Diagnostic Uses of Radiopharmaceuticals in Nuclear Medicine

  • Gopal B. Saha


In previous chapters, we described various characteristics and production of radionuclides, preparation of different radiopharmaceuticals using various radionuclides, and their quality control. In the present chapter we shall describe clinical applications of these radiopharmaceuticals in the diagnosis of various diseases in humans. The discussion is primarily divided into sections on different human organs. In each section the anatomic structure and physiologic function of the organ are briefly described and appropriate nuclear medicine tests are discussed along with their clinical usefulness, particularly with respect to the radiopharmaceuticals used, their pharmacologic aspect, the mechanism of their localization, and diagnosis of various diseases.


Myocardial Perfusion Imaging Gamma Camera Medullary Thyroid Cancer Effective Renal Plasma Flow Scintillation Camera 


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References and Suggested Reading

  1. Anthony CP, Thibodeau GA. Textbook of Anatomy and Physiology. St. Louis: Mosby; 1979.Google Scholar
  2. Arnold RW, Subramanian G, McAfee JG, et al. Comparison of 99mTc complexes for renal imaging. J Nucl Med. 1975; 16:357.PubMedGoogle Scholar
  3. Atkins HL, Budinger TF, Lebowitz E, et al. Thallium-201 for medical use. Part 3: Human distribution and physical imaging properties. J Nucl Med. 1977; 18:133.PubMedGoogle Scholar
  4. Barrio JR5 Huang SC, Melega WP, et al. 6-[18F]fluoro-L-dopa probes dopamine turnover rates in central dopaminergic structures. J Neurosci Res. 1990; 27:487.PubMedCrossRefGoogle Scholar
  5. Berman DS, Kiat HS, Van Train KF, et al. Myocardial perfusion imaging with technetium-99m-sestamibi: comparative analysis of imaging protocols. J Nucl Med. 1994; 35:681.PubMedGoogle Scholar
  6. Dilsizian V, Rocco TP, Freedman NMT, et al. Enhanced detection of ischemic but viable myocardium by the reinjection of thallium and stress-redistribution imaging. N Engl J Med. 1990; 323:141.PubMedCrossRefGoogle Scholar
  7. Early PJ, Sodee DB, eds. Principles and Practice of Nuclear Medicine. 2nd ed. St. Louis: Mosby; 1995.Google Scholar
  8. Freeman LM, ed. Freeman and Johnson’s Clinical Radionuclide Imaging. 3rd ed. New York: Grune & Stratton; 1984.Google Scholar
  9. Gallagher BM, Anasri A, Atkins H, et al. Radiopharmaceuticals XXVII. 18F-labeled 2-deoxy-2-fluoro-D-glucose as radiopharmaceutical for measuring regional myocardial glucose metabolism in vivo: tissue distribution and imaging studies in animals. J Nucl Med. 1977; 18:990.PubMedGoogle Scholar
  10. Gould KL, Yoshida K, Hess MJ, et al. Myocardial metabolism of fluorodeoxy-glucose compared to cell membrane integrity for the potassium analogue rubi-dium-82 for assessing infarct size in man by PET. J Nucl Med. 1991; 32:1.PubMedGoogle Scholar
  11. Harbert J, Eckelman WC, Neumann RD, eds. Nuclear Medicine: Diagnosis and Therapy. New York: Thieme Medical; 1996.Google Scholar
  12. Hauser W, Atkins HL, Nelson KG, et al. Technetium-99m-DTPA: a new radiopharmaceutical for brain and kidney imaging. Radiology. 1970; 94:679.PubMedGoogle Scholar
  13. Henkin RE, Boles MA, Dillehay GL, et al., eds. Nuclear Medicine. St Louis: Mosby; 1996.Google Scholar
  14. Higley B, Smith FW, Smith T, et al. Technetium-99m-1,2-bis[bis(2-ethoxyethyl)-phosphino]ethane: human biodistribution, dosimetry and safety of a new myocardial perfusion imaging agent. J Nucl Med. 1993; 34:30.PubMedGoogle Scholar
  15. Johnson LL, Seldin DW. Clinical experience with technetium-99m teboroxime, a neutral, lipophilic myocardial perfusion imaging agent. Am J Cardiol. 1990; 66: 63E.Google Scholar
  16. Kiat H, Bennan DS, Maddahi J, et al. Late reversibility of tomographic myocardial Tl-201 defects: an accurate marker of myocardial viability. J Am Coll Cardiol. 1988; 12(6): 1456.PubMedCrossRefGoogle Scholar
  17. Kuhl DE, Barrio JR, Huang SC, et al. Quantifying local cerebral blood flow by N-isopropyl-p-123I-iodoamphetamine (IMP) tomography. J Nucl Med. 1982; 236:196.Google Scholar
  18. Leveille J, Demonceau G, DeRoo M, et al. Characterization of technetium-99m-L,L-ECD for brain perfusion imaging, Part 2: Biodistribution and brain imaging in humans. J Nucl Med. 1989; 30:1902.PubMedGoogle Scholar
  19. McAfee JG, Grossman ZD, Gagne G, et al. Comparison of renal extraction efficiencies for radioactive agents in the normal dog. J Nucl Med. 1981; 22:333.PubMedGoogle Scholar
  20. Mettler FA Jr, Guiberteau MJ. Essentials of Nuclear Medicine Imaging. 3rd ed. New York: Grune & Stratton; 1991.Google Scholar
  21. Narra RK, Nunn AD, Kuczynski, et al. A neutral technetium-99m complex for myocardial imaging. J Nucl Med. 1989; 30:1830.PubMedGoogle Scholar
  22. Phelps ME, Hoffman EJ, Selin C, et al. Investigation of F-18-fluoro-2-deoxyglucose for the measure of myocardial glucose metabolism. J Nucl Med. 1978; 19:1311.PubMedGoogle Scholar
  23. Saha GB, Go RT, Maclntyre WJ, et al. Use of 82Sr/82Rb generator in clinical PET studies. Nucl Med Biol. 1990; 17:763.Google Scholar
  24. Saha GB, Maclntyre WJ, Brunken RC, et al. Present assessment of myocardial viability by nuclear imaging. Semin Nucl Med. 1996; 26:315.PubMedCrossRefGoogle Scholar
  25. Sandler MP, Coleman RE, Walkers FJT, et al., eds. Diagnostic Nuclear Medicine. 3rd ed. Baltimore: Williams and Wilkins; 1996.Google Scholar
  26. Sapirstein LA, Vigt DG, Mandel MJ, et al. Volumes of distribution and clearances of intravenously injected creatinine in the dog. Am J Physiol. 1955; 181:330.PubMedGoogle Scholar
  27. Schelbert HR, Phelps ME, Huang SC, et al. N-13 ammonia as an indicator of myocardial blood flow. Circulation. 1981; 63:1259.PubMedCrossRefGoogle Scholar
  28. Sharp PF, Smith FW, Gemmell HG, et al. Technetium-99m HMPAO stereoisomers as potential agents for imaging regional cerebral blood flow: human volunteer studies. J Nucl Med. 1986; 27:171.PubMedGoogle Scholar
  29. Sisson JC, Shapiro B, Meyers L, et al. Metaiodobenzylguanidine to map scinti-graphically the adrenergic nervous system in man. J Nucl Med. 1987; 28:1625.PubMedGoogle Scholar
  30. Subramanian G, McAfee JG, Blair RJ, et al. Technetium 99m methylene dipho-sphonate—a superior agent for skeletal imaging; comparison with other technetium complexes. J Nucl Med. 1975; 16:744.PubMedGoogle Scholar
  31. Taylor A Jr, Eshima D, Christian PE, et al. Technetium-99m kit formulation; preliminary results in normal volunteers and patients with renal failure. J Nucl Med. 1988; 29:616.PubMedGoogle Scholar
  32. Taylor A Jr, Eshima D, Fritzberg AR, et al. Comparison of iodine-131 OIH and technetium-99m MAG3 renal imaging in volunteers. J Nucl Med. 1986; 27:795.PubMedGoogle Scholar
  33. Vallabhajosula S, Zimmerman RE, Pickard M, et al. Technetium-99m ECD: a new brain imaging agent. In vivo kinetics and biodistribution studies in normal human studies. J Nucl Med. 1989; 30:599.PubMedGoogle Scholar
  34. Wackers FJT, Berman DS, Maddahi J, et al. Technetium-99m hexakis 2-methoxy-isobutyl isonitrile: human biodistribution, dosimetry, safety and preliminary comparison to thallium-201 for myocardial perfusion imaging. J Nucl Med. 1989; 30:301.PubMedGoogle Scholar
  35. Wagner HN, Jr, Szabo Z, Buchanan JW. Principles of Nuclear Medicine. 2nd ed. Philadelphia: Saunders; 1995.Google Scholar
  36. Weiner RE. The mechanism of 67Ga localization in malignant disease. Nucl Med Biol. 1996; 23:745.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Gopal B. Saha
    • 1
  1. 1.Department of Nuclear MedicineThe Cleveland Clinic FoundationClevelandUSA

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