In the developed world, images of brain structure are available as an everyday diagnostic aid, and the characteristic appearances of most pathological conditions can be looked up in a textbook. Functional brain imaging is to this day less widely used, partly because most pressing diagnostic questions can be answered by refer ence to the patient's cerebral anatomy, partly for reasons of technical limitations of functional techniques. PET as a technique is sufficiently resource-demanding and complex to inhibit its use as an everyday diagnostic technique. SPECT lacked suitable tracers for many years, and early systems had poor spatial resolution. However, rotating gamma camera technology has advanced to the point where images of the brain of reasonable quality can be obtained at most large hospitals, and practical tracers, particularly of regional cerebral blood flow, are easily avail able. As research advances, clinical applications are emerging. A recent report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology! details a number of currently recognised clinical appli cations, some of which are dealt with in this book. Given this recognition, it is increasingly important that clinicians (particularly neuroclinicians, psychiatrists and specialists in cerebrovascular disease), nuclear medicine specialists and physicists acquire an idea of the major applications of the technique, and the research background on which these applications are based.

This compendium describes the major production routes of the six most relevant iodine radio isotopes and the various methods of labeling molecules of biological, diagnostic or pharmaceutical interest with them. The chapters describe the basic reaction mechanisms, and the influence of iodine introduction on physical/chemical and pharmacological properties. They include examples of important reaction pathways for the preparation of radio-iodine compounds.

Respiratory motion causes an important uncertainty in radiotherapy planning of the thorax and upper abdomen. The main objective of radiation therapy is to eradicate or shrink tumor cells without damaging the surrounding tissue by delivering a high radiation dose to the tumor region and a dose as low as possible to healthy organ tissues. Meeting this demand remains a challenge especially in case of lung tumors due to breathing-induced tumor and organ motion where motion amplitudes can measure up to several centimeters. Therefore, modeling of respiratory motion has become increasingly important in radiation therapy. With 4D imaging techniques spatiotemporal image sequences can be acquired to investigate dynamic processes in the patient's body. Furthermore, image registration enables the estimation of the breathing-induced motion and the description of the temporal change in position and shape of the structures of interest by establishing the correspondence between images acquired at different phases of the breathing cycle. In radiation therapy these motion estimations are used to define accurate treatment margins, e.g. to calculate dose distributions and to develop prediction models for gated or robotic radiotherapy. In this book, the increasing role of image registration and motion estimation algorithms for the interpretation of complex 4D medical image sequences is illustrated. Different 4D CT image acquisition techniques and conceptually different motion estimation algorithms are presented. The clinical relevance is demonstrated by means of example applications which are related to the radiation therapy of thoracic and abdominal tumors. The state of the art and perspectives are shown by an insight into the current field of research. The book is addressed to biomedical engineers, medical physicists, researchers and physicians working in the fields of medical image analysis, radiology and radiation therapy.

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. Biologically important micrmolecules, semimacromolecules, and macromolecules have been identified which, after iodination, almost maintain the same molecular configuration and similar biologic specificity as those of the parent molecules. The multiple techniques for iodination and the clinical use of iodinated products have made possible the present status of the development of diagnostic nuclear medicine. 125r, with a half-life of 60 days, has a crucial role in competitive protein-binding studies. 131r is useful for measuring thyroid uptake, for the diagnosis of thyroid carcinoma and metastasis, and for therapy. 1nr , with a reasonably shorter half-life, is almost ideal for thyroid workup and for a few useful labeled radiopharmaceutical. Although ~c is used more widely in diagnostic procedures, the radionuclides of iodine will always have a major role in biology and medicine. A considerable amount of information is scattered in the literature regarding the chemistry of radioiodination and the mechanism of tracer localization in cells and tissues. Labeled peptides, proteins, and antibodies are extensively used for protein turnover studies, receptor binding and tumor imaging studies, and radioimmunoassay. The general trend in the use of tracers in clinical nuclear medicine has been an evolution from 3H, 14C, 11C, and 13 to 125 , 131 and 123r to ~c and 111rn.

The application of magnetic resonance spectroscopy (MRS) to the cardiovascular system is a relatively new phenomenon. Its ability to noninvasively examine myocardial metabolism has led to its use to answer basic questions in animal models of normal and diseased myocardium. Extension of these investigations into the realm of human myocardial metabolism has been made possible by the advent of relatively high-field magnets with spectroscopy capabilities and sufficient bore dimensions to allow human studies. While ongoing and future studies promise to enhance our understanding of myocardial metabolism, their success will, in part, depend on a thorough understanding of the technical and biologic aspects of cardiovascular MRS, as well as the current state of research in the many areas encompassed by this discipline. It is with concept that the present monograph has been written. The organization and content should lend this book to both the beginning reader who is interested but not conversant in cardiovascular MRS, as well as to the active investigator who wishes to refer to a volume that deals with the many issues of this field in a concise but complete manner. The monograph is structured with a general overview of the field, followed by a section addressing the technical issues of cardiovascular MRS. The next section is devoted to biologic issues of both normal and abnormal myocardial metabolism, primarily devoted to investigations employing phosphorus-31. This is followed by a section dealing with more specialized issues, generally involving other nuclei such as protons, carbon, and sodium. Finally, the clinical applications of cardiovascular MRS are addressed.

This book is a comprehensive guide to PET and PET CT and serves as a valuable resource for practicing physicians and residents. The text covers topics ranging from the basic principles of physics, molecular assays, preparation of molecular imaging probes, and biochemistry relevant for PET. Additionally, clinical applications in cancer, cardiovascular diseases, and neurological disorders are thoroughly discussed. U.C.L.A. School of Medicine is recognized as one of the leading PET centers in the world. All of the contributors are U.C.L.A. School of Medicine faculty members and they combined their areas of expertise in order to create the premier reference book on PET. Each chapter provides a complete overview of the topic material and guides the reader through the subject matter. Figures, tables, and solved example problems are integrated into the text. Readers also benefit from the extensive references and suggested reading material.

This book provides a review of image analysis techniques as they are applied in the field of diagnostic and therapeutic nuclear medicine. Driven in part by the remarkable increase in computing power and its ready and inexpensive availability, this is a relatively new yet rapidly expanding field. Likewise, although the use of radionuclides for diagnosis and therapy has origins dating back almost to the discovery of natural radioactivity itself, radionuclide therapy and, in particular, targeted radionuclide therapy has only recently emerged as a promising approach for therapy of cancer and, to a lesser extent, other diseases. As effort has, therefore, been made to place the reviews provided in this book in a broader context. The effort to do this is reflected by the inclusion of introductory chapters that address basic principles of nuclear medicine imaging, followed by overview of issues that are closely related to quantitative nuclear imaging and its potential role in diagnostic and therapeutic applications.

The different chapters discuss the basic principles and various steps required for obtaining quantitatively accurate data from nuclear medicine images including data collection methods and algorithms used to correct them for physical degrading factors (e.g. collimator response, attenuation, scatter, partial volume effect), and image reconstruction algorithms (analytic, iterative) as well as image processing and analysis techniques as their clinical and research applications in neurology, cardiology and oncology. Some algorithms are described and illustrated with some useful features and clinical applications. Other potential applications of quantitative image analysis such asimage-guided radiation therapy are also discussed.

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.

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 Sentinel Lymph Node Concept is evaluated from the points of view of pathology, radiodiagnosis and nuclear medicine diagnostics, surgical treatment and clinical oncology. The concept and its practical applications are analyzed for breast cancer, malignant melanoma, tumors of the face, oropharynx, lung, gastrointestinal and urogenital tracts. The first part of the book describes the function and use of the nuclear medicine equipment, the tracers used, colloid solutions and modern developments in histological and immunohistochemical lymph node investigations, as well as possible pitfalls. The consequences of false-negative results are clearly delineated. In the second part, specific tumor-related problems are described.

Mankind has evolved in a sea of radiation. We have been bombarded constantly by X rays, y rays, UV rays, and particulate radiations from outer space, and by terrestrial radiations from the ground we walk on, from our building materials, and from our own bodies. Recently, we have become increasingly subjected to man-made radiations, especially from the medical and defense industries. All of these radiations are capable of affecting us biologically, both to our benefit and to our detriment. This book provides a thorough review of the physical and biological dosimetry of these radiations. It is targeted to those health professionals who are concerned with understanding the mechanisms fundamental to the biological action of ionizing radiation or who are involved in the application, measurement, or treatment of the effects of such radiations. The first chapter, on "Bioeffect Dosimetry in Radiation Therapy," should be of special interest to anyone involved in the treatment of cancer by radiation. It includes a brief review of the history of the manipulation of time-dose parameters in order to improve therapeutic benefit, and an up-to-date analysis of time-dose relationships designed for use in fractionated radiotherapy and brachytherapy. This is followed by two chapters reviewing and comparing national and international protocols for the precise measurement of photon and electron radiations in therapy. These chapters should be invaluable to radiation physicists responsible for treatment machine calibrations.

Proceedings of a Workshop Held in Angers, France, November 26-28, 1986, Sponsored by the Commission of the European Communities Directorate General for Science, Research and Development

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.

1. Advances in cancer imaging and therapy with radiolabelled antibodies.- 2. Evaluation of the diagnostic utility of immunoscintigraphy in oncology.- 3. The quality control and clinical testing of radiolabelled antibodies.- 4. Clinical utility of radiolabelled monoclonal antibodies in the management of gastrointestinal cancer.- 5. Use of 123-I radiolabelled F(AB')2 fragments of anti-CEA monoclonal antibody for the detection of primary and metastatic gastrointestinal carcinomas.- 6. Bispecific monoclonal antibodies for two phase radioimmunotherapy.- 7. Antimyosin antibody imaging in myocardial infarction.- 8. Antimyosin based radioimmunodetection of myocarditis cardiomyopathy and cardiac transplant rejection.- 9. Recent advances in the use of radiolabelled monoclonal antibodies in the management of ovarian cancer.- 10. Monoclonal antibodies for cell labelling with particular reference to thrombus imaging.- 11. The role of nuclear medicine in the evaluation of the patient with acquired immune deficiency syndrome (AIDS).- 12. Detection of inflammation/infection using radiolabelled anti-granulocyte antibodies: possibilities and limitations.- 13. A new marker for the detection of adenocardinomas by radioimmunoscintigraphy.- 14. New developments in the diagnosis of AIDS and strategies for therapy.

The purpose of this book is to provide the outline for the "nuts and bolts" establishment and operation of a nuclear cardiology laboratory. In so doing, the authors have attempted to deal with the relevant issues that a laboratory director must address in either setting up the laboratory or maintaining its competitive edge and clinical competence over time. The authors primarily attempted to identify issues related to outpatient imaging facilities. However, where appropriate issues related to inpatients in hospital-based laboratories are also discussed.

In this new edition, the authors have kept the basic format established in the first edition. In addition to reviewing, modifying and updating each chapter in the first edition, they have added entirely new chapters on PET imaging, hybrid imaging and the clinical appropriateness of nuclear cardiology procedures.

This book was conceived by Professor K.H. Ephraim, the former director of the Institute for Nuclear Medicine of the University Hospital of Utrecht. Unfortunately, due to a serious illness, he was not able to finish the work he started. He is, however, very pleased to know that the book is, nevertheless, being published. In principle the volume consists of two parts. The first is dedicated to basic science and technology in nuclear medicine. It provides the data which are necessary to a clear understanding of the possibilities and limitations of investigations which make use of radioactive materials. The second part of the book covers those disciplines in medicine in which nuclear medicine can be of help in solving certain clinical problems. Each chapter can be read separately, even without thorough knowledge of the first part of the book. The contributors to this book come from both Europe and North America. Each of them has written his chapter out of long-standing personal interest in his particular field of nuclear medicine. This book will be of value to a wide variety of professionals. It is of interest not only to clinicians of various specialties, but also to diagnostic professionals, i.e. radiologists and nuclear medicine clinicians. Last but not least it will be of use to physicians in training."

PET in Clinical Oncology describes the use of Positron Emission Tomography (PET) in the diagnosis and management of malignant tumors. Experts from Germany and the United States present basics, technical details, and clinical aspects for both standard and new PET techniques. The book illustrates the importance of PET in comparison to other imaging techniques.
Generously supplemented with charts, tables, and illustrations, each chapter provides the reader with well-delineated descriptions, from the basic technical situation through the clinical use of PET. This book is helpful to all those dealing with the diagnosis and therapy of cancer.

Edited by Dominique Delbeke and Ora Israel, two leading authorities in the field of nuclear medicine, this practical guide is a reference source of cases for images obtained on state-of-the-art integrated PET/CT and SPECT/CT imaging systems. The cases are presented in-depth so that they will be of value to residents training in nuclear medicine and radiology and to nuclear medicine physicians and radiologists who need to become familiar with this technology. Internationally recognized contributors provide the reader with in-depth coverage on the technical and clinical aspects of hybrid imaging. Principles of hybrid imaging, physics and instrumentation, normal distribution of radiopharmaceuticals and protocols central to the field are covered. A comprehensive review of nuclear oncology cases found in everyday practice, ranging from simple to complex are also addressed. The full spectrum of clinical applications is covered including head and neck tumors, breast cancer, colorectal cancer, pancreatic cancer, and genitourinary tumors. Additional chapters examine cardiac hybrid imaging, benign bone diseases and infection and inflammation. A wealth of illustrations reinforce the key teaching points discussed throughout the book.

Hypoxia, i.e. insufficient availability of oxygen within the tissue, is a more serious problem than realized in clinical routine work, although a large variety of theoretical and experimental data give clearly proven indications. During incidences and progress of many types of diseases hypoxia may enhance development and progress of the disease and, furthermore, decrease chances of efficient treatment of, e.g., tumors. Hypoxic tumor cells are up to three times more resistant towards radiation therapy than normoxic cells. With a diagnostic tool such as provided by hypoxia tracers suitable for PET and SPECT imaging, the particular tissue situation becomes detectable and, thus, treatable. Although the clinical importance of hypoxia imaging is obviously great, to date neither the clinical nor the scientific community at an international level has focused many research activities on the hypoxia problem. As the result of a workshop held by the Section for Radiopharmacy in TA1/4bingen, this book collects observations and findings in order to stimulate the on-going research resulting in important clinical applications. Hypoxia imaging is needed in areas of cardiology, neurology and oncology. Additional applications are to be expected in the field of diabetes, infections and organ transplantation. Therefore, the book addresses those who are basically involved in research in radiochemistry and radiopharmacy as well as those dealing with all biological aspects and facing direct clinical applications.

This volume addresses a wide range of issues in the field of nuclear medicine imaging, with an emphasis on the latest research findings. Initial chapters set the scene by considering the role of imaging in nuclear medicine from the medical perspective and discussing the implications of novel agents and applications for imaging. The physics at the basis of the most modern imaging systems isdescribed, and the reader is introduced to the latest advances in image reconstruction and noise correction. Various novel concepts are then discussed, including those developed within the framework of the EURATOM FP7 MADEIRA research project on the optimization of imaging procedures in order to permit a reduction in the radiation dose to healthy tissues. Advances in quality control and quality assurance are covered, and the book concludes by listing rules of thumb for imaging that will be of use to both beginners and experienced researchers."

The Physics of Three Dimensional Radiation Therapy presents a broad study of the use of three-dimensional techniques in radiation therapy. These techniques are used to specify the target volume precisely and deliver radiation with precision to minimize damage to surrounding healthy tissue. The book discusses multimodality computed tomography, complex treatment planning software, advanced collimation techniques, proton radiotherapy, megavoltage imaging, and stereotactic radiosurgery. A review of the literature, numerous questions, and many illustrations make this book suitable for teaching a course.
The themes covered in this book are developed and expanded in Webb's The Physics of Conformal Radiotherapy and the two may be used together or in successive semesters for teaching purposes.

The Fourth Edition of Dr. Gopal B. Saha's Physics and Radiobiology of Nuclear Medicine was prompted by the need to provide up-to-date information to keep pace with the perpetual growth and improvement in the instrumentation and techniques employed in nuclear medicine since the last edition published in 2006. Like previous editions, the book is intended for radiology and nuclear medicine residents to prepare for the American Board of Nuclear Medicine, American Board of Radiology, and American Board of Science in Nuclear Medicine examinations, all of which require a strong physics background. Additionally, the book will serve as a textbook on nuclear medicine physics for nuclear medicine technologists taking the Nuclear Medicine Technology Certification Board examination. The Fourth Edition includes new or expanded sections and information for: * PET/MR, including the attenuation correction method and its quality control tests; * accreditation of nuclear medicine and PET facilities; * solid state digital cameras; * time of flight and scatter correction techniques; * CT scanners and attenuation correction in SPECT/CT; * partial volume effects; * quality control of CT scanners; * ion chamber survey meters, proportional counters, and G-M counters.

This book is a compilation of the invited papers, which were presented at the Fourth European Symposium on Radiopharmacy and Radiopharmaceuticals, which was held in Baden, Switz- land, 1-4 May, 1991. The First and Third Symposia on Radiopharmacy and Radiopharmaceuticals (Elsinore, Denmark, 1983, 1987) concentrated on the safety and efficacy of radiopharmaceuticals, whereas this Fourth Symposium to some extent followed up the subject of the Second Symposium (Cambridge, UK, 1985): recent developments in radiopharmacy and current research on radiopharmaceuticals. The symposium was organized by the Radiopharmacy Group of the Swiss Society of Medical Radiology (Section Nuclear Medicine) under the auspices of the task group on radiopharmaceu- cals of the European Association of Nuclear Medicine (EANM). The organizing committee consisted of the cochairmen Drs. P.A. Schubiger (Paul Scherrer Institute (PSI), Villigen) and G. Westera (University Hospital, ZiJrich) and the members H.-F. Beer, P. Bl iuenstein, P. Hasler (all PSI) and H. M icke (Cantonal Hospital, Basel). The subjects of this Symposium ranged from isotope production to clinical testing of radioph- maceuticals, including the organisational prerequisites. In addition, the development of new radiopharmaceuticals and of PET radiopharmacy, and the concomittant ongoing evolution of regulatory guidelines by national (various European countries, USA) and international (EC) authorities, induced us to honor the vivid interest in this subject and to make it an important part of this symposium.

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. The Authors of this volume are leaders in the development of PET and MRI methods as well as clinical and translational researchers skilled in their use in patients with brain disorders. Individual chapters of this volume focus on the use of specific methodologies, covering the full range of PET chemistry based approaches as well as MRI methods from structural and diffusion tensor based imaging, to functional MRI of functional brain circuitry, to pharmacological MRI and MRI spectroscopic molecular imaging.

This book contains the original manuscripts, with summaries and diagnostic flow-charts, of speakers of the EANM 2001 post-congress meeting held in Capri, Italy, which examined management issues of patients with inflammatory bowel diseases, orthopaedic infections, vascular prosthesis infection, FUO and endocarditis, rheumatoid arthritis, and neurological infections. Nuclear medicine doctors attended together with radiologists and clinical specialists from different fields (gastroenterologists, orthopaedics, vascular surgeons, internal medicine doctors, rheumatologists, neurologists). The topics discussed in the book are of great importance for clinicians, nuclear medicine doctors and radiologists. At the end of each chapter, the commonly agreed diagnostic flow-charts for the management of patients with inflammation/infection are published.