Letter from the Editors

Article Outline

• Copyright

During the past three and a half decades that Seminars in Nuclear Medicine has been in publication, we have always striven to provide a balanced presentation of the “old” and the “new.” While many of the exciting new developments, particularly positron emission tomography/computed tomography (PET/CT), are of enormous interest to everyone, we cannot lose sight of the many important established techniques that constitute what we do in the everyday practice of nuclear medicine. Many of these older “bread & butter” procedures have, themselves, witnessed significant evolution in their methods of performance and interpretation. The subject of this issue—the gastrointestinal (GI) tract—certainly is an area where the continued upgrading of existing procedures has been greatly supplemented and, in many cases, replaced by PET/CT methodology.

We are indebted to Drs. Todd Blodgett, Barry McCook, and Michael Federle, who are body imagers at the University of Pittsburgh. It is important to note that the PET/CT concept originated at this medical center through the innovative work of Dr. David Townsend and his colleagues. One of us (L.M.F.) has heard Dr. Federle on more than one occasion speak of how PET scanning has “humbled him” and his fellow body imagers because of its ability to detect lesions that may not be recognized on CT studies. These same lesions are often seen retrospectively following their detection on PET. The nuclear medicine physician now is confronted with the new and important task of dealing with issues relating to a combined radionuclide and radiographic study. Dr. Blodgett and his colleagues discuss the several critical areas relating to how various protocol issues and options concerning the combined procedures may best be handled.

The diagnostic aspects of PET/CT in the GI tract are nicely discussed by Drs. Esteves, Schuster, and Halkar from Emory University. Most of the early success has been achieved with ¹⁸F-fluorodeoxyglucose (FDG) for colon and esophageal tumors. However, in other areas such as gastric, stromal, and pancreatic neoplasms, staging assistance and prognostic information appear to be provided by the exam.

The other more conventional areas of radionuclide usage in the GI tract are updated by several experienced colleagues. Drs. Alan Maurer and Henry Parkman review upper GI function studies and add the concept of “whole-gut transit scintigraphy” as it relates to specific symptomatology, such as dyspepsia and constipation.

The problem of functional hepatobiliary disease, particularly gallbladder and biliary dyskinesia, remains a difficult area of clinical diagnosis. Dr. Harvey Ziessman of John Hopkins shares with us his considerable experience with pharmacologic interventions in hepatobiliary scintigraphy. This has proven to be a key element in diagnosing chronic acalculous gallbladder disease.

We are pleased to include some exciting new work on peptide receptor therapy of advanced gastrointestinal and pancreatic neuroendocrine tumors being performed by Drs. Valkema and Krenning and their associates in Rotterdam, the Netherlands. The early objective response of their therapy, although modest, still appears encouraging. Continued work in this important area is planned.

An excellent article on GI bleeding by Australia’s Dr. Doug Howarth is also highlighted in this issue.

We had planned to include a review of abdominal infection imaging with ^99mTc-fanelesomab (NeutroSpec™) by Drs. Chris Palestro and Charito Love to complete the issue. Unfortunately, some recent adverse drug reactions using this antibody have created great concern and the FDA has removed it from the market. We are holding the article pending resolution of the fate of this agent. Dr. Palestro’s group has had extensive experience with it. If the problem is resolved we will include it in a later issue of Seminars. Nonetheless, we would like to thank Dr. Palestro and his group for their efforts on behalf of the journal. The article represented a great deal of time and effort, but we all agreed that it would be inappropriate to publish it at this time.

One final note. After many years of publication, we will be making a significant change commencing January 2007. Because of the accelerating growth in radionuclide methodology and clinical usage, we will begin a new publication schedule as a bimonthly rather than a quarterly publication. Also, it is worth mentioning that although we have only been a quarterly journal, Seminars has the highest impact factor among all imaging journals. We can only hope that as a bimonthly this impact factor will be even higher. We trust that it will be enjoyed by all.