Letter from the Editors

Article Outline

• Copyright

It became apparent early in the history of radionuclide imaging that the use of a variety of physiologic and pharmacologic interventions could provide important functional information. These data can greatly assist patient management decisions. Relatively early in the publication of Seminars in Nuclear Medicine, a well known colleague, James Thrall, suggested that we consider devoting one or two issues to this important subject. This was done in the April and July 1981 issues (Vol. XI, Nos. 2 and 3) before most investigators realized the great importance of interventional nuclear medicine.

The use of TSH to test thyroid functional reserve was one of the earliest interventions, along with stress testing during myocardial perfusion imaging. It became increasingly evident from these early studies that normal resting values of diagnostic studies may be observed even when significant disease is present. Subsequently, pharmacologic interventions have proven their worth in studying altered physiology and function in several other organs and organ systems. The articles in this issue were selected to highlight areas of currently important interventions.

Dr. George Sfakianakis and his colleagues at the University of Miami have been strong advocates of renal diuretic protocols for many years. They summarize their 17-year experience using furosemide-enhanced MAG₃ scintigraphy to provide both diagnostic and prognostic information concerning drainage and parenchymal function in a variety of congenital and acquired kidney disorders.

In assessing biliary tract disease, the use of morphine and cholecystokinin in adults as well as phenobarbital in neonates has proven useful. Dr. Harvey Zeissman shares with us his experience in using these drugs to study acute and chronic cholecystitis, biliary obstruction, sphincter of Oddi dysfunction, and biliary atresia.

Other excellent reviews included in this issue are motility studies of the gastrointestinal tract, vasodilator pharmacologic myocardial perfusion studies, and pharmacologic interventions for measurement of cerebral metabolism. Assimilating the information provided in each of these well-presented articles should help the reader increase his or her diagnostic accuracy in evaluating each of these organs and their associated diseases.

The use of nuclear medicine methodology to serially monitor the results of a variety of therapeutic interventions has always been considered one of our greatest potential strengths. Two previous issues of Seminars (January 1995 and July 2001) were devoted to reviewing this subject. With the enormous current interest and popularity of positron emission tomography (PET)/computed tomography, it is timely to examine how this powerful modality continues the ongoing tradition of nuclear medicine in fulfilling this important clinical function. Dr. Ken Herrmann and his Munich colleagues working under the direction of the very experienced Markus Schwaiger provide us with a powerful review of the role of ¹⁸F-fluorodeoxyglucose–PET in monitoring the response to therapeutic interventions in clinical oncology.

We are grateful to our colleagues for sharing their extensive experience and knowledge with us in this most important area of nuclear medicine practice.