Molecular Nuclear Medicine: The Challenge of Genomics and Proteomics to Clinical Practice
http://www.100md.com
《新英格兰医药杂志》
During the past decade, the perspectives of nuclear medicine have been totally transformed. This field is no longer only an imaging specialty that provides some functional information; it is progressively acquiring a central role in the understanding of many physiologic and pathological processes, both in research and in routine clinical practice.
This change in the field is related to such advances as the advent of whole-body positron-emission tomographic (PET) scanning and its fusion with computed tomographic (CT) scanning in routine practice, the refinement of existing technology (including the gamma camera and the methods used for uptake measurement), and the development of new radiotracers for both PET scanning and conventional nuclear imaging. In addition, new concepts have emerged in research and in the clinical sciences (including genomics and proteomics) that may have important applications in nuclear medicine. For instance, oncologists can now study specific tumor characteristics and general pathophysiological mechanisms — such as the proliferation rate of tumor cells, angiogenesis, and apoptosis — in vivo. These applications have been facilitated by improvements in imaging technology, but the revolution has come, to a great extent, from outside the field.
The editors of Molecular Nuclear Medicine have brilliantly analyzed this revolution by gathering an impressive set of data on genomics and proteomics and by outlining the implications of these fields for medicine in general. An overview of nuclear medicine is followed by a description of many whole-body imaging procedures and their uses in studying organ systems and tumors. The respective interests of nuclear medicine and other imaging techniques are evaluated in the last part of the book. Clearly, nuclear medicine will soon permit the evaluation of many organ systems and functions with the use of specific new tracers resulting from biologic advances.
The book's emphasis on the potential applications of nuclear medicine hints at the complete transformation that will face this specialty in the near future. Not only will nuclear medicine provide anatomical, diagnostic, and therapeutic data, but it will also contribute to a better understanding of in vivo biologic processes, both under normal conditions and in diseases. Indeed, the authors underline this viewpoint by describing currently accepted models of diseases and their corresponding diagnostic tests — including thyroid diseases and radioiodine, endocrine tumors and somatostatin analogues, and cardiac diseases and viability tracers (such as thallium).
These changes in the field will have far-reaching consequences, both for the specialty and for the education of future specialists. Nuclear medicine teams will probably be expanded to include clinicians, biologists, researchers, and radiopharmacists, in addition to traditional specialists and radiologists. This will mean that the aims of nuclear medicine studies will have to be radically modified and the number of specialists on each multidisciplinary team dramatically increased. All these specialists will help to define new objectives for the field and work with other clinical and research teams.
In conclusion, this book is a comprehensive survey of nuclear medicine today and points to developments that are likely to emerge in the near future. It should be carefully read by all specialists and researchers in nuclear medicine and by clinicians in other fields who may find in it new fields of research or applications of their own discoveries or a way to solve clinical problems. What is more, decision makers will benefit from learning about the potential of this specialty and its future role in clinical medicine and biology.
Martin Schlumberger, M.D.
Institut Gustave Roussy
94805 Villejuif, France
schlumbg@igr.fr(Edited by Ludwig E. Feine)
This change in the field is related to such advances as the advent of whole-body positron-emission tomographic (PET) scanning and its fusion with computed tomographic (CT) scanning in routine practice, the refinement of existing technology (including the gamma camera and the methods used for uptake measurement), and the development of new radiotracers for both PET scanning and conventional nuclear imaging. In addition, new concepts have emerged in research and in the clinical sciences (including genomics and proteomics) that may have important applications in nuclear medicine. For instance, oncologists can now study specific tumor characteristics and general pathophysiological mechanisms — such as the proliferation rate of tumor cells, angiogenesis, and apoptosis — in vivo. These applications have been facilitated by improvements in imaging technology, but the revolution has come, to a great extent, from outside the field.
The editors of Molecular Nuclear Medicine have brilliantly analyzed this revolution by gathering an impressive set of data on genomics and proteomics and by outlining the implications of these fields for medicine in general. An overview of nuclear medicine is followed by a description of many whole-body imaging procedures and their uses in studying organ systems and tumors. The respective interests of nuclear medicine and other imaging techniques are evaluated in the last part of the book. Clearly, nuclear medicine will soon permit the evaluation of many organ systems and functions with the use of specific new tracers resulting from biologic advances.
The book's emphasis on the potential applications of nuclear medicine hints at the complete transformation that will face this specialty in the near future. Not only will nuclear medicine provide anatomical, diagnostic, and therapeutic data, but it will also contribute to a better understanding of in vivo biologic processes, both under normal conditions and in diseases. Indeed, the authors underline this viewpoint by describing currently accepted models of diseases and their corresponding diagnostic tests — including thyroid diseases and radioiodine, endocrine tumors and somatostatin analogues, and cardiac diseases and viability tracers (such as thallium).
These changes in the field will have far-reaching consequences, both for the specialty and for the education of future specialists. Nuclear medicine teams will probably be expanded to include clinicians, biologists, researchers, and radiopharmacists, in addition to traditional specialists and radiologists. This will mean that the aims of nuclear medicine studies will have to be radically modified and the number of specialists on each multidisciplinary team dramatically increased. All these specialists will help to define new objectives for the field and work with other clinical and research teams.
In conclusion, this book is a comprehensive survey of nuclear medicine today and points to developments that are likely to emerge in the near future. It should be carefully read by all specialists and researchers in nuclear medicine and by clinicians in other fields who may find in it new fields of research or applications of their own discoveries or a way to solve clinical problems. What is more, decision makers will benefit from learning about the potential of this specialty and its future role in clinical medicine and biology.
Martin Schlumberger, M.D.
Institut Gustave Roussy
94805 Villejuif, France
schlumbg@igr.fr(Edited by Ludwig E. Feine)