Introduction of nuclear medicine research in Japan

Eur J Nucl Med Mol Imaging (2016) 43:2449–2452 DOI 10.1007/s00259-016-3468-4 REVIEW ARTICLE Introduction of nuclear medicine research in Japan Masayuki Inubushi 1 & Tatsuya Higashi 2 & Ichiei Kuji 3 & Setsu Sakamoto 4 & Manabu Tashiro 5 & Mitsuru Momose 6 Received: 9 July 2016 / Accepted: 13 July 2016 / Published online: 4 August 2016 # The Author(s) 2016. This article is published with open access at Springerlink.com Abstract There were many interesting presentations of unique studies at the Annual Meeting of the Japanese Society of Nuclear Medicine, although there were fewer attendees from Europe than expected. These presentations included research on diseases that are more frequent in Japan and Asia than in Europe, synthesis of original radiopharmaceuticals, and development of imaging devices and methods with novel ideas especially by Japanese manufacturers. In this review, we introduce recent nuclear medicine research conducted in Japan in the five categories of Oncology, Neurology, Cardiology, Radiopharmaceuticals and Technology. It is our hope that this article will encourage the participation of researchers from all over the world, in * Masayuki Inubushi 1 Division of Nuclear Medicine, Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan 2 National Institute of Radiological Sciences, National Institutes of Quantum and Radiological Science and Technology, 4-9-1 Anakawa Inage-ku, Chiba, Chiba 263-8555, Japan 3 Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama 350-1298, Japan 4 PET Center, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan 5 Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center, Tohoku University, 6-3 Aoba Aramaki Aoba-ku, Sendai, Miyagi 980-8578, Japan 6 Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University, 8-1 Kawada-cho Shinjuku-ku, Tokyo 162-8666, Japan particular from Europe, in scientific meetings on nuclear medicine held in Japan. Keywords 11C-4′-Thiothymidine (4DST) . IgG4-related disease . 18F-FRP170 . 18F-FE-PE2I . Semiconductor SPECT . Spillover correction Introduction Every time we attend annual meetings of the European Association of Nuclear Medicine, we are surprised at the large number of attendees from Japan. In contrast, at the Annual Meeting of the Japanese Society of Nuclear Medicine there were fewer attendees from Europe than expected, probably due in part to the language issue. However, there were many interesting presentations of unique studies in Japan. These include research on diseases that are more frequent in Japan and Asia than in Europe, synthesis of original radiopharmaceuticals, and development of imaging devices and methods with novel ideas especially by Japanese manufacturers. In this review, we discuss recent nuclear medicine research conducted in Japan in the five categories of Oncology, Neurology, Cardiology, Radiopharmaceuticals and Technology. Oncology Okasaki et al. conducted a prospective study in an undeveloped medical field: a comparative study of the diagnostic evaluation of multiple myeloma (MM) using three different PET tracers, 18F-fluorodeoxyglucose (FDG), an amino acid tracer 11C-methionine (MET), and a tumour proliferation tracer 11C-4′-thiothymidine (4DST) which has been recently introduced in Japan [1]. The progression of MM from care-not- 2450 required premalignant conditions, including monoclonal gammopathy of undetermined significance (MGUS) and smouldering MM (SMM), to care-required MM with endstage organ damage requires clinical evaluation, but the diagnostic imaging for this purpose has not been established. In addition, MM occurs as the disease spreading type, focal lytic bone lesions (FLL) and diffuse bone marrow lesions (DBML). These are major challenges for imaging modalities, not only for morphological imaging, but also for PET. Okasaki et al. performed two different studies with relatively large numbers of patients: study 1 in FLL (24 patients, 55 lesions) and study 2 in DBML (36 patients, 36 lesions). In both studies, metabolic PET imaging using MET and 4DST showed higher accuracy than FDG, and clearly distinguished MGUS from SMM and MM in DBML. Their methodology (separate evaluation of FLL and DBML) is feasible in clinical use and may be a standard imaging method for PET/CT evaluation in the diagnosis of MM. Their method may also be applicable to PET imaging using 18F-fluorothymidine (FLT), a more commonly used PET tracer for evaluation of tumour proliferation. A follow-up study using FLT would be interesting. IgG4-related disease (IgG4-RD) has been reported more frequently in Japan than in Europe. However, we believe that knowledge of the exact criteria for the diagnosis of this disease is also important in Europe. Tokue et al. retrospectively evaluated FDG PET/CT images in patients with IgG4-RD to determine the involvement of the head and neck glands in this disease [2]. Despite the small number of patients included (17), they evaluated in detail the clinical manifestations, including the chief complaints, serum blood data, and the pattern of extraglandular involvement including the lung, pancreas, kidney, retroperitoneum, and prostate. They found that almost 90 % of patients showed extraglandular involvement and that almost 95 % showed elevated serum IgG4 values. These findings indicate that serum IgG4 examination is important when a multiple organ involvement pattern is observed on FDG PET/CT. IgG4-RD can easily be differentiated from malignant lymphoma by determination of serum IgG4, rather than by lymph node biopsy. In view of its low invasiveness and saving of medical costs, an understanding of the use of FDG PET/CT for the diagnosis of IgG4-RD would be valuable. Neurology Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia following Alzheimer’s disease (AD). The hypometabolic regions observed in DLB brains are similar to those in AD brains, although DLB brains also exhibit involvement of the occipital lobe. There is a controversy regarding the correlation between amyloid deposition Eur J Nucl Med Mol Imaging (2016) 43:2449–2452 and the symptom profile, severity and progression, as some patients with DLB can show a pattern of AD-like reduced glucose metabolism without amyloid deposition. Ishii et al. examined regional hypometabolism and amyloid deposits (using Pittsburgh compound B, 11C-PiB) in the DLB brain in order to investigate the relationship between the reduced glucose metabolism in the parietotemporal and posterior cingulate and amyloid deposition in the DLB brain and the degree of regional hypometabolism in DLB in relation to that in AD [3]. They found that in the DLB brain regional glucose metabolism is affected both in subjects positive and in those negative for PiB uptake showing a reduction patte (...truncated)