This volume highlights the remarkable new developments in brain imaging, including those that apply magnetic resonance imaging (MRI) and Positron Emission Tomography (PET), that allow us to non invasively study the living human brain in health and in disease. These technological advances have allowed us to obtain new and powerful insights into the structure and function of the healthy brain as it develops across the life cycle, as well as the molecular make up of brain systems and circuits as they develop and change with age. New brain imaging technologies have also given us new insights into the causes of many common brain disorders, including ADHD, schizophrenia, depression and Alzheimer's disease, which collectively affect a large segment of the population. These new insights have major implications for understanding and treating these brain disorders, and are providing clinicians with the first ever set of biomarkers that can be used to guide diagnosis and monitor treatment effects. The advances in brain imaging over the last 20 years, summarized in this volume, represent a major advance in modern biomedical sciences.

This very practical "how-to" guide comprehensively covers both the common and less common pathologies affecting the paediatric skeleton. It provides clear explanations of the materials and instrumentation, as well as teaching points, technical comments, discussions, and the avoidance of pitfalls. The images presented here have been produced using whole-body scanning, gamma-camera, high-resolution spot images, pinhole and SPECT, as well as three-phase bone scans - each procedure backed by indications for its use. These 350 illustrations thus allow the paediatrician, orthopaedic surgeon, radiologist and nuclear medicine physician a comparison with their own images as well as with the "normal" images presented in the authors' companion volume, Atlas of Bone Scintigraphy in the Developing Paediatric Skeleton.

Neurological applications of PET include using itto identify Alzheimer's Disease, including differentiating between other forms of Dementia, to show causes of seizures that were otherwise unclear, and to diagnose psychiatric disorders like Schizophrenia. Although other books on PET may have a chapter or section on neurological applications, this is the only comprehensive and up-to-date book on neurological PET. It reviews PET in neuroscience with particular emphasis on findings that indicate its potential for improving diagnosis and treatment in neurology and psychiatry. Improving the transfer of the huge scientific developments in brain PET into clinical carewill produce tangible human benefit. To this end, "NeuroPET" focuses on practical and potentially clinically relevant issues and identify solid ground as well as open questions. In addition, the book includes major chapters on the methodological background, including tracer physiology and kinetic modeling, and a comprehensive literature review."

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.

The series of workshops sponsored by the European Communities started with "Methodology of PET" at Hammersmith Hospital, London, in March 1984. This was followed by "Radiochemistry, Methodology and Standardization in PET" at the Service Hospitalier Frederic Joliot in Orsay, France, in March 1985. Both these meetings were, in the opinion of all participants, great successes, and it was agreed that such work shops should continue and be organized on the same basis. After these two workshops on the fundamentals of PET, time now is ripe to evaluate the clinical efficacy of PET investigations, and to discuss to what extend the information provided by this high technology and theoretical area has contributed to the understanding of disease mechanisms, leading to immediate clinical applications. As pointed out in the previous meetings, PET using short-lived radioisotopes produced in an on-line cyclotron is restricted to a few centers. Therefore, the topics studied so far were mainly of scientific interest and clinical problems were dealt with only marginally. Before this costly technique can be spread and new information made accessible to a broader clinical clientele, its clinical value must be demonstrat ed. So far, in the majority of studies, the central nervous system was the primary target organ, and PET has contributed a great deal to our understanding of brain physiology and pathology. Also on the heart, a substantial number of studies have been performed in various centers, but the application of PET to this organ is still somewhat limited."

Echocardiography has now reached its maturity and plays a key role in the clinical assessment of cardiac function. However, its ability to assess myocardial perfusion remains a clinical challenge.

Myocardial contrast echocardiography is a technique that uses microbubbles. These microbubbles remain entirely within the intravascular space and their presence in any myocardial region denotes the status of microvascular perfusion within that region. During the last few years, a large number of research studies have been dedicated to this topic. The latest developments in echocardiographic techniques and second-generation contrast agents allow for the potential assessment of myocardial perfusion and provide an accurate endocardial border delineation.

In the present book, these new echocardiographic techniques dedicated to the assessment of myocardial perfusion are described in detail by experts from both sides of the Atlantic. Tips and tricks are included, explaining the basic concepts that are needed to understand and perform contrast echocardiography.

Nuclear Imaging of the Chest provides up-to-the minute information on the diagnostic nuclear imaging of chest disorders. The authors habe endeavored to integrate and consonsolidate the many different subspecialities in order to enable a holistic understanding of chest diseases from the nuclear medicine standpoint. Highlights of the book include the description of aerosol lung imaging in COPD and the updates on breast and lung cancer imaging. It is required reading not only for nuclear medicine practitioners and researchers but also for all interested radiologists, traumatologists, pulmonologists and cardiologists.

This volume is the scientific chronicle of the NATO Advanced Research Workshop on Computational Aspects of the Study of Biological Macro molecules by Nuclear Magnetic Resonance Spectroscopy, which was held June 3-8, 1990 at Il Ciocco, near Barga, Italy. The use of computers in the study of biological macromolecules by NMR spectroscopy is ubiquitous. The applications are diverse, including data col lection, reduction, and analysis. Furthermore, their use is rapidly evolv ing, driven by the development of new experimental methods in NMR and molecular biology and by phenomenal increases in computational perfor mance available at reasonable cost. Computers no longer merely facilitate, but are now absolutely essential in the study of biological macromolecules by NMR, due to the size and complexity of the data sets that are obtained from modern experiments. The Workshop, and this proceedings volume, provide a snapshot of the uses of computers in the NMR of biomolecules. While by no means exhaustive, the picture that emerges illustrates both the. importance and the diversity of their application."

The disorders induced by iodine deficiency affect at least one billion people. Because ofits effects on brain development, iodinedeficiency is the single most preventable cause of mental retardation in the world. Therefore, the United Nations and the Heads of State of almost all the world's countries represented at the Summit for Children in 1990 adopted resolutions to eradicate the disorders induced by iodine deficiency (IDD) by the year 2000. For geological and socio-economic reasons, most of the populations affected by iodine deficiency disorders live in isolated and usually mountainous areas, in pre industrialized parts ofthe world. The problem of iodine deficiency in Europe has been greatly underestimated in the last decades. After the remarkable studies on the effects of iodine deficiency and their prevention and correction in Switzerland, IDD was generally considered no longer a significant public health problem in Europe. However, surveys carried out in the early 1980's under the auspices of the European Thyroid Association, clearly demonstrated the persistence of moderately or even severely affected areas. These surveys also highlighted the lack ofinformation about large parts ofEurope, especially its eastern part. It is only quite recently, following major changes in international relations and thanks to the support of UNICEF, WHO, the International Council for the Control of Iodine Deficiency Disorders and the European Thyroid Association, that more extensive surveys have been conducted in several parts of Europe hitherto almost unexplored. These surveys showed that most European countries were iodine deficient."

Since questions about wireless phones andbrain cancer were first raised in early 1993, numerous scientificstudies and reviews have been conducted and published throughout the world with support from industry and government. The most comprehensive colloquium to date covering this science was co sponsored byt he International Committee on WirelessCommunication Health Research and Wireless Technology Research, LLC,a t the University "La Sapienza" ofR omein November 1995. Papers fromt hat colloquium with appropriate updates formt he foundation for the current volume. A follow up tothat colloquium isbeing planned fort he spring of 1999 byt he same group and thereport of that colloquium will bet he basis for Volume II ofthis series. As thescientific story about wireless phones and health effects continues to unfold over the next several years, it is important to evaluate thework ina context t hat isb eneficialt ot he enhancement ofpublic health. Two themesa re critical to an appropriate contextual understanding ofthis science.

There are many human cancers which actively synthesize specific characteristic proteins such as melanomas, thyroid cancer and squamous cell carcinoma. Many cancer researchers have of course tried to utilize this specific activity as a key for the selective treatment of cancers. In the past for example, the molecular hybrid compound of DOPA, a substrate of melanin, and nitrogen mustard N-oxide hydrochloride, a ctyotoxic anti-tumor drug, was synthesized as Melphalan and used to treat malignant melanoma. A major problem arose though in that it was soon found to be highly suppressive toward bone marrow and quite toxic while not being remarkably effective. Thus, malignant melanoma could not be cured by it. Such failure led us to develop a novel bimodal therapeutic system which includes the use of non-toxic potentially cytocidal chemicals which selectively accumulate within the cancer cells and which are converted by a controllable modality into an actively cytocidal element in situ. We can now non-surgically cure malignant melanoma and glioblastoma with our selective cancer treatment, neutron capture therapy (NCT); as can be found in this volume. Included are 124 papers on the latest breaking developments discussed at the Sixth International Symposium on NCT for Cancer held in Kobe during the late autumn of 1994.

The North Atlantic Treaty Organization (NATO) has sponsored research and personnel safety standards development for exposure to Radiofrequency Radiation (RFR) for over twenty years. The Aerospace Medical Panel of the Advisory Group For Aerospace Research and Development (AGARD) sponsored Lecture Series No. 78 Radiation Hazards,! in 1975, in the Netherlands, Germany, and Norway, on the subject of Radiation Hazards to provide a review and critical analysis of the available information and concepts. In the same year, Research Study Group 2 on Protection of Personnel Against Non-Ionizing Electromagnetic Radiation (Panel VIIl of AC/243 Defence Research Group, NATO) proposed a revision to Standardization Agreement (STANAG) 2345. The intent of the proposal was to revise the ST ANAG to incorporate frequency-dependent-RFR safety guidelines. These changes are documented in the NATO STANAG 2345 (MED), Control and Recording of Personnel Exposure to Radiofrequency Radiation,2 promulgated in 1979. Research Study Group 2 (RSG2) of NATO Defense Research Group Panel VIII (AC1243) was organized, in 1981, to study and contribute technical information concerning the protection of military personnel from the effects of radiofrequency electromagnetic radiation. A workshop at the Royal Air Force Institute of Aviation Medicine, Royal Aircraft Establishment, Farnborough, U. K. was held to develop and/or compile sufficient knowledge on the long-term effects of pulsed RFR to maintain safe procedures and to minimize unnecessary operational constraints.

Marking the 200th National Meeting of the American Chemical Society, The Division of Nuclear Chemistry and Technology hosted a group of about 90 scientists from 15 different countries to discuss the new trends in radiopharmaceutical synthesis, quality assurance and regulatory control. This event took place in Washington, D.C. on August 27-30, 1990. When I first suggested the idea for this symposium, a group of scientists who pioneered the proposed topics offered their help to organize and run such a big task with me. Their names are listed here in appreciation. Thomas E. Boothe Cyclotron Facility, Mt. Sinai Medical Center, Miami Beach, Florida, USA Robert F. Dannals Division of Nuclear Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA Anthony L. Feliu Julich Nuclear Research Center, Julich, Germany Joanna S. Fowler Chemistry Department, Brookhaven National Laboratory, Upton, New York, USA George W. Kabalka Department of Chemistry, University of Tennessee, Knoxville, Tennessee, USA Hank F. Kung Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA James F. Lamb Imagents, Inc., Houston, Texas, USA Harold A. O'Brien, Jr. Los Alamos National Laboratory, Los Alamos, New Mexico, USA Joseph R. Peterson Dept. of Chemistry, University of Tennessee, Knoxville, Tennessee, USA Hernan Vera Ruiz International Atomic Energy Agency, Vienna, Austria Roy S. Tilbury University of Texas, M. D. Anderson Cancer Center, Houston, Texas, USA In addition, a number of distinguished colleagues have participated in the process of reviewing the manuscripts presented in this volume. Their effort is sincerely acknowledged.

Nuclear Medicine is a diagnostic modality which aims to image and in some cases quantify physiological processes in the body to highlight disease or injury. Within nuclear medicine, over the past few decades, major technological changes have occurred and concomitantly changes in the knowledge and skills required have had to evolve. One of the most significant technological changes has been the fusion of imaging technologies, to create hybrid systems such as SPECT/CT, PET/CT and PET/MR. With these changes in mind, Practical SPECT/CT in Nuclear Medicine provides a handy and informative guide to the purchase, clinical implementation and routine use of a SPECT/CT scanner. Practical SPECT/CT in Nuclear Medicine will be a valuable resource for all personnel working in nuclear medicine and it will be of particular value to trainees.

To continue the support for the growing trend of chemistry involvement in nuclear medicine, the Division of Nuclear Chemistry and Technology (DNCT) of the American Chemical Society (ACS) planned for a symposium to cover this aspect. This was expressed in arequest to me, as a member of the Program Committee, to organize a symposium on topics related to nuclear and radiochemistry applications to nuclear medicine. Realizing the growing interest in imaging, specially with positron emitting radioisotopes, I invited several colleagues to study with me the idea of imaging centers and the involvement of chemists in their structure and function. The formulated Organizing Committee supported this idea which evolved in proposing an extended international symposium to be held in conjunction with the 206th ACS National meeting in Chicago, Illinois, U. S. A. on August 22-27, 1993. The following are the members of the Organizing Committee: Jorge R. Barrio, Ph. D. Thomas E. Boothe, Ph. D. J. Robert Dahl, Ph. D. Robert F. Dannals, Ph. D. Bruce R. Erdal, Ph. D. Mark M. Goodman, Ph. D. George W. Kabalka, Ph. D. James F. Lamb, Ph. D. Ronald G. Manning, Ph. D. Henry C. Padgett, Ph. D. Roy S. Tilbury, Ph. D. Steven W. Yates, Ph. D. and Ali M. Emran, Ph. D.

Atlas of Selective Lymphadenectomy for Melanoma, Breast Cancer and Colon Cancer emphasizes a multidisciplinary approach combining the experiences of a nuclear medicine physician, surgeon, and pathologist. This is an important reference also for researchers and clinicians who want to become familiar with sentinel lymph node mapping. The underlying thesis in solid tumor biology is that metastasis in general starts in an orderly progression with lymphatic spread first to the sentinel lymph node (SLN) in the nearest lymph node basin. Therefore, the logical approach is to harvest that specific SLN for thorough analysis.

Published as a companion to Volume 12, the current volume presents the latest advances in electron paramagnetic resonance of iron proteins, metalloproteins, and free radicals. The book features a diskette containing programs for iron ERP spectral simulation and ENDOR analyses.

This volume is unique in reporting on strategies for the application of molecular targeted imaging agents such as antibodies, peptides, receptors and contrast agents in the biologic grading of tumors, differential diagnosis of tumors, prediction of therapeutic response and monitoring tumor response to treatment. It also includes updated information on the imaging of tumor angiogenesis, hypoxia, apoptosis and gene delivery as well as expression in the understanding and utility of tumor molecular biology for better cancer management.

Covering the entire spectrum of this fast-changing field, Diagnostic Imaging: Nuclear Medicine, third edition, is an invaluable resource for nuclear medicine physicians, general radiologists, and trainees-anyone who requires an easily accessible, highly visual reference on today's rapidly changing nuclear medicine therapies. Updated throughout, it addresses the most appropriate nuclear medicine options available to answer specific clinical questions within the framework of all imaging modalities, making this edition a useful learning tool as well as a handy reference for daily practice. Reflects recent advances in the field with information on new guidelines, new imaging protocols and equipment, and new radiotracers -including I-131 therapy for thyroid cancer; new tracers for PET/CT for prostate cancer, carcinoid tumor, pancreatic neuroendocrine tumors, and many more; new procedures for GI motility; new SPECT/CT protocols for sentinel lymph node mapping, parathyroid adenoma, pulmonary embolism, and more Contains new chapters on approach to nuclear medicine therapy, Lu-177 Dotatate therapy for SRS positive tumors, Lu-177 PSMA therapy for prostate cancer, GFR Analysis, pulmonary carcinoid tumor, meningioma, and pediatric CNS and neuroendocrine tumors Details new targeted nuclear medicine therapies, including theranostics: using one radioactive drug to diagnose and a second radioactive drug to deliver therapy to treat a main tumor and any metastatic tumors Features more than 1,500 high-quality images, many new or updated, including pediatric imaging, oncology imaging, radiology images, full-color drawings and illustrations, and 3D renderings Covers the physics behind nuclear medicine with safety considerations for both patients and radiologists Uses bulleted, succinct text and highly templated chapters to help you make informed decisions at the point of care Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices

Digital radiography is a general term describing any projection radiological system in which the image exists in digital form at some stage between acquisition and viewing. In an earlier form, radiographic films were dig itized in an attempt to enhance and redisplay information of interest. The field has evolved to its current state, in which X-ray signals are detected electronically, converted to digital form, and processed prior to being recorded and displayed. A primary goal of digital radiography is the re moval of interfering effects from secondary structures in an image, so that clinically significant details can be displayed with enhanced visibility. The achievement of this goal involves many parameters, including con trast agents, subtraction techniques, processing techniques, filtering tech niques, system noise, and quantitative aspects. It is the purpose of this book to present material by noted individuals in the field covering several of the above topics. The authors acknowledge the secretarial and editorial assistance of Mrs. Helen Taylor and the editorial assistance of Mrs. Ruth McDevitt. James G. Kereiakes Stephen R. Thomas Cincinnati, Ohio Colin G. Orton Detroit, Michigan ix Contents 1. DIGITAL RADIOGRAPHY: OVERVIEW B. A. Arnold, 1. G. Kereiakes, and S. R. Thomas 1. Introduction . . . . . . . . . 1 2. Point-Scanned Detector Systems 3 3. Line-Scanned Detector Systems 4 4. Area Detector Systems 5 4.1. Stimulable Phosphors 5 4.2. Selenium Detectors ."

Despite the many advances made in the diagnosis and therapy of cancer, the mortality rate is still about half that of the incidence rate. However, the odds are not evenly distributed. Prognosis for some cancers is good, but for others, few patients will survive 12 months. This latter group of cancers is characterised by a proclivity to disseminate malignant cells in the host organ. The degree of surgery possible may be limited by the critical nature of the organ, and chemotherapy and radiotherapy are of palliative value only. In some cases systemic metastases occur, but in other cases, failure to achieve local control results in death. First among these cancers are the high grade brain tumours, astrocytoma 3,4 and glioblastoma multiforme. Local control of these tumours should lead to cure. Other cancers melanoma metastatic to the brain, for which a useful palliative therapy is not yet available, and pancreatic cancer for which localised control at an early stage could bring about improved prognosis. Patients with these cancers have little grounds for hope. Our primary objective is to reverse this situation with Neutron Capture Therapy (NCT). The purpose of this fourth symposium is to hasten the day whereby patients with these cancers can reasonably hope for substantial remissions. The first symposium on NCT was held in Boston in 1983, followed by Tokyo in 1985 and Bremen, Germany in 1988.

During the last two decades significant advances have been made in the in vivo-diagnosis of gastrointestinal diseases. Although Ultrasound and CT as well as Endoscopy have had a major impact on the evaluation of liver, pancreas and bile diseases, there are a lot of indications for Nuclear Medicine procedures. These include new investigational procedures like esophageal scintigraphy, proof of bleeding sites, scintigraphy of inflammatory diseases, and intestinal resorption tests. Further, immunoscintigraphy with radiol- elled antibodies has gained wide-spread application especially in colon cancer. The differential diagnosis of liver tumors like haemangioma and focal nodular hyperplasia by means of blood pool and HID A-scintigraphy is nowadays a routine procedure. Other established methods like hepatobiliary scintigraphy and liver perfusion scintigraphy have proved to be reliable tools in the pre-and postoperative evaluation of patients with bile duct obstruction and portal hypertension. The aim of this book is to present the entire spectrum of Nuclear Medicine in Gastroenterology to our colleagues from internal medicine and surgery. Ultrasound and Sonography as well as CT will rule the field of gastroenterology, but there remain a certain number of unanswered questions. Nuclear Medicine provides a lot of reliable answers. H. J. Biersack and P. H. Cox July 1990 VB List of contributors Duncan M. Ackery, Department of Nuclear Medicine, Southampton General Hospital, Tremona Road, Southampton, Hampshire S09 4XY, U. K. Roland Bares (co-author: U. Buell), Department of Nuclear Medicine, Te- nical University of Aachen, Pauwelsstr. 1, DW-5100 Aachen, Germany.

Metastases determine malignancy. The main attention so far has been focused upon organ metastases. The molecular mechanisms thereof, while far from being totally elucidated, are increasingly well understood. Modern diagnostic tools now enable detection and precise localization of small lesions. In contrast, our knowl edge and diagnostic capabilities regarding metastatic spread to the'lymphatic system are rather limited. However, there have re cently been a number of interesting advances. It is the aim of this volume to submit these developments to detailed analysis. The therapeutic relevance of enhanced sensitivity in detection of lymph node metastases has to be considered in the light of in creased morbidity versus eventual prognostic improvements by modification of therapy. An interesting concept which might im prove diagnostic accuracy while reducing operative morbidity is the "sentinel node" technique. Surgical standards are lacking, however, and many fundamental questions pertaining to precise lymphatic mapping remain unanswered. Whether the sentinel node concept is of general relevance or whether it is applicable in only a few organs remains to be determined. This book offers intensive discussion of the concept from methodological and tu mor biological viewpoints. World-renowned experts with long term involvement in related basic and clinical research provide the reader with a broad survey of actual knowledge together with a critical appraisal of recent and future developments. We sincerely hope this book succeeds in providing an outlook as a reference for all clinicians on future prospects and serving and researchers in this extremely important field.

It was only in 1980 that the first recognisable magnetic resonance images of the human brain were published, by Moore and Holland from Nottingham University in England. There then followed a number of clinical trials of brain imaging, the most notable from the Hammersmith Hospital in London using a system designed by EMI, the original manufacturers of the first CT machines. A true revolution in medicine has ensued; in only a few years there are thousands of scanning units, and magnetic resonance imaging (MRI) has assumed a central importance in medical investigation. It is an extraordinary fact that within a few years of development, the esoteric physics of nuclear spin, angular momentum, and magnetic vector precession were harnessed to provide exquisite images of living anatomy; modem science has no greater tribute. That indisputable king of neurology and the oldest of recorded conditions, epilepsy, has not been untouched by the new technology; indeed, it is our view that the introduction of MRI of electroencephalography (EEG) in the late has been as important to epilepsy as was that 1930s. Now, for the first time, the structural and aetiological basis of the condition is susceptible to thorough investigation, and MRI can provide structural detail to parallel the functional detail of EEG. MRI has the same potential as had EEG over 50 years ago, to provide a new level of understanding of the basic mechanisms, the clinical features and the treatment of epilepsy.