Nuclear medicine history has its share of captivating personalities, controversial claims, and forgotten pioneers. Publications and documents that came out relatively recently, provide us with new ...perspectives on its history. Primary sourced material might contradict some of the long-held beliefs of the reader who only has a casual familiarity with the events, including basics such as who discovered radioactivity. Because of the nature of the specialty, the importance of the contributions of colleagues in related fields, like physics and chemistry, cannot be overstated. Many of the important discoveries were marked by serendipity, but the pioneers must be given credit for having the necessary insights to interpret the new phenomena correctly, sometimes turning perceived "failure" into novel scientific principles. In addition, most of our pioneers had to deal with inadequate facilities and funding, religious and racial discrimination, and even misogynism. The early history of nuclear medicine is presented in this article as a series of its most interesting anecdotes, from the early work on radioactivity, to the conception of the tracer principle, until the development of radioactive iodine therapy.
Abstract
Dr. Saul Hertz was Director of The Massachusetts General Hospital's Thyroid Unit, when he heard about the development of artificial radioactivity. He conceived and brought from bench to ...bedside the successful use of radioiodine (RAI) to diagnose and treat thyroid diseases. Thus was born the science of theragnostics used today for neuroendorine tumors and prostate cancer. Dr. Hertz's work set the foundation of targeted precision medicine.
In 1942, eighty years ago, Dr. Hertz first conducted radioiodine (RAI) diagnosis and therapy for thyroid disorders followed later by the successful treatment of thyroid cancer patients using RAI. In ...2022, memorial 80 years later, alpha emitter astatine (
211
At), an analogue for iodine, was successfully administered to a patient with refractory thyroid cancer in Japan as a phase-1 clinical trial (first-in-human). Over the past two decades, the use of
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Ga labeled peptides for somatostatin receptor (SSTR)-targeted PET imaging followed by beta or alpha emitters labeled SSTR-analogues for peptide receptor radionuclide therapy (PRRT) has demonstrated remarkable success in the management of neuroendocrine neoplasms. In addition, theranostics targeting prostate-specific membrane antigen (PSMA) have dramatically changed the management and treatment of advanced prostate cancer patients. Novel radionuclides and new targets, ligands targeting the tumor microenvironment, optimized peptides and antibodies, combinations of radioligands with immunotherapy, radioprotectors and radiosensitizers as well as new delivery strategies are currently systematically explored. Now the dream of conquering cancer, that Saul Hertz began eight decades ago is coming to fruition.
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