Path B: Randy Brill

Now: Picture taken 2012Randy Brill came to Vanderbilt after 7 years in the U.S. Public Health Service , the first 2 years were in Japan studying leukemia in the A-bomb survivors with Bob Heyssel. Both had been recruited by the National of Sciences (NAS) and commissioned by the PHS (which provided two years credit toward the Doctor’s draft). Recruiting of Hematologists centered on several research centers (Wash U, and Utah), given the Academy’s strong interest in quantitating radiation-induced risk for leukemia in man. The leukemia increase was first noted in1950 in Hiroshima and Nagasaki survivors, before radiation dose data was available. We both arrived in Japan with interests in hematology and leukemia at the time the first A-bomb dose distance data became available and enabled the first  publications of dose-response data. (Blood, and the Annals of Internal Medicine).

1964-79. Randy Brill joined Bob Heyssel at Vanderbilt in 1964, with appointments in Medicine, Radiology and Physics. They studied the late effects of  59Fe from the Hahn studies, and conducted dosimetry studies quantitating iron and iodine transport and metabolism needed to correlate with late effects observed in the epidemiology follow-up study. They extended the body composition and tracer metabolism using the whole body counter using the fixed chair geometry. After its modification to a dual opposed detector scanning system in the WBC, the system capability was extended  to provide quantitative whole body and organ uptake and turnover studies. Computer methods were developed first by Meneely and we later adapted them to include acquisition and processing of  clinical and research data and images. Other applications included Computer Assisted Instruction (CAI), and administrative tasks, patient diagnosis and patients scheduling. Instrumentation innovations included the testing of new detector materials and geometries in collaboration with Physics and Engineering students and faculty, and Industrial partners.

EARLY CLINICAL STUDIES.  Vanderbilt first radioisotope scanner was a Picker 3” NaI (Tl) crystal rectilinear scanner that cost about $40,000 and was purchased in the spring of 1964. There was not have enough money in the budget to purchase the device so, Bob in turn,  approached the Chairs of Medicine (Dave Rodgers), Radiology (Gene Klattee), Surgery (Bill Scott), and Frank Blood (Head of the Division of Laboratories that controlled the Radioisotope Center budget), for their support. Each was led to believe that Bob had all but ¼ of the money needed and if the current person addressed would come up with his share, Vanderbilt could buy the scanner. Starting with nothing, Bob got the needed assurances, and the first Vanderbilt scanner was purchased.
It was installed in a room adjacent to the Radioisotope Center the wet lab on the second floor of the Hospital, above the Whole Body Counter. The scanner was in use several months when Randy arrived without prior scanner experience, and they all learned together. The major problem was how to set scan speed and display factors before knowing the range of counts that would be obtained. With more experience, the scan images improved but was ultimately resolved when we coupled the scanner output to a buffer memory  and later to computers. These enabled efficient data analysis and display options. Image display from gamma cameras when they came along were less of a problem, as stationary detectors accumulated and displayed counts on a cathode ray tube viewed by 3 different f-stop lenses. These produced 3 different intensity  images on film, one of which was virtually guaranteed to be useable. A later optical adaptation used an 81-lens aperture plate to record that many sequential images of dynamic processes.
The Berkeley Donner Lab, Hal Anger group led the field in the development of devices and applications. The Henry Wagner and the Johns Hopkins group, and the Paul Harper/Bob Beck University of Chicago group followed with strong clinical and theoretical programs.  These leaders published high quality scanner and camera images of brain, kidney, liver, kidney, lung, bone/bone marrow-seeking tracers. Their work stimulated great interest in radioisotope imaging and in the development of new radiolabeled drugs.

At Vanderbilt, we first imaged patients suspect of brain tumors with 203Hg ; and hyperthyroid, and thyroid cancer, with 131I . Our studies included imaging the liver with  198Ag colloid, the lung with 131I macro aggregated albumen, and the heart with 132Cs It was after 1964 that progress accelerated when Paul Harper and the Chicago group demonstrated the versatility of  99mTc for many clinical studies and the number and kind of procedures then grew rapidly. The Vanderbilt imaging and computing innovations were developed in collaboration with students and faculty from the Physics Department and the School of Engineering.

The next section introduces the clinical and research faculty who played major roles in the evolution of nuclear medicine at Vanderbilt.

Randy Brill, MD., Ph.D.
Dominique Delbeke, M.D., Ph.D.
Paul Hahn, M.D.
Robert Morris Heyssel
Jerry Jones
Leon Partain, M.D.
Dennis Patton, M.D.
David Rollo, M.D.
Martin Sandler, M.D.
Ed Staab, M.D.
Michael G. Stabin, M.D.
Juan Touya, M.D.

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