Diagnosis and treatment of neoplasms with radionuclide-labeled antibodies

The in vivo use of radionuclide-labeled antibodies to several types of tumor-associated antigens or products has proven to be a reliable method for defining primary, recurrent, metastatic, and occult carcinoma. Specificity for the radioimmunodetection procedure is high; however, the sensitivity varies depending on the size and site of the lesions. The relative roles of polyclonal- and monoclonal-type antibodies are still to be defined, since at this stage of development little difference can be demonstrated in the detection of tumor with either one. The introduction of emission computed tomography should simplify the imaging techniques appreciably and improve the resolution between nontarget and target radioactivity. Satisfactory radionuclide labels with photon energies more compatible with current imaging equipment will enhance resolution and sensitivity.     

Anatomic correlations in radiogallium imaging of the peritoneum and retroperitoneum

Radiogallium (67Ga) imaging of the abdomen and pelvis has been useful not only in detecting inflammations in these regions, but in pointing out their precise anatomic localization. Once the anatomic site is determined, it is often possible to infer the source of origin of the problem (such as ruptured viscus or pancreatitis). Interpretation of the images depends on recognition of patterns that define known anatomic boundaries such as the transverse mesocolon, root of the small mesentery, perirenal space, and pararenal space, or else show diffuse peritoneal uptake. The anatomic patterns may have continued usefulness in future studies, such as when radiolabeled leukocytes are employed to localize inflammations.     

Clinical nuclear magnetic resonance imaging of the body

NMR promises great advances in diagnosis and has delivered so much already that it is expected that in the future it will replace many applications of the currently used imaging modalities. Although x-ray computed tomography is continuing to advance in speed of scanning and resolving power, NMR will most likely soon eliminate its use in many studies of the central nervous system and also in many other areas of the body. The promise of combining topical spectroscopy with imaging is also exciting and should provide further information about metabolic processes of various organs. Progress in NMR is so rapid and the future is so bright that one of the great problems will be to develop a new breed of radiologists who are versatile in biochemistry, mathematics, and computers, as well as competent in morphologic anatomy and pathologic physiology. As time goes on, advances in NMR will be achieved only by teams of clinical and basic scientists encompassing multiple disciplines.