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A History of Radionuclide Studies in the UK
TemáticasEarth System Sciences; Environmental Chemistry; Climatology; Marine & Freshwater Sciences; Atmosphere ocean interaction; Chemical Exchanges; Biogeochemistry; COST 735; air-sea interface; Trace gases; SOLAS;
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History of the BNMS 1966–2016
The post-war period of the late 1940s and the 1950s was a productive time for developments in the use of radionuclides to diagnose and treat human disease. But the field failed initially to capture the imagination of clinicians. Nuclear Medicine Society (NMS) was formed in 1966 and later in the early 1970s efforts were concentrated on the creation of annual meetings, AGM and collaboration with various national and international organisations. Nuclear medicine as a specialty and BNMS as a society have evolved significantly over the years. The success and challenges behind the scenes from 1966–2016 is shared in this article.
A History of Nuclear Medicine in the UK
There is a long tradition in the use of radionuclides in the UK for the study of human physiology and more recently for imaging human pathology. Starting with von Hevesy in 1911 who performed the first radiotracer experiment in Manchester medical physicists and doctors have developed many radionuclide techniques and equipment for imaging normal physiology and human disease. Notable have been the invention of the radionuclide measurement of Glomerular Filtration rate, early scanners with background subtraction and persistence screens, colour scanning, radioimmunoassay for thyroid hormones, the first semiconductor gamma camera, and the first brain blood flow images with HM-PAO. First studies using cyclotron produced radionuclides demonstrated the increased uptake of FDG in cancer. Strontium 89 was commercialized for the treatment of pain in prostate cancer. The UK can be proud of its continuing contribution to the diagnosis and treatment of disease.
The Evolution of Training in Nuclear Medicine in the UK
Training in Nuclear Medicine in the UK has evolved over the years. It was in the late 1960s that physicians became involved in the developing speciality and a key driver was the creation of the Institute of Nuclear Medicine at the Middlesex Hospital. Nuclear Medicine in those days included much more in-vitro work. Nuclear Medicine training program has evolved significantly over the years due to significant advances in tracers and techniques. This memoire is a personal view, based on a (fallible) memory and documents kept over the years.
A Technologists Viewpoint
When radio-isotope departments were developed in the early 1950’s most studies on patients involved laboratory based techniques using blood samples etc. Usually run by physicists who often made their own equipment with the investigations carried out by physics technicians. However, with the advent gamma camera imaging, the specialty evolved and the training of nuclear medicine technologists has changed over the years reflecting increased complexity of equipment and procedures. This chapter explores the historical changes and milestones in the British nuclear medicine technology and technologists from technologist viewpoint.
Evolution of Nuclear Medicine Physics in the UK
Richard S. Lawson
The earliest nuclear medicine studies were performed without any imaging, just using blood or urine samples or external counting. The first nuclear medicine study that produced anything like an ‘image’ of organ function was performed in Liverpool and but today nuclear medicine has produced cutting edge technology like the PET/CT and PET/MRI. Many scientists have made and continuing to make important contributions to nuclear medicine throughout the UK, towards its growth and expansion. This chapter will briefly summarise the Evolution of Nuclear Medicine Physics in the UK.
The Institute of Nuclear Medicine London
Jamshed Bomanji; Peter J. Ell
The institute of Nuclear Medicine (INM) Founded in 1961 with Professor J.E. Roberts as the first director (1961–1963), and later under the direction of Professor E S Williams (1963–1985) and matured into international Institute under the directorship of Professor Peter J. Ell. Leading the speciality in the UK, the INM developed with the Royal Postgraduate Medical School and the Institute of Cancer Research, the first intercollegiate Master of Science Course (MSc) in Nuclear Medicine. This gained wide recognition, and at the INM, some 100 MSc graduates, mostly from overseas, obtained their diploma over the ensuing years. This chapter will briefly summarise some significant early contributions from the institute of Nuclear Medicine.
A History of Nuclear Medicine in the UK Radionuclide Investigation of the Brain
Peter J. Ell
In the UK, the institute of Nuclear Medicine in London has played an important role in the development of radionuclide investigation of brain. This chapter summarises the very early days of blood brain barrier imaging with labelled pertechnetate, and the use of 3" and 5" sodium iodide crystal scanners in the 60’s, with added simple data processing in the 70’s, progress was continuous, with the introduction of SPET, lyphophilic Tc99m labelled tracers for blood flow studies, the emergence of dopamine transporter imaging in patients with presumed Parkinson’s disease, followed by PET/CT and assessment of glucose metabolism with labelled FDG, and finally the UK introduction of PET/MR and the investigation of the dementias, with labelled amyloid.
A History of Nuclear Cardiology in the UK
S. Richard Underwood
The first cardiac images were produced using a rectilinear scanner but further advances were made with the development of more suitable radioactive tracers and more sophisticated imaging equipment. The invention of the Anger’s gamma camera in 1957 opened the door for rapid development, initially with blood pool imaging, progressing to myocardial imaging, cardiac PET, and the multi-faceted discipline that is now an essential part of clinical cardiology. This chapter will summarise the History of Nuclear Cardiology in the UK.
Great Ormond Street Hospital for Children, Paediatric Nuclear Medicine in the UK
The history of paediatric nuclear medicine in the United Kingdom is closely related to Great Ormond Street Hospital (GOSH) for Children. Paediatric nuclear medicine at GOSH is inseparably linked to Professor Isky Gordon, a was a consultant radiologist with special interest in nuclear medicine at GOSH. The paediatric nuclear medicine unit at GOSH is a reference point of paediatric nuclear medicine practice in the UK and abroad. Ground breaking work has been done and novel work is in progress. This Chapter will summarise the growth and expansion of Paediatric Nuclear Medicine services at the GOSH and in the UK.
Renal Radionuclide Studies
Adventure with the kidneys started at the Middlesex Hospital culminating in 1971 with Britton and Brown’s monograph Clinical Renography. and the team later cleaned up the renogram with Computer assisted blood background subtracted, CABBS, Renography etc. Clinicians and scientists from the UK have played a major and significant role in developments of radionuclide renal studies have an established place in Nephrology and Urology. This chapter explores the early days of radionuclide renal studies with special emphasis mainly to the work at St Bartholomew’s Hospital.
St Bartholomew’s Hospital and Medical School: Department of Nuclear Medicine
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.
Nuclear Medicine at the Hammersmith Hospital
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.
Nuclear Medicine in Nottingham: Antibodies, Gamma Probes and Drug Delivery
Alan C. Perkins
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.
The Introduction and Development of Clinical PET in the United Kingdom
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.
Bone Radionuclide Imaging, Quantitation and Bone Densitometry
Glen M. Blake; Ignac Fogelman
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.
Therapeutic Nuclear Medicine 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.
Hospital Radiopharmacy in the UK
James R. Ballinger
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.
Development of Computers in Nuclear Medicine
E. David Williams
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 Future Direction of Radiopharmaceutical Development
Philip J. Blower
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.
A Personal Reflection
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! .
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