Volume 45, Number 1
January 2015
Letter From the Editors
I
maging of the skeletal system has long been an area of great interest to nuclear medicine practitioners. The January 1972 issue of Seminars in Nuclear Medicine (Vol. 2, No. 1) was devoted to this subject.1 The popular agent, strontium-85 chloride, had a high 512-KeV gamma photon, which made it a good fit for the rectilinear scanner, with its thick 2-in sodium iodide crystal providing optimal interaction. However, its long half-life of 64.8 days limited the diagnostic dose to 100 mCi and allowed its use only in malignant or suspect malignant disease. Amazingly, these relatively poorly resolved images were still 30%-35% more sensitive than plain film radiographs in detecting neoplastic lesions. This was, of course, several years before the discovery of computed tomography. The advent of the technetium-99m phosphates in the early 1970s created a marriage with Anger's scintillation camera whose thinner half-inch crystal was better suited to interact with technetium's lower 140-KeV gamma emission. Its relatively short 6-hour half-life allowed investigations into benign osseous abnormalities as well. This became the subject of the January 1976 issue of Seminars (Vol. 6, No. 2).2 Over the years, we have periodically presented updates on skeletal scintigraphy, culminating in this state-of-the-art issue. Another agent that deserves special comment is the positron emitter, 18F-fluoride. Interestingly, this was selectively used more than 40 years ago. In our aforementioned January 1972 issue, Blau, Ganatra, and Bender presented a review of their experience with this agent.3 The limited supply, relatively high cost, and suboptimal interaction of the positron with the scintillation camera greatly restricted its use. The current boom
http://dx.doi.org/10.1053/j.semnuclmed.2014.08.003 0001-2998/& 2015 Elsevier Inc. All rights reserved.
in PET and PET/CT has greatly renewed interest in 18F-fluoride after its many years of remaining dormant. Jadvar, Desai, and Conte provide us with a current status report in this issue.4 Considerable progress has also been witnessed in palliating painful bone metastases, particularly those from prostate cancer. The most recent addition to this area is the alpha emitter radium-223. Although a very expensive treatment, it has shown great promise and has recently been approved by the Food and Drug Administration. Dr Abi-Ghanem and his associates at the Upstate Medical Center in Syracuse review this newer development in targeted therapy.5 We thank Drs Goldsmith and Mihailovic for assembling an outstanding group of colleagues to present this current status report on one of our important daily procedures. Leonard M. Freeman, MD M. Donald Blaufox, MD, PhD
References 1. Radionuclide studies of the osseous structures. Semin Nucl Med 1972;2(1) 2. Benign bone disorders. Semin Nucl Med 1976;6(1) 3. Blau M, Ganatra R, Bender MA: 18F-Fluroide for bone imaging. Semin Nucl Med 1972;2:30-37 4. Jadvar H, Desai B, Conti P: Sodium 18F-fluoride PET/CT of bone, joint and other disorders. Semin Nucl Med 2015;45 5. Abi-Ghanem AS, McGrath MA, Jacene HA: Radionuclide therapy of osseous metastases in prostate cancer. Semin Nucl Med 2015;45
1
January 2015
Letter From the Editors
I
maging of the skeletal system has long been an area of great interest to nuclear medicine practitioners. The January 1972 issue of Seminars in Nuclear Medicine (Vol. 2, No. 1) was devoted to this subject.1 The popular agent, strontium-85 chloride, had a high 512-KeV gamma photon, which made it a good fit for the rectilinear scanner, with its thick 2-in sodium iodide crystal providing optimal interaction. However, its long half-life of 64.8 days limited the diagnostic dose to 100 mCi and allowed its use only in malignant or suspect malignant disease. Amazingly, these relatively poorly resolved images were still 30%-35% more sensitive than plain film radiographs in detecting neoplastic lesions. This was, of course, several years before the discovery of computed tomography. The advent of the technetium-99m phosphates in the early 1970s created a marriage with Anger's scintillation camera whose thinner half-inch crystal was better suited to interact with technetium's lower 140-KeV gamma emission. Its relatively short 6-hour half-life allowed investigations into benign osseous abnormalities as well. This became the subject of the January 1976 issue of Seminars (Vol. 6, No. 2).2 Over the years, we have periodically presented updates on skeletal scintigraphy, culminating in this state-of-the-art issue. Another agent that deserves special comment is the positron emitter, 18F-fluoride. Interestingly, this was selectively used more than 40 years ago. In our aforementioned January 1972 issue, Blau, Ganatra, and Bender presented a review of their experience with this agent.3 The limited supply, relatively high cost, and suboptimal interaction of the positron with the scintillation camera greatly restricted its use. The current boom
http://dx.doi.org/10.1053/j.semnuclmed.2014.08.003 0001-2998/& 2015 Elsevier Inc. All rights reserved.
in PET and PET/CT has greatly renewed interest in 18F-fluoride after its many years of remaining dormant. Jadvar, Desai, and Conte provide us with a current status report in this issue.4 Considerable progress has also been witnessed in palliating painful bone metastases, particularly those from prostate cancer. The most recent addition to this area is the alpha emitter radium-223. Although a very expensive treatment, it has shown great promise and has recently been approved by the Food and Drug Administration. Dr Abi-Ghanem and his associates at the Upstate Medical Center in Syracuse review this newer development in targeted therapy.5 We thank Drs Goldsmith and Mihailovic for assembling an outstanding group of colleagues to present this current status report on one of our important daily procedures. Leonard M. Freeman, MD M. Donald Blaufox, MD, PhD
References 1. Radionuclide studies of the osseous structures. Semin Nucl Med 1972;2(1) 2. Benign bone disorders. Semin Nucl Med 1976;6(1) 3. Blau M, Ganatra R, Bender MA: 18F-Fluroide for bone imaging. Semin Nucl Med 1972;2:30-37 4. Jadvar H, Desai B, Conti P: Sodium 18F-fluoride PET/CT of bone, joint and other disorders. Semin Nucl Med 2015;45 5. Abi-Ghanem AS, McGrath MA, Jacene HA: Radionuclide therapy of osseous metastases in prostate cancer. Semin Nucl Med 2015;45
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