Diagnostics Methods In Clinical Thyroidology

Diagnostic Methods in Clinical Thyroidology provides a forum for discussion of controversial issues in three major categories: diagnosis of thyroid function, non-invasive evaluation of structural abnormalities, and needle biopsy diagnosis of thyroid nodules. For each category, a free interchange of ideas based on extensive clinical experience is followed by a summary that strives to resolve these controversial issues within a framework of sound clinical practice. The volume will this serve as a ready reference for the many physicians who evaluate thyroid patients.

"Man's natural instinct, in fact, is never toward what is sound and true. It is toward what is specious and false . . . The ideas that conquer the race most rapidly and arouse the wildest enthusiasm and are held most tenaciously are precisely the ideas that are most insane. This has been true since the first 'advanced' gorilla put on underwear, cultivated a frown and began his first lecture tour, . . . " H. L. Mencken, from Meditation On Meditation in the Smart Set, June, 1920 pp 45-46 In our opinion there is no field of clinical medicine in such a state of dynamic disequilibrium as clin ical thyroidology. Thyroid diseases are very common. The moderately complex but easily understandable physiological interrelationships between the thyroid, pituitary and hypothalamus have provided stimuli for the application of mod ern technology in the development of an array of diagnostic procedures. Although therapeutic methods have been more stable, and recent advances more limited, their application by phy- Joel I. Hambufl~er. M. D. sicians representing different disciplines has pro vided an ample basis for the expression of differ ing viewpoints. Unfortunately there are few opportunities for in-depth exploration of different attitudes and experience relevant to issues of current interest. The review process employed by medical journals often seems to stifle the expression of controver sial viewpoints.

"Man's natural instinct, in fact, is never toward what is sound and true. It is toward what is specious and false . . . The ideas that conquer the race most rapidly and arouse the wildest enthusiasm and are held most tenaciously are precisely the ideas that are most insane. This has been true since the first 'advanced' gorilla put on underwear, cultivated a frown and began his first lecture tour, . . . " H. L. Mencken, from Meditation On Meditation in the Smart Set, June, 1920 pp 45-46 In our opinion there is no field of clinical medicine in such a state of dynamic disequilibrium as clin ical thyroidology. Thyroid diseases are very common. The moderately complex but easily understandable physiological interrelationships between the thyroid, pituitary and hypothalamus have provided stimuli for the application of mod ern technology in the development of an array of diagnostic procedures. Although therapeutic methods have been more stable, and recent advances more limited, their application by phy- Joel I. Hambufl~er. M. D. sicians representing different disciplines has pro vided an ample basis for the expression of differ ing viewpoints. Unfortunately there are few opportunities for in-depth exploration of different attitudes and experience relevant to issues of current interest. The review process employed by medical journals often seems to stifle the expression of controver sial viewpoints.

Thyroid carcinoma is an uncommon malignan ing the available non-human lines, as models cy. In the vast majority of patients, if treated for cell cycle studies and oncogene/anti appropriately, it is associated with a benign oncogene regulation, because they are unaware clinical course. Why then does it hold a con of the often fundamental dichotomy between tinuing fascination for so many physicians? thyroid malignancy and prognosis. Third, the The answer is probably directly dependent very nature of the benign clinical course has suggested to the major health research fund on the very benign nature of most thyroid ing agencies that thyroid cancer is not worthy maligllancies. While there are terrible excep of study in a time of scarce resources. tions, the follicular and papillary thyroid can Nothing could be further from the truth. cers behave in a way quite alien to "common" This gratifying clinical course is the very reason neoplasia, since they grow and metastasize why the study of human thyroid cancer has the slowly. We believe that if only we could under potential for contributing further to our fun stand such a transformed state, we would be able to learn a great deal about the normal and damental understanding of malignancy and, abnormal regulation of the cell cycle and im perhaps more importantly, the mechanisms by prove our understanding of cancer. which the human body can resist neoplastic However, recent advances in the biology of cells.

Thyroid Diseases is a comprehensive reference supported by a useful selection of schematic diagrams, tables, and charts. Its basic science section supplements classic and recent reviews of the subject by discussing structural and functional aspects of the thyroid gland, including thyroid hormone action (receptor and non-receptor mediated) and the hypothalamic-pituitary-thyroid control mechanisms. The clinical aspect of the book critically reviews current diagnostic modalities and addresses the choice of specialized tests and optimal sequence of their performance. Diagnostic modalities discussed include in vitro radioisotopic and nonradioisotopic assays of thyroid hormone, TSH, thyroglobulin, calcitonin, and autoantibodies. The various techniques are evaluated to show which procedures are applicable for each condition. This book brings together information dispersed across the medical and radiological literature. It will benefit professionals in radiology, nuclear medicine, and endocrinology, as well as students in these fields.

This handbook will provide updated information on nuclear medicine and molecular imaging techniques as well as its clinical applications, including radionuclide therapy, to trainees and practitioners of nuclear medicine, radiology and general medicine. Updated information on nuclear medicine and molecular imaging are vitally important and useful to both trainees and existing practitioners. Imaging techniques and agents are advancing and changing so rapidly that concise and pertinent information are absolutely necessary and helpful. It is hoped that this handbook will help readers be better equipped for the utilization of new imaging methods and treatments using radiopharmaceuticals. Contents:Basic Sciences:Basic Nuclear Physics and Instrumentation (Jae Sung Lee)Radiopharmaceutical Chemistry (Yun-Sang Lee)Clinical Applications:Unexpected Nuclear Scan Findings Due to Radiopharmaceutical, Technical, or Patient-Related Factors (Usha A Joseph, David Q Wan, Asad Nasir, David Brandon, Isis W Gayed and Bruce J Barron)Nuclear Medicine in Neurological Disorder (Yu-Keong Kim and Dong-Soo Kim)Scintigraphic Imaging of Cerebral Spinal Fluid Flow, Blockage, and Leakage (Franklin C Wong and E Edmund Kim)Nuclear Endocrinology (Ho-Young Lee, June-Key Chung and E Edmund Kim)Nuclear Cardiac Imaging (Jin-Chul Paeng and Dong-Soo Kim)Pulmonary Nuclear Medicine (E Edmund Kim and Franklin Wong)Gastrointestinal Nuclear Medicine (Gi-Jeong Cheon and E Edmund Kim)Nuclear Imaging of Esophageal, Gastric, and Pancreatic Cancers (Hirofumi Shibata, Ukihide Tateishi and Tomio Inoue)Nuclear Urology (Ukihide Tateishi and E Edmund Kim)Bone and Joint Nuclear Imaging (Seok-ki Kim)Lymphoscintigraphy and Nuclear Venography (E Edmund Kim and Franklin Wong)Infection and Inflammation Imaging (So-Won Oh, Ukihide Tateishi,Yu-Kyeong Kim, Jin-Chul Paeng and E Edmund Kim)Tumor Imaging (Ukihide Tateishi and E Edmund Kim)Receptor-Binding Peptide Imaging (E Edmund Kim and Richard Baum)In vivo Molecular Imaging (Keon Wook Kang)In Vitro Nuclear Medicine Tests (E Edmund Kim)Therapeutic Applications of Radiopharmaceuticals (Franklin C Wong and E Edmund Kim) Readership: Trainees and practitioners of nuclear medicine, radiology and general medicine seeking updated information on nuclear medicine and molecular imaging techniques as well as its clinical applications, including radionuclide therapy. Keywords:Nuclear Medicine;Molecular Imaging;PET/CT;SPECT/CT;Radionuclide TherapyKey Features:Written by experienced international experts in the field of nuclear medicine and molecular imagingCombined information on nuclear medicine and molecular imaging in one textbookEmphasis on practical, important and useful imagings and treatments using internal radiationReviews: “The text, highlighting the continuing evolution of imaging techniques and radiopharmaceuticals also used for therapeutic purposes, may certainly be considered a manual of instruction, simple and understandable, user–friendly for the practice of nuclear medicine, and offering interesting insights into current clinical applications and future prospects.” European Journal of Nuclear Medicine and Molecular Imaging

First multi-year cumulation covers six years: 1965-70.