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Advancing Nuclear Medicine through Innovation
dionuclides and radiolabeled compounds. In fact, one can trace the major advances in nuclear medicine directly to research in chemistry. These advances have had a major impact on the practice of health care. According to the Society of Nuclear Medicine, 20 million nuclear medicine procedures using radiopharmaceuticals and imaging instruments are carried out in hospitals in the United States alone each year to diagnose disease and to deliver targeted treatments. These techniques have also been adopted by basic and clinical scientists in dozens of fields (e.g., cardiology, oncology, neurology, psychiatry) for diagnosis and as scientific tools. For example, many pharmaceutical companies are now developing radiopharmaceuticals as biomarkers for new drug targets to facilitate the entry of their new drugs into the practice of health care and to objectively examine drug efficacy at a particular target relative to clinical outcome (Erondu et al. 2006). This has created a demand for new radiopharmaceuticals and a corresponding need for chemists and other imaging scientists who are trained to develop them.
6.2 SIGNIFICANT DISCOVERIES
Government investments in chemistry have facilitated the advancement of nuclear medicine, molecular imaging,1 and targeted radionuclide therapy. For example, research in nuclear chemistry and radiochemistry (Sidebar 6.1), coupled with accelerator technology and engineering, has enabled the introduction of new radionuclides into the practice of medicine. Similarly, progress in synthetic organic and inorganic chemistry laid the groundwork for dozens of compounds labeled with positron emitters or single photon emitters, which are now used in many clinical specialties. These discoveries have resulted from the collaborative efforts of multi-disciplinary teams of scientists and clinician-scientists, ultimately translating new concepts into clinical practice. Three examples are provided in the following sections.
Tumors and some organs, such as the brain, use glucose as a source of energy. FDG (Sidebar 2.2) is a fluorine-18-labeled derivative of glucose (fluorodeoxyglucose) which is used with positron emission tomography (PET) to provide a map of where glucose is metabolized in the body. Because tumors, as well as the brain and the heart, all use glucose as a source of energy, FDG is widely used in cancer diagnosis and in cardiology, neurology, and
Molecular imaging is a scientific discipline that studies new ways of imaging molecular events and biochemical reactions in a living organism using labeled tracers with high molecular specificity.