Volume 45, Number 2
March 2015
Editorial: Hypoxia Imaging in Nuclear Medicine hen we first conceived of a Seminar devoted to Nuclear Medicine, we discussed the concept with a colleague. He asked how would we continue to find topics to review after a couple of years and questioned the concept of a journal devoted to the subject. As we are about to enter our 45th year of publication, it is evident to everyone that there are more than enough subjects to review in the field of Nuclear Medicine for many years to come. Interest in Nuclear Medicine remains intense, and the journal continues to place among the top imaging journals in the Science Citation Index. Another question that often is asked is how topics are chosen. Subjects of seminars are derived from a variety of sources. The editors attend meetings throughout the world devoted to Nuclear Medicine, and we follow the literature closely. We discuss with our colleagues those areas that might be of the greatest interest to our readership and worthy of the kind of in-depth review and perspective that the Seminars in Nuclear Medicine makes possible. From time to time, we receive a submission from an investigator asking if the work they have been doing is of interest to us. In many situations, if the article is of excellent quality, we will add it to a seminar that has a related topic. In some cases, we simply do not have a suitable topic and even though the article may be of great interest and importance, we return it to the author because of our inability to put it in a proper area in the journal, where it can be appreciated. Another action that is sometimes taken with a submission is the decision that because of its significance and importance, it should be part of an issue of the seminars devoted solely to that subject. That is exactly how this seminar on hypoxia came to be. Dr Christopher Bell submitted to us an article devoted to hypoxia imaging in glioma.1 We thought the article was of great interest and that it was a subject of great importance. We asked Dr Bell if he would be willing to wait until we could put together a complete issue on hypoxia in which his article would be suitably placed. He agreed and when the time came to publish it, he updated accordingly so that it represents the current state-of-the-art on that subject. The reason we chose to devote this issue to hypoxia is because it is the editors belief that the time has come to consider this a modality that is about to become an important part of clinical practice in Nuclear Medicine. It has always been the aim of diagnostic modalities to detect disease, before it is
W
http://dx.doi.org/10.1053/j.semnuclmed.2014.11.001 0001-2998/& 2015 Elsevier Inc. All rights reserved.
clinically apparent. A Nuclear Medicine test, for instance, that allows one to separate out a specific disease in a high-risk population is the captopril renogram. Unfortunately that test and most of the tests like it carry with them an unavoidable false-positive rate. In most populations that are screened, the prevalence of disease will be relatively low, so that even a low false-positive rate ends up yielding many false-positive results, making it inefficient to use. Therefore, the dream of screening for disease before it occurs, even in high-risk populations, with some exceptions remains elusive. For this reason, investigators have sought, alternatively, to discover means of detecting ischemia or hypoxia or both in an effort to find early disease and seek a cure. We have chosen to focus this issue on hypoxia. We are particularly indebted to Drs Sean Carlin and John Humm who graciously agreed to be the guest editors of this issue. Drs Carlin and Humm played a critical role in compiling the table of contents for this issue and suggesting subjects and suitable authors. Their guest editorial2 in this issue puts into perspective the various contributions chosen and the rationale for including them here. The reader would do well to read this clear and concise guest editorial first and then seek out the individual articles in this seminar. Although the prospect of hypoxia imaging has been around since the introduction of misonidazole,3 it has taken many years to reach this point of clinical application. It is clear to us and we believe it will be clear to the reader that hypoxia imaging is going to be an important part of Nuclear Medicine practice in the next decade. Leonard Freeman, MD M. Donald Blaufox, MD, PhD
References 1. Christopher Bella, et al: Hypoxia imaging in gliomas with 18FFluoromisonidazole PET: Towards clinical translation. Semin Nucl Med 2014;45(2):122-136 2. Sean Carlin, John Humm: Guest editorial. Semin Nucl Med 2014;45(2): 98-100 3. Grunbaum Z, et al: Synthesis and characterization of congeners of misonidazole for imaging hypoxia. J Nucl Med 1987;28(1):68-75
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March 2015
Editorial: Hypoxia Imaging in Nuclear Medicine hen we first conceived of a Seminar devoted to Nuclear Medicine, we discussed the concept with a colleague. He asked how would we continue to find topics to review after a couple of years and questioned the concept of a journal devoted to the subject. As we are about to enter our 45th year of publication, it is evident to everyone that there are more than enough subjects to review in the field of Nuclear Medicine for many years to come. Interest in Nuclear Medicine remains intense, and the journal continues to place among the top imaging journals in the Science Citation Index. Another question that often is asked is how topics are chosen. Subjects of seminars are derived from a variety of sources. The editors attend meetings throughout the world devoted to Nuclear Medicine, and we follow the literature closely. We discuss with our colleagues those areas that might be of the greatest interest to our readership and worthy of the kind of in-depth review and perspective that the Seminars in Nuclear Medicine makes possible. From time to time, we receive a submission from an investigator asking if the work they have been doing is of interest to us. In many situations, if the article is of excellent quality, we will add it to a seminar that has a related topic. In some cases, we simply do not have a suitable topic and even though the article may be of great interest and importance, we return it to the author because of our inability to put it in a proper area in the journal, where it can be appreciated. Another action that is sometimes taken with a submission is the decision that because of its significance and importance, it should be part of an issue of the seminars devoted solely to that subject. That is exactly how this seminar on hypoxia came to be. Dr Christopher Bell submitted to us an article devoted to hypoxia imaging in glioma.1 We thought the article was of great interest and that it was a subject of great importance. We asked Dr Bell if he would be willing to wait until we could put together a complete issue on hypoxia in which his article would be suitably placed. He agreed and when the time came to publish it, he updated accordingly so that it represents the current state-of-the-art on that subject. The reason we chose to devote this issue to hypoxia is because it is the editors belief that the time has come to consider this a modality that is about to become an important part of clinical practice in Nuclear Medicine. It has always been the aim of diagnostic modalities to detect disease, before it is
W
http://dx.doi.org/10.1053/j.semnuclmed.2014.11.001 0001-2998/& 2015 Elsevier Inc. All rights reserved.
clinically apparent. A Nuclear Medicine test, for instance, that allows one to separate out a specific disease in a high-risk population is the captopril renogram. Unfortunately that test and most of the tests like it carry with them an unavoidable false-positive rate. In most populations that are screened, the prevalence of disease will be relatively low, so that even a low false-positive rate ends up yielding many false-positive results, making it inefficient to use. Therefore, the dream of screening for disease before it occurs, even in high-risk populations, with some exceptions remains elusive. For this reason, investigators have sought, alternatively, to discover means of detecting ischemia or hypoxia or both in an effort to find early disease and seek a cure. We have chosen to focus this issue on hypoxia. We are particularly indebted to Drs Sean Carlin and John Humm who graciously agreed to be the guest editors of this issue. Drs Carlin and Humm played a critical role in compiling the table of contents for this issue and suggesting subjects and suitable authors. Their guest editorial2 in this issue puts into perspective the various contributions chosen and the rationale for including them here. The reader would do well to read this clear and concise guest editorial first and then seek out the individual articles in this seminar. Although the prospect of hypoxia imaging has been around since the introduction of misonidazole,3 it has taken many years to reach this point of clinical application. It is clear to us and we believe it will be clear to the reader that hypoxia imaging is going to be an important part of Nuclear Medicine practice in the next decade. Leonard Freeman, MD M. Donald Blaufox, MD, PhD
References 1. Christopher Bella, et al: Hypoxia imaging in gliomas with 18FFluoromisonidazole PET: Towards clinical translation. Semin Nucl Med 2014;45(2):122-136 2. Sean Carlin, John Humm: Guest editorial. Semin Nucl Med 2014;45(2): 98-100 3. Grunbaum Z, et al: Synthesis and characterization of congeners of misonidazole for imaging hypoxia. J Nucl Med 1987;28(1):68-75
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