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.

Nearly 20 million nuclear medicine procedures are carried out each year in the United States alone to diagnose and treat cancers, cardiovascular disease, and certain neurological disorders. Many of the advancements in nuclear medicine have been the result of research investments made during the past 50 years where these procedures are now a routine part of clinical care. Although nuclear medicine plays an important role in biomedical research and disease management, its promise is only beginning to be realized. Advancing Nuclear Medicine Through Innovation highlights the exciting emerging opportunities in nuclear medicine, which include assessing the efficacy of new drugs in development, individualizing treatment to the patient, and understanding the biology of human diseases. Health care and pharmaceutical professionals will be most interested in this book's examination of the challenges the field faces and its recommendations for ways to reduce these impediments.

This book is a comprehensive guide to radiopharmaceutical chemistry. The stunning clinical successes of nuclear imaging and targeted radiotherapy have resulted in rapid growth in the field of radiopharmaceutical chemistry, an essential component of nuclear medicine and radiology. However, at this point, interest in the field outpaces the academic and educational infrastructure needed to train radiopharmaceutical chemists. For example, the vast majority of texts that address radiopharmaceutical chemistry do so only peripherally, focusing instead on nuclear chemistry (i.e. nuclear reactions in reactors), heavy element radiochemistry (i.e. the decomposition of radioactive waste), or solely on the clinical applications of radiopharmaceuticals (e.g. the use of PET tracers in oncology). This text fills that gap by focusing on the chemistry of radiopharmaceuticals, with key coverage of how that knowledge translates to the development of diagnostic and therapeutic radiopharmaceuticals for the clinic. The text is divided into three overarching sections: First Principles, Radiochemistry, and Special Topics. The first is a general overview covering fundamental and broad issues like “The Production of Radionuclides” and “Basics of Radiochemistry”. The second section is the main focus of the book. In this section, each chapter’s author will delve much deeper into the subject matter, covering both well established and state-of-the-art techniques in radiopharmaceutical chemistry. This section will be divided according to radionuclide and will include chapters on radiolabeling methods using all of the common nuclides employed in radiopharmaceuticals, including four chapters on the ubiquitously used fluorine-18 and a “Best of the Rest” chapter to cover emerging radionuclides. Finally, the third section of the book is dedicated to special topics with important information for radiochemists, including “Bioconjugation Methods,” “Click Chemistry in Radiochemistry”, and “Radiochemical Instrumentation.” This is an ideal educational guide for nuclear medicine physicians, radiologists, and radiopharmaceutical chemists, as well as residents and trainees in all of these areas.

The publication of this volume, which is based upon presentations made to the Third European Symposium on Radiopharmacology at Noordwijkerhout, April 22 - 24, 1982, is indicative of the continued interest in this sub-branch of Nuclear Medicine. The transactions of the first two meetings were published as Progress in Radiopharmacology, Volumes 1 and 2 by Elsevier/North-Holland Bio medical Press. We are particularly pleased to have reached an agreement with Martinus Nijhoff Publishers to include Progress in Radiopharmacology 3 in the series Developments in Nuclear Medicine. This not only ensures the continuity of the series but by including it in a series of Nuclear Medical Monographs the availability of the text to more general readers, for background information, is greatly enhanced. As with the previous two volumes each of the three topics has been so treated as to relate the biodistribution of the radiopharmaceuticals to normal and pathophysiological conditions to provide background information for the practising nuclear medical specialist. Special attention has been given to European activities but these have been clearly placed in context in relation to developments from outside Europe. The Third European Symposium on Radiopharmacology was held under the auspices of the European Joint Commitee on Radiopharmaceuticals of the European Nuclear Medicine Society and the Society of Nuclear Medicine Europe. Solco Nuclear, Basle, provided both financial and material support and I would like to thank Dr M. de Schrijver, Mr. I. Waser and Mrs. E. Rufenacht for their continued help and encouragement.

The decay product of the medical isotope molybdenum-99 (Mo-99), technetium-99m (Tc-99m), and associated medical isotopes iodine-131 (I-131) and xenon-133 (Xe-133) are used worldwide for medical diagnostic imaging or therapy. The United States consumes about half of the world's supply of Mo-99, but there has been no domestic (i.e., U.S.-based) production of this isotope since the late 1980s. The United States imports Mo-99 for domestic use from Australia, Canada, Europe, and South Africa. Mo-99 and Tc-99m cannot be stockpiled for use because of their short half-lives. Consequently, they must be routinely produced and delivered to medical imaging centers. Almost all Mo-99 for medical use is produced by irradiating highly enriched uranium (HEU) targets in research reactors, several of which are over 50 years old and are approaching the end of their operating lives. Unanticipated and extended shutdowns of some of these old reactors have resulted in severe Mo-99 supply shortages in the United States and other countries. Some of these shortages have disrupted the delivery of medical care. Molybdenum-99 for Medical Imaging examines the production and utilization of Mo-99 and associated medical isotopes, and provides recommendations for medical use.

A comprehensive, authoritative and up-to-date reference for the newcomer to radiopharmaceuticals and those already in the field. Radiopharmaceuticals are used to detect and characterise disease processes, or normal biological function, in living cells, animals or humans. Used as tracer molecules, they map the distribution, uptake and metabolism of the molecule in clinical studies, basic research or applied research. The area of radiopharmaceuticals is expanding rapidly. The number of PET centers in the world is increasing at 20% per year, and many drug companies are utilising PET and other forms of radiopharmaceutical imaging to evaluate products. * Readers will find coverage on a number of important topics such as radionuclide production, PET and drug development, and regulations * Explains how to use radiopharmaceuticals for the diagnosis and therapy of cancer and other diseases * The editors and a majority of the contributors are from the United States

Radioimmunotherapy, also known as systemic targeted radiation therapy, uses antibodies, antibody fragments, or compounds as carriers to guide radiation to the targets. It is a topic rapidly increasing in importance and success in treatment of cancer patients. This book represents a comprehensive amalgamation of the radiation physics, chemistry, radiobiology, tumor models, and clinical data for targeted radionuclide therapy. It outlines the current challenges and provides a glimpse at future directions. With significant advances in cell biology and molecular engineering, many targeting constructs are now available that will safely deliver these highly cytotoxic radionuclides in a targeted fashion. A companion website includes the full text and an image bank.