LAUSR

This year Satoshi Minoshima, President of the Society of Nuclear Medicine and Molecular Imaging, wrote that ‘Nuclear medicine has been a trailblazer in imaging and sciences for more than a century’ [1]. In the 1950s, before the Internet, faxes and texting, trailblazing in nuclear medicine was taking place on both sides of the Atlantic, but without the benefits of instant communication by Internet, fax or text. Next year, 2020, will mark the 70th anniversary of the start of automatic radionuclide imaging and the beginning of nuclear medicine and molecular imaging as we understand it today. Until the 1950s, radionuclide studies concentrated on physiological measurements of body function. The first attempts at studying the distribution of radionuclides within organs used hand-held Geiger-counter detectors. The count rates were plotted on graph paper and isocount lines were drawn. Manual linear scanning was reported in the British Journal of Radiology in November 1948. Ansell and Rotblat [2] evaluated a retrosternal mass seen on X-ray with manual linear Geiger-counter scanning and 90 microcuries of I in a solution of 2 mg inert iodine. The first documented automatic scanner radionuclide images of radioiodine in the female human thyroid were presented by Ziedses des Plantes, a Dutch neuroradiologist, at the International Congress of Radiology in London in June 1950. Made in Holland, (Fig. 1) the apparatus for ‘indirect autoradiography’ used a shielded Geiger–Müller tube of 5 cm length and a single-hole aperture of 1.5 cm moving at a constant speed zig-zag relative to the patient’s thyroid [3–5]. Ziedses des Plantes used an electrochemical method of recording the activity, with a lead stylus and paper moistened with a solution containing potassium iodine, potassium bromide, and dextrene. Unfortunately, the automatic radionuclide scanner received little attention at the time. In July 1951 at the Oxford Isotope Techniques Conference, Val Mayneord from the Institute of Cancer Research in London demonstrated ‘a method of making visible the distribution of radioactivity from a source of ionising radiation’. The proceedings were published in the UK by Her Majesty’s Stationery Office for the princely sum of £2 10s 0d (or by post £2 11s 0d). The apparatus, originally designed for imaging brachytherapy sources, was soon used to image radioiodine in the thyroid. Interestingly, it had a novel scanning mechanism where the head with two Geiger counter detectors (one for background radiation subtraction) was mounted on a gimbal. The motion of the head was brought about by two rotating cams being arranged so that one produced a scan along a vertical axis and the other along a horizontal axis. For the raster display, two cathode ray tubes were used; one with long persistence for viewing, and the other with short persistence for photography. This clever but rather complicated device was soon replaced with a rectilinear scanner frame similar to that used by Cassen [5, 6] but using a novel continuous detector Fig. 1 The first documented automatic radionuclide scanner 1950. Reprinted from Selected works of B G Ziedes des Plantes Amsterdam: Excerpta Medica, B G Ziedes des Plantes Direct and indirect radiography pp 199-204 1973