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The nuclear medicine department at St Bartholomew’s Hospital was started by the Nobel prize-winning Professor Sir Joseph Rotblatt in 1965 as a Radioisotope department with Ms McAlister and Mr Laurie Hawkins as Physicists. It was mainly equipped through various grants including one from the St Bart’s Trustees and not by the NHS. St Bartholomew’s Hospital introduced and were the first to use the Hermes system in the UK. The three main influences that helped determine the teaching, research and staffing at St Bartholomew’s Hospital were the IAEA, ICRF, and the EANM. This chapters summarises the inside story of Personal reflections, achievements and challenges.

In the early days, Hammersmith campus was probably the leading medical research hospital in the UK, and enjoyed a reputation based on a fantastic multidisciplinary approach and spirit of collaboration, co-operation and clinical support. Nuclear medicine at the Hammersmith Hospital was established as a separate unit by Peter Lavender in the early seventies. It was called the Radioisotope Unit to distinguish it from the pre-existing Department of Medical Physics. As well as providing a clinical service, the unit, was active in clinical research complemented by the extensive academic activities of the MRC Cyclotron Unit. This chapter will enlighten us with the contributions from Hammersmith Hospitals’ to the science and practice of nuclear medicine in the UK and worldwide.

The Cancer Research Laboratories at Nottingham University were a collection of old single story huts on the university site now occupied by the Biomedical Sciences Building, on the opposite side of the ring road to the Medical School. In the early 1980’s Professor Robert Baldwin lead a team of 50 scientists who were developing the then new monoclonal antibody technology. Along with the University of Birmingham, and the Charring Cross Hospital, London, Nottingham pioneered the in vivo use of monoclonal antibody imaging. This chapter describes the fascinating inside story of nuclear medicine in the UK and development of Antibodies, Gamma Probes and Drug Delivery.

25 years ago (half the life of the BNMS) in 1990 clinical PET imaging began to be accepted as an important clinical diagnostic tool. There were then approximately 60 pet centres in the United States 20 in Japan and even six in Belgium however there was not a single clinical PET service in the United Kingdom in spite of the fact that the Medical Cyclotron and PET unit at the Hammersmith Hospital was at the cutting edge of research in this area. The first clinical PET centre in the UK was finally opened in August 1992 by HRH Prince Charles. This chapter explores the dreams, challenges and success towards the introduction and development of clinical PET in the United Kingdom.

Radionuclide bone imaging is a common investigation performed in most nuclear medicine departments. In early days, 87mSr was the bone agent used and interest in 99mTc for Nuclear Medicine imaging began in the early 1960’s. The first technetium labelled bone agent, 99mTc-polyphosphate, was described by Subramanian and McAfee in 1971. Recent years have seen a further change in the choice of optimum tracer as the wider availability of PET scanners has brought renewed interest in 18F-fluoride. The 99mTc-MDP bone scan is an old and trusted friend that continues to perform with some distinction, but it is apparent that we can do significantly better with 18F. This chapters summarises, the growth and expansion of Bone Radionuclide Imaging, Quantitation and Bone Densitometry in the UK.

The delivery of radionuclide therapy also requires further craft group skills in particular trained clinical scientists, technologists, radiopharmacy and nursing. Therapeutic Nuclear Medicine in the United Kingdom has developed in a fairly inconsistent way over the last 50 years. As we enter into the age of personalized medicine theranostics and radionuclide therapy should become more important not less. This chapter explores the evolution of therapeutic nuclear medicine in the UK with some challenges for the future.

In the early days, hospital radiopharmacy usually fell under the remit of medical physics and regulation was somewhat informal. An early guideline on preparation of radiopharmaceuticals in hospitals was published by the British Institute of Radiology in 1975. With the loss of Crown Immunity in 1991, radiopharmacy came under the full scrutiny of the MHRA and standards have been continually tightened since then. Indeed, the UK led the world in this, for which the world does not thank us. Members of the UK community continue to play an important role nationally and internationally in advancing the practice of hospital radiopharmacy. This chapter explores the evolution of hospital radiopharmacy in the UK.

The story of computing in nuclear medicine is one of a role enabling continually improving performance and an interaction between technologies and applications, but sometimes with a pause for technical performance to catch up with user demand. At the beginning of the medical use of radioactivity in clinical research and diagnosis, measurements of nuclear radiation, typically using a Geiger-Muller or a scintillation counter, enabled comparisons between the radioactivity of samples to be made. The next step forward came from the advent of minicomputers in the 1970s and for clinical nuclear medicine, developments in the 2000s decade included the introduction of systems giving more integration of nuclear medicine in diagnostic imaging. This chapter summarises the development of Computers in Nuclear Medicine.

The first use in humans of 24Na-sodium chloride by Hamilton and Stone in 1936 began a story in which 131I-iodide became established for treating thyroid disease and radionuclide imaging became routine in hospitals. Later a range of 99mTc-radiotracers quickly became available and they were easily synthesised in hospitals using simple kit vials, firmly establishing 99mTc as the staple medical radionuclide. In general, the close cooperation of clinicians, physicists, engineers, biologists and chemists identifies capabilities, conceives challenges, discovers solutions and applies them in the clinic. Each discipline produces innovations that in turn drive innovations in the others. This chapter explores the past and future direction of radiopharmaceutical development.

Nuclear Medicine changed out of all recognition. Few of the types of study that I started with are routine now, they have either been replaced by other imaging modalities (liver scans), been significantly modified (SPECT bone and lung scans) or are completely new (sentinel node and PET/CT). Thus although people may say again ‘don’t consider Nuclear Medicine as a career because it will not last’ – they are and have been wrong! .