Bone Metastases brings together the many recent developments that are gradually improving the prospects for patients with secondary involvement of the skeleton in a primary cancer elsewhere. The morbidity from bone metastases is extensive, and the palliative and supportive treatment that sufferers require for many months or even years constitutes a major health problem. A multidisciplinary approach is essential since a variety of specialists are involved: radiation and medical oncologists, general and orthopaedic surgeons, general physicians, radiologists and nuclear medicine physicians, symptom control and terminal care specialists. The book's editors, themselves authorities in the fields of oncology and bone disease respectively, have brought together experts from all these disciplines to provide comprehensive coverage of metastatic bone disease. They cover the biology and pathophysiology, hypercalcaemia, imaging, assessment of response to treatment, types of treatment (systemic, radiotherapy, surgery), and symptomatic and supportive care. Particularly new approaches included are magnetic resonance imaging, the assessment of skeletal response and isotope therapy.

Conventional nuelear medieine proeedures study the dis- tribution of radiolabelled eompounds (radiopharmaeeutieals) in the body under physiologieal as well as under pathologieal eonditions. Beeause of their ability to visua- lise and to quantify the distribution of radiopharmaeeuti- eals within the body by means of external deteetors, nuelear medieine teehniques are basieally non invasive and funetion oriented. The spatial variation of the traeer distribution in the field of view, or the ehange in distribution during a time interval are interpreted as representing speeifie phy- siologie or pathophysiologie processes. As eompared to other diagnostie imaging teehniques, the spatial resolution of seintigraphie images is rather poor, their temporal resolu- tion is good. Faetors that will therefore determine the ultimate diag- nostie value of a seintigraphie study inelude 1. The speeifieity of the labelled eompounds for the process under study, 2. The resolution in time and space of the instrumentation, and its ability of measuring quantitatively tissue aetivity eoneentrations, 3. The formulation of physiologieal or pathophysiologieal models from whieh the distribution of the traeer ean be predieted. 2 While interpreting nuclear medicine data, the interrelations between these factors should permanently remain under consi- deration. The generalised use of minicomputers has resulted in major advances in information processing in nuclear medicine imaging procedures. Central to this is image digitisation.

Just prior to the 1982 Annual Meeting of the European Thyroid Association in Brussels, a number of outstanding experts in the field of X-ray fluorescence gathered at the Academisch Ziekenhuis of the Free University of Brussels in a joint effort to more clearly define the actual place and value of the latest newcomer among the techniques available for the in vivo assessment of thyroid function. It is the merit of Prof. M. Jonckheer to have organised this meeting and to have made available the work presented there to a larger public in the form of this monograph. Both, the meeting and the written accounts thereof are greatly appreciated by all thyroidologists who care for properly defining the genuine value of X-Ray fluorescence in scientific research and in clinical management of thyroid disorder. Three main conclusions can be drawn from the work presented 1. X-ray fluorescence has become a safe, convenient and reliable tool for measuring intrathyroidal iodine stores in vivo with an inter-assay reproducibility estimated at roughly 10% 2. X-ray fluorescence, used by expert hands, is a highly interesting tool to follow changes of intra thyroidal iodine stores in time, subsequent e. g. to the exposure of the thyroid gland to excess iodine 3. In contrast, no definite place of X-ray fluorescence as a technique in routine assessment of thyroid disease is yet at the horizon This latter conclusion may appear somewhat disappointing.

Under an association contract linking the Co~ission of the European Communities and the Gesellschaft fUr Strahlen- und Umweltforschung mbH, a research programme on the patho- genesis of somatic radiation damage has been under way for a number of years. Experimental research on long-term radiation effects following the incorporation of bone-seeking radionuclides and an epidemiological study of the conse- quences for patients treated with 224Ra for therapeutical reasons have been among the main features of the work. The research carried out on tumor induction in the low dose range and for low dose rates is particularly important as regards assessing the radiation hazard to man. The second Symposium on the biological effects of 224Ra, held at Neuherberg, provided a welcome opportunity to take stock of what has been achieved so far and to discuss the own research efforts in an international setting. The dis- cussions focussed on two topical aspects of radiation protection. One aspect was the long-term effects of high-LET ionizing radiations on man and the quantitative data involved in risk assessment at low doses. The epidemiological studies and experimental research carried out under the association contract should provide facts and figures for an objective assessment of the radiation hazards from incorporated radio- nuclides, which is one of the fundamental and controversial problems of the nuclear energy debate.

AIMS OF THE COLOGNE-SYMPOSIUM ON RADIOLABELLED PLATELETS In 1976, M. Thakur et al (1) were the first to publish a paper concerning the in vivo thrombus detection with 111- In-labelled platelets. Previous attempts at scintigraphic thrombus localisation had been disappointing because of the unspecific binding of a number of the isotopes used, as well as the poor labelling efficiency or an insufficient low gamma-emitting property. Because of its physical characteristics (2.8 days half-life, 94% gamma emission) 111 Indium turned out to be the best isotope for platelet kinetic studies as well as for the measurement of platelet incorporation by Thrombi to be used up until now. The lipophile complexes of Ill-In (8-hydroxyquinoline, acetylacetone, tropolone) diffuse passively into the platelets without altering the function or the life span of the platelets. This advantage has let to an increase in the clinical applications of 1211-In labelled platelets. Today, radiolabelled platelets are used for thrombus detection in several different medical areas such as cardiology, nephrology. angiology or neurology. Even though many scientists and hospital doctors now routinely use radiolabelled platelet as a diagnostic tool, there is as yet not a standardized labelling method. In addition to this, there are neither standardized image procedures for the different clinical applications nor an agreement about specificity and sensitivity of the method. In 1983, a symposium on Radiolabelled Cellular Blood Elements was organized by M.Thakur, M.R.Hardeman and M.D.

Oncological surgeons are often requested in their clinical practice to identify and manage uncommon and complex situations. It is therefore of the utmost importance that they are well aware of the most recent technological evolutions, in order to achieve the best possible results in term of oncological outcome, with a concern on quality of life and economical issues. Furthermore, new techniques can give a fundamental contribution in overcoming the limitations of standard approaches.

An essential aim of this book is to underline the great importance and the need of an effective coordination of multi-disciplinary care among surgeons, medical oncologists, radiation therapists, plastic surgeons and ancillary services, in order to optimise patient outcome.

During the last decade many significant advances have been made in the in vivo diagnosis of disease. An area of partic- ular success has been the application of nuclear medical procedures to the detection of cardiac disease. Not only is it possible to detect infarction or ischemia by scintigraphic techniques but by the use of labelled metabol- ites and analogues of potassium the viability of myocardial tissue can be evaluated. The efficiency of the heart pump can be calculated and wall motility observed in one simple proce- dure. The use of ultra short life radionuclides has made the evaluation of rapid changes in myocardial function feasible. Altogether a broad and impressive diagnostic package. In this volume up-to-date reviews of all of the available techniques have been collected including methods which are still in the development phase. There is an inherent emphasis on European experience in Nuclear Cardiology which is then placed in context with world wide experience in the field. This volume will be of interest to all concerned with cardiac diseases and we hope that it will serve to stimulate further developments in the future. H.J. Biersack, Bonn P.H. Cox, Rotterdam VIII CONl'RIBUTORS Bauer, R. - Nukleanredizinisdl.e Klinik und Poliklinik redl.ts der Isar der Tedlnisdl.en Universitat Mlinchen, FRS. Biersack, H.J. - Institut fur klinisdl.e und experimentelle Nukleanredizin der Universitat Bonn, FRG. Breuel, H.P. - Degussa Phanna Horrburg, Frankfurt 1, FRG. Cox, P .H. - Department of Nuclear Hedicine, Rotterdamsdl. Radio-Therapeutisdl.

A compilation of researchers' experience in the areas of bioanalysis, pharmacokinetics, and drug metabolism, to present an up-to-date and comprehensive treatise on the application of these and related technologies in drug discovery, development, and clinical use. Contents cover descriptions of analytical methods, in vitro metabolism technology and membrane transport, reappraisal of classical pharmacokinetic problems, and the time course of drug action. The book concludes with a description of PET and imaging methods in pharmacokinetics and an appendix containing a critical appraisal of computer methods and pharmacokinetic software available for PCs.

Pediatric Radiology texts typically provide only a cursory discussion of pediatric nuclear medicine techniques and applications while pediatric nuclear medicine texts typically review the so-called "structural imaging" modalities in only a superficial fashion. The standard texts do not adequately address the similarities and differences among different imaging modalities (X-rays, scintigraphy, ultrasonography, angiography, CT, MRI, etc.). The result is that the reader of these texts can not gain an understanding of the true role of nuclear medicine in pediatrics. With PEDIATRIC SKELETAL SCINTIGRAPHY, DRS. Connolly and Treves demonstrate the relative merits of scinitigraphy and other imaging tests in evaluating pediatric skeletal disorders. The emphasis is on situations where a complementary relationship exists between nuclear medicine and other modalities. In addition to showing cases in which scintigraphy is abnormal and structural imaging normal, the book also features cases where both scintigraphy and structural imaging are abnormal. The reader will gain an understanding of what can be gained from each modality, and when specific studies are indicated.

The herpes group consists of viruses which have been placed together on the basis of a number of distinguishing features that they share in common (ANDRE WES, 1962). All these viruses are relatively large, possess identical morphological characteristics, contain DNA, and are extremely sensitive to inactivation by ether; these viruses are also assembled within the nucleus of the host cell and induce the formation of eosinophilic intranuclear inclusions. The epidemiology of some of the best known viruses in this group (herpes simplex, pseudorabies, and B-virus) is also similar (BURNET et aI., 1939). Herpes simplex virus exists in the latent state in man, the natural host for this virus, and becomes overt in individuals subject to some form of stress; this condition appears to be paralleled by pseudorabies virus in its natural host, swine and by B-virus in monkeys. In each instance, transmission of the virus to a susceptible host other than the natural one results usually in marked symptoms and death. This chapter is confined to a description of herpes simplex and pseudorabies viruses; B-virus is described separately elsewhere in the Hand book. Since the clinical aspects of the diseases caused by herpes simplex virus and pseudorabies virus have been well described, greater emphasis will be placed, therefore, on the basic biological and biochemical properties of these viruses; their clinical features will be discussed only briefly."

The main subject of this book is the investigation of cardiac function and in particular ventricular function with radionuclide-based techniques. Emphasis is given to the study of clinical cases which can routinely occur in the life of a busy cardiological practice, by comparing conventional techniques, such as the electrocardiogram, the echocardiogram or the catheter study, with the newer nuclear medicine imaging procedures. Four basic images are given (end systole, end diastole, amplitude and phase), obtained either with a first pass or an equilibrium methodology, and the information analyzed. The clinical material is not exhaustive but covers a broad spectrum, with examples of coronary artery disease, valvular disease, cardiomyopathy, conduction disease and congenital heart disease. The book is aimed not only at the practising specialist (cardiologist, radiologist, nuclear medicine physician) but also at the general physician and surgeon interested in finding out what modern non invasive nuclear medicine procedures have to offer in the investigation of the heart. London, June 1982 ACKNOWLEDGEMENTS We are specially grateful to the Sir Jules Thorn Charitable Trust for its continuous support and interest."

This book contains a selection of communications presented at the Third International Meeting on Fully Three-Dimensional Image Reconstruction in Radiology and Nuclear Medicine, held 4-6 July 1995 at Domaine d' Aix-Marlioz, Aix-Ies-Bains, France. This nice resort provided an inspiring environment to hold discussions and presentations on new and developing issues. Roentgen discovered X-ray radiation in 1895 and Becquerel found natural radioactivity in 1896 : a hundred years later, this conference was focused on the applications of such radiations to explore the human body. If the physics is now fully understood, 3D imaging techniques based on ionising radiations are still progressing. These techniques include 3D Radiology, 3D X-ray Computed Tomography (3D-CT), Single Photon Emission Computed Tomography (SPECT), Positron Emission Tomography (PET). Radiology is dedicated to morphological imaging, using transmitted radiations from an external X-ray source, and nuclear medicine to functional imaging, using radiations emitted from an internal radioactive tracer. In both cases, new 3D tomographic systems will tend to use 2D detectors in order to improve the radiation detection efficiency. Taking a set of 2D acquisitions around the patient, 3D acquisitions are obtained. Then, fully 3D image reconstruction algorithms are required to recover the 3D image of the body from these projection measurements.

This book introduces the fundamental aspects of Radiation Protection in Medical Physics and covers three main themes: General Radiation Protection Principles; Radiobiology Principles; Radiation Protection in Hospital Medical Physics. Each of these topics is developed by analysing the underlying physics principles and their implementation, quality and safety aspects, clinical performance and recent advances in the field. Some issues specific to the individual techniques are also treated, e.g. calculation of patient dose as well as that of workers in hospital, optimisation of equipment used, shielding design of radiation facilities, radiation in oncology such as use of brachytherapy in gynecology or interventional procedures. All topics are presented with didactical language and style, making this book an appropriate reference for students and professionals seeking a comprehensive introduction to the field as well as a reliable overview of the most recent developments.

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. No such review has been available until now to assist PET researchers in understanding and implementing 3D methodology, and in evaluating the performance of the available imaging technology. In all the chapters, the subject matter is treated in sufficient depth to appeal equally to the physicist or engineer who wishes to establish the methodology, and to PET investigators with experience in 2D PET who wish to familiarize themselves with the concepts and advantages of 3D, and to be made aware of the pitfalls.

Dr. Peter S. Conti is a Professor of Radiology and the Director of the PET Imaging Science Center at the University of Southern California, and is a Fellow of both the American College of Radiology and American College of Nuclear Physicians. He is a pioneer in the development of the clinical applications of PET and more recently PET-CT. He and one of his fellows, Dr. Daniel Cham, have published this groundbreaking PET-CT case-based book, which reveals how PET-CT can be applied in routine clinical scenarios. Leading authorities in the field examine a wealth of heavily-illustrated original PET-CT cases that showcase both common and uncommon cancers, and the latest PET-CT applications for neurological and cardiovascular disorders. Correlative three-dimensional cross-sectional PET and CT images highlight pathological findings. Each of the clinical applications is accompanied by a concise explanation of the patient history and interpretation of the PET-CT study. Insightful discussions and "pearls and pitfalls" are included to assist in a better understanding of pathology, diagnosis, and imaging approaches. Readers also find important coverage of pathophysiology and technical artifacts. This unique book is ideal for nuclear medicine practitioners, radiologists, and residents, as well as referring clinicians interested in learning more about how this new medical imaging technology can be applied in their patient populations.This unique book is ideal for nuclear medicine practitioners, nuclear medicine residents, and clinicians interested in medical imaging for tumor patients.

The NATO Advanced Study Institute (ASI) on Physics and Engineering of Medical Imaging has addressed a subject which in the wide area of biomedical technology is one of those which are showing greater impact in the practice of medicine for the ability to picture both Anatomy and Physiology. The information and accuracy obtained by whatever imaging methodology is a complex result of a multidisciplinary effort of several sciences such as Physics, Engineering, Electronics, Chemistry, Medicine, etc ... Development has occurred through work performed in different environments such as basic and applied research laboratories, industries and clinical centers, with the aim of achieving an efficient transfer of know-how and technology for the improvement of both investigation possibilities and health care. On one hand, such an effort requires an ever-increasing committment of human and financial resources at research and industrial level, and, on the other, it meets serious difficulties in recruiting the necessary human expertise oriented to this technology which breaks with the tradi tiona I academic borders of the single disciplines. Furthermore, the scientific community is continually dealing with the problem of increasing the performance and, at the same time, complexity and costs of instruments, applying more and more sophisticated technology in an effort to meet the demand for more complete and accurate clinical information. The scientific program of this ASI and the qualification of the authors reveals the intrinsic complexity of the development process of the Imaging methodologies.

Radiochemical methodology constitutes the most important base for the successful functioning of a PET group in the routine production and development of radiopharmaceuticals. Of the several hundred products which have been labelled with positron emitters during the past two decades about 35 are presently considered to be of major interest. The time for a state-of-the-art review is right, since this field has advanced over the past fifteen years to reach a level where guidelines can now be suggested. Chapters of this book deal with each of the main methodological aspects of the chemistry needed to develop an effective radiopharmaceutical, namely radionuclide production, automation and metabolite analysis. A further chapter on QA/QC is written by a broadly-based expert group and is meant to provide a guideline and a base for future monographs and regulations on major PET radiopharmaceuticals of today. This book will help the increasing numbers of scientists who are now entering the field of PET to appreciate the methodological aspects that are normally addressed by chemists in relation to PET radiopharmaceuticals; it provides many useful practical guidelines and will promote early success in their own endeavours, since these will often necessarily begin by establishing chemical methodology of the kind discussed here.

This book is designed to give the reader a solid understanding of the

physics and instrumentation aspects of PET, including how PET data are collected and formed into an image. Topics include basic physics, detector technology used in modern PET scanners, data acquisition, and 3D reconstruction. A variety of modern PET imaging systems are also discussed, including those designed for clinical services and research, as well as small-animal imaging. Methods for evaluating the performance of these systems are also outlined. The book will interest nuclear medicine students, nuclear medicine physicians, and technologists.

Presents an overall analytical treatment of MRI physics and engineering. Special attention is paid to the treatment of intrinsic artefacts of the different sequences which can be described for the different scan methods. The book contains many images, especially showing specific properties of the different scan methods. The methods discussed include RARE, GRASE, EPI and Spiral Scan. The 3rd edition deals with stranger gradient and new RF coil systems, and sequences such as Balanced FFE and q-space diffusion imaging and SENSE.

There can never be enough material in the public domain about cancers, and particularly breast cancer. This book adds much to the literature. It provides general information on breast cancer management and considers all new methods of diagnosis and therapy. It focuses on nuclear medicine modalities by comparing their results with other diagnostic and therapeutic approaches. The coverage provides readers with up-to-date knowledge on breast cancer as well as information on the advances in the field of diagnosis. It also details data on the development of some new modalities and provides a general overview of the available tools for breast cancer treatment.

PACS: A Guide to the Digital Revolution, Second Edition, fills an incredible need by explaining the technological advances associated with the transition of radiology departments to filmless environments. The editors are leaders in the field of medical imaging and they provide insight into emerging technologies for physicians, administrators, and other interested groups. Chapters address key topics in current literature with regard to the generation, transfer, interpretation, and distribution of images.

This new edition has been updated to include: 1. An overview of the latest medical imaging standards; 2. A discussion of security issues as they relate to PACS, especially regarding HIPAA; 3. An introduction to current information on PACS workstations, including the impact of new software and hardware on radiologists; 4. An updated explanation of data storage and compression that highlights how advancements are applied; 5. A section on how PACS influences research and education.

This work has true international scope, being a unique European/American joint venture that focuses on the state of the art in both diagnostic and therapeutic radionuclide methodology. Pertinent clinical applications are emphasized rather than attempting to cover everything included in the several large comprehensive texts available in our field. This "practical" approach should make it an essential guide to nuclear medicine physicians, technologists, students and interested clinicians alike.

Special emphasis on teaching the CT technologists getting started in MDCT

This book provides a contemporary reference to the science, technology and clinical applications of PET and PET/CT. The book is designed to be used by residents and fellows training in medical imaging specialties as well as imaging experts in private or academic practice who need to become familiar with this technology and its applications. It is also for use by those whose specialties carry over to PET and PET/CT, referring physicians such as oncologists, cardiologists, neurologists and surgeons.

Developed as an offshoot/update of the "clinical practice" portion of the main book, edited by PE Valk et al, published in 2003 (Positron Emission Tomography: basic science and clinical practice), this offshoot covers the second half of the main book only, dealing with mainly the clinical research and practice. Most of the book comprises chapters updated from the "Clinical practice" portion of the main Valk book. It contains 6 brand new chapters and 22 completely revised and updated chapters from the main Valk book.

The third edition of this book has been comprehensively rewritten and rearranged. In addition to the bone and joint diseases described in the two earlier editions, it now encompasses hitherto unpublished novel applications of pinhole scanning to the diagnosis of a broader spectrum of skeletal disorders. The book has been considerably expanded to discuss five new themes and is complemented by the addition of some 90 recently acquired cases.