Dear Colleagues,
We just crossed 100 years of the discovery of tracer principle and nuclear medicine. It was in May
1923, George de Hevesy used thorium B (212Pb) to quantify the biological processes of absorption and
translocation in the roots, stem, and leaves of Vicia faba (broad bean plant). Later, in November
1936, Dr. Samuel Hertz, Thyroid Physician from Massachusetts General Hospital & Dr. Arthur
Roberts, young physicist from Harvard Medical School, gave us 131Ioidine for diagnosis and therapy
(theragnosis) for targeting Thyroid cancers which we are extensively using everywhere across
boundaries.
Targeted radionuclide therapy has demonstrated significantly longer progression – free condition and higher response rate in ALSYMPCA, NETTER 1, Phase 3, and VISION Phase 3 trials. Therefore, there is renewed momentum in precisely targeting the tumours with alpha, beta or Auger – Meitner electron emitting radionuclides because of their higher linear energy transfer. Significant reduction in disease burden is due to single and double stranded DNA breaks as well as interference with DNA synthesis and repair, resulting in regression of inflammation, atherosclerosis, fibrosis, and enhancing apoptotic factors. In precision radionuclide therapy, there is significant reduction in irradiation and damage to non – target, normal cells (‘cross – fire effect’) and cellular perturbances from cytokines as well as reactive oxygen species (‘bystander effect’). Vehicles for transporting towards their cellular and subcellular targets like extracellular vesicles (microvesicles, exomes, apoptotic bodies), peptides, chemokine receptors and monoclonal antibodies are being seriously explored.
While we exult about our successes in the field of precision nuclear medicine, we also need to seriously work on the various other factors involved – like catching up with evolving technology, science, economics, quality & standards, availability, regulatory norms, policies and protocols, knowledge sharing, partnering with our colleagues from specialties including communicable and noncommunicable diseases and ethics. The real achievement lies only in globally serving the common man with all our strengths and potentials.
Regards and Respects,
Dr. E Prabhu
MD, DRM, FICNM, FRCP (London),
FRCP (Glasgow), FRSM, FACP,
FICP, FICCMD, FIMSA
Institute of Nuclear Imaging & Molecular Medicine,
Tamil Nadu Govt. Multi Super Speciality Hospital,
Omandurar Government Estate,
Chennai. Pin: 600002