Abass Alavi, MD

In recent years, several groups have demonstrated the promise of FDG-PET imaging in the management of patients with suspected and/or documented infection. This technique appears to be particularly useful in the evaluation of osteomyelitis, infected prostheses, fever of unknown origin, and acquired immunodeficiency syndrome. Considering the extraordinary sensitivity of FDG-PET in detecting disease activity and nonactivity in malignant and benign disorders, this powerful method may prove valuable also in a variety of infectious processes. We speculate that it will be widely employed in the near future for detecting, characterizing, and monitoring patients with suspected or proven infection.

A noninvasive technique to detect vulnerable atherosclerotic plaque is critically needed. Formation of atherosclerotic plaque is a dynamic inflammatory process that involves interactions between atherogenic lipoproteins and macrophages. As vulnerable plaques are usually numerous, extending beyond the culprit plaque and involving multiple vessels, targeting a single plaque underestimates the complexity and extent of disease. Thus, an ideal imaging modality should be able to identify the vulnerable arterial bed and, therefore, the vulnerable patient, to prevent the serious complications of atherosclerosis.

Imaging in medicine dates its origin to 1895, when Roentgen discovered the x-ray. This exciting and novel technology opened an unprecedented era in medicine, which continued through the 20th century and remains a major element of the day-to-day practice of radiology. Limited, modest efforts made during the mid-20th century to employ tomographic methodologies eventually led to the introduction of x-ray CT by Sir Godfrey Hounsfield in 1973.

When Sir Godfrey Hounsfield introduced CT for brain imaging in 1973, my colleagues and I at the University of Pennsylvania were using a dedicated SPECT instrument, designed and assembled at our institution, to examine blood-brain barrier abnormalities in a variety of neurological disorders.