PET Imaging Leaps Forward

PET Imaging Leaps Forward

This piece was originally published in the December 2017 issue of electroindustry.

Walter Smith, Director of Nuclear Products Marketing, Lantheus Medical Imaging, Joel Lazewatsky, PhD, Director of Clinical Imaging Lantheus Medical Imaging

Since the discovery of positron-emitting radionuclides, their use for medical imaging has seen a series of clinical and technical advancements. Today, many nuclear medicine and molecular imaging scientists and physicians believe that positron emission tomography (PET) is making another leap forward.

Technological Past

Our understanding of positron-emitting nuclides began with their discovery in the 1920s and continued with major advancements into the 1940s. In 1934, phosphorus-30 was first produced artificially; soon after, the first patent for the cyclotron was issued. These events paved the way for the development of carbon-11, nitrogen-13, oxygen-15, fluorine-18, gallium-68, and other radionuclides.

From the 1940s through the 1960s, positron-based imaging research advanced as these short-lived radionuclides increased our understanding of human biological and physiological processes. In the early 1950s, the first sodium iodide rectilinear scanner was developed and clinical neurologic positron imaging was introduced. The first true PET imager emerged in 1961, with multi-detector PET introduced in 1968.

In 1975, major improvements in PET scanner technology, including circular geometry and attenuation correction, advanced the field. In parallel, nuclear scientists successfully labeled a glucose analog with fluorine-18, and 18F-fluorodeoxyglucose (FDG) molecular imaging was born. Broad use of 18FDG imaging remains a mainstay of cancer diagnosis and a critical adjunct to treatment to this day.

Personalized Future

In the 1980s and 1990s, PET imaging continued to advance with the introduction of rubidium-82 and nitrogen-13 ammonia for myocardial perfusion imaging, while the fusion of PET and computed tomography (CT) was named the medical invention of the year by Time magazine in 2000.

In 2012, the Food and Drug Administration (FDA) approved florbetapir F 18 for neurologic imaging and C 11 choline was approved for prostate imaging. Since then, two additional PET neurologic imaging agents have received FDA approval. In 2016, the FDA approved fluciclovine F 18 for prostate imaging and gallium-68 dotatate for neuroendocrine tumor imaging.

With a focus toward personalized medicine, molecular imaging and theranostics (i.e., the combination of diagnostics and therapy) is moving toward the forefront of medicine.

The exciting research with PET nuclides gallium-68, lutetium-177, and copper-64, as well as the continued expansion of PET/CT and the introduction of PET with magnetic resonance (MR) imaging, has led many nuclear medicine and molecular imaging scientists and physicians to believe that PET is again poised for a leap forward.

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