungal sinusitis. This review summarizes common radiologic appearances of IFDs of the lung, sinus, and brain. The advantages and limitations of computed tomography (CT) and magnetic resonance (MR) imaging are discussed as are recent developments in nuclear medicine and proton MR spectroscopy technology.

Message from the New Editor-in-Chief.

Message from the New Editor-in-Chief.

ВОЗМОЖНОСТИ СИСТЕМНОЙ РАДИОНУКЛИДНОЙ ТЕРАПИИ В ПАЛЛИАТИВНОМ ЛЕЧЕНИИ БОЛЬНЫХ С МЕТАСТАТИЧЕСКИМ ПОРАЖЕНИЕМ КОСТЕЙ

The pain syndrome accompanying metastatic damage of bones, significantly reduces quality of patients life. In recent decades, medical practice implemented methods systemic radionuclide therapy of bone metastases using different radionuclides, which allows to stop both the pain and the progression of the disease. Results of their application give the grounds to consider the perspective development in nuclear medicine of the direction on treatment bone metastatic defeats by means of systemic radionuclide therapy.

POSSIBILITIES OF SYSTEMIC RADIONUCLIDE THERAPY IN PALLIATIVE TREATMENT OF P ATIENTS WITH METASTATIC BONES DISEASE

The pain syndrome accompanying metastatic damage of bones, significantly reduces quality of patients life. In recent decades, medical practice implemented methods systemic radionuclide therapy of bone metastases using different radionuclides, which allows to stop both the pain and the progression of the disease. Results of their application give the grounds to consider the perspective development in nuclear medicine of the direction on treatment bone metastatic defeats by means of systemic radionuclide therapy.

SiPM MEPhI Megagrant Developments in Nuclear Medicine

Three projects has been started in our laboratory as part of megagrant “High energy physics and nuclear medicine with silicon photomultiplier detectors” in NRNU MEPHI. The goal of these projects is development of devices for nuclear medicine in which replacement of photomultiplier tubes (PMT) with solid-state silicon photomultipliers promises various advantages. The first project is full-body SPECT, where replacement of PMT's could reduce size of the detector module and improve spatial resolution while keeping other parameters. The second project is development of a TOF-PET module. Replacement of PMTs with silicon photomultipliers makes it possible to use that detector not only in high magnetic fields but also for Time-of-Flight measurements (higher signal-to-noise ratio on final image) due to very high timing resolution of a SiPM. And the last project is the SiPM-based position-sensitive Gamma-spectrometer for dose monitoring in neutron-capture therapy based on SiPM's.

Thirty years from now: future physics contributions in nuclear medicine.

BackgroundThis paper is the first in a series of invited perspectives by pioneers of nuclear medicine imaging and physics. A medical physicist and a nuclear medicine physician each take a backward and a forward look at the contributions of physics to nuclear medicine. Here, we provide a forward look from the medical physicist’s perspective.DiscussionThe author examines a number of developments in nuclear medicine and discusses the ways in which physics has contributed to these. Future developments are postulated in the context of an increasingly personalised approach to medical diagnostics and therapies.ConclusionsA skill set for the next generation of medical physicists in nuclear medicine is proposed in the context of the increasing complexity of ‘Molecular Imaging’ in the next three decades. The author sees a shift away from ‘traditional’ roles in instrumentation QA to more innovative approaches in understanding radiobiology and human disease.

The contribution of Medical Physics to Nuclear Medicine: looking back - a physicist's perspective.

BackgroundThis paper is the first in a series of invited perspectives by four pioneers of Nuclear Medicine imaging and physics. A medical physicist and a Nuclear Medicine clinical specialist each take a backward look and a forward look at the contributions of Medical Physics to Nuclear Medicine.DiscussionContributions of Medical Physics are presented from the early discovery of radioactivity, development of first imaging devices, computers and emission tomography to recent development of hybrid imaging.SummaryThere is evidence of significant contribution of Medical Physics throughout the development of Nuclear Medicine.

Nuclear Medicine Milestones

As part of the Next Accreditation System (NAS), all accredited specialties have developed specialty-specific educational Milestones as competency-based learning and assessment tools. In the NAS, Milestone data will be used in the assessment and provision of feedback to residents and will be a key indicator of programs' educational effectiveness. Nuclear medicine participated in this process as a Phase II specialty. The guiding principles behind Milestone development in nuclear medicine were to create an appropriate number and variety of Milestones that would be widely applicable across all programs and provide meaningful and valid data, while simultaneously making the Milestones manageable and not overly burdensome.

EJNMMI Physics—Access is open for open access

At the 2013 Annual Meeting of the European Nuclear Medi-cine Association (EANM) in Lyon, Springer launched a newcompanion journal to the European Journal of Nuclear Med-icine and Molecular Imaging (EJNMMI):the EJNMMI Phys-ics journal. EJNMMI Physics will be a partner journal ofEJNMMI Research, of which Angelika Bischof Delaloye hasbeentheeditor-in-chiefsince2011[1]. Thewell-versed readermay stop here with a grunting sound: “YAJ! ” (“yet anotherjournal”). However, there is more to this announcement.The development of nuclear medicine is indebted to manycontributions from physicists, including the discovery of ra-dioactivity by Henri Becquerel, the isolation of radioactiveisotopes by Marie Sklodowska-Curie, the discovery of thepositron by Carl David Anderson and the discovery of theneutron by James Chadwick, subsequently leading to thediscovery of artificial radioactivity by Irene and FredericJoliot-Curie, who received the Nobel Prize for Chemistry in1935.Itisperhapssurprising,therefore,thatatpresentthereisno journal dedicated to the field of physics in nuclear medi-cine, and it is very noticeable that such papers are scatteredacross a range of journals that either cover general physics inmedicine or are more focussed on clinical issues. With theincreasing emphasis on molecular imaging and personalisedmedicine, physics can only become more central to futuredevelopments, and a platform is needed to focus such ideas.EJNMMI Physics will fill that gap by providing a publica-tion platform for the exchange of scientifically sound infor-mationonphysicsand physics matters inthe realm ofnuclearmedicine. In recognition of today’s multi-disciplinary ap-proach to nuclear medicine and nuclear medicine physics,the journal will publish original materials and studies with afocus on applied physics, mathematics and multi-modalityimaging instrumentation as well as imaging system engineer-ing and prototyping in nuclear medicine. This includesphysics-drivenapproachesoralgorithmssupportedbyphysicsthatfosterearlyclinicaladoptionofnuclearmedicineimagingand therapy regimens.The journal is open for a variety of contributions, rangingfrom original articles and short communicationsto, for exam-ple, artefact reports that will describe both a methodologicalproblem leading to a visual or quantitative distortion of nu-clear medicine imaging and a solution to the problem. Inaddition, opinion papers, pictorial assays and review articlesaddressing controversies and timely developments will bepublished, relevant to both nuclear medicine physics andinstrumentation. One section, “Young Investigator Reports ”,will provide young medical physicists with a submissioncategory suitable for summary reports of their research activ-itiesaspartoftheirthesiswork.Thisjournalisnotintendedtoreplace theEJNMMIas the publication of choicefor physics-related articles that are of interest to the wider clinically

IAEA Support to Medical Physics in Nuclear Medicine

Through its programmatic efforts and its publications, the International Atomic Energy Agency (IAEA) has helped define the role and responsibilities of the nuclear medicine physicist in the practice of nuclear medicine. This paper describes the initiatives that the IAEA has undertaken to support medical physics in nuclear medicine. In 1984, the IAEA provided guidance on how to ensure that the equipment used for detecting, imaging, and quantifying radioactivity is functioning properly (Technical Document [TECDOC]-137, "Quality Control of Nuclear Medicine Instruments"). An updated version of IAEA-TECDOC-137 was issued in 1991 as IAEA-TECDOC-602, and this included new chapters on scanner-computer systems and single-photon emission computed tomography systems. Nuclear medicine physics was introduced as a part of a project on radiation imaging and radioactivity measurements in the 2002-2003 IAEA biennium program in Dosimetry and Medical Radiation Physics. Ten years later, IAEA activities in this field have expanded to cover quality assurance (QA) and quality control (QC) of nuclear medicine equipment, education and clinical training, professional recognition of the role of medical physicists in nuclear medicine physics, and finally, the coordination of research and development activities in internal dosimetry. As a result of these activities, the IAEA has received numerous requests to support the development and implementation of QA or QC programs for radioactivity measurements in nuclear medicine in many Member States. During the last 5 years, support was provided to 20 Member States through the IAEA's technical cooperation programme. The IAEA has also supported education and clinical training of medical physicists. This type of support has been essential for the development and expansion of the Medical Physics profession, especially in low- and middle-income countries. The need for basic as well as specialized clinical training in medical physics was identified as a priority for healthcare providers in many countries. The IAEA's response to meet the increasing needs for training has been 2-folds. Through its regular program, a priority is given to the development of standardized syllabi and education and clinical training guides. Through its technical cooperation programme, support is given for setting up national medical physics education and clinical training programs in countries. In addition, fellowships are granted for professionals working in the field for specialized training, and workshops are organized at the national and regional level in specialized topics of nuclear medicine physics. So as to support on-the-job training, the IAEA has also setup a gamma camera laboratory in Seibersdorf, Austria. The laboratory is also equipped with QC tools and equipments, and radioisotopes are procured when training events are held. About 2-3 specialized courses are held every year for medical physicists at the IAEA gamma camera laboratory. In the area of research and development, the IAEA supports, through its coordinated research projects, new initiatives in quantitative nuclear medicine and internal dosimetry. The future of nuclear medicine is driven by advances in instrumentation, by the ever increasing availability of computing power and data storage, and by the development of new radiopharmaceuticals for molecular imaging and therapy. Future developments in nuclear medicine are partially driven by, and will influence, nuclear medicine physics and medical physics. To summarize, the IAEA has established a number of programs to support nuclear medicine physics and will continue to do so through its coordinated research activities, education and training in clinical medical physics, and through programs and meetings to promote standardization and harmonization of QA or QC procedures for imaging and treatment of patients.

Current research in nuclear medicine and molecular imaging: highlights of the 23rd Annual EANM Congress

The most recent research developments in nuclear medicine and molecular imaging were presented at the 2010 Annual Congress of the EANM. This review summarizes some of the most relevant contributions made in the fields of oncology, cardiovascular science, neurology and psychiatry, technological innovation and novel tracers. Presentations covered basic and clinical research in nuclear medicine and molecular imaging, and diagnostic and therapeutic applications of radioisotopes and radiopharmaceuticals on a global scale. The results reported demonstrate that investigative strategies using nuclear medicine techniques facilitate effective diagnosis and management of patients with most prevalent disease states. At the same time novel tracers and technologies are being explored, which hold promise for future new applications of nuclear medicine and molecular imaging in research and clinical practice.

Nanotechnology and Radiopharmaceuticals: Diagnostic and Therapeutic Approaches

Nanotechnology is a novel but rapidly advancing domain of Therapeutics. Nanoscale-diameter particles such as liposomes and dendrimers may be conscribed for the effective and safe administration of several drugs. The main advantages of nanosystem-mediated drug delivery are the following; i) sufficient absorption, ii) delayed metabolism and excretion, iii) longer half-life, iv) ability to cross several anatomical barriers, v) enhanced accumulation in specific target-tissues (e.g. malignant tumors), vi) lower toxicity of the drug. During the last years there is a growing interest around the potential contribution of Nanotechnology in the development of Nuclear Medicine and vice versa. Radioactive agents called radiopharmaceuticals are already used in several medical procedures. Exploiting their ability to accumulate selectively on specific organ-targets, radiopharmaceuticals serve in diagnostic applications, such as scintiscan, PET scan and in therapy of several diseases (e.g. thyroid cancer). The use of nanosystems may further ameliorate the properties of radiopharmaceuticals regarding their targeting ability and their unique pharmacokinetic properties. On the other hand radionuclides may serve in experimental studies for the pharmacological evaluation of nanosystems. Nevertheless further research is required in order to confirm the effectiveness and safety of nanosystem-mediated radiopharmaceutical applications.