Nuclear medicine physicians, also callednuclearradiologists or simply nucleologists,[1][2] aremedical specialists that use tracers, usuallyradiopharmaceuticals, for diagnosis and therapy.Nuclear medicine procedures are the major clinical applications ofmolecular imaging and molecular therapy.[3][4][5] In the United States, nuclear medicine physicians are certified by theAmerican Board of Nuclear Medicine and theAmerican Osteopathic Board of Nuclear Medicine.
In 1896,Henri Becquerel discoveredradioactivity.[6] It was only a little over a quarter of a century (1925) until the first radioactive tracer study in animals was performed byGeorge de Hevesy, and the next year (1926) the first diagnostic tracer study inhumans was performed by Herman Blumgart and Otto Yens.[7]
Some of the earliest applications of radioisotopes were therapy of hematologic malignancies and therapy of both benign and malignant thyroid disease. In the 1950sradioimmunoassay was developed bySolomon Berson andRosalyn Yalow. Dr. Yalow was co-winner of the 1977 Nobel Prize in Physiology or Medicine (Dr. Berson had already died so was not eligible). Radioimmunoassay was used extensively in clinical medicine but more recently has been largely replaced by non-radioactive methods.
In 1950, human imaging of bothgamma andpositron emittingradioisotopes was performed.Benedict Cassen's work with a directional probe lead to the development of the first imaging with arectilinear scanner.[8] Gordon Brownell developed the firstpositron scanner.[9] In the same decade (1954) theSociety of Nuclear Medicine (SNM) was organized in Spokane, Washington (US),[10] and (1958)Hal Anger developed thegamma scintillation camera,[11] which could image a whole region at the same time.
Initial introduction of radioisotopes into medicine required individuals to acquire of a considerable background information which was foreign to their medical training. Often a particular application drove the introduction of radioisotopes into a health care facility. As other applications developed the physician or group that had developed knowledge of and experience with radioisotopes usually provided the new service. Consequently, the radioisotope service found homes in several established specialties – commonly in radiology due to an interest in imaging, in pathology (clinical pathology) due to an interest in radioimmunoassay, and in endocrinology due to the early application of131I to thyroid disease.[12]
Nuclear medicine became widespread and there was a need to develop a new specialty. In the United States, theAmerican Board of Nuclear Medicine was formed in 1972.[13] At that time, the specialty include all of the uses of radioisotopes in medicine – radioimmunoassay, diagnostic imaging, and therapy. As use of and experience with radioisotopes became more widespread in medicine, radioimmunoassay generally transferred from nuclear medicine to clinical pathology. Today, nuclear medicine is based on the use of thetracer principle applied to diagnostic imaging and therapy.
 | This articleis inlist format but may read better asprose. You can help byconverting this article, if appropriate.Editing help is available.(January 2011) |
| This articleis inlist format but may read better asprose. You can help byconverting this article, if appropriate.Editing help is available.(January 2011) |
![[icon]](/mt/?noimg=&dark=on&url=https%3a%2f%2fen.wikipedia.org%2fwiki%2fFile%3aWiki_letter_w_cropped.svg) | This sectionneeds expansion. You can help byadding to it.(January 2011) |
In the United States, theAccreditation Council for Graduate Medical Education (ACGME) and theAmerican Osteopathic Association Bureau of Osteopathic Specialists (AOABOS) accredit nuclear medicine residency programs, and theAmerican Board of Nuclear Medicine (ABNM) and theAmerican Osteopathic Board of Nuclear Medicine (AOBNM) certify nuclear medicine physicians. After completingmedical school, a post-graduateclinical year is followed by three years of nuclear medicineresidency. A common alternate path for physicians who have completed a radiology residency is a one-year residency in nuclear medicine, leading to sub-specialty certification by the American Board of Radiology. A less common path for physicians who have completed another residency is a two-year residency in nuclear medicine.[15]
| This sectionneeds expansion. You can help byadding to it.(January 2011) |
Nuclear medicine procedures are performed byNuclear Medicine Radiographers,[16] who require extensive training both in underlying principles (physics, instrumentation) but also in the clinical applications.Nursing support, especially in the hospital setting, is valuable, but may be shared with other services. Nuclear medicine is a technology embedded specialty depending upon a large number of non-physician professional, includingmedical physicists,health physicists,radiobiologists,radiochemists, andradiopharmacists.
Residency trained nuclear medicine physicians have the most extensive training and highest level of certification, including all aspects of diagnosis and radionuclide therapy. However, current U.S. regulations do not prohibit other physicians from interpreting nuclear medicine studies and perform radionuclide therapy.Radiologists who are not sub-specialty trained in the specialty, nonetheless often limit their practice to practicing nuclear medicine. Somecardiologists, especially non-invasive cardiologists, will interpret diagnostic cardiology studies including nuclear medicine studies.Radiation oncologists perform all forms of radiation therapy, sometimes including radionuclide therapy. Someendocrinologists treat hyperthyroidism and thyroid cancer with131I. The mix of physicians rendering nuclear medicine services varies both between different countries and within a single country.
| International | |
|---|---|
| Other | |
