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Application of Physics in Medicine

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DOI: 10.5915/22-2-13560

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DOI: http://dx.doi.org/10.5915/22-2-13560

Application of Physics in Medicine

Syed Farooq Akber, Ph.D.

Houston, Texas

Abstract
The application of physics principles to medical practice has made an outstanding contribution in the
diagnosis and treatment of cancer. Further amalgamation of research, application, cooperation and understan-
ding of physics and medicine will enhance new perspectives on the benefits of ionizing and nonionizing radia-
tions for medical diagnosis and therapy. Jn this paper, a general survey has been made ofphysics applications in
medicine.

Key words: Medical imaging, NMR, MRS, radioisotope.

The application of physics principles to medical Nobel laureate Professor Abdus Salam, developed an
practice bas made an astounding contribution in the elegant technique for deciphering the genetic code,
prognosis and treatment of cancer. The discovery of for which he was awarded the Nobel Prize in
x-rays by Roentgen 1 in 1895 opened a new vista of chemistry in 1980.
medical imaging and was awarded the Nobel prize in Thus evolved a new frontier of medical science
physics in 1901. The discovery of artificial radioac- known as "genetic engineering". No one would have
tivity by Joliot and Trene Curie1 in 1934 Jed John thought that the concept of nuclear angular momen-
Lawrence two years later to inject a radioisotope tum introduced by Wolfgang Pauli, would be utilized
(Phosphorus-32) into a patient to treat leukemia. In by physicists 60 years later in the 1980s, for the
the 1950s, nuclear physicists Rosalyn Yalow and visualization of anatomical and physiological func-
Solomon Berson 1 developed the radioimmunoassay tions of the human body. Physicists, on the other
method of insulin, based on the principle of com- hand, using high energy accelerators for nuclear
petitive binding by antibodies of natural and labeled physics experiments, saw immediate application of
hormones. This process is used by physiologists to such a method in the treatment of cancer. They
visualize human organ functions. Rosalyn Yalow• in modified these accelerators for clinical purposes pro-
1977 received the Nobel Prize in medicine. viding several million electron volts (MeV) of energy
Physicists Cormack5 and Hounsfield 6 earned the to treat cancer by ionizing radiation at any location
Nobel prize in medicine in 1979 for their independent in the body.
and unique contributions to the invention of x-ray The widespread use of computers and digital imag-
computed tomography (XCT). Walter Gilbert,~ a ing techniques in the 1970s ushered in a revolution
theoretical physicist who did his doctorate under that continues to influence imaging modalities today.
With these advances came both nuclear and x-ray im-
agers capable of producing true cross-section images
From the Department of Radiology of any surfaces.
University of Texas Medical Center Other areas of medicine in which physicists have
Houston, TX
made their contributions are ultrasound diagnosis,
Reprint Requests: Syed Farooq Akber
hypertbermia, audiology, opthalmology, en-
Department of Radiology docrinology, physiology, physical therapy and
University of Texas Medical Center general medical instrumentation. Laser scapels figure
6431 Fannin, 2.130 MSMB prominently as powerful tools in many surgical pro-
Houston, TX 77030 cedures.

Page 72 - JJMA: Volume 22, 1990

Roentgenography
A radiograph is a pictorial representation of
human anatomy of x-ray absorption by a three
dimensional body onto a two dimensional film. Of
all the imaging modalities to date, roentgenography
features the best spatial resolution for high contrast
objects. Even so, the vivid contrast is lost in the im-
aging of chest, breast and extremities for soft tissue
characteristics, due to low differential attenuation of
x-ray photons. Contrast resolution also is limited by
the scatter inherent in the attenuation process, and by
the film-observer system dynamic range.
Interaction of matter with energy involves at least
ten different processes. The amount of attenuation
depends on the energy of the photons and the
characteristics of the substances, such as atomic
number, density and electrons per gram. X-ray
photon energy and atomic number determine the
relative percentage of photoelectric and Compton
reactions. Density affects attenuation greatly, as
evidenced in radiographic image contrast, due to
tissue density variation.

Dual energy subtraction roentgenography

Tissue characteristic can be enahnced by the use of Figure 1. X-ray computed tomography image of the
two photon energies.• It provides spatial information normal human brain, providing visual evidence of
as well as x-ray intensity. The use of two photon size, shape, position and symmetry of the fluid filled
energies provide us with two images simultaneously ventricles.
and can be resolved into water (soft tissue) and bone
(mineral) components pixel by pixel. The intensity
values are proportional to the overlying thickness of x-ray tube revolves around the patient. The rotation
tissues and bone. A soft tissue image (that is, a bone of the x-ray fan beam produces a charge signal pro-
canceled image) can be generated by computer by ad- portional to the absorbed x-ray energy in the detec-
ding a small fraction of the bone image to the soft tors. The depth information is obtained by moving
tissue image to patch up the voids left by the removal the x-ray source about a fixed array of detectors and
of bone. A single image can then be generated by ad- obtaining projections of the same section from 360 °.
ding the original low and high energy images Collection of data talces 1 to 10 seconds. Projection
together. data is digitized, corrected for scatter, focal spot size
The advantage of the computer manipulated and detector characteristics, and is reconstructed as a
technique is a particular asset in chest roen- two dimensional map of the local attenuation coeffi-
tgenography. It provides an image free from the cients, commonly known as CT numbers.
disturbing influence of bone. For example, a nodule XCT is basically a diagnostic tool. It provides
under the rib can be vividly seen on the soft tissue im- three dimensional information on the shape, dimen-
age, without the bone. This technique is also used to sions and positions of anatomical structures. It offers
visualize the breast, the measurement of bone scant value to physiologists in that it lacks the fourth
mineral content (for detecting and monitoring of dimension, temporal resolution.
osteoporosis), and the assessment of metabolic XCT is indispensable in clinical practice. It is ex-
calcification of the lungs in kidney disease. tremely useful in the diagnosis of central nervous
system disease as the thickness of the human skull
X-Ray computed tomography (XCT) makes radiographic examination of the brain very
" Torno graph" is derived from the Greek difficult. XCT hurdles this barrier by providing
"tomos", meaning "to slice", and "graph" mean- visual evidence of size, shape, position and symmetry
ing "picture". Thus a tomograph is a pictorial of the fluid-filled ventricles and cisterns critical to
representation of a slice taken from a body. The detection of hydrocephalus, brain atrophy, tumors,
x-ray beam in computed tomography (CT) is col- cysts, abscesses and edema (Figure I). XCT images
limated into a thin (1.5 to 10 mm) fan that lies in a can be enhanced through use of contrast substances
plane perpendicular to the long axis of the body. A such as iodine to reveal hyperfusion or hypoperfu-
circular array of detectors enclose the patient. The sion, usully indicative of stroke or trauma.

JIMA: Volume 22, 1990 - Page 73

 Radionuclide imaging of endothelial amine receptors by demonstrating the
Nuclear medicine is the scientific and clinical active competition between 1-123 IMP and pro-
discipline in which radiotracers are distributed in pranolol and 1-123 IMP and ketamine. This was the
vivo when administered either orally or intravenous- first noninvasive in vivo radioimmunoassay techni-
ly. The radiotracers for imaging purposes must que, demonstrated by Akber," between two biogenic
satisfy the following criteria: amines of different chemical structure with similar
1. higher organ specificity binding sites in the lung. This technique has opened a
2. appropriate physical half-life that is compatible new vista to assess pulmonary endothelial receptors
with the physiological half-life of the phenomenon in the lungs in vivo. It is well known that pulmonary
under sutdy endothelial amine receptors are the primary site of
3. highly abundant gammas of energies greater than damage in a number of disease states such as oxygen
20 keV for adequate tissue penetration and less toxicity, adult respiratory distress syndrome and a
than 500 keV for higher sensitivity, better collima- variety of toxin and drug induced lung injuries.
tion, and minimal septal penetration Assessment of pulmonary endothelial receptor sites
4. no particulate radiation in normal and pathological condition is an important
5. monoenergetic step in understanding of receptor related diseas~.
6. should be nontoxic and taken up differently by With currently available radiotracers and detectors
normal and abnormal tissues. (Anger scintillation camera, single photon computed
In clinical nuclear medicine, radionuclides such as tomgrapby, and positron computed tomography) it is
Technetium 99m, Iodine 123, etc., are labeled to a possible to scan, either in static mode or dynamic
chemical compound, which when administered to a mode, the brain, the lungs, the liver, bones, the
patient, will localize within a specific organ. A kidneys, the spleen and tumors. Akber 20 has discuss-
chemical compound has specific binding sites within ed the various aspects of radionuclide imaging and
the target organ and the radioactive isotope acts only therefore, we will restrict our discussion to positron
as an indicator of the physiological path of the drug. emission tomography (PET).
However, nuclear medicine technique does not depict A number of radionuclides decay through the
structural anatomy as does ultrasound or XCT, or emission of positrons. A positron combines with an
conventional radiographs. It is an established nonin- electron, which in turn are annihilatd into two
vasive technique available to investigate organ photons of 511 keV each, at a 180° angle from each
physiology, though NMR has shown its capability to other. These photons can be detected by two scintilla-
investigate organ physiology and anatomy without tion detectors connected in a coincidence circuit. A
ionizing radiation.,_,, field of view is established that does not vary with
Despite the many advances that have been made, depth in PET. The attenuation can be computed by
the introduction of new radiopharmeceuticals has measuring the thickness of the object traversed
not been encouraging. The availability of new tracers (assuming a uniform absorbent), or by measuring its
results in increased application of radionuclide imag- absorption through placement of a position-emit-
ing. The introduction of Iodine 123 in recent years ting source outside the integral line.
has provided new incentive to label biogenic amines, PET yields sectional images of the distribution of
antibodies and free fatty acids. 11 While biogenic positron-emitting radionuclides in an organ of the
amines and free fatty acids have already found their patient in an analogous manner as XCT. The only
way into clinical diagnostic inventories, antibodies difference is that in PET the x-ray source is replaced
for in vivo detection of tumors are now used in by the body of a patient, injected with a radiophar-
clinical trials. maceutical .which acts as a source, surrounded by a
The most promising of all biogenic amines is ring of detectors.
N-lsopropyl-1-123-p-lodoamphetamine (1-123 IMP). PET provides an analytical and noninvasive
1-123 IMP binds to nonspecific sites after in- technique for studying brain, heart, lungs, or pan-
travenous administration in the brain in accordance creas. Physiological and biochemical functions can
with regional cerebral blood flow. It has also been us- be visualized by the use of physiologically active
ed to study cerebrovascular disorders and metabolic compounds labeled with positron emitting ra-
activities of the brain using SPECT, and bas been dionuclides such as carbon-I I, nitrogen-13,
very successful in the detection of Alzhemier's oxygen-15, or nuorine-19. The assessment of
disease. regional blood flow, oxygen consumption, variety of
1-123 IMP is also retained in the lung. •i-u Akber" metabolic activities, transport and hemodynamics,
has modified the Chinard-Crone's invasive indicator and neuroreceptor mapping have enabled us to ex-
dilution technique and developed a totally nonin- amine ischemia and several degenerative disorders
vasive in vivo technique using convolution and such as Huntington's disease, Alzhemier's disease,
deconvolution analysis using nuclear medicine schizophrenia and Parkinson disease.
methodology. Akber 11-1• provided further evidence

Page 74 - JIMA: Volume 22, 1990

 magnetic field Ho is recovered as the stimulated
spins emit their energy to their surroundings, i.e.,
to the lattice. The time constant for this process is
called spin lattice relaxation time (Tl).
2. The phase coherence is lost through spin-spin ex-
change processes. In this, two nuclear spins, lower
and upper state, flip simultaneously. The phase in-
coherence is contributed by the inhomogeneity of
the magnetic field Ho, which leads to differing
Larmor frequencies of individual spins. The time
constant for this process is known as spin-spin
relaxation time (T2).
Contrast in NMR images is based on relaxation
time dissimilarities between normal and malignant
tissues. However, no positive correlation has been
provided by the NMR investigators as to why the
NMR relaxation times are different in normal and
pathological states. Akber 2 2-11 has proposed an
hypothesis to explain this enigma: the dissimilarities
in relaxation time is due to the concentration of
paramagnetic molecular oxygen dissolved in cetJ
water. Under the purview of this hypothesis, Akber
1
1-29 has also recently shown that the variation in

relaxation times from organ co organ is due to the

consumption of oxygen.
Figure 2. Precession of nuclear angular momentum One of the advantages of NMR imaging is that it
(L) of proton about the direction of static magnetic obtains high contrast images compared to XCT. In
field (H 0 ). NMR imaging, brain tissue divides into two classes:
gray and white matter. Gray matter appears as a col-
lection of nerve cell bodies and white matter consists
of nerve fibers. Hydrogen in gray matter is nearly all
Nuclear magnetic resonance imaging (NMR) water, whereas in white matter a significant amount
Nuclear magnetic resonance (NMR) is a nuclear is contained in lipids. A vivid contrast can be seen
phenomena. All nuclei with odd numbers of protons between gray and white matter due to signal intensity
or neutrons, or both protons and neutrons of an ele- differences (Figure 3) which makes it possible to
ment such as hydrogen in water, have nuclear spin define internal structures of the brain with a clarity
(I= 112). When spinning nuclei are subjected to a not seen by XCT. The reason XCT does not
strong magnetic field, the nuclei will align themselves distinguish between gray and white matter so vividly
with the magnetic field and precess along the external is because the attenuation difference of x-ray
magnetic field with a frequency proportional to the photons is 0.517/o, one of the factors inhibiting image
magnetic field strength (Figure 2). This precession is enhancement in XCT.
caHed Larmor frequency. The application of a NMR imaging bas been described as a quantum
radiofrequency excitation energy to the precessing leap in medical imaging. By use of gradient coils in
nuclei will flip the magnetic moment at an angle <'.'.l NMR imagers, one can generate images in sagittal,
When the radiofrequency of precession is equal to coronal and transverse planes. The advantage of
La rm or frequency, then resonance will occur, hence NMR imaging can clearly be seen in the central ner-
the phenomena is called nuclear magnetic resonance. vous system. It excels in this domain over all other
When the radiofrequency is stopped, the nuclei will imaging modalities. For other anatomic regions such
return to their original positions. In so doing, the as the cardiovascular system, angiography, helim,
nuclei will emit radiofrequency waves of the energy mediastinum, kidneys and orbits (eye), NMR imag-
absorbed. These energy waves can be externally ing has shown its potential to surpass other imaging
detected by the radiofrequency coils enclosing the pa- techniques. Among current advances in NMR imag-
tient, generating the NMR signal that is ing is the development of the surface coil. The signal-
reconstructed to form an image. 21 to-noise ratio can be enhanced by the use of the sur-
When the radiofrequency is turned off, two pro- face coil when placed close to the region of interest
cesses occurs at the same time, which are commonly such as the eye, ear, spine, knee, or breast.
known as relaxation processes. NMR imagers are also available with spectroscopy
1. The equilibrium magnetization in the direction of capability. This enables physicists and clinicians to

JIMA: Volume 22, 1990 - Page 75

 -
Ho
0.8

0.7

0.6
0

...r.I 0.5,

-...
0:
(.)
a.
0.4

0.3

0.2

0. 1
0 20 40 60 80 100 120

INSPIRED OXYGEN (%)

Figure 4. Relationship between the percent of in-

spired oxygen and PCr /Pi ratio in murine tumors.

H-1 NMR spectroscopy can be observed if the in-

Figure 3. NMR image of the normal human brain, tense water and lipid signals can be suppressed. This
showing vivid distinction between gray and white is done by using special pulse sequence. H-1 spectra
matter. measure various metabolities such as lactate,
N-acetylaspartate and amino acids. The C-13 spectra
on the other hand, characterize high concentration of
noninvasively monitor the biochemical processes of lipids and gylcogen. The use of C-13 labeled sub-
human organs in normal and pathological states. trates also allows the monitoring of metabolism by
Magnetic resonance spectroscopy (MRS) has been the C-13 NMR spectroscopy.
developed over the past 30 years as an analytical tool MRS is not, however, free of constraints. The two
in chemistry. The sole objective of MRS is to extract most important limiting factors are sensitivity and
information about the molecular structure, con- resolution. To enhacne both spatial resolution and
figuration, and dynamics of chemical compounds. sensitivity, higher magnetic field are necessary. But,
MRS can also be applied noninvasively to study given the constraint that the magnetic field strength
metabolism and physiology in living tissues and ranges from 0.3 to I.ST, the decrease in signal inten-
organisms. The nuclei that are of biological impor- sity can be compensated by the use of a surface coil,
tance and which have magnetic moments are P-31, signal averaging and large volume of interest.
Na-23, C-13, and N-14. New applications of NMR imaging are now seen in
The biochemical process of phosphorus in living geology, agronomy, botany and 'material science.
beings provides information about the metabolites of NMR imaging is a very suitable technique for study-
phosphates such as phosphocreatine (PCr), ing plant root systems within the soil. They can be
adenosinetriphosphate (ATP), and inorganic observed for transponation of water, sunlight in-
phosphate (Pi) using P-31 MR spectroscopy. Assess- fluence, water stress and disease. NMR also may pro-
ment of tumors using MRS provides information vide a useful index for assessing the influence of car-
regarding tumor perfusion. Okunieff et aP 0 assessed bon dioxide, pollutants, chemicals and herbicides, as
the P-31 spectra of murine tumors in vivo in rat at well as opHmizing growth conditions in seed beds.
100/o, 21 O/o, and 1000/o of inspired oxygen. Figure 4 This technique would be of immense value to
shows a linear relationship between percent of in- Hakims, who use herbs and plant roots in their
spired oxygen and PCr/ Pi ratio. Oyulai et al, JI from medication. This will provide them an opportunity to
their P-31 studies on graded hypoxia and hyperoxia evaluate the potency of herbs and roots and their
in vivo in the gerbil brain, showed a decease in moisture content and relation to potency of the roots
PCr/Pi ratio at differing percentages of inspired ox- and herbs.
ygen. SimHarly, P-31 spectra before and after suc-
cessful radiation treatment of the tumor reveals nor- Ultrasound
mal spectra, clearly favoring the concept of normal In medical sonography, frequencies between 1
perfusion after radiation treatment. MHz and 20 MHz are used. Such high frequencies

Page 76 - JIMA: Volume 22, 1990

are generated by piezoelectric crystals made either of case with soft tissues and bone.
quartz or synthetic ceramic. The piezoelectric crystals To avoid high reflection of an ultrasound beam at
are sandwiched between silver or gold electrodes and the air-tissue interface, water paths, cream or gels are
are enclosed in a box called a transducer. If voltage is used to eliminate the air pockets which block good
applied across the crystal face and then quickly acoustic coupling between the transducer and the pa-
removed, the crystal will vibrate. This vibrating tient's skin.
crystal, coupled with the body, gives rise to an The velocity of the sound beam changes as it
ultrasonic longitudinal wave that propagates into the traverses from one medium to another. However, the
body. frequency remains constant, though the wavelength
The transducer in sonography acts both as changes. U the ultrasound beam strikes a second
transmitter and as receiver. A short ring down time is medium at an angle, the beam is refracted, or bent.
therefore essential for the production of high quality The degree of refraction depends on the angle of in-
images. In a pulse echo system, the transducer is ex- cidence and difference in the velocity of sound in the
cited once every millisecond. The time between two media. Refraction is a major cause of artifacts in
generation of t he first and second pulse is used for images obtained from ultrasound.
detection of returning echoes from the body reflec- Frequencies can help differentiate between tissues.
ting surfaces. The sound beam is attenuated in the Use of higher frequencies results in better resolution.
body by the processes of diffusion, reflection, refrac- However, the use of higher frequencies results in
tion and absorption. poor beam penetration of the organ. Attenuation is
In diagnostic applications of sonograpby, use is approximately linearly proportional to the frequen-
made of reflected ultrasound waves from interfaces cy.
between different tissues in the patient. The part of With the many advances made in ultrasonography
the incident energy reflected from an interface instrumentation, the state-of-the-art instrument is
depends on the difference in acoustic impedance of the Duplex ultrasound. It is a high resolution, real-
the media on the other side of the interface. The time, B-mode imaging system with pulsed Doppler
acoustic impedance of a medium is given by the for- color flow imaging. Linear array transducers or
mula: mechanical sector transducers are used to generate
color flow images by computing the amplitude, phase
z =fc and frequency of ultrasound signals relected from the
f
where is the density of the medium and C is the tissue. Stationary or slow moving tissue signals are
not eliminated from the image formation in the real-
velocity of ultrasound in the medium. The greater the
discrepencies in acoustic impedance of the two time. The reflected ultrasound signals from the tissue
media, the larger part of the incidence beam is deter- are assigned a gray scale which is proportional to the
mined by the angle of incidence of the beam at the in- echo signal amplitude. The phase of the echo, on the
terface. The higher the angle of incidence, i.e., close other hand, provides information regarding the
to 90°, the lesser the amount of reflected beam. presence and direction of motion. Color assignments
Below a certain critical angle, the entire beam is are made based on phase changes. For example, red
reflected. The reflected beam can be written as represents flow away from the transducer while blue
follows: represents flow towards the transducer. Different
shades of red and blue represent arterial and venous
R = [(Z2 - Zl)/(Zl + Z2))2
flow. The shades of either blue or red depend·on the
where Zi and Z2 are the acoustic impedance of velocity of the blood flow. Maximum Doppler shift is
medium 1 and 2. The part of the incident energy represented by white, representing maximum veloci-
transmitted through an interface is: ty. The image obtained by this system represents the
hemodynamic characteristics of flow within the
T = 4 Zl Z2/(Zl + Z2) 2 vessel. Gomez et all2 has discussed the technical
However, R + T = 1. background and clinical applications of color flow
imaging.
At the muscle-liver interface only 1OJo of the beam
There are clinical applications of ultrasound scan-
is reflected while 99% transmitted. Even though 1%
ning in obstetrics, gynecology, abdominal and pelvic
of the total beam reflected seems small, it never-
pathology, cardiology, opthalmology and oncology.
theless depicts the profile of the liver. In the case of
Although the image quality of ultrasound is not very
chest walls and the lungs, the mimons of air tissue in-
good, it nevertheless, offers a valuable diagnostic
terfaces within the lungs provide a greater degree of
tool for imaging soft tissues without the use of ioniz-
impedance mismatch at the interface. This results in
ing radiation. Visualization of gall stones by this
strong reflection of the ultrasound beam at the boun-
technique has been performed with 100% assurance.
dary, which prevents the clinical applications of
Study of the growth of the fetus is conducted routine-
ultrasound imaging of the lung. This is likewise the
ly in most departments of obstetrics.

JIMA: Volume 22, 1990 - Page 77

 Radiotherapy 1978;35: 1236-1245.
The established clinical practice of racliation 5. Cormack AM. Representation of a function by
therapy uses non-invasive, external ionizing radiation its line integrals with some radiological applica-
beams (x-rays, gamma rays from cobalt 60, and elec- tions. J Appl Phys. 1963; 34:2722.
tron beams) for the treatment of tumors and cancer 6. Hounsfield ON. Computerized transverse axial
in morbid persons. The purpose of racliotherapy is to scanning (tomography). Br J Racliol. 1973;
achieve a concentrated radiation dose to the tumor 46:1016.
and yet to avoid damage to healthy tissue. While 7. Jacobson B. Acta Radio!. 1953;39:436.
making treatment plans physicists have to be very 8. Gilbert W. Science. 198 1;214:1305.
prudent to ensure that radiation sensitive organs such 9. Akber SF. Nuclear medical resonance medical
as the eyes, spinal cord, kidneys and heart, receive as imaging. JPMA. 1984;34:64-71.
little racliation as possible. If the patient receives over 10. Akber SF. The physics of NMR tomography.
4500 rads on his spinal cord because of improper Nuklearmeclizin. 1986;25:33-37.
treatment planning, the patient may be paralyzed. 11. Akber SF. Clinical ramifications of NMR imag-
Neutron beams and negative pions therapy are in ing. Compr Ther. 1987;13:41-45.
the offing. 33 Advances in radiation therapy are likely 12. Akber SF. Clinical ramifications of iodine. Com-
to occur in areas such as the combination of pr Ther. 1987;13:19-25.
chemotherapy-radiotherapy, hyperthermia- 13. Akber SF. Lung as a metabolic organ. Eclitorial.
radiotberapy and modification of radiation dose JPMA. 1986;36:132-136.
fractionation schemes. Since diagnosis of malignant 14. Touyo J, Akber SF, J Rahimian J, Bennett LR.
diseases often is made at advanced stages, treatment Metabolic lung scanning with N-Isopropyl-1-123-
of such dfaeases is a clifficult proposition. p-Jodoamphetarnine. In: Nuclear Meclicine and
Another method for treating tumors using ionizing Biology, Proceedings of the Third World Con-
radiation internally is brachytherapy. Radium and gress of Nuclear Medicine and Biology, Raynaud
radon seeds were used but are now being replaced by C, ed. Paris: Pergamon Press III, 1982, pp.
Co-60, Cs-137, Ir-192 and 1-125. These raclionuclides 2554-2557.
are encapsulated in needle and tubes. The sources in 15. Rahlmian J, Glass EC, Touya JJ, Akber SF,
moulds or placques are located on superficial lesions Graham LS, Bennet LR. Measurement of
inserted interstitially in the tissue of the lesion or metabolic extraction of tracers in the lung using a
nearby, or is placed within natural body cavities. ln multiple inclicator dilution technique. J Nucl
order to enhance the tumor dose, both external and Med. 1984;25:31-37.
internal treatment occasionally are carried out. 16. Akber SF. On the theory of the first pass
pulmonary extraction using inclicator clilution
Conclusion technique. Nuklearmedizin. 1987 ;26:21-27.
Physicists and medical physicists laid the cor- 17. Akber SF. Ketamine influence on the first pass
nerstone in the diagnosis and treatment of cancer in pulmonary extraction of N-Isopropyl-I-123-p-
today's medical practice. Further coalescence of Iodoamphetamine using indicator dilution
research, application, cooperation, and understan- technique. Proceedings of the 14th International
ding will enhance new perspectives on benefits of Conference on Medical and Biological Engineer-
ionizing and nonionizing radiations for medical ing and 7th International Conference on Medical
diagnosis and therapy of cancer. The advances in Physics. Espoo, Finland, August 11-16, 1985.
medicine will continue to depend on the foresight of Med Biol Engin Compt 23: (Suppl. Part
physicists and physicians who will amalgamate in- 2):1377-1378, 1985.
strumentation, physics, chemistry, mathematics and 18. Akber SF. Demonstration and quantitation of
physiology into medicine. pharmacological inhibtion of pulmonary uptake
of N-lsopropyl-I-123-p-lodoamphetarnine by
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