Guest Editorial

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Science and technology generally progress in a series of incremental advances. In his seminal work, The Structure of Scientific Revolutions,¹ the noted scientific philosopher Thomas Kuhn aptly characterized such incremental progress as “normal science.” The normal science of nuclear medicine may be illustrated, for example, by the introduction of technetium-99m as a diagnostic radionuclide and the replacement of the analog gamma camera with its digital counterpart. Occasionally, however, a dramatic advance fundamentally and permanently alters the scientific landscape, propelling a particular discipline forward in a qualitatively new direction. In the context of nuclear medicine, the introduction of “hardware” multimodality imaging—positron emission tomography/computed tomography (PET/CT), single-photon emission computed tomography (SPECT)/CT, and now PET/magnetic resonance imaging (MRI)—represents such a paradigm shift. Within a few short years, for example, the PET/CT scanner has displaced almost entirely the PET-only scanner in the nuclear medicine marketplace and in clinical practice.

The series of articles in this issue of Seminars in Nuclear Medicine, by some of the leading authorities in the world in their respective fields, provides excellent technical summaries offering a rather unique perspective—that of the innovators themselves—on the history, current status, and future direction of PET/CT, 4D PET/CT, SPECT/CT, PET/MRI, and preclinical molecular imaging. Importantly, these articles provide not only a broad historic context for their respective subjects, but also practical guidance on issues confronting today’s practitioner. Townsend, for example, discusses the impact of accurate co-registration of PET and CT images on cardiac perfusion studies, radiotracer uptake measurements in tumors, radiation dosimetry for planning of radionuclide therapy, and monitoring therapeutic response. Nehmeh and Erdi describe a number of currently marketed products and clinically practical techniques for correction of respiratory motion in PET/CT. Seo and colleagues discuss newly marketed SPECT/CT systems incorporating innovative detector designs for high-throughput cardiac imaging (with acquisition times as short as two minutes). For the preclinical investigator, Rowland and Cherry discuss a number of very practical methodologic considerations impacting the clinical translatability of small-animal imaging. Even in the area of PET/MRI, which some may consider impractical at the moment, Pichler and his coauthors present the first images obtained with a clinical PET/MRI brain scanner developed by one of our leading manufacturers of medical imaging equipment.

In providing the perspective of some of the leading innovators in the world, this issue of Seminars truly represents the living history of nuclear medicine, what Kuhn might have characterized as its latest “scientific revolution.”

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Reference 

1. Kuhn TS. The Structure of Scientific Revolutions. Chicago, IL: University of Chicago Press; 1962;
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