Radiopharmaceuticals for nuclear endocrinology at the University of Michigan.

The historical background at the University of Michigan laid a foundation for the innovative development of radionuclides in diagnosis and treatment of endocrine diseases. From that background, Dr. William Beierwaltes, the chief of Nuclear Medicine, inspired two talented young chemists to synthesize unique radiopharmaceuticals that transformed diagnostic approaches to certain endocrine disorders. Dr. Raymond Counsell's 131-I-radiocholesterol, enabled imaging that defined function in the adrenal cortex, and thereby distinguished the different forms of Cushing's syndrome and of primary aldosteronism; in addition, this new technique differentiated benign adrenal cortical adenomas from other adrenal cortical tumors. Dr. Donald Wieland created metaiodobenzlylguanidine (MIBG), a compound that can be tagged with either 131-I or 123-I, and led to the scintigraphic depiction of adrenergic tumors, particularly pheochromocytomas and neuroblastoma, anywhere in the body of a patient. Treatments with large doses of MIBG have reduced the malignant forms of pheochromocytomas and brought remissions to children with neuroblastomas. MIBG also concentrated in the autonomic neurons and so the nerves of the heart were also portrayed. Subsequent novel syntheses included positron-emitting nuclides that, through positron emission tomography, have revealed the physiology and altered physiology of the human heart. These men and their discoveries exemplify the creative endeavors that compel us to seek further the wonders of nuclear science.

[Present status and progress of endocrine nuclear medicine].

The author reviewed present status and progress of endocrine nuclear medicine including thyroid, parathyroid, adrenocortical, adrenomedullary and somatostatin receptor imaging and also radionuclide therapy of Basedow's disease, metastatic foci of post-operative thyroid cancer and malignant neural crest tumor. Relatively new imaging agents include 99mTc-MIBI and 99mTc-tetrofosmin for parathyroid imaging and 111In-pentetreotide for somatostatin receptor imaging. It is hoped that therapy of malignant neural crest tumors such as metastatic pheochromocytoma and neuroblastoma with 131I-MIBG and somatostatin receptor imaging will be available in Japan as soon as possible.

[Radiotherapy of benign non-tumorous diseases from the viewpoint of the Hospital for Oncology (Charité): experiences, possibilities and limitations]. / Zur Strahlentherapie gutartiger nichttumoröser Erkrankungen aus der Sicht der Klinik für Onkologie (Charité): Erfahrungen, Möglichkeiten und Grenzen.

With the development of the state of medical knowledge in the special subjects and the increase of medicamentous and physiotherapeutic possibilities the indications of radiotherapy of benign nontumourous diseases changed. The application of radiotherapy altogether decreased in benign diseases. In tabular form the basic rules radiation technique of benign diseases, the indications and possibilities as well as the contraindications of the radiotherapy of benign non-tumourous diseases are described. Own experiences and evaluations confirm that the radiotherapy, for instance in acute parotitis, axillary hidradenitis, degenerative changes of the skeleton, kelloid revisions or chronic pancreatitis is an effective, rapidly acting and economic form of therapy. The knowledge about the possibilities and limits of the radiotherapy of benign non-tumourous diseases belongs to the speciality of internal medicine.

[Radiation treatment of benign diseases--indications, results and technic]. / Die Strahlenbehandlung gutartiger Erkrankungen--Indikationen, Ergebnisse und Technik.

Radiotherapy is an effective means to treat several benign diseases; in fact, the therapeutic effects set in quickly and are of a long-term nature. Relapses are rare. Side effects or other undesirable reactions are negligible. The gonads are under risk that should not be underestimated, but this is usually acceptable within reasonable limits. The age of the woman patient and localisation of the disease are decisive factors. Definite dosage reductions can be achieved by suitable radioprotective measures. Nevertheless, indications for any kind of radiotherapy with ionising radiation should be strict as a matter of principle.

[Radiotherapy in endocrine ophthalmopathy--evaluation of 56 cases]. / Strahlentherapie der endokrinen Ophthalmopathie--Auswertung von 56 Fällen.

The authors present the radiotherapeutic results achieved in 56 patients with endocrine ophthalmopathy, 15 out of them with severe, so-called malignant course. All patients were irradiated conventionally with small doses between 3 and 10 Gy at the surface. For this purpose, a deep therapy unit with 250 kV was used. The X-ray irradiation produced an improvement in 62% of the cases; the separate evaluation of cases with malignant course showed an improvement in nine cases. Thus the results produced by this method are as good as those of high doses, the greater possibilities in case of recurrence, however, are to be considered as an advantage. The irradiation should be applied early, and the simultaneous administration of a cortisone preparation is preferred by our team.