I am dr. Leonard Freeman and I am from
the Albert Einstein College of Medicine
and Montefiore Medical Center in New
York and what I was asked to talk to you
about was to give you a little
background history on nuclear medicine I
noticed you did have a talk this morning
a little bit explaining what nuclear
medicine was I'll do a little bit of the
same and I'll tell you some things that
allowed nuclear the US and develop you
know historically which I think will be
a little entertaining and of interest to
you so in any event I think you've
learned pretty much from what you've
heard so far today you know what nuclear
medicine is and you know we deal with
both diagnosis and treatment and I
understand many of you if not all of you
really have had some exposure to nuclear
medicine but I guess principally on a
diagnostic standpoint although some of
you therapeutically as well and you see
it says as a discipline of medicine it's
restricted to unseal sources what does
that mean well you're all familiar with
radiation therapy and cobalt machines
and things like that and high-energy
x-ray those are called sealed sources in
other words when you use radiation
actually itself to treat unseal sources
means that's what we give the patient
either orally or intravenously whatever
that's called unsealed sources and
that's what we deal with in nuclear
medicine and as you see it it
conceptually relates to what we call the
trace of principle and that I'm going to
explain to you but basically for them
work you know what's the difference
between x-ray and and nuclear medicine
and again you may have heard some of
this earlier as well but you know with
all x-ray procedures you're dealing with
structure anatomy things like that you
know plant using a plane chest x-ray
like on the lower left or a cat scan
this deals all with the way an x-ray
beam passes through a patient and the
differences between let's say soft
tissue in the lung and the ribs you know
bony structures and things like that
that's what really makes the picture by
us giving what we call radio
pharmaceuticals and I'll get to that in
just a moment to you we basically are
looking at various things in this case
this is a lung scan this is looking at
blood flow to the lungs
and it deals with looking at things
likes to say you've probably familiar
with the disease called pulmonary
embolism where clots go to the lungs I
mean most recently I can think in terms
of celebrities and many celebrities have
gotten pulmonary embolism Serena
Williams the tennis player last year had
quite about with pulmonary embolism and
that's how the diagnosis is made very
often
here's another example here's his
gallbladder disease well that's a very
common disease now
there's supposedly 2025 million
americans walking around with gall
stones which is I don't even know it and
that's called chronic gallbladder
disease or the term is called
cholecystitis chronic cholecystitis okay
and what you're seeing on the left is an
ultrasound exam and the ultrasound exam
but there it is right here whoops my red
arrow is coming and going
the ultrasound exam shows you these
these white things all over here that
those are gold stones okay now that's
how one diagnosis chronic cholecystitis
these are patients who you know may have
fatty food intolerance or you get
discomfort when you have fatty foods
that type of thing
now that is how you make a diagnosis of
chronic cholecystitis but as you know
unfortunately people sometimes develop
an acute attack of cholecystitis an
acute koil bladder problem what course
is that well the little schematic
diagram on the top shows you is that
woman one of those stones gets out of
the gallbladder and blocks the duct that
leads to the gallbladder okay then the
gallbladder starts expanding it gets
infected and that's what causes an acute
attack so how do we diagnose acute
gallbladder disease or acute
cholecystitis we do that with the skin
that we call the height of skin we give
the patient a material intravenously
that gets picked up by the liver and
gets transported out into the bile and
out into the intestine and for instance
you can see in the middle here here's
the liver here's the bile ducts and
here's the gallbladder okay so if this
patient we're having acute pain now we
can do this kind of skin which we call a
hider scan and we can say the patient is
not having an acute attack of
cholecystitis right now but if you look
at the picture on the right notice
here's the liver here's the intestine
and there's no gold bladder so this
means that that duct going to the
gallbladder is blocked and the patient
does have an acute attack this is
information you can't get from an x-ray
but you can get from a nuclear medicine
scan because we are studying function
the way the organ works okay and the way
the organ handles a material and we
basically fool the organ in many
respects because we may give the organ
we give the patient's something that a
particular organ cannot distinguish
between what it might normally use
metabolically in terms of its own
function and what we're giving it
radioactively but now because it's
radioactive we can now actually take a
picture and see what's going on
so in nuclear medicine we have two tools
to our trade we have our radioactive
drugs which is what I've just been
talking about we call those radio
pharmaceuticals and on the bottom you
see we have instruments in order to
image them now radio pharmaceuticals
Radio isotopes have different types of
properties you've probably heard and you
know some place back in high school or
college physics you've learned about the
fact that isotopes have alpha rays beta
rays gamma rays different things like
that okay well in order to study a
patient alpha and beta isotopes that
have alpha and beta radiation that
doesn't leave the body that stays within
the body it's great if we want to treat
the patient or treated disease but if we
want to take pictures and see what's
going on we can't do that we need an
isotope that's a gamma ray emitter and
that leaves the body and we have
instruments which we call gamma cameras
and we take pictures and can see exactly
how that thing like I just showed you
with the liver how that thing is moving
to that through that particular organ
okay now
let's go ahead okay so a good example of
two different radio pharmaceuticals used
for use used for different purposes is
radioiodine now iodine is very important
in our diet and the Glenn that's most
involved with iodine is the thyroid
gland okay
of course would have sold you have salt
in your diet whatever the thyroid picks
it up it makes thyroid hormone out of
the iodine okay so if we want to study
problems of the thyroid gland we can use
a radioactive iodine and the thyroid
gland cannot distinguish that
radioactive iodine that we give it from
the normal iodine that it picks up and
salt okay so it goes to the thyroid good
but now because it's got the one
particular isotope iodine 123 has gamma
radiation then we can take pictures and
take a picture of the thyroid but we
also have another material iodine 131
you know why because we treat thyroid
disease we treat hyperthyroidism we
treat thyroid cancer okay so when we
treat hyperthyroidism with thyroid
cancer we use iodine 131 rather than
iodine 123 but we're doing a diagnostic
study we don't want that beta radiation
we just want the gamma radiation to get
our pictures because the patient's going
to get a bigger radiation dose under
those circumstances okay
so I'm supposed to talk about history
and this is just a little cartoon of
course you always like to know where you
came from and in any event let's talk a
little bit about history okay so the
tracer principle that's essentially what
I just described to you that's the whole
concept of being able to image an organ
with a radioisotope okay and the
important thing is is that we can give
tiny tiny amounts of this these agents
for diagnostic purposes and it doesn't
change the body at all it doesn't change
the way that organ functions but it gets
into the normal pathway of metabolism
for the organ and we can take pictures
and follow it along so we're able to get
what we call physiologic localization
without any pharmacological effects okay
this is one of the fathers of our
specialty dr. george de hevesy
as a Hungarian man and we go all the way
back to the 1920s and 1930s okay and he
started off he did something really
really interesting long before the stuff
was being used in humans
he took an isotope of lead okay and he
put it in the soil and plants right
where a bunch of plants were and
whatever and then he actually waited a
couple of days and he took samples of
the leaves and samples of the stem and
stands the samples of different plots of
that plant and he showed and this is the
instrument that he used actually to do
what this was called the goldleaf
electroscope so he took the stem and he
took the leaves and he put it next to
this electroscope and this is a little
gold leaf here and this is a lead bar
and if it was radioactive and it was
picking the stuff up that gold leaf
would flick away from the lead bar okay
now you of course know the term Geiger
counter okay this is an updated version
of this old goldleaf electroscope that
allows you to detect radiation so he was
able to show that this lead was picked
up at different rates by the by the stem
of the plant by the leaves of the plant
that didn't handle it the same way now
there's a very interesting aside about
dr. de Hevesy which I'm going to tell
you he won the Nobel Prize for this by
the way dr. de Hevesy was a bachelor he
was an anorectic okay and he lived in a
boarding house in Budapest and the
boarding lady lady who owned the
boarding house would feed the tenants
food every night and he fed them corned
beef hash and each night you know he
wouldn't even hardly eat the stuff and
he left some over and she would serve
the same thing every night so he had a
sneaking suspicion that she was you
reusing the same stuff instead of
serving at night after night so he
figured he would do something clever he
took some of his radioactive lead okay
and he put it in the food after he
shoveled the to the side of his plate
the first night the next night when she
served the corned beef hash
he took a napkin put some of the stuff
in a napkin and brought it back to his
lab and counted and sure enough the lead
in it so he went ahead and he confronted
to the landlady and told her what she'd
been doing she didn't have too much of a
sense of humor so she kicked him out
but that was one of the first examples
of using the trace of principle okay
okay now here's the next thing that was
done no this says 58 because we're still
being done is know recently is 58 which
historically is not that long ago you
see what happens here's a little helmet
that was put over the patient's head and
they put a small amount of this human
serum albumin isotope label with iodine
131 and you can see there were little
pockets on that helmet and they took a
little counter like a little Geiger
counter and they count it over those
this patient had a you know brain tumor
and they were counting over those little
areas to see exactly where it was okay
obviously long before cat scanning long
before a lot of things okay so this is
what they were doing okay now in 1931 a
very famous chemist named dr. Ernest
Lawrence invented machine that you've
probably all heard of it's called the
cyclotron okay the cyclotron produces
isotopes and basically he produced
iodine compounds very very early he
produced phosphorus Ernest Lawrence was
a chemist and you see the picture next
to him is his brother John Lawrence John
Lawrence was a physician so John
Lawrence used some of his brothers p32
which is a pure beta emitter okay no
gammas a pure beta emitter and he
treated patients who had blood disgraces
leukemias and things of that sort
now the name Enrico Fermi on the left
there is a name some of you might
recognize why he was one of the fathers
of the atomic mom he worked under the
stands at the University of Chicago and
the a-bomb was being developed okay he
came over from Italy and he was of
course very very very important to
American defense okay
and he dealt with some of these cyclone
products and you see a dr. Joseph
Hamilton who also worked with dr.
Lawrence at Berkeley California where he
developed a cyclotron and he was using
some of this radioiodine he was learning
how to do uptake studies you know using
it in an understanding how the thyroid
gland would actually
okay I'm now going to skip to somebody
called dr. Sam sideling who's dr. Seidel
and dr. Seidelman is actually from my
hospital for Montefiore Medical Center
in the Bronx
dr. sideling was an endocrinologist who
worked at Montefiore hospital from the
1930s through the 1950s okay and he had
a patient with a very advanced thyroid
cancer okay and what did he do well what
could he do well you know there wasn't a
lot he can do for the patient you know
chemo wasn't really very developed it's
not a lot of chemo you can use for
thyroid cancer anyway
but he was aware of the fact that in
Berkeley California dr. Ernest Lawrence
was had a cyclotron it was producing
radio iodine and also there was another
one up in Boston at MIT so of course
this was 1943 I think it was the war was
on and basically you know it was much
easier to speak to somebody in Boston
that to speak to somebody in California
and he treated his patient which I'll
get to in a moment very successfully and
he wrote a paper which was published on
December 7th 1941 of the American
Medical Association very prophetic date
right December 7th Pearl Harbor day five
years earlier and that's about 1415
months before the a bombs were dropped
on Hiroshima and Nagasaki to end the war
so everybody was frightened you know the
feeling everybody had in 9/11 same
feeling everybody was very very
frightened about this nuclear energy and
the US Congress was wrestling with the
whole thought of what could they
possibly do with this horrible horrible
stuff and then all of a sudden back to
Sam Seidman writes this paper and say
hey you can do good things also you can
treat cancer with it and that's why it's
been called the most important paper
ever written in nuclear medicine well
this is just a little anecdote dr.
Sampson was a physiology he was a
Canadian okay he was from McGill during
the 1930s he came to New York he worked
at Montefiore Medical Center and he had
this patient with thyroid cancer I'm not
going to go
this whole thing he called up dr. Evans
in Boston who ran the cyclotron at MIT
to get the radioiodine set cost $1,800
an hour he didn't know what that meant
he says how many milic URIs do you what
he didn't know what that meant so he
says give me an hour's worth you know
anyway but uh he went through this whole
thing I'm not going to go through the
whole thing now but what I want to show
you here is this is typical of what was
achieved this is a bone here you could
see the hip and this is a bone that's
it's cool the ischium it's the bone that
comes down in a lower part of the pelvis
it's totally destroyed by the cancer and
here's what the radioiodine did it
filled it all in completely very very
dramatically okay well that was 1943 the
patient BB okay he went public
he went to Life magazine in 1949 six
years later the name was mr. Bronstein
and here's a story of what he was he was
a Brooklyn shoe salesman destined to
become one of most famous patients in
medical history the first person known
to be cured of metastatic cancer
metastatic cancer has always been 100%
fatal but tumors were destroyed in a
simple almost miraculous way by the
drinking of four doses of radioactive
iodine he appeared to be suffering from
a overactive thyroid gland he was too
weak and emaciated his thyroid gland had
been moved surgically radioiodine was
given on the theory that his thyroid
tumor would absorb the drug if they did
they would be destroyed three months
after he drank the first glass of
tasteless colorless liquid he started to
put on weight after three additional
dates the tumors eventually disappeared
completely okay so this is one of the
seminal events in terms of thyroid
therapy okay and this is a very routine
we think we do I treat at least a couple
of cases a week of thyroid cancer with
radioiodine
okay so it's a very very specific
treatment that you have because here you
were radioactive iodine is picked up by
the thyroid gland well how could you be
more specific than that as you well know
when you get chemotherapy and things
like that
there are effects on other organs and
things like that this is something very
specific for the thyroid gland
it was done I can say proud proudly in
my hospital I wasn't there but it was
done there all right the most common
isotope you probably heard the name
today technetium-99m technetium is the
most common isotope we use it's a gamma
emitter and we use this for diagnostic
purposes dr. Glenn Seaborg also worked
in Berkeley California and he was the
first Commissioner of the Atomic Energy
Commission when it was formed after
World War two
dr. su gray from Italy came and joined
him and was involved in all of this
so technetium-99m literally 90% of the
diagnostic studies we do in any given
day is done with that isotope it's
incredibly versatile and it can we can
attach it to a lot of different tracers
that can image various organs throughout
the entire body and you see it's got a
half that's another property of an
isotope is a half-life 6 hours so
basically you know things like uranium
and radium they have enormous Li long
half-life hundreds and hundreds of years
here's something that's got a six hour
half-life so it works very well for
diagnostic purposes it's a pure gamma it
doesn't give a lot of radiation to the
patient and you know it's the most
common thing that we use okay let's turn
our attention now to the instruments
well here are our two instrument
pioneers dr. Benjamin Caston and dr. hal
hanger okay dr. khazzan would first
developed an instrument called a
rectilinear scanner because I showed you
the way we just used to count things and
I showed you the helmet over the head
but now we had these instruments that
actually were able to move along and
actually plot out and make a picture of
an entire organ and here you see a very
early rectilinear scan the patient laid
under this detector on the right and
this detective moved back and forth
across them and you got this thing that
with tap holes on a paper would tap
little little holes and you get a
picture of an organ well it got more
sophisticated then the next development
was actually developing the use of x-ray
film for taking images and exposing
x-ray film so now if you look at all
these different examples around that his
is a lung scan I showed you that before
his a thyroid scan
okay here's a bone scan okay I'll show
you more examples of that as we go along
and these were almost all technician
compounds so we were able to image all
these different types of organs anger
developed the camera where instead of
moving back and forth across the patient
this was a bigger detector head and this
was able to in fact pick up how the
radiation was I know you had a talk this
morning on how nuclear medicine works so
hopefully this will be a little bit
familiar to you
okay now look at this look at the dates
here here's how a bone scan developed
from the old rectilinear scanner through
a early camera picture and now most
recently through a much fancier thing
used something we call PET scanning and
how fancy can we get okay this is what's
happened with technology this
unfortunate particular patient you know
has obviously those are old old bone
lesions patient had prostate cancer he
actually got better though nowadays and
it's amazing i I see scans that look
like this and then with the new
medications for prostate cancer boy I
mean I've seen them disappear completely
it's absolutely incredible
before we had cat scans you know the
pancreas was always considered a very
hidden organ of course now you look at
it with CT you look at it with MRI but
before we had that we did have materials
that actually allowed us to see the
pancreas as well this is the liver and
this is the pancreas here we don't do
this anymore
here's a kidney scan so here's a patient
that was in an accident and you can see
this is this is looking from behind this
is the right kidney this is the left
kidney and this patients injured their
left kidney you can see the difference
the diminished uptake that you have
throughout that left kidney and here's a
cat scan that shows you there's a big
blood clot around the kidney this is a
lung scan now lung scans this is looking
at blood flow to the lungs something we
inject intravenously and this is some
particles we have the patient breathe in
and basically if you have a clot in the
lung usually the Airways remain open
they don't change so if you have let's
say a patient who's got emphysema
or some chronic lung disease the
perfusion scan which is the blood flow
scan and the ventilation scan will look
identical the fact that we have that big
defect on the perfusion scan and we have
a normal ventilation scan that's what
makes the diagnosis of a clot in the
lung of pulmonary embolism look at these
pictures now okay we can do cities we
can make movies okay this is an isotope
that stays in the bud what is it what's
the patient's own blood cells we draw
some blood out from the patients and
outside the body we label it with some
technetium and then we re inject it back
into the patient so where does it stay
it stays in the blood stream so you're
seeing the heart seeing the liver you're
seeing the spleen and unfortunately it's
little too much light in the room but
you're seeing these are the blood
vessels coming down why do we do this
this is a study we do for GI bleeding if
a patient comes in and he's got some
blood in his stool whatever and the
first question is where is it coming
from okay GI tracts a pretty big thing
going from the esophagus all the way
down to the lower colon okay so
basically where is it bleeding from so
if we put this material the patient's
own red cells back into them and take
images in this case movies which I'll
show you what happens is it will where
will it leak it will leak out of the
blood stream into the intestine where
the bleeding is occurring okay watch see
that so basically the bleed is here
watch watch what happens here it's going
to start here and it's going to go
upwards and downwards this is the
descending colon so if this patient son
needs something done therapeutically and
this can be done angiography the N
Geographers can actually put some gel
foam they can stop the bleeding by
putting some directly you know into
through a catheter but this tells the
angiography
which blood vessel to get a bunch of
blood vessels supplying different parts
of the bow
so by him knowing that this is coming
from the area of the descending colon
they can specifically go after that
particular blood vessel that supplies
that part of the colon okay here's
another one now look at this one now
notice it's coming from the upper
abdomen and it's forming this is coming
the stomach is coming down like this
this is coming from the duodenum which
is the first part of the small intestine
that's an entirely different situation
in the first case I showed you okay so
here again it would be a different
vessel they would go after if I mean the
bleeding was really bad and the patient
we're not stable and the surgeon had to
operate it also tells the surgeon where
to go if they have to operate without a
study like this they're going in blindly
that they have to open up the belly and
first figure out where the problem is
okay so this gives them a very specific
localization as to where that bleeding
is occurring from okay well you know
about cat scan the cat scanning is a
body section x-ray okay well the nuclear
medicine we have body section also okay
we have two types you know once called
SPECT and you've probably heard of PET
scanning you've probably heard about
that this morning and whatever well the
whole idea or concept dr. David cool who
was at the University of Pennsylvania
when he did this actually developed a
methodology for doing body section
imaging in nuclear medicine okay and
here you see for instance on the Left
those red lines are going through a
particular part that is a big abscess
that the patient has in the brain and
you can see on the right a specific body
section imaging that more precisely
localizes exactly where it is as
compared to looking at the overall image
you know as a whole now here's a brain
scan that's done with pet and this is a
body section you know you got a picture
this okay this is going crosswise
through the brain okay from top to
bottom so basically this is the very top
of the head right over here and you're
going from front to back
this is the front of the head this is
the back of the head so notice as we go
from front to back that notice this rim
okay
this rim is very uniform throughout this
is again blood flow we're looking at or
and and the way the brain is utilizing
sugar glucose metabolism going from the
front to the back of the head so this is
a normal study now what do you see here
do you notice that the whole left side
is missing here okay
see that pretty clear this patients had
a stroke so the left side of his brain
is not getting the blood supply that the
right side of the brain is getting okay
look at this one now what you should
notice here if you go from front to back
notice that the back portion here fins
out you can see it very well here in
color the yellow is the brain okay the
brain perfusion and notice that it's
missing all the way back here if you
look at the side view of the brain
notice this is the front of the head
this is the back of the head can you see
that the UPS can you see that the
posterior portion of doesn't have as
much activity as the area more forward
to it okay what is this this is
Alzheimer's disease this is a PET scan
of the brain and here is a patient with
a very advanced so with the red arrows
are showing you here is that that
posterior part of the brain has really
considerably lost its blood flow this is
the typical picture of Alzheimer's
disease on a PET scan of the brain okay
here's what a PET scan looks like looks
like a cat scanner okay and if the
patient's inside the PET scanner the
signal from the isotope that we're
giving goes is a whole set of detectors
around the patient so simultaneously it
goes 180 degrees and that's what gives
us very very precise localization from
what's going on okay now this is the
very first PET scan ever performed
okay this doctor Brownell was up in
Boston and this was published in 1953
but he had very crude instruments he
didn't have what we have now and this
was a tumor and he used an isotope core
a positron isotope that's what pet
stands for arsenic 74 not the arsenic
that kills you a different arsenic
okay now fusion images and this is the
point now we've talked a little bit
about x-ray we've talked a little bit of
nuclear medicine a lot about nuclear
medicine why choose why not put them
both together and get optimal
information okay and that's what we do
now we do a study these are different
instruments we do study called PET CT
okay and we have both and what are we
achieved by that well here's an example
of a patient with a lung tumor here it
is on the cat scan here it is on the PET
scan okay and here it is what we call a
fusion of each one the PET scan is
superimposed on the x-ray are the cat
scan and this is called a fusion image
okay and it gives us very very precise
localization and this is pretty much
state-of-the-art now okay so you know
what is CT Edie
well you know it lets us see it it's
better resolved it's got better
resolution we can see it better low
localize the uptake the in bone versus
soft tissue
it can help distinguish a benign from
malignant tumor because sometimes if a
patient has let's say a nodule in the
lung and your doctors not sure if it
might be benign or a malignant see if
you do a PET scan because if it picks up
this glucose compound very avidly
there's more of a chance that it's
malignant most benign things would not
pick it up so what do we use well this
particular PET scan the most common
thing that use is sugar a glucose
compound here's the structure of glucose
okay and what you see the way we make
the isotope of the radiopharmaceutical
is we take this is called a hydroxyl
group this guy over here see it and we
substitute an isotope it happens to be
something called fluorine 18 so now we
have a glucose compound but with an
isotope attached to it so we're label to
look at sugar metabolism throughout the
body here's a patient that has a
non-hodgkins lymphoma and you see one of
the beauties of the PET scan here
after two treatments I mean all of the
black stuff that you're seeing here is
actual disease this is lymph node
disease if the two treatments look at
the PET scan it's all going okay and
that's what we like to see obviously and
you can see what a tremendous help this
is to your doctor treating you because
you know if you just look at an x-ray a
patient may have a mass let's say in the
chest and let's say they've gotten the
treatment and they're getting better but
you know the mass in the chest
anatomically on an x-ray may not go away
immediately maybe it takes a few months
before it shrinks down and goes away but
this is something we're looking at
function here and the sugar metabolism
that we're looking at here is going
immediately so that tells the doctor
they're really on the right track as far
as the treatment is concerned here's a
patient it's got an esophagus cancer and
all these black things in the middle are
lymph nodes and here's a lymph node up
here also and after therapy you can see
this is before surgery you can see that
it's much much better this is much
smaller these are the kidneys and all
that stuff in the middle and the lymph
nodes are all going okay this indicates
the patient is now a good candidate for
surgery and should do well with surgery
the fact that they've responded so well
to the initial chemotherapy
here's a breast-cancer you can see the
breast cancers picking up very very
actively unfortunately this particular
patient is he does have lymph nodes in
the axillary region and in the chest and
the near the heart and the mediastinum
and in the lung but this will likely
respond to chemotherapy and this is the
way that we monitor it this is called a
sentinel node lymphomas localization
study and if you know any people or if
anyone in the audience might have had
breast cancer you know that one of the
things that we do before he is a nuclear
medicine test we inject some isotope
around the tumor and we look at the site
of drainage and these lines that you see
these are for different patients so here
you see this is called a lymphatic
channel this is going to the armpit the
axilla there's one lymph node here in
this case the patient has two lymphatic
channels in this case the patient's got
three but they're all going to the same
place in the axilla so what happens is
the surgeon takes out those lymph nodes
okay with a little probe we can locate
almost like a Geiger counter can locate
where the activity is he removes them
and sends them to the pathologist while
the patient is still on the operating
table the pathologist examines him if
those lymph nodes are negative and no
tumor has spread to those lymph nodes
that's the end of the surgery the
patient doesn't have to have a more
extensive axillary dissection and you
probably know patients who have
lymphedema their arms swell and all
sorts of problems like that so this is
what the current state of the art is and
it's a nuclear medicine study called
sentinel node you know - sentinel is
centel's the guy - poor guy that's
looking out for the troops or all the
other guys are sleeping you know he's
watching the front lines so basically
this is called a sentinel node
localization all right we're almost
finished doctors just quickly doctors
Rosalyn yellow and Solverson developed a
technique called radioimmunoassay
this is used to measure tiny amounts of
substances in the body and the
bloodstream which they use it originally
for insulin it's used now for drug
overdose things like that it's it's
called radioimmunoassay dr. person died
but dr. Yalow won the Nobel Prize for
particular discovery these are some of
the therapies that we do I've mentioned
thyroid hypothyroidism thyroid cancer we
do have a treatment if somebody is
suffering from bone metastasis from bone
spread we do have treatments to help
them out and help with the pain
we do have treatments antibody
treatments for non-hodgkins lymphoma as
well and we have specific treatments now
where we treat if there's been any tumor
spread to the liver we actually have a
method of putting radioactive spheres
directly through an artery that goes
into the liver and get very very
selective therapy right thing obviously
as I mentioned before these are beta
room it is not Gamera medicine so
basically okay just quickly the Society
of nuclear medicine society nuclear
medicine which you're sitting at here
1950 Ford originated this is their
Declaration of Independence you can see
the signatures and interestingly you can
see that this started in Spokane
Washington very locally in 1954 the 12
people who signed that document
interesting nine physicians and three
physicists chemists dr. Fahy who just
spoke to you before he and was of course
a physicist because on the basis of that
original setup for the society they
decided that every fourth year the
president of the Society should be a non
physician and dr. Fahy who just is
finishing his year as physician as right
now so you know here the first second
third and fourth president you recognize
the name Norman halter you hear the
halter monitor okay the same guy okay he
was from Montana and he developed a
whole term and he was also the fourth
president of the Society of nuclear
medicine and he was a basic scientist
these are the executive directors dr.
Virginia Pappas is our current director
right now
there are a bunch of chapters as you see
regionally broken up throughout the
country that have their own meetings and
function also this of course is the big
national meeting you're at the American
Board of nuclear medicine nuclear
medicine physicians are examined and
board-certified this was set up in 1972
and of course we have our philanthropic
arm
the education and research foundation
which gives grants of various sorts to
young investigators people like that
and the two gentlemen I mentioned the
two instrument pioneers will they made
so much dough from their inventions that
they were very generous and in their
wills in their estates you see they
donated doctors Casson and anger donated
considerable amounts to the education
and research foundation of a lot of
grants and awards that are put out and
essentially that's it so I've taken you
for a little trip through the history of
what's going on with our specialty and
hopefully you've enjoyed it you've
learned a little bit more about you know
how we operate what nuclear medicine is
all about and it really should not be a
mystery to you