@ROCH@CALIF 94806ROCHE INC.

Technetium Tc 99riiGenerator

Secondary shieldto further reducerad at on

5cc and lCicc elution vials

Elution vial shield

I 20m1 elution vialsavailable on request

Sterile needle pack and labelsfurnished with each generatorAdaptors for various elution vials

medi+p@hq@Ø©@MEDI-PHYSICS, INC., RICHMOND,SUBSIDIARY OF HOFFMANN-LA

Featuring:•Indicatedforuseinadultsand

childrenforurinarybladderimaging(directisotopiccystography).

•TheonlyGeneratorwithan“open/closed―valvetoeliminatepossibleleakage,bothduringshipmentandinyourhotlab.

•Uniquehorizontalelutionprocedureincreaseseaseofuseandeliminatesneedle-vialalignmentproblems.

•Anewsterileneedleisutilizedforeachelution,reducingthechancesofa septicorpyrogenic

situationoccurringinroutineclinicalusage.Thismethodissuperiortocompetitivedrycolumnsystemswherethesameneedleassemblyisusedforthelifeoftheproduct.

•Fissionproductmolybdenum99isusedintheTechnetium99mGeneratortoprovideSodiumPertechnetateTc99mactivityconcentrationssufficientforbolusinjections.

•Internalsalinereservoireliminatestheneedtostocksalinevials.

•Evacuatedelutionvialsareavailablein5cc,.10cc,and20ccvolumes,allowingyoutooptimizetheelutionconcentrationtomeetyourneeds.

•Optimumshieldingdesignminimizesradiationtopersonnelinworkareas,providingmaximumprotection.

a Generator is compact, providingforoptimummaneuverability.Generatorhandleandshippingcartonprovideforeaseinhandlingandlifting.

medi+p@©c@®MEDI-PHYSICS,INC.,RICHMOND,CALIF 94806

® SUBSIDIARY OF HOFFMANN-LA ROCHE INC.

IC99mcanmuseI@IsIharmwnenadministeredtoapregnantwomanorcanatfactreproductivecapacity.TechnetiumTc99mshouldbegivsn101pregnanlwoma@onlyIftheexpicladbenstilstobs9ainedclewlyouMtQhthepotentialhazards.

shouldbepertormsdduringthefirsttw(approximatsly1O)daysfollowingIhsorrsal01 @Sfl$$$.. Nursing MOthS,s

TechnatlumTcgg,nIsascrelidinhumanmilkduringlacIMlon,andIhKefOrIformulaleadingsshouldbesubstitutedforbreastfeedings.

PdlatricUsiSeehedicatfansandUsigs,dousandadminislrallon.Sesalsodescripllonofadditionalriskunderwarnings.RadlogharmeceuficaisshouldbeusedonlybyphyslclanswhoarsQualifiedbyfrainingandexperienceinthesafeuseandhandlIngofredlonuclides,andwhoseexperienceandtrainingPawbeenapprovedbyltreappropriateqovernmenlagencyauthorhad10licensetheuseofradlonuchdes.Thegenerdiotshouldnotbeusedafter15daysfromthedateandtimeofcalibrationAttimeofadmInIstratIon,thesolutionshouldbecrystalclear.ADVIRU NIACTION$: AllergicreactionsincludinganaphylaxishavebeenreportedinfrequentlyfollowinglbsadminislrationofSodiumPertsctinetateTc99m.140W$UPPUID:SodiumPertechnetateIc99missuppliedasaMolybdenumMo99/TechnetiumIc99mgeneratorInslzeslrom3Omillicurlesuplo16,@OOmilllcurles(inapproximately83omillicurleincrements)ofMolybdenumMo99asof10:00P.M.EasternTimeofthedayofcalibration.TheTECHNETIUMTc99mGENERATORconsislsof:1)slerliegenerator,2)SodIumChlorIdeInlecllonsource,3)10ccsterileevacuatedviils,4)sterileneedles.5)elulionvialshleld@6)finIsheddruglabels.ElutlonvialsIn5ccand20ccsizesareavailableuponrequest.‘inItIalorderonlyTheTECHNETIUMTc99mGENERATORshouldnotbeusedaftersixteen(16)daysfromthedateandtimeofcalibration

TECHNETIUMTc Nm GENERATORfor thi Productionof SodiumP•rtschn•tat•Tc NmOE8CNIPTION:TheTechnetiumTc99mGeneratorIspreparedwithfissionproducedMolybdenumMo99absorbedonaluminainalead-shieldedcolumnandprovidesameansforobtaInIngsterIlepyrogen•freesolutIonsofSodiumPertechnetateTc99mInsodiumchlorideln(ectlon.Theeluateshouldbecrystalclear.WithapHof4.5-7.5,hydrochlorIcacidand/orsodiumhydroxidemayhavebeenusedlorpHadjustment.OverlIrelifeoldiegenerator,anelutionwillcontainayieldof80%to100%ofthetheoretIcalamountofTechnetiumTc99mavailablefromtheMolybdenumMo99onthegeneratorcolumn.Eacheluateof thegeneratorshouldnotcontainmorethan0.15microcurieof theMolybdenumMo99permillicurieTechnetIumTc99mperadministereddoseatthetimeofadmInIstratIon.andnotmorethan10mIcrogramsofaluminumpermilliliterofthegeneratoreluate,bothofwhlchmustbedetermInedbytheuserbeforeadminlstrafton.INDICATIONSAND USAGE:SodiumPertachnetateTc99mIsusedINADULTSasanagentfor:brainimagingIncludingcerebralradlonuclideanglography;thyroidImagIng;salivaryglandImaging:placentaFocalization:bloodpoOlimagingincludlngradlonuclideanglography:andurinar9ladderlmaglng(dlrectIsotopiccyslogmphy)lordetectionofveslco-ureteralratIos.SodiumPertecfrnetateTc99misusedINCHILDRENasanagentfor:brainImagingIncludingcerebralradlonuclideangloaraphy;thyroidImaging:bloodpoolimagIngincludingradlonuclideanglography;andurinarybladderImaging(directIsotopiccystography)lorthedetectionotveslcoureleralratIos.CONYNAINDICATIONS:Noneknown.WANNINOS:RadiationrisksassocialedwiththeuseofSodiumPertechnetateTc99maregreeterinchildrenthanInadullsIngeneral,theyoungerthechildthegreetertherIskowingtogreeterabsorbedradiationdosesandlongerIllsexpectancy.ThesegreaterrisksshouldbetakenfirmlyIntoaccountinallbeneflt.rlskassessmentsInvolvingchIldren.PRICAUTION$: AsIntheuseofanyradioactivematerial,careshouldbelakentominimizeradiationexposurelothepatientconsistentwithproperpatientmanagementandtoinsureminimumradiationacposuretooccupetlonatworkom

Csrcinogsnssls,Mutaqsrsssls,lmpadrmsntoOFIrIMfyNolong-termanimalsludieshavebeenperformedtoevaluatecarcinogenicpolentlalorwhetherTechnetiumTc99mmayaffectfertililyInmalesorfwvtales. Jointlymanufacturedby:

CINTICHEM,INC.Tuxedo,N.Y.10987

June,1983and UNIONCARBIDECORPORATION

Tuxedo,N.Y.10987PrwnnsncyCstwnoryC

AnimalreproductivestudieshavenotbeenconducTedwithTechnetiumTc99m.It IsalsonotknownwhetherTechnetium

N N N @i

GENERATORSTechnetium Tc99m Generators for the Production

of Sodium Pertechnetate Tc99m

NUCLEAR ASSOCIATESA Division of VICTOREEN, INC.100 VOICE ROAD

IVICTDREENJCARLE PLACE, NY 11514-1593(516)741-6360A Subsidiary of Sheller-Globe 5jj

Measures activity, calculates concenfration andperforms °@Moassay.

Calculates and prints out the concentration andvolume for any desired dose, corrected fordecay, at 30-minute intervals.

Calculates syringe volume required for a patientdose.

U

I

.

. . and much more

I Provides permanent printed record of date,

time, radioisotope, activity, concentration,syringe volume, °°Moassay result and decaychart.

I Measures background and automatically

subtracts it from all radioisotope measurements.

S Enters and prints patient's ID number.

Send for full details.Request Bulletin 354B.

TM Victoreen, Inc.

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Does EVERYTHING the highprice units do:

Earlydiagnosisof excessivebone mineral loss is possibleby noninvasivedeterminationof bone mineral content (BMC)in the axial skeleton.ReliableDatafromRelevantAreasLoss of bone mineral, and fracturesassociated with the axial skeleton,areclosely associatedwith metabolicbone disease.Trabecularbone,predominantly present in the axial skeleton, notablythe lumbarvertebrae,isaffectedto a largerextent than corticalbone present in the peripheralskeleton. BMC measurementsin potentialfracturesitesintheaxialskeletonprovide the most reliableindicationoffracturerisk.The Novo BMC-LAB22a measuresBMCinthe lumbarspine,thefemoralneck and other parts of the skeleton.

ImprovedPatient ManagementA largenumberof drugs and regimensinfluencethecalciumbalance.BMCmeasurementis a cost-effectiveanddirect meansof monitoringpatients inhaemodialysis,during nutrientsupplementation,exerciseand drug administrationprograms.Easeof operationand low radiationdosemaketheNovoBMC-LAB22aidealfor routinemonitoringandscreeningof patients.

AutomaticSoftTissueCompensationTheNovoBMC-LAB22ais a dualphoton bone densitometer.Thetechniqueobviatestheneedforsofttissueequivalentmaterials,without sacrificing the excellentprecision of the proyensingle-photonmethod.

Safety,FlexibilityandEaseofOperationAdvancedsoftwareguides the userthrough the measurementsandpromptsthe operator in case of error.Extensiveinteractivecapabilitiesprovide extremelyflexibleselectionofregionsof interest.

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r@@ovoDIAGNOSTIC SYSTEMSNovoAllé,2880 Bagsvaerd,Denmark,tlph.45-2-982333

Germany:NovolndustriGmbH,Mainz,tlph.49-6131-3-1001Belgium:NovolndustriS.A.,Brussels,tlph.32-2-465-2400USA:NovoDiagnosticSystems,Wi/ton,f/ph.1-203-846-8420UK:VertecScientific,Slough,tlph.44-6286-4808Holland:NucletronTradingB.V,Leersum,tlph.31-3434-5-4224Switzerland:NucletronS.A.,Lausanne,tlph.41-2125-2423France:Semsa,Boulogne,tlph.33-1-621-6666Italy:TecnologieAvanzate,Turin,tiph.39-11-550284Japan:NisseiSangyoCo.Ltd..Tokyo.tiph.3-504-7111Korea:SamWooMedicalCo.Ltd.,Seoul,tlph.568-3166Australia:BaltekMedicalSystems, ______BerowraHeights,tiph.2-456-1245 NOVO

NovoBMC-LAB22a

PostmenopausalOsteoporosis-acureable

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The Novo BMC-LAB22a featuresthree dedicated programs:for COLUMNA,and for right and left COLLUMFEMORIS.A fourth OPTIONALprogramis includedto meetindividualrequirements.

Forfurther informationpleasecontact:

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Digital Dyná@Camera...The added speed and precision Variable IntegrationCircuitry (VIC)gained by digital electronics make for high count ratestheDigitalDynaCamera(DDC)virtuallyunlimitedin handlingyour@ Advancedcomputerbusstructurepresentandfuturerequirements, . . architecturewhetherit be conventionalimaging,singleor dualdetectorECT,or newradiopharmaceutical developments. : 4 pulse height analyzers

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features that nuclear cardiologyhas come to expect from EDC.

We think the EDC Model 8450has everything you wifi everwant, or need, for Cardiac StressTesting. Give us a call for furtherdetails.

Introducing the most advancedcardiac stress system —the EDCModel 8450. Now you can program any protocol in seconds —either workload or heart rate —right at the front panel by a meretouch of the programmer.

Our powerful microprocessorinsures the highest accuracy ofany stress system —and as anoption, you can have a permanent printed record of the entirestress test, with digital readingsof elapsed time, workload, andheart rate every six seconds —and with the integrated workload(in KPM) at the end of each program segment.

These three new advanceshave been added to the alreadywell accepted features of ourclassic model 8430, with itsability to be used either as astress testing table or as ageneral imaging table —its fullyadjustable table and ergometer— its clear, error-proof, digital

readouts —its sturdy construction —and all the other excellent

ENGINEERINGDYNAMICB

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The UltimateCardiacStressSystem.Designed to put more muscle into your Cardiac Testing.

@.. . .

AS

Morethan 90% of particles in optimal10 to 90 micron rangeTheaverage sizeis20 to 40 microns.. .and no parlides are greater than 150microns.You'llget excellent images throughout a full ó hours afterreconsfifuflon. Meets all your lung perfusion evalualion needs...scheduled or stat.Reconsiltuliontime. . . only 6 minutes.

More than 80% lung uptake for reliablebiological efficacyLow supernatant actMly (SA)and very high radiochemical purily (PCP)help assure biological efficacy youcan depend on time after time.

P@asesee adjacent page for brief summary

Theonly MAAproduct indicated for usein isotopicvenography

Toll-FreeTeChnicalCustomer Servlce/f-800-257-5181/NewJersey/1-800.582-5913

Volume 25, Number 9 llA

NOW AVAILABLE

Intheevalualionofpulmonaryperfusion

TechnetiumTc99mA@buminAggregatedKitAS

POSSIBLE

®SQU1BWe Diagnostics

©SQUiBBTM€1DiagnosticsNew

Brunswick,NJ0890301984Lk Squibb &So,* k@c.Pdnc@Icr@NJ05840 604.502 S@Ø@984

DESCRIPTiON

Mocrotec Is a sterile nonpyrogenic, lyophilized preparatIon ofalbuminaggregated Each5ml vialof Macrotec contains1.5mgof AibumlnAggregated 10.0mgAlbumInHuman,0.06mg(mInimum)stannouschloride(maximumstannicandstannouschlorideQ16m9).1.8mgof sodiumchloridewithtraceamountsof sodiumacetata acetic acid and hydrochloric acid Macrotec containsnopreservatives.ThepHof the reconstitutedproductisbetween38 and aa

Theaggregatedparticlesare formedbydenaturatlonofAlbummHumanina heatingandprecIpItationprocessEachvialcontains1-8millIonparticles,90% of whichare between10and 90mIcrons in @z&The average size Is20 to 40 mIcrons; no parliciesare greater than 150mlcrons@

Reconstitutionof Macrotec with sterlie sodium pertechnetateTc99mformsan aqueoussuspensionof TechnetiumTc99m1@JbummAggregated for diagnostic use by intravenousinjection.Nolessthan 90%of the pertechnetate Tc99madded to the reactionvlai isbound to the aggregates at preparatIon time and remainsbound throughoutthe 6-hourlIfetimeof the suspension.INDICATIONSAND US4@GE

LungImagingMacrotec (TechnetiumTc99mAlbuminAggregated injection)isalung imaging agent which may be used as an adjunct in theevaluatIonof pulmonaryperfusioninadultsand children.Itisuseful in the early detection of pulmonaryemboli and Inthe evaluation of the statusof the pulmonary circulation in suchcondmonsas pulmonary neoplasm, pulmonary tuberculosis andemphysemaIsotopicVenographyMacrotec isalso indicated for use in Isotopicvenography as anadjunct In the screening, diagnosisand management of deepveinthrombosisinthelowerextremities.

Combined isotopic venography of the lower extremitiesandthe pulmonaryvasculaturemay be performedCONTRAINDICAT1ONSTechnetiumTc99mAlbuminAggregated Injection should not beadministeredto patientswIthseverepulmonaryhypertension.

TheuseofTechnetiumTc99mAlbuminAggregatedinjectioniscontraindlcated in personswitha historyof hypersensitivItyreoctionsto productscontaining humanserumalbumin.WARNINGS

Theliteraturecontainsreportsof deathsoccurringaftertheadministrationof AlbuminAggregated to patientswith pre-existingseverepulmonaryhypertension.Instancesof hemodynamicor Idiosyncraticreactionsto preparationsof TechnetiumTc99mAlbuminAggregated have been reportedPRSCA@ONSGene@Iinpatientswithrightto leftheartshunts,additionalriskmayexistdue to the rapid entry of AlbuminAggregated into the systemiccirculation.Thesafetyof thisagent Insuchpatientshasnot beenestablished

Hypersensitivityreactionsare possiblewhenever proteincontaining materials such as pertechnetate labeled AlbuminAggregatedare usedin man. Epinephrlne,antihistaminesand corticosteroldsshouldbe kept available for immediateuse@

Theintravenousadministrationof any particulate materIalsuchasAlbuminAggregated Imposesa temporary smallmechanicalimpedimentto blood flow.Whilethiseffect isprobably physiologically insignificantin mostpatients,the administrationof AlbuminAggregated is possiblyhazardousin acute cor pulmonale andotherstatesofseverely impaired pulmonaryblood flow.

Thecomponents of the Macrotec (TechnetiumTc99mAlbuminAggregated Kit)are sterileand non-pyrogenlc It is essentialtofollowdirectionscarefullyandadheretostrictasepticproceduresduringpreparation.

Contentsofthevialare IntendedonlyforuseinthepreparationofTechnetiumTc99mAlbuminAggregatedInjectionandareNOTtobeadministereddirectlytothepatient

Thecontentsof the kit before preparation are not radioactive.However,after the sodium pertechnetate Tc99mIsadded, ade

quote shieldingof the final preparation mustbe maintainedThetechnetiumTc99mlabeling reactionsinvolveddepend on

maintainingthestannousioninthereducedstate.Hence,sodiumpertechnetateTc99mcontainingoxldantsshouldnot beemployed

Thepreparation contains no bacterlostatic preservative TechnetiumTc99mAlbuminAggregated Injectionshouldbe storedat2-8°Cand discarded 6 hours after formulation.

TechnetiumTc99mAlbuminAggregatedInjectionisa physically unstablesuspensionand consequentlythe particles settlewith time. Failure to agitate the vial adequately before use mayresultinnon-uniformdistributionofradloactive particles.

If blood Isdrawn into the syringe unnecessarydelay prIor toinjectionmay resultInclot formation.

Radlopharmaceuticalsshouldbe usedonly by physicianswhoarequalifiedbytrainingandexperienceinthesafeuseandhandling of radionuclidesand whoseexperience and training havebeen approved by the appropriate governmentagency authorIzedto licensethe useof radionuclides.

Asintheuseof anyotherradioactivematerIal,care shouldbetaken to minimizeradiation exposureto patients consistentwithproper patient management and to minimizeradiationexposuretoclinicalpersonnel.Carcinogenesls, Mutagenesis, Impairment of FertilityNo long-termanimalstudieshave been performedto evaluatecarcinogenic potential or whether TechnetiumTc99mAlbuminAggregated Injectionaffectsfertilityin malesor females.PregnancyCategoryCAnimal reproduction and teratogeniclty studieshave not beenconductedwithTechnetiumTc99mAlbuminAggregatedInjection.It IsalsonotknownwhetherTechnetiumTc99mAlbuminAggregated Injection can cause fetal harm when administeredtoa pregnantwomanorcanaffectreproductivecapacity.Therehave been no studiesin pregnant women. TechnetiumTc99mAlbuminAggregatedInjectionshouldbe given to a pregnantwomanonly Ifclearly needed

ldealI@examinations using radiopharmaceuticals, especiallythoseelective in natura of a woman of childbearing capab1Ilt@shouldbe performed during the firstfew (approximately10)daysfollowingthe onsetof menses.NursingMothersTechnetiumTc99misexcretedin humanmilkduringlactation.Therefore,formulafeedingsshouldbe substitutedforbreastfeedings.PediatricUseThe lowest possible number of particles should be used in theright-to-leftshunting,in neonates and In severe pulmonarydIseaseADVERSEREACTIONSAlthoughadversereactionsspecificallyattributabletotheTechnetlumTc99mAlbuminAggregatedInjectionhavenotbeennote4 the literaturecontainsreportsof deathsoccurringafter theadministrationof AlbuminAggregated to patientswith pre-existingseverepulmonaryhypertension.instancesofhemodynamicoridiosyncraticreactionsto preparatIonsofTechnetiumTc99mAlbuminAggregated have been reportedHOWSUPPliEDMacrotec (TechnetiumTc99mAlbumin Aggregated) is suppliedasa kItcontaining10reactionvials(5ml sizer

l2A THE JOURNAL OF NUCLEAR MEDICINE

E@&©EtT@C@TechnetiumTc99m@buminAggregatedKit

Diagnostic—ForIntravenousUse

New SynteVent is a unique aerosol system designed to deliveruniformsubmicronic(0.5micronmassmediandiameter)droplets to the lung for ventilation scanning.

A complete,closedsystem,SynteVentiseasilyassembled,lightweight and portable. Normal tidal breathing for 3 to 5 mmutes allows up to six views of the lung.

Formore complete information,call 415-856-2422,or writeSynaco,Inc.at theaddressbelow.

SynacoA SYNTEX COMPANY

P0.Box10059PaloAlto.CA94303-084736 Steacse DriveKanata, OntarioCanada K2K 2A9©1984.Synaco. Inc. VL SYN11O4 8054

Ventilationscanning

Nowit'sconvenient,accurate.Introduci ng SynteVent@erosoDeliverySystem

,!@@

L@ @gflOstiC

@@ .@ @.

Quality...

@.:@ .@.I.

:&@‘:1c;@ —.

C Mallinckrodt, Inc. 1984

9@1

SkeletalImagesinTwoHours!

MalIinckrodtOSTEOSCAN@HDP(TechnetiumTc99m OxidronateKit)

AVERAGE VALUES—lOPATiENTS5

BLOODLEVEL(%Dose/L)

,-.-,..@ .@‘@.@,.,.—@.@.f

@:‘

HDPSiDE-BY-SIDE COMPARISON OFMDPIMAGES AT 2 AND 4 HOURS7

Image Quality Grade(1 excellent,8poor)

HDPMDPNumber

of Dose-to-ImagePatientsTime28

2hours2.78±0.11* 3.11±0.14284 hours2.37 ±0.16 2.29 ±0.165sgn4icaniiy

diiiererii p< 0 05)

.@4o

‘@2O

ClO

1.4.

1.2.1.0.0.8.0.6.0.4.0.2.0.0

contributionto departmentalproductivityand patientconvenience.Toarrangeanevaluationof OSTEOSCAN-HDP,contactyourMaiiinckrodtrepresentativetoday.

Scintiphotos courtesy of Howard J. Dworkin, MD, and William C. Porter,Pharm. 0., Wm. Beaumont Hospital, Royal Oak, Michigan.

References1. PauwelsEKJ,BlomJ Aarts JCNM:A comparison betweenwhole body scans m@deat two hours and three hours afterintravenousinjectipWofTc-99m HDPas to image quality andlesiondetectability C/inNuc/Med9:75-78, 1984.2. Fogelmanl@PearsonDW,BessentRG,et al: A comparisonof skeletal uptakes of three diphosphonates by whole bodyretention: Concise communication. J Nuc/ Med 22:880-883,19813.CowanRJ,ChiltonHM,BallJO,et al: Acomparisonoflo-99mOxidronate(HDP)and Tc-99m Medronate(MDP)of the detection of skeletalmetastases C/inNuc/Med7:P71,1982.4. Domstad PA, Coupal J,J,Kim EE, et al: 99mTc-Hydroxymethane Diphosphonate:A new bone imaging agent with alowtin content.Radio/136:209-211,1980.

5. Litt/efie/d JL, Rudd TG: Tc-99m Hydroxymethylene Diphos

phonateandTc-99mMethyleneDiphosphonate:Biologicaland @R1I.fl@f1T@TU@clinical comparison: Concise communication J Nuc/ Med24:463-466, 1983,C/inNuc/Med5:S28, 1980.6 Silberstein EB: A radiopharmaceutical and clinical compar

ison of 99mTc-Sn-Hydrosymethylene Diphosphonate with99mTc-Sn-Hydroxyethylidene Diphosphonate. Rad,o/136:747-751, 1980.

7.Van Duzee BF Schaefer JA, Ball JO, et at: Relativelesiondetectionability of Tc-99m HMDPand Tc-99m MDP.Concisecommunication JNuc/Med2S: 166-169,1984

DiagnosticProductsDivisionMallinckrodt,Inc.Post Office Box 5840St Louis. MO 63134

Pleaseseenextpagefor Osteoscan-HDPprescribing information.@

ClinicalStudiesVerifytheTwo-HourAdvantageofOSTEOSCAN:HDPOverMDPinSkeletalImaging

Higher Bone UptakeThan MDP at Two Hours2“Imagequalityis principallyrelatedto theabsoluteretentionofthe skeletal imaging agent on bone and the time availabletoallowthesoft-tissuetracercomponenttobeexcretedbythe kidneys.―2In clinical comparisons,2 OSTEOSCAN-HDPaveraged21%higherwholebodyretentionthanMDPand99% higherthan HEDPAnothercomparativestudyshowed

that“@FhuU@ @ignificdntIygr@dt@r@Qne(@c@rQunUr@tiQat 2 hours than MDP

Rapid Blood Clearance...Up to 16% Higher _______Bone to Soft-Tissue RatiosThan MDP45InclinicaluseofOSTEOSCAN-HDP,approximately6%of the _________dose remained in the blood attwo hours post-injection6 (No _________ _________other bone-imaging agent clears faster.)Theresultant/owsoft-tissuelevelspermitearlyimagingandcontributetohighresolutionimages.

Side-by-Side ComparisonsRatedHDPImages“Better―at Two HoursIn a controlled multi-center crossover study,7HDPwas foundto give images of better quality than MDP at a dose-to-imagetimeof twohours.

Diagnostic-qualityskeletal imagesintwo hours...an important

2 HOURS 4 HOURSp<o.1o P<O.05

NOTE: 2-hr. blood levels of HDP aresignificantlylowerthan MDPindicatingfaster bloodclearance.

‘:.‘J @_

I@(rads/2OmCi)TotalBody013BoneTotal070Red

Marrow056Kidneys080Liver006Bladder

Wall2hrvoid26048hrvoid620Ovaries2hrvoid02448hrvoid034Testes2hrvoid

48hrvoid016

Physic@Characteñst@sTechnetiumTc99mdecays by isomerictransitionwithaphysicalhalf-lifeof 6 02 hours' Photonsthat are usefuifordetectionand imagingstudiesare listed in TableITable

I. PrincIp@RadiatiOnEmissionDataMean

% MeanEnergyRadiation Désintegration(keV)Gamma-2

8896 1405

TableII. RadiationAftenuationby LeadShie4d@ngShieldThickness

(Pb)mmCoefficientof

Attenuation02

0816253305

10@'10-2i@-@

i@-@

FractionFraction.!i@RemarningHoursRemaining-51.7785562.415856501-314137447-212598398-1112293550@100010316189111282279412251370818126463124063@CaIibration

Time

CLINICALPHARMACOLOGY

DESCRIPTIONOSTEOSCAN-HDP (Technetium Tc99m Oxidronate Kitl is

suppliedas a lyophulizedpowder.packagedunder nitrogenin vials for intravenousadministrationafter reconstitutionwithADDITIVE-FREEsodiumpertechnetateTc99m Eachvialcontains2 0 mg oxidronatesodiumand 0 16mg stannouschlorideas active ingredients.and 0 56 mg gentisicacid asa stabilizer The contents of the vial are sterile andflon-pyrogenicThisradiopharmaceuticaldiagnosticagent.whenreconstitutedwithADDITIVE-FREEsodiumpertechnetateTc99mformsa complexof unknownstructure

CONTRAINDICATIONSNoneknown

WARNINGSThis class of compounds is known to complex cations suchas calcium Particularcautionshouldbe usedwith patientswhohave.or whomaybe predisposedto hypocalcemia(i e.alkalosisl

PRECAUTIONS

GeneralContentsof the vial are intendedonly for use in thepreparation of Technetium Tc99m Oxidronate and are NOT tobe administereddirectly to the patientTechnetiumTc99mOxidronateshouldbe formulatedwithineight (8) hoursprior to clinical use Optimalimagingresuitsare obtainedone to four hoursafteradministrationTechnetiumTc99mOsidronateas well as other radioactivedrugs. must be handled with care, and appropriate safetymeasuresshouldbe used to minimizeradiationexposuretothe patients consistent with proper patient managementRadiopharmaceuticalsshouldbe usedonly by physicianswhoare qualifiedby specific trainingin the safeuse andhandlingof radionuclidesand whoseexperienceand traininghavebeenapprovedby the appropriategovernmentagencyauthorizedto licensethe useof radionuclidesTo minimize radiation dose to the bladder, the patientsshouldbe encouragedto drink fluidsand to void immediatelybeforethe examinationand as oftenthereafteras possibleforthe nest four to six hours

Carcinogenesis,Mutagenesis.Imp@rmentof FertiltyNo long-term animal studies have been performed toevaluatecarcinogenicpotentialor whetherTechnetiumTc99m Oxidronate affects fertility in males and females

Pregnancy—CategoryCAnimal reproduction studies have not been conducted withTechnetiumTc99mOxidronate It is alsonot knownwhetherTechnetiumTc99mOxidronatecan causefetal harmwhenadministeredto a pregnantwomanor can affect reproductioncapacity TechnetiumTc99mOxidronateshouldbe given to apregnantwomanonly if clearlyneeded Ideally.examinationsusingradiopharmaceuticals,especiallythoseelectiveinnature,of a womanof childbearingcapabilityshouldbeperformedduringthe first few (approximately10)daysfollowingthe onsetof menses.NursingMothersTechnetiumTc99mis excretedin humanmilkduringlactation,thereforeformulafeedingsshouldbe substitutedforbreastfeedingsPediatricUseSafety and effectiveness in children have not beenestablished

ADVERSE REACTIONS

Althoughadversereactionshavenot been reportedthat arespecificallyattributableto the useof TechnetiumTc99mOxidronate,allergicdermalologicalmanifestations(erythema)havebeen infrequentlyreportedwithsimilaragents

DOSAGEANDADMINISTRATIONGener@ InstructionsTherecommendedadult doseof TechnetiumTc99m-labeledOSTEOSCAN-HDPis 15mCiwitha rangeof 10to 2OmCiTheactivityof each dose shouldbe measuredby a suitableradiationcalibrationsystemlust prior to administrationThedose shouldbe given intravenouslyby slowInlection Foroptimal results imaging should be done 1-4 hourspost-infectionRadiationDos4metryTheestimatedabsorbedradiationdose to an averagepatient(70 kg) from an intravenous intectionof 20 millicuriesofTechnetium Tc99m-Iabeled OSTEOSCAN-HDP are shown inTable IV

Thisreagentkit is approvedfor useby personslicensedb@]theU S NuclearRegulatoryCommissionpursuanttoSection35 14 and 35 100 Group Ill of 10 CFR Part 35 or underequivalentlicensesof AgreementStates

@Methodof calculation “S'•AbsorbedDoseper UnitCumulatedActivitySelectedRadionuclidesand Organs.MIRDPamphletNo. 1, 1975

PreparationsFor UseAll proceduresshouldbe conductedusingwaterproofgloves Useshieldedsyringeduring transportandadministrationof Tc99msolutions

1 Remove metal disc from OSTEOSCAN-HDP vial andcleansetop by swabbingwith alcohol Note If dose for asinglepatient,see unitdose preparationmethodbelow

2 Placevial in leadvial shield Add 3-6 ml of sodiumpertechnetateTc99msolutionand securewitha fittedleadcover In choosingthe amountof Tc99mnradioactivityto be used, the number of doses desired, the activity ofeachdose (recommendedadult dose is 15mCiwitharangeof 10-20mCi)and radioactivedecay mustbe takeninto account The recommended maximum amount ofTc99mradioactivityto be addedto the vial is 200 triO.Note Thecontentsof the vialare now radioactiveMaintainadequateshieldingusingthe lead vial shieldandfitted lead cover during the life of the radioactivepreparation

3 Shakethe vial for approximately30 secondsto assurecompletedissolution

4 Recordthe time,date of preparationand the activityof theTc99m-IabeledOSTEOSCAN-HDPon the radiationlabeland affix this label to the shield

5 Usewithineight (8) hoursof preparation.Refrigerationofthe radiolabeledcomplexis not necessary.Discardexcessmaterialin accordancewith NuclearRegulatoryCommissionor agreementstateregulationspertainingtothe‘disposalof radioactivewastes

Forpreparinga dose for a single patient.to minimizevolumein@eciedand to insureoptimumsolutionconcentration.reconstitutethe vial contentsin 3-6 ml of sterilesaline Shakethe vial for approximately30 secondsto assurecompletedissolution.withdrawand discard all but approximately1 mlof the solution.Add appropriateamountof sodiumpertechnetateTc99mand shake Proceedwith steps4 and5 Parenteraldrug productsshouldbe inspectedvisuallyforparticulatematterand discolorationprior to administrationwheneversolutionand containerpermit

HOWSUPPLIEDOSTEOSCAN-HDPis suppliedas a lyophilizedpowderpackagedin vials Eachvial contains2 0 mg osidronatesodiumand 0 16mg stannouschlorideas active ingredients.and 0 56 mg gentisicacid as a stabilizer Kitscontaining5vials (NDC00019-N099-BO)or 30 vials(NDC00019-N099-DO)are available Thedrug can be storedatroomtemperatureboth prior to and followingreconstitutionwithADDITIVE-FREEsodiumpertechnetateTc99rn

DiagnosticProductsDivisionMalllnckrodt,Inc.Post Office Box 5840St Louis. MO 63134

1 Martin, M J . Ed . Nuclear Decay Data for SelectedRadionuclides.ORNL#5114.p 24. March. 1976

ExternalRadiahonThespecificgammarayconstantfor TechneliumTc99mis0 8 R/mill,curie-hrat 1cm Thefirsi half-valuelayeris 0 2mmofPb A rangeofvaluesfortherelativeattenuationof theradiationemittedby this radionuclidethat resultsfrominterpositionof variousthicknessesof Pb is shownin TableIITofacilitatecontrolof the radiationexposurefrommillicurieamountsof thisradionuclidetheuseofa 25 mmthicknessofPb will attenuatethe radiationemittedby a factorof about1.000

To correct for physical decay of this radionuclide, thefractionsthat remainat selectedintervalsof timeofcalibrationare shownin TableIll

TableIII. Physic@DecayChart;Tc99m,half-life6.02hours

Duringthe 24 hoursfollowingintectron.TechnetiumTc99m-labeledOSTEOSCAN-HDPis rapidlyclearedfrombloodand othernon-osseoustissuesand accumulatesin theskeletonand urine In humans,blood levelsare about 10%ofthe infecteddose at one hourpost-infectionand continuetofall to about 6%. 4% and 3% at 2. 3 and 4 hours respectivelyWhenmeasuredat 24 hoursfollowingits administration.skeletalretentionis approximately50%of the infecteddoseOSTEOSCAN-HDP exhibits its greatest affinity for areas ofalteredosteogenesisand activelymetabolizingbone

INDICATIONSAND USAGEOSTEOSCAN.HDP(TechnetiumTc99mnOsidronateKitI is adiagnosticskeletalimagingagent used to demonstrateareasof altered osteogenesis

Manufacturedfor:Mallinckrodt,Inc.,St.Louis,MO63134by Lypho-Med,Inc.,Chicago,IL60651

16A THE JOURNAL OF NUCLEAR MEDICINE

Mallinckrodt

TechnetiumTc99mOxidronateKit

For orders, caft800-325-3688 ToIl-Freeexceptin Missouri,Alaskaand Hawaii. In Missouri(except St. Louis),call800-392-4779

. InSt. Louis, call 344-3880

. InAlaska and Hawaii,callcollect:314-344-3880

For technical assistance, call800-325-8181 Toll-Free(In Missouri,314-895-2405 Collect)

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SiemensNuclearImagingSystemstellyouthe truth...Someyearsago, SiemensintroducedZLC@the innovativeenergyand linearitydistortionremovalsystem. ZLC corrects intrinsic energyvariationsand spatialnon-linearities—themajorcausesof non-uniformitiesin gammacameras.

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DIGITRAC@Mthe newestinnovationin SiemensCamera Systems, is a microprocessorcontrolledPMTgain adjustmentcircuitincorporated in the detector. DIGITRACautomaticallyadjusts individualPMTgain(ordrift) so that gamma ray photopeaksareprecisely aligned throughout the camera fieldof view.Usingnuclearradiationas the primarystandard,the camera is recursivelycalibratedfor the isotopebeing imaged.

SIEMENS

Why accept“cosmetically―manipulatedImages?A diagnosticimageshouldtell youthe truth.Nexttimeyou'rereadingthe specificationsona nuclearimagingsystem,watchfor wordslike ,“ ,“or “operatorcalibrated.“Thesewords may be tellingyouthatwhatyouget maynot be whatyou'relookingfor.

.-@. -@@ ‘@‘ r@@ . and nothing but the truth.

SiemenscameraswithZLCTMand DIGITRACofferenergycorrection,linearitycorrectionandrecursivecalibrationwithoutcount skimming,countadding,or other“cosmetic―manipulationsof the display.

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“stateof the art―ZLCwith DIGITRACis the step forwardthatmakesall previouscameratechnologyobsolete.Here'swhatZLCwith DIGITRACoffers:S Improved image quality by precisephotopeak“windowing―—allowingincreasedtargetto backgroundratio. Exclusivesystemdiagnosticsto increasepatientthroughputand to allowmaintenanceof maximumsystemperformance. Theabilityto scheduleservicewhen it'sconvenient...becauseyoualwaysknowthestatusof yourPMT'sS Minimal system downtimeS Reliable quality control information. Consistentsystemperformance—monthaftermonth,yearafteryear

Note:Imagesshownareenhancedforgraphicpresentationonly

Siemens CounterbalanceSystemsThesesystemsofferall the flexibilityyou need for SPECT,whole body andplanarimaging.-,withoutthe needforadditionalspace.

ZLC 75005 SPECT System withDIGITRAC. zLc 75005offers¼―or ¾―crystalfor optimumsensitivityor resolution. convenientpush-buttonsetupreducesscatterand improvesimagequalityS Patentedcounterbalancestand withsimplifiedcontrolsand uniquepivotingbasefor easierpatientsetup. N@ pcmeredSPECTtablefacilitatesbody contourtracking. SPECTprocessorwith dual isotopeimagingcapabilityallowsautomaticbody contourmappingfor attenuationcorrection. ECTcolor monitoravailableas anoption

Siemens ZLC 3700 System withwhole body tableI ZL@3700 camera with¾―crystaland DIGITRAC. N@sophisticatedelectronicssubstantiallyincreasesthroughputinwhole body scanning

SiemensNuclearImaging5ystemsarequalitysystems... designedandmanufacturedto provideyouwith themostaccuratediagnostic informationobtainable.Siemensiscommittedtoadvancingthe stateof the art of nuclearimagingthroughresponsibleinnovation,userorienteddesign and dedicated,knowledgeableservice.

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Siemens Mobile SystemsLow-cost,efficientmobilesystemstomeet the imaging needs of @ivurreferringspecialists.. .includingpediatricians,cardiologists,endocrinologists,joint diseasespecialistsand others.

NewZLCLowEnergySmallAreaCamera. Lightweightdesignforeasymaneuverability. Add-ondataprocessingforcompletesystemcapabilities. Hardcopyreadouton8―x10―filmS ECG gating available. ExpandedcountratecapabilityImproved LEMtm ZLC Low EnergyMobileCamera. !@@rotationalcolumnswivelsforcritical patientpositioningwithlightweight design. Uniquepowerdriveforeasiermaneuverability. ZLCwithDIGITRACforimageintegrity

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Siemens ROTA SystemThe ROTACamera is uniquelydesigned to offer field upgrading.Choosea dualdetectorsystemnowora singledetectorsystemfor upgradinglater.. ZLCwithDIGITRAC. Highersensitivityandbetterimageresolutionin SPECT. Digitalreadoutformoredefinitivedetector location

SiemensMedicalSystems,Inc.Nuclear Medicine Division186WoodAvenueSouthIselin,NewJersey08830(201)321-4500InCanada,contactSiemens Electric Ltd.MedicalSystemsDivision1180Courtney Park DriveMississauga, Ontario L5T1P2(414)673-1995

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Measurements of RegionalCerebral Blood Flow (rCBF) by2-D noninvasivel33-Xeclearancetechniquesprovide a reliablemethod for the functional assessment of brain pathophysiology.The method is beingincreasinglyused within thefields of neurology,neurosurgery,intensive care, psychiatryandanesthesiology.MultidisciplinaryClinicalApplicationAn evident advantageof the 133-Xeinhalationtechnique is the possibilityof measuring noninvasivelya physiological parameterof brain functionbefore,during and after therapeuticintervention.The noninvasivetraceradministration—combined with thelow radiationdosage and easy procedure —makes this low cost techniqueideal for serial follow-up CBFdeterminations.

Neurosurgery— evaluation of surgically amenable

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and depression.The NovoCerebrographwlOaA compact, fully mobile, 10detector,bedside monitor, using the IV and IA133—Xe injection technique.

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r@jovoDIAGNOSTIC SYSTEMSNovo Allé.2880 Bagsvaerd.Denmark,tiph.45-2-982333

Germany:Novo IndusfriGmbH,Mainz.tiph.49-6131-3-1001Belgium:Novo IndustriS.A.,Brussels.tlph. 32-2-465-2400USA:Novo DiagnosticSystems,Wilton.tiph. 1-203-846-8420UK:VertecScientific,Slough,tlph. 44-6286-4808Holland: Nucletron TradingB.V,Leersum,tiph. 31-3434-5-4224Switzerland:NucletronS.A.,Lausanne,tlph.41-2125-2423France:Semsa,Boulogne,tlph. 33-1-621-6666Italy: TecnologieAvanzate,Turin,tlph. 39-11-550284Japan:NisseiSangyoCo. Ltd.,Tokyo.tlph,3-504-7111Korea:SamWooMedical Co. Ltd..Seoul,tlph,568-3166Australia:BaltekMedical Systems,BerowraHeights,tlph.2-456-1245

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Thewell-acknowledged,versatilemethodforroutine

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Forfurther informationpleasecontact:

@ULTRASOUND

4COMPUTERIZED NUCLEAR MEDICINE

COMPUTED TOMOGRAPHY -9

NUCLEARMAGNETIC RESONANCE

Only you know the lookyou like in video images.Show that look to a Kodakrepresentative, and we'repreparedto deliver thatlook. And keep it. It'sa bigcommitment, but one we'reequippedto back up.

BecomeaVIEThis service, and many more, is part of acomprehensive Kodak video imaging program. It's a complete package of productsand services designed to makeyour life easier in ...@..-@ -any modality that@@

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It all begins with the widest choice offilms in video imaging: five films, ideallysuited to recording images from video

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ment, each of these@ A@high-resolution,

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-.-- As a first step, your

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@.-

CEastman Kodak Company, 1983

look @.@

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With Kodaflexproducts you canhave a roomlightfilm-handling systemwith a difference.And that differenceis the reliable operation you expect fromKodak products withthe knowledgeablebackup you expectfrom your Kodakrepresentative. Thesystem includes filmholders and dispensers, magazines,unloaders, and, ofcourse, your favorite

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Now,watch the monitor on your multiformat camera as your KOdak representativehelps you arrive at the specific look youlike. Then, drawing on special training andexperience, and the Kodak video displayanalyzer, your technical sales representative can—withmany multiformat cameras—literally“putnumbers―on that look.

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Even write them on a special label appliedto your camera. So you can always returnthe monitor to the exact settings which produce the results you prefer. Your look isrepeatable.

All in full room ffluniination...with Kodaflex products.

We've even improved on the way you doeveryday jobs like loading, unloading, andprocessing film. Made them easier, moreconvenient. Because new Kodaflex products let you do all these things in full roomillumination! It's not only handy; it meansyou can now make more efficient use ofavailable space.

23A

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24A THE JOURNAL OF NUCLEAR MEDICINE

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For more information, call or write today:

The XENAMATIC. Our Xenon TrapCartridge Pack offers 20 feet of continuous activated charcoal pathway (3―indiameter) via nine individual tubes connected in series. Additionally, the mdividual tubes are specially constructed toinhibit the normal redistribution of“trapped―Xenon which occurs evenwhen the trap is not being used.

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THE SOLUTION:Xenon 127. Its higherenergiesallow effectiveelimination ofTc 99m gammasfrom subsequent ventilation Images.

THE PROBLEM:The short half-life ofXenon 133 makes availability a problem, increases shipping costs,andwe lose much of it through decay.

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so'UTII

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Fundamentals ofNuclear MedicineEdited by

Naomi P.Alazraki, MD,and Fred S. Mishkin, MDOtherContributors:Manuel L. Brown, MD, Frederick L. Datz, MD,Leon S. Malmud, MD, Isaac C. Reese, PhD, Barry A. Siegel, MD,

JamesA. Sorenson,PhD, LeroyA. &igarman,MD, AndrewT.Taylor,Jr., MD, Heidi S. Weissmann, MD, Henry N. Weilman, MD

. . . a basic introductory guide to acquaint medical students

and physicians with the most useful nuclear medicine techniques for detecting and evaluating common disorders.

8. Genitourinary Tract

9. Skeletal System

10. Central Nervous System

Imaging Disease Processes

11. Trauma

12 . Inflammatory and Infectious Processes

13.Cancer

Nonimaging Diagnostic Techniques14. Nonimaging Procedures

AppendixGlossary

Index

Ordering InformationAdd $2.50 postage and handling for each book ordered. Prepayment required in U.S.funds drawn on U.S. banks only. For payments made in U.S dollars, but drawn on a foreign

bank, add a bank processing fee of $4.50 for Canadian bank drafts or $40.00 for all other

foreign bank drafts. Check or purchase order must accompany all orders. Make checks

payable to: The Society of Nuclear Medicine. Prices are in US. dollars and are subject to change

without notice.

The Society of Nuclear Medicine475 Park Avenue South, New York, NY 10016 (212)889-0717

34A THE JOURNAL OF NUCLEAR MEDICINE

AbbreviatedContentsRadiation in Perspective

1. Basic Science of Nuclear MedicineRadiation and DoseRadiation EffectsImaging of Radiation

2. The Diagnostic Process and Nuclear MedicineSensitivity, Specificity, and Prior Probability

Organ Imaging With Radionuclides

3. Thyroid Uptake and Imaging

4. Cardiovascular System

5. Pulmonary System and Thromboembolism

6. Liver and Gastrointestinal Tract

7. Biliary Tract

By E. Edmund Kim, M.D., University of Texas Medical School,Houston, and Thomas P. Haynle, M.D., The University of TexasSystemsCancerCenter, M.D. AndersonHospitaland TumorInstitute, Houston.

This unique book presents an overview of various nuclear imaging studies for each category of cancer. With it you will gaindetailed information for selecting an optimal imaging approach toa particular cancer patient. An introduction discusses the basicprinciples of oncology and nuclear medicine and reviewsthe available imaging procedures most commonly used inoncology —with specific protocols.Take this opportunity to acquire a rare and valuable book —oneof the first to relate nuclear medicine to the field of oncology. Besure it has a place on your professional library shelves!

Contents: Basic Principles. Tumors of the Central NervousSystem. Head and Neck Tumors. Lung and Médlastinal Tumors.Breast Cancer. Tumors of the Digestive Tract. GenitourinaryCancer. Gynecologic Neoplasms. Musculoskeletal Neoplasms.Endocrine Tumors. Hematologic Tumors. New Modalities forNuclear Imaging. Appendix 1: Review of Nuclear ImagingProcedures. Appendix 2: Physical Properties of Imaging Radionuclides. Appendix 3: Radiopharmaceuticals Used in CommonNuclear Imaging Procedures. Index.

1984, 262pp. , illus., A6973-0, $52.50

By Leonard Rosenthall, M.D., Director, Division of NuclearMedicine, The Montreal General Hospital, and Robert Lisbona,M.D., The Royal Victoria Hospital, both of McGill University,Montreal.

In this new book you are given a general review of all aspects ofradionuclide skeletal imaging. Abundantly illustrated with materialculled from the McGill University Hospitals, the text examines thepathophysiology and the clinical manifestations of the diseaseentities in detail.

The radionuclide modality is examined for its sfren@ths andweaknesses and its place in the diagnostic algorithm is suggestedfor many of the entities in view of other competing or cornplementing diagnostic imaging techniques.

Take advantage of our 30-day trial offer and view this resourcefulbook firsthand. Simply fill out the coupon below and drop it inthe mail today.Contents: Skeletal Radiopharmaceuticals. Primary Bone Tumors.Malignant Metastatic Bone Disease. Marrow Imaging. Noninfectious Arthritis and Allied Disorders. Bone and Joint Infectionand Allied Disorders. Bone and Joint Trauma. Osteonecrosis andRevascularization. Metabolic Bone Disease. Paget's Disease. Extraskeletal Localization of Radiophosphate. Proliferative Disease ofthe Bone. Index.

ORDER COUPONMail To: APPLETON-CENTURY-CROFTS

Medical/Nursing Publishers NAME ________________________________________

25 Van Zant Street ADDRESS ___________________________________East Norwalk, CT 06855 CITY ____________ STATE _________ ZIP_________

Pleasesendthefollowingon 30-dayapproval: Pleasechargemypurchaseto:@ MasterCardD VISA0 Nuclear Imaging In Oncology, A6973-O, $52.50 ACCOUNT NO. __________________________________0 Skeletal Imaging, A8563-7, $55.00 EXP. DATE ___________________________________0 Paymentenclosed(publisherpayspostageandhandling).@ N R ______________________________________0 Billmelater.

Prices subject to change without notice.DEPT. B AMA366-5

35AVolume 25, Number 9

Keep ups-to-date with ACC references!

1984, 322pp. , illus., A8563-7, $55.00

@ Appleton-Century-Crofts

P272@@;6XPublicationDate: June1984$22.00

members;$29.00nonmembers

Bruno J. Sufka, James K. O'Donnell, Hong N. Yeung,David H. Feiglin, and William Pavlicek

Imaging True Motion Velocity and Higher Order MotionQuantities by Phase Gradient Modulation Techniques forNMR Scanners, Paul R. Moran and Richard A. Moran

iv.NewTechniquesIn Vivo Spectroscopic Imaging, A.A. Maudsley

In vM Breast Magnetic Resonance Imaging Using a PrOtOtypeBreast Coil, Paul C Wing, Carol B@Stelling, Sally S.Mattingly, and Deborah E. Powell

Three-Dimensional Display ofNMR Images, John D. Austin,Benjamin M.W Tsui, Dorothy C Strickland, Stephen M.Pizer, Edward V Staab, and C Leon Partain

A Universal Pulse Programmer for NMR Imaging, Dye J.Jensen, William W Brey, Victor Tong, Thnnada A. Nara,wjza,and Jean L. DeLayre

V. installationConsiderationsInstallation ofHigh-Field NMR Systems into Existing Clinical

Facilities: Special Considerations, Steven G. Einstein,Andrew A. Maudsley, Seong Ki Mun, Hoswird E. Simon,Sadek K. Hilal, Richard M. Sano, and Peter Roeschmann

Architectural Considerations in Designing a MR Facility,William Pavlicek, William Macintyre, Raymundo Go, JamesO'Donnell, and David Feiglin

RF Shielding for NMR Imagers, James A. Graham, Jr.

Ordering InformationAdd $2.50 postage and handling for each book ordered. Prepayment required in U.S. funds drawn on U.S. banks only.

For payments made in U.S. dollars, but drawn on a foreign bank, add a bank processing fee of $4.50 for Canadianbank drafts or $40.00 for all other foreign bank drafts. Check or purchase order must accompany all orders. Make

checkspayableto: The Societyof NuclearMedicine.Prices are in U.S.dollars andare subjectto changewithoutnotice.

The Society of Nuclear Medicine475 Park Avenue South, New York, NY 10016 (212)889-0717

36A THE JOURNAL OF NUCLEAR MEDICINE

NEW!Technologyof

Nuclear Magnetic ResonanceEdited by

Peter D. Esser, PhD, and R. Eugene Johnston, PhD

. . . provides a source for physicians and scientists seeking introductory

material or informationon current developmentsof NMR technology

ContentsI. Overview

An Overview of MR System Design, David D. Faul

Overview of NMR Reconstruction Principles, TM. Petersand B.C. Sanctuary

Optimization of Signal-to-Noise Ratio in NMR SystemDesign, Mark E. Riehi and Robert E. Glusick

An Introduction to the Applications of Fourier TransformAnalysis in Medical Imaging, William G. Hawkins andPeter D. &ser

II. Pulse Sequences and Parameter Extraction

Uncertainties in the in vivo Measurement of RelaxationParameters, G. Allan Johnson, Robert Herficens, Mark A.Brown, and James R. MacFall

Pulse Sequence Considerations For Computed T1, T2, andSpin Density Images, James R. MacFall

NMR Image Synthesis in Realtime, Stephen J. Riederer,Stuart A. Bobman, Steven A. Suddarth, James N. Lee,Henry Z. Wang, and James R. MacFall

A Systematic Approach to Optimization of Pulse Sequencesin NMR Imaging By Computer Simulations, Gernot Bielke,M. Meves, S. Meindi, A. Bruckner, W v.Seelen, P Rinck,and P Pfannenstiel

iii. Flow and Motion

Flow and Motion in NMR Imaging: A Thtorial Introduction,Richard E. Wench III, Paul H. Murphy, Joseph J. Ford,R. Nick Bryan, and John A. Burdine

Gated Cardiac Imaging with Nuclear Magnetic Resonance(NMR) Techniques, William J. Macintyre, Ra@mundoT Go,

State c@1:@flE@@ Pertormance

To provide up-to-date information about the mostaccurateproceduresforensuringqualitycontrolofradiopharmaceuticals,TheSocietyofNuclearMedicine presents Chromatographyof Technetium-99m Radiopharmaceuticals—APracticalGuide.

This new manual offers readers a collectionof miniaturized chromatographic methods for therapidandprecisedeterminationoftheradiochemicalpurityofcommonlyusedTc-99mradiopharmaceuticals.

Topics covered include the nature and sourceofimpurities,principlesandclassictechniquesofchromatography, methods for counting miniaturechromatographic StripS, and pitfalls of miniaturemethodsand howto avoidthem. Also containedhereinis a listingofeach radiopharmaceuticalwiththeUSPcriteriaforradiochemicalpurity,typicalscansofimpureproducts,andstandardsandinterlaboratory comparisons for miniaturized systems.

Preparedto aid nuclearmedicinepersonnelin implementing voluntary quality-assurance programs,thematerialmayalso be usedas a trainingresource for individuals preparing for professionallicensureand certification.

Ordering Information:

Chromatog@phyofTechnetium-99rnRadiophar@naceuticoJs

)TheS@ @Nit*w @I

8½ x 11―softcover, 48 pages$12fX@SNM members;$16@Xlnon-membersPublication Date: January 1984

—54Pnictical Guide

Add$2.50postageandhandlingforeachbookordered.PrepaymentrequiredinU.S.fundsdrawnonU.S.banksonly.For payments made in U.S. dollars, but drawn on a foreign bank, add a bank processing fee of $4.50 for Canadianbank drafts or $40.00for all other foreign bank drafts. Check or purchase order must accompany all orders. Makecheckspayableto: The SocietyofNuclear Medicine.Prices are in US. dollars andare subjectto changewithownotice.

The Society of Nuclear Medicine, 475 Park Avenue South, New York, NY 10016

38A THE JOURNAL OF NUCLEAR MEDICINE

Chromatography ofTechnetium-99mRadiopharmaceuticals

A Practical GuideBy Philip J. Robbins

Signature

Name

Street

Citv/Sta@/Zip

Computerized Tomography of the Lung: NEWNormal Anatomy and Most CommOn DisordersbyMuiarn Sperbei,M.D.208 pages, 134 illus., 5 tables, May 1984ISBN 0-87993-209-0 . $3230‘Theremarkably rapid development ofneurologic and abdominal applications ofCF scanning has overshadowed itsuse for thoracic diseases. This volume may correct this imbalanceby directing attention to the enormous potential ofcomputed tomography in the diagnosis and managementofchest diseases'—HaroldL. Israel, M.D., Emeritus ProJèssorofMedicine, ThoniasJefferson l,lniversityHospital, Philadelphia, Pennsylvania“Allthose involved in the diagnosis and management ofpulmonary problems, Iamconvinced, wifi benefitfrom thisinterestingtextand enjoyreading it―—ColinE.Mackintosh,M. D., Consultant Radiologist, Royal Free Hospital, London,England

CT of the Heart and the creat VesselsExperimental Evaluation and Clinical Evaluationedited by Charles B. Higgins, M.D.associate editors: Erik Carlssón, M.D., PhD.

Martin J. Lipton, M.D.416pages (8½‘X11' format), 317 illus., 9 tables, 1982ISBN 0-87993-180-9 $68.00

“Thisbook is a collection ofarticles dealing with the development of computed tomographic (CT) imaging of theheart, and to a much lesser extent, the aorta. The materialpresented represents the combined efforts of many of thecurrently recognized authorities in this rapidly advancingfield of imaging. This book currently is the best availablesingle source that provides an in-depth discussion of cardiac CT. It will likely become the standard text thatdocuments the development of cardiac CT.―

—MayoClinic Proceedings

Please send.

:J Higgins #1809E1Silberstein #2031

@ Soin & Brooks #1310

ElSperber #2090

For shipments within New York or New Jersey, applicablesales tax must be added.

All prices are in U.S. Dollars.

Futura Publishing will pay all shipping chargeswhen payment accompaniesorder.

N@vBone Scintigraphyedited by Edward B. Silberstein448pages,350illus., 18tables,February1984ISBN 0-87993-203-i $6730‘Thisbook is the most complete and definitive work onradionuclide skeletal imagingto date. Itaptlycondenses theimportant information on this subject which has grownexplosivelyduring thelast decade. It emphasizes the needto individualize the radionucide techniques for specificdiagnosticproblems and the dependenceofimage interpretation on thecorrelation with dinical andradiographic findings. Mycompliments to the editor and the authors for theirnew book. It will remain a valuable addition to the literature,even though the fieldofnuclear medicine is stillchanging.―— theforewordbyJohn G. McAfee, M.D., Professor&Direc

to,; NuclearMedicine, Department ofRadiology, SUNY UpstateMedical Center, Syracuse, NY

Nuclear Cardiology for Cliniciansedited by Jagmeet S. Soin, M.D., and

Harold L. Brooks, M.D.320 pages, 123 illustrations, 1980ISBN 0-87993-131-0

“Thisapproach is indeed excellent. . .The authors achievetheirgoal andlwould recommend thisbook to all physicianswho wish to obtain a rapid and accurate introductIon to themajor techniques in nuclear cardiology.―

—MayoClinic Proceedings

“Drs.Soin and Brooks present in this text the clinical andtechnical material necessary for clinicians to understandnuclearcardiology. Itis ofvalue andwill present the dinicianwith a reasonable perspective on this exciting field.―.—CHEST

$3430

“Forthose interested in this area of investigation, this is anexcellent compilation of cufrent knowledge and the bib!iography is éxtènsive@―—AmericanJournal of Roentgenology

ft tui@publishing company, Inc.@ 295MaInStreet,P.O.Box330,MountKisco,NY10549

Date________________

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CanadianCustomers:On orders from Canadaa surcharge will be appliedtoaccommodatetherateofexchangeandbankcollectioncosts.IfinvoicesazepaidbyaU.S. dollarcheckdiawnonanAmericanbank, theabove charges will be waived.

(JNM9/84)

@iJf!sturapublishingcomiusny___MountKisco,NewYorkl(914)666.7528. .. . IMPORTANT TITLES

Edited by Wanda M. Hibbard, CNMT,andSueP Lance,CNMT

Inresponsetoa needforstandardizingthelearningexperiencesofstudenttechnologists,theLaboratoryManualforNuclearMedicineTechnologyhasbeenpreparedfor nuclearmedicinetechnologytrainingprograms.Theexerciseswerewrittenbyeducatorswithyearsofexperienceintheirrespectiveareasofexpertiseandwerefieldtestedbytechnologistsin nuclearmedicineschools—bothinstructorsandstudents.

Individualexerciseshavebeen groupedintomajorsubjectareas.Thepurposeofeachexerciseisclearlydefinedinthe rationale;andthe objectives,materials

tobeused,step-by-stepprocedures,studyquestions,andselectedreferencesareincluded.Instructorsmayrearrangetheformataccordingtothefacilitiesandrequirementsof theirparticularprograms.

This manual will serve to enhance the student'sknowledgeof a standardcurriculumand developcompetency in clinical practice. It provides the mostcomprehensive training resource available to be usedina laboratorysetting.Inaddition,thismanualwillaidresidentsin fulfilling the NRC requirementsforlicensure.

ABBREVIATEDCONTENTSCONTRIBUTORSCharlesT.Adams,RobertT.Anger,NancyA.Clifton, Robert J. English, Casimir Eubig,MichaelFreeman,WandaM.Hibbard,KennethA.Holmes,RonnieD.Jeffcoat,JudithE.Kosegi,RebeccaW. Lam, Sue R Lance,Joan A.McKeown,EvelynR. Merritt, Maria Nagel,JamesA. Ponto,John H. Powell,RaymondWilemzick,JamesJ. Wirrell

InstrumentationPhysicsRadiopharmacyRadiochemistryPatientCare

$12.00 per copy. Add $2.50 postage and handling for each book ordered. If ordering in bulk quantities, contactthe Order Dept. for postage fees. Prepayment is required in US funds drawn on US banks only. No foreign funds areaccepted. For payments made in US dollars but drawn on aforeign bank, add a bank processing fee of$4.50 for Canadianbank drafts or $40.00for all other foreign bank drafts. Check or purchase order must accompany all orders. Make checkspayableto:

The Society of Nuclear Medicine475 Park Avenue South, New York, NY 10016

(212)889-0717Prices are in US dollars and subject to change without notice.

Part II:Part III:Part IV:Part V:Part VI:

Softcoverformat,81/2x 11―,163 pp.Publication date: July 1984

ORDERNOW!

40A THE JOURNAL OF NUCLEAR MEDICINE

NEWfrom The TechnologistSection!

LABORATORYMANUALforNuclearMedicineTechnology

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Add $2.50 postage and handling for each book ordered. Prepaymentrequired in U.S.funds drawn on U.S banks only. For payments made in U.S dollars, but drawn on a foreignbank, add a bank processing fee of$4.50 for Canadian bank drafts or $40.00 for all otherforeign bank drafts. Check or purchase order must accompany all orders. Make checkspayable to: The Society of Nuclear Medicine. Prices are in US. dollars and are subjectto changewithout notice.

@ The Society of Nuclear Medicine,475 Park Avenue South, New York, NY 10016

42A THE JOURNAL OF NUCLEAR MEDICINE

\“@y

@-------------

6 x 9 “softcover; 312 pages$35.00 SNM members;

$47.00 non-membersPublication Date: January 1984

HIGHLIGHTSFROMTHE CONTENTS

NMR SpectroscopyM.R. Wilicoti and Gaty E. Martin

The Basis of Imaging and Chemical Analysisby NMR

Paul A. Bottomley

Magnet Systems: Resistive, @iperconducting

and Permanent

William Oldendorf

Pulse Sequences for NMR Imaging UsingMultidimensional Reconstruction Techniques

Lawrence E. Crooks, John C. Hoenninger,and Mitsuaki Arakawa

Pulse Sequence and Image Contrast

John C. Gore

Nuclear Medicine—NMR Correlation

F David Rollo

NMR and PET for Metabolic Studies

R. EdwardColeman,Robertj Herfk€ns,Michael E. Phelps, and Burton P Drayer

NUCLEAR MAGNETICRESONANCE andCorrelative ImagingModalitiesEditedbyC. LeonPartain,PhD,MD

This multi-authored book contains state-of

the-art summaries on ultrasound, x-ray,computed tomography, and digital radiog

raphy in addition to NMR. The correlativeaspects of each modality with nuclear

medicine are investigated. Material devoted

to NMR covers topics such as basic prin

ciples and instrumentation; considerationsof site preparation; safety and quality

control; pulse sequences and tissue contrast;

and the current clinical results at certain

hospital installations. Facts on the economic,legal, and political aspects of NMR arealso included.

Anyone in nuclear medicine—from profes

sional to student—interested in new technologies to ensure a quantitative, physical,

and biochemical basis for accurate medical

diagnosis will profit from reading thiscomprehensive publication.

OrderingInformation:

MODEL210TheBRAilLEP-DETECToffersyoufullyautomaticR-wavetriggeringand iscompatiblewithall nuclearmedicinecomputers.Inaddition,the model211has a stripchart withEKGand event markermdicalingtheexactlocationoftheP-DETECTsignal.

SpecialFeaturesS Fully automatic threshold

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. Pacemakerpulserejection

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. StripchartwithEKGand R-DETECTeventmarker(model211only)

@ MedicalElectronicsCorporationBrattleInstrumentDivision335 Newbury StreetBoston,Massachusetts 02115

MODEL211

TheBRAilLEP-DETECToffersyoufullyautomaticR-wavetriggeringand iscompatiblewithall nuclearmedicinecomputers.@naddition,the model211hasa stripchart withEKGand eventmarkermdicafing the exact location ofthe P-DETECTsignal.

SpecialFeatures. Fullyautomaticthreshold. OnlyIwoelectrodes. Highheartratecapability'. . . idealforstresstesting. SelectablePVCrejection. Digital heartrate readout. Pacemakerpulserejection. FlashingLEDindicatesQRS. LEDindicatesfauuyelectrodeconnections. AnalogECGoutput. Compatiblewithall nuclearmedicinecomputersS Strlpchart wllh EKG and R-DETE@T event marker (model 21 1 only)

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44A THE JOURNAL OF NUCLEAR MEDICINE

NUCLEAR MEDICINE TECHNOLOGIST.Knewledgeofnuclearcardio1o@j,,knowledgeof Baird77. Contact: Cardiac Extension,9-5, Mon-Wed;(212)586-081&

NUCLEAR MEDICINE TECHNOLOGIST. Pbsition now available 5r an espeñencedNuclear Modicine Technologist certified by SNM or re@isteredtechnologist in a private progressive outpatient nuclear medicine laboratory in a large city in a largemedical center inthe Sun Belt. Knowledgeof radioimmunoassay, imaging, computer, and nuclear cardiologyinadditioutosupervisor@cadministrative,andteachingexperience required. Pleasesend resumeto:Box900,SocietyofNuclearMedicine,475ParkAwSo., New York, NY l00l6@

POSITRONEMISSIONTOMOGRAPHY(PET).A postdoctoralor junior facultyposition in radiochemistryisavailablebeginningOctober 1, 1984.Thesuccessful applicant will synthesize and label novelorganic radiopharmaceuticals with short half-lifepositronemitters(e.g., “C,15F,13N)lbr PET studiesof regional cerebral metabolism and physiology.Though helpful, a background in radiochemistry is

not a prerequisite for this position; however,experience in organic synthesisand preparation techniques(HPLC, GC)is required. Salary commensurate withtalent and experience. Send curriculum vitae, bibliography and references to: James Z. Ginos, PhD,DepartmentofNeurology, MemorialSloan-KetteringCancer Center, 1275 York Avenue, New York,NY 10021.

POSITIONS WANTED

PATHOLOGIST (AP&CP)/NUCLEAR MEDICINE.Physicianwithexcellentexperienceandtopcredentialsdesires relocation. Reply Box902, Society of Nuclear Medicine, 475 Park Ave. So., NewYork,NY l001@

FOR SALE

GE STAR COMPUTER,software updated.Contact: Materials Management Department;(406)482-2l20@ext. 173for prices.

POSITIONS OPENHEAD, DEPARTMENTOF NUCLEAR MEDI

cm@.D@t@ ntt@n-ti@üc@mbent.Si JOSeph'SHOSpItaI@a6W-bedactiveteachinghos@, affihiatedwiththe6culty ofhealthsciences,McMaster University. This is an excellent opportunity @rstungp@ic@nandofferslong-tenncareerpotential. Candidatesshould hold certification in fluclear medicine or its equivalent. Please reply to:Mr. D. Scott. Assistant Executive Director, St.Joseph's Hospital, Hamilton, Ontario LSN 4A6;(416)5224941.

NUCLEAR MEDICINE PHYSICIAN. Experienced Nuclear Medicine Pysician in expending progressive private in vivo and in vitro NM outpatientlaboratory. Applicant should be board certified byABNM or board eligible in Nuclear Medicine withpreferably t@ years internal medicine residencytraining. Medical school association or affiliationpossible ifdesired. Please send resume to: Box 901,Societyo(NuclearMedicine, 475ParkAve.So., NewYork,NY l00l@

].d@;.. .ft@@ FIoidi @.dT•@. “.& ‘@@ @&*@yp.og'. - -@ @‘@d....@@ top@@•d@@•I@ tr@.G.ds Q.@•$DI€@,@C.@@bo,f...@o..s

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45AVolume 25, Number 9

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A nuclear medicine resident position is available beginning July 1, 1985for a 2-year program at San Francisco General Hospital Medical Center.The program, approvedbythe ACGMEand satisfyingthe requirements of the American Board of NuclearMedicine, includes didactic instruction in radiologicalphysics and mathematics, electronics, radiation safety,dosimetry,andnuclearmedicineinstrumentation.Practical experience is provided in performance andinterpretationof static and dynamic imaging,computer techniques, radioimmunoassay and other in vitrotests,radiopharmacy,andtherapywithradionuclides.Residentsparticipatefullyintheintegrationofthesemodalities Into patient care.Prerequisite: Prior training In an ACGME-approvedprogram in internal medicine, pathology, pediatrics,or radiology.The University ofCalifornia Is an Equal Opportunity,Affirmative Action Employer.Requests forfurther information (include CV) shouldbe directedto:

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