Radiopharmaceuticals for nuclear endocrinology at the University of Michigan

The historical background at the University of Michigan laid a foundation f or the innovative development of radionuclides in diagnosis and treatment o f endocrine diseases. From that background, Dr. William Beierwaltes, the ch ief of Nuclear Medicine, inspired two talented young chemists to synthesize unique radiopharmaceuticals that transformed diagnostic approaches to cert ain endocrine disorders. Dr Raymond Counsell's 131-I-radiocholesterol, enab led imaging that defined function in the adrenal cortex, and thereby distin guished the different forms of Cushing's syndrome and of primary aldosteron ism; in addition, this new technique differentiated benign adrenal cortical adenomas from other adrenal cortical tumors. Dr. Donald Wieland created me taiodobenzlylguanidine (MIBG), a compound that can be tagged with either 13 1-I or 123-I, and led to the scintigraphic depiction of adrenergic tumors, particularly pheochromocytomas and neuroblastoma, anywhere in the body of a patient. Treatments with large doses of MIBG have reduced the malignant fo rms of pheochromocytomas and brought remissions to children with neuroblast omas. MIBG also concentrated in the autonomic neurons and so the nerves of the heart were also portrayed Subsequent novel syntheses included positron- emitting nuclides that through positron emission tomography, have revealed the physiology and altered physiology of the human heart. These men and the ir discoveries exemplify the creative endeavors that compel us to seek furt her the wonders of nuclear science.