This volume is based upon presentations made to the 4th European Symposium on Radiopharmacology which was held under the auspices of the European Joint Committee on Radiopharma ceuticals (ENMS / SNME) in Athens from March 28 - 31, 1984. The Medical Insurance Foundation of the National Bank of Greece (TYPET) sponsored this meeting and the Joint Committee would like to express their gratitude to the local organising committee: G. Limouris, M. Pierroutsakou, A. Sarris, A. Tzoulis and C. Binas. A word of thanks also to Mrs. Tineke Busker who prepared the camera ready copy. The meeting reflects the continuing and growing interest in biodistribution and factors which can influence bio distribution in the clinical situation. The choice of sub jects, respiration, cerebral function, biodistribution and metabolism complement earlier volumes in this series and reflect European interests in these areas. P.H. Cox Rotterdam, April 1985 VII CONTENTS Foreword P.H. Cox v Contributors XI I. THE RESPIRATORY SYSTEM Physiology and pathophysiology of the respiratory system J. Roth, E. Henze, W.E. Adam 3 Generator-produced Krypton-81m in gas and liquid phases for medical applications M. Guillaume, N. Garzaniti, H. Zicot, T. Khuc, P. Bartsch 23 Noble radionuclides for lung ventila tion studies I. Bofilias 49 Radioaerosols in nuclear medicine M. Pillay, B. Shapiro, P.H. Cox 57 99m A dry aerosol of Tc -albuminmilli micro spheres for lung ventilation scintigraphy: preparation, inhalation apparatus and examples of clinical results P. Angelberger, I. Zolle, A. Strigl, H. Kahn, A. Mostbeck, W.

This book is a compilation of the invited papers, which were presented at the Fourth European Symposium on Radiopharmacy and Radiopharmaceuticals, which was held in Baden, Switz- land, 1-4 May, 1991. The First and Third Symposia on Radiopharmacy and Radiopharmaceuticals (Elsinore, Denmark, 1983, 1987) concentrated on the safety and efficacy of radiopharmaceuticals, whereas this Fourth Symposium to some extent followed up the subject of the Second Symposium (Cambridge, UK, 1985): recent developments in radiopharmacy and current research on radiopharmaceuticals. The symposium was organized by the Radiopharmacy Group of the Swiss Society of Medical Radiology (Section Nuclear Medicine) under the auspices of the task group on radiopharmaceu- cals of the European Association of Nuclear Medicine (EANM). The organizing committee consisted of the cochairmen Drs. P.A. Schubiger (Paul Scherrer Institute (PSI), Villigen) and G. Westera (University Hospital, ZiJrich) and the members H.-F. Beer, P. Bl~iuenstein, P. Hasler (all PSI) and H. M~icke (Cantonal Hospital, Basel). The subjects of this Symposium ranged from isotope production to clinical testing of radioph- maceuticals, including the organisational prerequisites. In addition, the development of new radiopharmaceuticals and of PET radiopharmacy, and the concomittant ongoing evolution of regulatory guidelines by national (various European countries, USA) and international (EC) authorities, induced us to honor the vivid interest in this subject and to make it an important part of this symposium.

First multi-year cumulation covers six years: 1965-70.

The contents of this volume are based upon presentations made to the Second European Symposium on Radiopharmacy and Radiopharmaceuticals which was held in St. Catharine's College Cambridge in March 1985. This meeting was organized by the Radiopharmacy Group of the British Nuclear Medicine Society under the auspices of the European Joint Committee on Radio pharmaceuticals of the ENMS / SNME. The Joint Committee acknowledges the special effort which was made by the local organizers to prepare this meeting the quality of which is undoubtedly reflected in the proceedings. The wide ranging aspects of Radiopharmacy are reflected in this volume which not only deals with specialized topics, such as aerosols and biodistribution studies, but which also deals with the professional aspects of Radiopharmacy Practice. We are of the opinion that this book complements earlier publications to give an ongoing picture of the practice of Radiopharmacy and the state of the art in Europe. As well as acknowledging the contribution of the British Radiopharmacists I would also mention the support of my co chairman Prof. Dr M.G. Woldring, the members of the Joint Committee and last but not least Mrs. M. Busker, who prepared the camera ready copy. P.H. Cox Co-ordinating Chairman European Joint Committee on Radiopharmaceuticals Rotterdam XI CCNrRIBUTORS Anderson, M.L. - Pharnacy department, London Hospital London, UK. Angelberger, P. - Osterreichische Forschungszentrum Seibersdorf GmbH, Wien, Austria. Claessens, R.A.M.J. - Department of Nuclear Medicine, St. Radboud Ziekenhuis, Nijrnegen, The Netherlands.

Among the readily available -emitting radionuclides, the nuclides of iodine have the greatest versatility in labeling both the hydrophilic and the lipophilic compounds that are used in biology and medicine. Biologically important micrmolecules, semimacromolecules, and macromolecules have been identified which, after iodination, almost maintain the same molecular configuration and similar biologic specificity as those of the parent molecules. The multiple techniques for iodination and the clinical use of iodinated products have made possible the present status of the development of diagnostic nuclear medicine. 125r, with a half-life of 60 days, has a crucial role in competitive protein-binding studies. 131r is useful for measuring thyroid uptake, for the diagnosis of thyroid carcinoma and metastasis, and for therapy. 1nr , with a reasonably shorter half-life, is almost ideal for thyroid workup and for a few useful labeled radiopharmaceutical. Although ~c is used more widely in diagnostic procedures, the radionuclides of iodine will always have a major role in biology and medicine. A considerable amount of information is scattered in the literature regarding the chemistry of radioiodination and the mechanism of tracer localization in cells and tissues. Labeled peptides, proteins, and antibodies are extensively used for protein turnover studies, receptor binding and tumor imaging studies, and radioimmunoassay. The general trend in the use of tracers in clinical nuclear medicine has been an evolution from 3H, 14C, 11C, and 13 to 125 , 131 and 123r to ~c and 111rn.

This second edition now includes practical information on drug enhancement of nuclear medicine studies; radiopharmaceuticals as therapeutic agents; pharmacokinetics and a section on current radiopharmaceutical research. This book begins with the basic scientific principles of radiation physics, generator systems and preparation of radiopharmaceuticals. It deals with methods of localization of radiopharmaceuticals such as lung deposition, ion exchange, membrane transportation, phagocytosis and pinocytosis. The important role of radiolabelling blood components is reviewed. The latest information on factors affecting biodistribution, adverse and unusual reactions, the integrity of radiopharmaceuticals and dosimetry is also included. There is also a section on new radiopharmaceuticals. The final chapter on paediatric radiopharmacy deals with the preparation of doses for children, methods of calculating doses and documentation.