Medical Imaging with Anti-Matter
High Resolution Positron Emission Tomography
John Sunderland
Professor of Radiology
Associate Professor of Physics & Astronomy
University of Iowa
Sponsored by PSW Science Member Michael Sandifer
About the Lecture
Positron Emission Tomography (PET) is a remarkably versatile clinical medical imaging modality that distinguishes itself from more well-known techniques like MRI, CT, and ultrasound imaging because PET images the underlying biochemistry of disease rather than simply the anatomy. This is critically important because most diseases are biochemical in nature, and manifest themselves first through biochemical signatures, long before anatomical changes become detectable. By directly imaging amyloid or tau protein in the brain, PET can diagnose Alzheimer’s disease in its very early stages. By imaging glucose metabolism in the body, PET can identify even tiny, hidden tumors because cancer cells rely on inefficient aerobic glycolysis to provide energy to proliferate. By imaging the expression of estrogen on the surface of breast cancer cells, PET can identify which patients will and will not respond to particular cancer therapies.
To a patient, PET imaging is relatively simple. A small injection of an unimaginably tiny amount of a radioactive drug followed by a short wait, and then a twenty minute scan of their whole body. But behind the scenes is a remarkable marriage of nuclear physics, engineering, neighborhood cyclotrons producing the necessary radioactivity, rapid radiochemistry syntheses performed under aseptic conditions, that occurred only minutes to hours beforehand. The radiopharmaceuticals that are injected were chemically engineered to be highly specific to a particular biochemical target and had to go through the rigorous FDA approval process to demonstrate safety and efficacy before becoming available.
This talk will explore the elegant but easy to understand nuclear and atomic physics that lie at the heart of PET imaging technology, and the critical role that positrons (anti-matter electrons) play in image creation. It will discuss new technological and engineering developments that continue to drive PET scanners to higher sensitivities and resolution, and new radiopharmaceutical developments that are expanding the use PET in both the research and clinical domain.
Lastly, the talk will discuss how the remarkable specificity of PET radiopharmaceuticals to bind to proteins on the surface of cancer cells has led to the exploding field of Radiopharmaceutical Therapy (RPT). By replacing the short-lived positron-emitting radionuclide on the targeting radiopharmaceutical used in PET imaging with a longer-lived beta-emitter, RPT can deliver lethal amounts of targeted radiation directly to cancer cells while minimizing damage to healthy tissue. The clinical (and commercial) success of the first of these novel radioactive drugs has resulted in a frenzied drug development environment amongst both big and small Pharma.
Selected Reading & Media References
PET Scanner Design Explained: https://www.youtube.com/watch?v=QsU3TrgArJw
Image Reconstruction: https://sites.google.com/a/fulbrightmail.org/kesnersmedicalphysics/
PET Cyclotron and Radiopharmacy Facility: https://www.youtube.com/watch?v=5aaXMLPLt20
General PET Overview: https://www.youtube.com/watch?v=l2OVu-JSU2Y
Dosimetry in Radiopharmaceutical Therapy: https://www.youtube.com/watch?v=4MLrn7Xx3Yg
About the Speaker
John J. Sunderland is Professor of Radiology in the Division of Nuclear Medicine at the University of Iowa, and of Physics & Astronomy and Radiation Oncology. In addition, he directs the Positron Emission Tomography (PET) Imaging Center and the Small Animal Imaging Core Laboratory. Previously he was Vice President for Operations at the Biomedical Research Foundation of Northwest Louisiana, directed the Creighton University Center for Metabolic Imaging and held senior leadership roles in the Society of Nuclear Medicine and Molecular Imaging.
John is widely recognized for pioneering efforts that expanded clinical PET imaging across the southern United States through centralized radiopharmaceutical production and distribution. Under the Russian Nuclear Cities Initiative, he led the development of a PET imaging center in the Urals, retraining former weapons scientists for medical applications. He was the principal author of the University of Iowa’s New Drug Application for gallium-68 edotreotide, approved by the FDA in 2019 for imaging neuroendocrine tumors—one of the few such approvals owned by an academic institution. He has also been a leading figure in advancing international PET standardization, enabling consistent quantitative imaging in multicenter clinical research.
His research spans more than four decades in medical imaging, from cyclotron targetry and radionuclide production to pharmacokinetic modeling and quantitative PET and SPECT imaging. His recent work has focused on improving the accuracy and reproducibility of quantitative imaging across different scanners and clinical sites through international harmonization initiatives. He currently co-leads the FNIH Precision Dosimetry Imaging Biomarker project, a global collaboration developing quantitative SPECT imaging standards to support radiopharmaceutical therapy trials.
John is an author on more 250 scientific publications, technical reports, and invited presentations. He has also contributed chapters to reference works in nuclear medicine and molecular imaging.
Among other honors and awards, he is a Fellow of the Society of Nuclear Medicine and Molecular Imaging and has been recognized through numerous invited lectures.
John earned a BA in Physics at Williams College, an MS and a PhD in Medical Physics at the University of Wisconsin–Madison, and an MBA at Centenary College – Frost School of Business.
Social Media Links
LinkedIn Profile: https://www.linkedin.com/in/john-sunderland-5103458/