Nuclear medicine comes of age: its present and future roles in diagnosis.
Nuclear medicine comes of age: its present and future roles in diagnosis.
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核医学的成熟：它在诊断中当前和未来的作用。
DOI：
10.1148/radiology.174.3.2406775
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发表时间：
1990
期刊：
影响因子：
19.7
通讯作者：
Frymoyer,PA
中科院分区：
文献类型：
--
作者：
McAfee,JG;Kopecky,RT;Frymoyer,PA
核医学在临床诊断中的作用是由两名内科医生在回顾性审查病历中调查的。大约20例放射性成像研究中有1例是放射性核素检查，在门诊患者中进行的比例稍大。内科医生发现，核医学的诊断筛查程序影响了63%的住院患者的管理，定量/监测类型的测试影响了56%的管理。在美国4900亿美元的预计医疗保健费用中，所有成像程序将仅占120亿美元，核医学程序将占约10亿美元。核医学研究继续开花。1988财政年度，美国国立卫生研究院用于诊断成像研究的预算总额为8660万美元，其中核医学项目占43%，所有其他放射学项目占30%，放射学以外的项目占30%。正电子发射体和正电子发射断层扫描的研究总额为2050万美元，放射性标记单克隆抗体的研究总额为620万美元。与其他发达国家相比，两个主要问题可能阻碍美国核医学的未来实践：（a）美国食品和药物管理局和其他机构批准新放射性药物的程序严重滞后;（B）缺乏专门用于连续生产用于生物医学研究的放射性核素的设施。现在，只有在高能物理实验中才允许零星生产。在不久的将来，可能引起临床核医学最大变化的最新发展是单光子发射计算机断层摄影设备的设计和使用的改进以及新放射性药物的多产，特别是用于脑和心肌成像的锝-99m剂和肿瘤剂。
The current role of nuclear medicine in clinical diagnosis was surveyed in a retrospective review of medical records by two internists. About one radiologic imaging study in 20 was a radionuclide procedure, and a somewhat larger fraction was performed in outpatients. The internists found that diagnostic screening procedures in nuclear medicine influenced patient management in 63% of hospital inpatients, and quantitative/monitoring types of tests influenced management in 56%. Of the projected health care costs in the United States of $490 billion, all imaging procedures will account for only $12 billion, and nuclear medicine procedures will account for about $1 billion. Nuclear medicine research continues to blossom. The National Institutes of Health budget for diagnostic imaging research in fiscal year 1988 totaled $86.6 million; nuclear medicine projects represented 43% of this total, all other projects in radiology represented 30%, and projects outside radiology represented 30%. Research with positron emitters and positron emission tomography totaled $20.5 million, and research with radiolabeled monoclonal antibodies totaled $6.2 million. Two major problems may hinder the future practice of nuclear medicine in the United States compared with that in other developed countries: (a) the serious time lag in the approval process for new radiopharmaceuticals by the U.S. Food and Drug Administration and other agencies and (b) the lack of a facility dedicated to the continuous production of radionuclides for biomedical research. Now, there is sporadic production permitted only during high-energy physics experiments. The recent developments which will probably induce the greatest changes in clinical nuclear medicine in the near future are the improvements in design and utilization of single photon emission computed tomographic devices and prolific generation of new radiopharmaceuticals, especially technetium-99m agents for cerebral and myocardial imaging and tumor agents.