Preface

It has been an honor and a privilege to chair the committee on the state of science in nuclear medicine. As a diagnostic radiologist, a clinician-scientist, and the chairperson of a large academic radiology department, I have been exposed to the many advances in nuclear medicine and have observed their clinical benefits up close. Participating in this review, however, has allowed me to step back and appreciate the magnitude of the progress that has been achieved, and the crucial role that government funding has played in it. Investments in chemistry, physics, engineering, and training are responsible for the state-of-the-art radiopharmaceuticals and imaging instruments that we now rely on to improve our understanding of human physiology through non-invasive disease detection and treatment monitoring.

These advances have already had a major impact on all branches of imaging and medicine, yet, they pale in comparison to those on the horizon. Nuclear medicine offers a unique, non-invasive view into intracellular processes and enzyme trafficking, receptors and gene expression, and forms the theoretical and applied foundation for molecular medicine. The contributions of nuclear medicine are creating the possibility of a future of personalized medicine, in which treatments and medications will be based on an individual’s unique genetic profile and response to disease processes.

Although the progress in nuclear medicine research in the United States has been spectacular, potential obstacles to its continuation have been noted in previous reports, including a critical shortage of chemists and other personnel trained in nuclear medicine, and an inadequate supply of radionuclides for research and development. In addition, uncertainty has arisen about how, and to what degree, the government should continue to fund nuclear medicine research. For years, the basic chemistry and physics research behind the growth of the field has been supported by the Medical Applications and Sciences Program of the Department of Energy (DOE) Office of Biological and Environmental Research. However, the uniqueness of this program relative to the nuclear medicine research funded by the National Institutes of Health (NIH) has long been under debate. The DOE and the NIH commissioned this study on the state of the science in nuclear medicine because of the uncertainty surrounding the support of the Medical Applications and Sciences Program. Specifically, the sponsoring agencies asked that the National Academies assess areas of need in nuclear medicine research, examine the program and make recommendations to improve its impact on nuclear medicine research and isotope production.

In response to this request, the National Research Council of the National Academies appointed a committee of 14 experts to carry out this study. The committee gathered information from members of the public, experts on nuclear medicine, scientific and medical societies, and federal agencies. In composing its report, the committee decided to describe the needs in nuclear medicine research primarily in terms of future opportunities in the field. Thus the report, in my view, is an exciting, forward-looking document that makes clear the potential of the field for further advancing medicine, and suggests practical steps to facilitate progress. I hope and believe that it will have a positive impact on the future of nuclear medicine.

Hedvig Hricak, Chair