Basic Knowledge Radiology: Nuclear Medicine and Radiotherapy With 215 Illustrations

Description

Clear and compact, this textbook provides you with a complete overview of all radiology content relevant to the exam. It guides you in an easy-to-understand and GK-oriented manner through the entire basic knowledge from the fundamentals to the most important clinical pictures, including nuclear medicine and radiation therapy. Benefit from the many years of experience of the lecturers, who have carefully selected and prepared the essentials for you. Preface Contents About the Editors Contributors Editors and Contributors I: Basics 1: Physical Basics 1.1 Radioactivity and Its Interactions 1.1.1 Radioactive Decay Modes 1.1.2 The Physical Half-Life 1.1.3 Physical Interaction Processes of Electromagnetic Radiation with Matter Interaction of Photon Radiation with Matter 1.1.4 Interaction of Particle Radiation with Matter 1.2 X-Rays 1.3 Dose Terms 1.3.1 Kerma = Kinetic Energy Released in Matter 1.3.2 Ion Dose 1.3.3 Absorbed Dose 1.3.4 Equivalent Dose 1.3.5 Incident Dose 1.3.6 Surface Dose 1.3.7 Deep Dose 1.3.8 Dose Area Product 1.3.9 Dose Length Product 1.3.10 Organ Dose 1.3.11 Effective Dose 1.3.12 Personal Dose, Local Dose and Body Dose 1.4 Effect of Ionizing Radiation on the Organism 1.4.1 Radiation Effects Stochastic Radiation Effect Deterministic Radiation Effect 1.4.2 Phases of the Radiation Effect Physical Phase Physical and Chemical Phase Biochemical Phase Biological Phase 2: Conventional X-ray Diagnostics 2.1 Design and Operation of an X-ray System 2.1.1 The X-ray Source Structure of the X-ray Tube The Depth Stop with Light Sighting 2.1.2 The X-ray Generator Tube Voltage Tube Current Dose Exposure Point System Automatic Exposure Control 2.1.3 Mapping Laws Ray Theorem Projection/Parallax Distortion Law of Distance Squared 2.1.4 Quality of the X-ray Image and Quality Improvement Measures The Good X-ray Image Motion Blur Scattered Beam Reduction Image Noise in Digital X-ray Images 2.1.5 Setting Up a Bucky Workstation Bucky Table Grid Wall Stand Tripod 2.1.6 Mobile X-ray Equipment 2.1.7 Special Radiation Protection Measures Direct Radiation Protection Indirect Radiation Protection 2.2 Digital Image Processing 2.2.1 Matrix 2.2.2 Color Depth 2.2.3 Error Correction 3: Mammography 3.1 Design and Function of a Mammography Device 3.1.1 The Heel Effect 3.1.2 Compression, Scattered Radiation Reduction 3.1.3 Magnification Mammography 3.1.4 Automatic Exposure Control 3.1.5 Image Receiver, Image Viewing 4: Transillumination 4.1 Image Intensifier (BV) 4.1.1 Structure of A Fluoroscopy Unit 5: Angiography, Rotational Angiography/Angio-CT 5.1 DSA Technique 5.2 Angiography-CT Rotational/Angio-CT 5.3 Seldinger Technique 6: Computed Tomography (CT) 6.1 History 6.2 Design and Operation of A Computer Tomograph 6.3 Investigation Techniques 6.3.1 CT Sequence 6.3.2 CT Dynamic 6.3.3 CT Spiral/CT Singleslice (SS-CT) 6.3.4 CT Multislice (MS-CT) Detector Design 6.3.5 CT Dual-Source (DS-CT) 6.4 Important Parameters in Spiral CT 6.4.1 Pitch Factor 6.4.2 Collimation 6.4.3 Tube Voltage (kV) 6.4.4 Tube Current-Time Product (mAs) 6.4.5 Scan Time (S) 6.4.6 z-sharp Technology 6.5 Parameters for Image Reconstruction 6.5.1 Layer Thickness 6.5.2 Increment 6.5.3 Convolution Kernel, Reconstruction Filter or Algorithm 6.5.4 Windowing 6.5.5 z-Interpolation 6.6 Image Formation 6.6.1 Filtered Back Projection 6.6.2 Iterative Reconstruction 6.6.3 Hounsfield Scale 6.6.4 Window Technology 6.7 Post-Processing 6.7.1 2D Representation 6.7.2 3D Representation 6.8 Artifacts 6.8.1 Movement Artefact 6.8.2 Pulsation Artefact 6.8.3 Metal Artifact 6.8.4 Partial Volume Effect/Partial Volume Effect 6.8.5 Hardening Artefact 6.8.6 Measuring Field Overrun 6.8.7 Photon Starvation Artefact 6.8.8 Ring Artefact 6.8.9 Line Artifact 6.9 Radiation Protection Measures and Dose Reduction 6.9.1 Dosage Modulation 6.9.2 Adaptive ECG Pulsing 6.9.3 Avoidance of Overranging 6.9.4 Iterative Reconstruction 7: Magnetic Resonance Imaging (MRI) 7.1 Which Core Is Actually Spinning Here and What Does It Have to Do with Magnets? 7.2 Longitudinal Magnetization 7.3 MR Signal 7.3.1 T1 Relaxation Time 7.3.2 T2 Relaxation Time 7.4 Location Coding 7.4.1 Layer Selection 7.4.2 Phase Coding 7.4.3 Frequency Coding 7.4.4 K-space and Fourier Transformation 7.5 Proton Thrusting and Gradient Ballet: the Interplay of High-Frequency Pulses and Spatial Coding 7.5.1 Refocusing 7.5.2 Echo and Repetition Time or T1 and T2 Contrast T1 Weighting T2 Weighting Characteristics of Different Weightings 7.6 Sequence Theory 7.6.1 Gradient Echo Sequences 7.6.2 Fat Saturation Inversion Recovery Frequency Selective Saturation or Spectral Saturation Chemical Shift or Dixon Method 7.6.3 Vessel Mapping Angiography Time-of-Flight Phase Constrastangiography Angiography Contrast-Enhanced 7.6.4 Diffusion Imaging 7.7 Contrast Agent 7.8 Security 7.8.1 Attraction of the Magnet 7.8.2 Implants 7.8.3 Volume 7.8.4 Tissue Stimulation 7.8.5 Emergency Bell 8: Sonography 8.1 Physical Basics of Sonography 8.1.1 Ultrasonic Waves 8.1.2 Procedure A-Mode M-Mode B-Mode Sonography Doppler Sonography Color Doppler and Power Doppler 8.2 Design and Operation of a Sonography Device 8.2.1 Transducers 8.2.2 Where to Press… 8.3 Possibilities and Limits of Ultrasound Diagnostics 9: Contrast Agent 9.1 X-ray Contrast Medium 9.1.1 Classification of X-ray CMs Contrast Media Negative Contrast Media Positive Water-Soluble Contrast Media Containing Iodine (. Fig. 9.4) Water-Insoluble Contrast Media Contrast Media Containing Oil 9.2 MR Contrast Medium 9.2.1 Gadolinum 9.3 Sonographic Contrast Agent 9.4 Contraindications 9.5 Side Effects 9.6 Pregnancy and Breastfeeding 10: Radiotherapy 10.1 Possibilities and Principles of Radiooncology 10.1.1 Brachytherapy 10.1.2 Particle Therapy 10.1.3 Therapy Concepts in Radiooncology 10.1.4 Fractionation 10.2 Irradiation Planning 10.2.1 Further Processing 10.3 Design and Function of Radiooncological Irradiation Equipment 10.3.1 Linear Accelerator Respiratory Gated Radiotherapy 10.3.2 Dose Distribution in Tissue Deep Dose Profile 10.3.3 Irradiation Techniques 10.3.4 Irradiation Variants 10.3.5 X-ray Therapy Equipment 11: Nuclear Medicine 11.1 Imaging and Therapeutic Options 11.1.1 Scintillation Counter: Scanner, Gamma Camera, Gamma Probe 11.1.2 Semiconductor Cameras 11.1.3 PET 11.1.4 Hybrid Systems 11.1.5 Therapy Options Radioiodine Therapy Radiosynoviorthesis (RSO) Palliative Pain Therapy for Bone Metastases Radioimmunotherapy 131I-MIBG (Meta-Iodo-Benzyl-Guanidine) Therapy Peptide Therapy Selective Internal Radiotherapy (SIRT) 11.2 Radiation Protection 11.2.1 Hot Laboratory Generator Lead Castle (Screening Wall) Spacers Syringe Shields Transport Equipment Waste Containers Decay Space 11.2.2 Investigation Area 11.2.3 Leaving the Department 11.3 Detection of Radioactivity 11.3.1 Scintillation Detectors Probe Measuring Station Gamma Probe Borehole Logging Station Liquid Scintillators Gas Ionization Detectors Activimeter Personal Dosimeter Ring Dosimeter Electronic Dosimeters Whole Body Counter Contamination Measuring Equipment 11.4 Image Formation Systems 11.4.1 Gamma Camera Collimators Sodium Iodide Crystal Photomultiplier Gamma Spectrum Measuring Head Electronics SPECT 11.5 Radionucleotides in Medical Application 11.5.1 Diagnostic Imaging 11.6 Radiopharmacology 11.7 Quality Assurance Measures of Radiopharmaceuticals 11.7.1 Radioisotope Purity 11.7.2 Chemical Purity 11.7.3 Radiochemical Purity 11.7.4 Specific Activity 11.7.5 Stability 11.7.6 Microbiological Purity 11.8 Contamination and Decontamination Measures 11.8.1 Contamination 11.8.2 Decontamination 12: Emergencies and Extreme Situations 12.1 Extreme Situations 12.1.1 Polytrauma 12.1.2 Anaphylactoid Reaction 12.1.3 CT-Guided Puncture 12.1.4 Seizure During Stent Angioplasty 12.2 Contrast Agent Incident and Emergency Medication 12.2.1 Side Effects Contrast Induced Nephropathy (CIN) Hyperthyroidism and Thyrotoxic Crisis Nephrogenic Systemic Fibrosis (NSF) Circulatory Arrest Seizures 13: Legislation 13.1 Basic Law (GG) 13.2 Patients’ Rights Act 13.2.1 Reconnaissance Duties/Rights During the Practical Year What Must Be Disclosed? Information Requirements 13.3 Data Protection 13.4 Atomic Energy Act (AtG) 13.5 X-ray Ordinance (RöV) 13.6 Radiation Protection Ordinance (StrSchV) 13.7 Radiation Protection Areas 13.8 Occupationally Exposed Persons 13.9 Technical Knowledge 13.10 Justifying Indication 13.11 Medical Devices Act (MPG) 13.12 Maternity Protection Act (MuSchG) 13.13 Working Time Act II: Disease Patterns 14: Neurology 14.1 Anatomical Structures 14.2 Disease Patterns 14.2.1 Intracranial and Spinal Hemorrhages 14.2.2 Ischemic Diseases 14.2.3 Intracerebral Tumors 14.2.4 Cerebrospinal Fluid Circulation Disorder 14.2.5 Intracranial Extraaxial Tumors 14.2.6 Cystic Intracranial Lesions 14.2.7 Chronic Inflammatory CNS Processes: Multiple Sclerosis 14.2.8 Acute Inflammatory CNS Processes 14.2.9 Epilepsy 14.2.10 Phacomatoses 14.2.11 Neurodegenerative Diseases 14.3 Diagnostics 14.3.1 Diagnostic Radiology Sonography Conventional X-ray Diagnostics Fluoroscopy/Angiography Computed Tomography (CT) Magnetic Resonance Imaging (MRI) 14.3.2 Nuclear Medicine Brain Blood Flow, Regional Cerebral Blood Flow (RCBF) Neurodegenerative Diseases Brain Tumors CSF Space 14.3.3 Valence 14.4 Therapy 14.4.1 Interventional Radiology Angiographic Interventions 14.4.2 Radiotherapy Gliomas Glioblastoma Astrocytoma Oligodendroglioma Skull Base Meningiomas Acoustic Neuromas (Vestibular Schwannomas) Pituitary Adenoma Chordomas, Chondrosarcomas of the Skull Base Craniopharyngeomas Childhood Cerebrospinal Fluid Space Whole Brain Brain Metastases Therapy for Multiple Brain Metastases Therapy for 1–3 Brain Metastases Glioblastoma Brain Metastases 15: Head/Neck 15.1 Anatomical Structures 15.2 Disease Patterns 15.2.1 Head Sinusitis Mucocele Tumors Nasopharyngeal Area Orbit Salivary Glands Fractures Skull Base Zygomatic Bone Middle Face Orbital Floor 15.2.2 Neck Laryngocele Trachelastenosis Cervical Cyst Thyroid Gland Parathyroid Gland Tumors Laryngeal Carcinoma Thyroid Carcinoma Salivary Gland Carcinoma 15.3 Diagnostics 15.3.1 Diagnostic Radiology Sonography Conventional X-ray Diagnostics Fluoroscopy/Angiography Computer Tomography (CT) Magnetic Resonance Imaging (MRI) 15.3.2 Nuclear Medicine 15.3.3 Valence 15.4 Therapy 15.4.1 Radiotherapy Head/Neck Tumors Nasopharyngeal Carcinoma (Carcinoma of the Nasopharynx) Oropharyngeal Carcinoma (Carcinoma of the Oral Cavity) Oral Cavity Carcinoma (Carcinoma of the Floor of the Mouth, Carcinoma of the Tongue) Hypopharyngeal Carcinoma (Carcinoma of the Lower Pharynx) Laryngeal Carcinoma (Carcinoma of the Larynx) 16: Gynecology 16.1 Anatomical Structures 16.2 Disease Patterns 16.2.1 Chest Breast Carcinoma Fibroadenoma Cysts Fibrocystic Mastopathy Mastitis (Plasma Cell Mastitis) 16.2.2 Small Basin Tumors of the Ovary 16.2.3 Tumors of the Uterus Fibroids Polyps Carcinoma of the Corpus Cervical Carcinoma Endometriosis Cysts Inflammatory Changes Endometritis Adnexitis Torsions 16.2.4 External Female Genitalia 16.3 Diagnostics 16.3.1 Diagnostic Radiology Sonography Conventional X-ray Diagnostics Computed Tomography Magnetic Resonance Imaging 16.3.2 Nuclear Medicine Breast Carcinoma Vulvar Carcinoma SLN Diagnostics in Other Gynecological Tumors Ovarian Carcinomas 16.3.3 Valence 16.4 Therapy 16.4.1 Interventional Radiology Stereotactic Vacuum Suction Biopsy of the Breast 16.4.2 Radiotherapy Cervical Carcinoma Breast Carcinoma Vaginal Carcinoma Vulvar Carcinoma 17: Respiratory System 17.1 Anatomical Structures 17.1.1 Trachea and Lungs (Pulmo) 17.2 Disease Patterns 17.2.1 Pleura Pleural Effusion Pleural Callosity Pneumothorax Mesothelioma 17.2.2 Emphysema 17.2.3 Bronchiectasis 17.2.4 Pulmonary Oedema 17.2.5 Pulmonary Fibrosis 17.2.6 Infectious Diseases Pneumonia Tuberculosis Ascaridosis Echinococcal Infection 17.2.7 Interstitial Lung Disease Silicosis Asbestosis Organic Dusts 17.2.8 Pneumonitis Radiation 17.2.9 Lymphangiosis Carcinomatosa 17.2.10 ARDS 17.2.11 Sarcoidosis 17.2.12 Tumors Bronchial Carcinoma Malignant Lymphoma Metastases 17.2.13 Pulmonary Embolism 17.2.14 Childhood Surfactant Deficiency Syndrome Hemorrhage Pulmonary Emphysema Lung Cyst Transient Neonatal Tachypnea Meconium Aspiration 17.3 Diagnostics 17.3.1 Diagnostic Radiology Sonography Conventional X-ray Diagnostics Fluoroscopy/Angiography Computed Tomography Magnetic Resonance Imaging 17.3.2 Nuclear Medicine Pulmonary Ventilation Scintigraphy Lung Perfusion Scintigraphy Evaluation Determination of Postoperative Pulmonary Function Right-Left-Shunt Pulmonary Hypertension Lung PET 17.3.3 Valence 17.4 Therapy 17.4.1 Interventional Radiology Angiography Computed Tomography 17.4.2 Radiotherapy Bronchial Carcinoma 18: Gastrointestinal Tract 18.1 Anatomical Structures 18.2 Disease Patterns 18.2.1 Pharynx, Oesophagus Oesophagitis Diverticula of the Oesophagus Swallowing Disorders Achalasia Oesophageal Carcinoma Postoperative/Posttherapeutic Changes 18.2.2 Stomach and Duodenum Gastritis, Ulcers and Complications 18.2.3 Duodenal Diverticulum Benign Tumors Gastric Carcinoma, Duodenal Carcinoma Gastrointestinal Stromal Tumors (GIST) Postoperative Changes 18.2.4 Jejunum and Ileum Inflammatory Diseases Coeliac Disease Meckel’s Diverticulum Small Intestinal Tumors Postoperative Imaging/Complications 18.2.5 Colon and Rectum Acute Inflammatory Diseases Chronic Inflammatory Bowel Disease (IBD) Voiding Disorders/Dysfunction of the Pelvic Floor Polyps of the Colon Colorectal Carcinoma Postoperative/Posttherapeutic Changes and Complications 18.2.6 Mesentery, Peritoneum and Abdominal Wall Hernias Positional Changes of Organs of the Abdominal Cavity Benign Changes of the Mesentery and Abdomen Malignant Changes of the Peritoneum and Abdomen 18.2.7 Liver and Biliary System Fatty Liver (Steatosis Hepatis) Storage Disorders Liver Cirrhosis Benign Tumors of the Liver and Biliary Tract Cystic Lesions of the Hepatic Cavity Pseudotumours Budd-Chiari-Syndrome Malignant Tumors of the Liver and Biliary Tract 18.2.8 Gall Bladder and Bile Ducts Cholecystolithiasis Gall Bladder Polyp Primary Sclerosing Cholangitis (PSC) Gallbladder Carcinoma Cholangiocellular Carcinoma (CCA), Klatskin-Tumor 18.2.9 Pancreas Pancreas Divisum and Pancreas Anulare Acute and Chronic Pancreatitis Pancreatic Laceration Pancreatic Carcinoma Cystic Pancreatic Neoplasms Pancreatic Endocrine Tumors 18.3 Diagnostics 18.3.1 Diagnostic Radiology Sonography Conventional Diagnostics Swallowing Study Esophageal Swallow CT Abdomen Colonic Contrast Enema, Conventional and MR Defecography MRI Liver MR-Sellink and MR-Rectum 18.3.2 Nuclear Medicine Oesophagus Stomach Gastric Function Examination Gastric Carcinoma, Gastrointestinal Stromal Tumors (GIST) Liver Liver Perfusion with MAA, Calculation of A Liver-Lung Shunt (. Table 18.5) Liver Tumors and PET/CT Intestine Bleeding Source Search Intestinal Carcinomas Pancreas 18.3.3 Valence 18.4 Therapy 18.4.1 Interventional Radiology Puncture and Drainage Thermal Ablation of Liver Metastasis Transjugular Intrahepatic Portosystemic Shunt (TIPSS) Acute GI Bleeding Vascular Occlusions and Stenoses Portal Vein Embolization 18.4.2 Radiotherapy Oesophageal Carcinoma Rectal Cancer 19: Urogenital 19.1 Anatomical Structures 19.2 Disease Patterns 19.2.1 Urinary Tract Urinary Retention 19.2.2 Urolithiasis 19.2.3 Urothelial Carcinoma Bladder Fistulas and Leaks Bladder Emptying and Micturition Disorders 19.2.4 Kidney Diseases Inflammatory Renal Changes Cystic Masses Uncomplicated Blanched Cysts Complicated Cysts Cystic Kidney Disease Solid Masses of the Kidney Angiolipoma Oncocytoma Lymphoma Metastasis Renal Cell Carcinoma (NCC) Nephroblastoma Vascular Stenoses and Occlusions Renal Infarction Renal Artery Stenosis Investment Variants Renal Agenesis Malrotation Horseshoe Kidney Accessory Vascular Supply 19.2.5 Injuries to the Kidneys and Urinary Tract 19.2.6 Adrenal Gland Pheochromocytoma Adrenal Metastases 19.2.7 Prostate Prostatic Hypertrophy Prostate Carcinoma Prostatitis 19.2.8 Testis and Epididymis Hydrocele Testicular Torsion Inflammatory Changes of the Testis Varicocele Testicular Retention Testicular Tumors Seminal Vesicles 19.3 Diagnostics 19.3.1 Diagnostic Radiology Sonography Conventional X-ray Diagnostics Fluoroscopy/Angiography Computed Tomography Magnetic Resonance Imaging 19.3.2 Nuclear Medicine Renal Scintigraphy 19.3.3 Valence 19.4 Therapy 19.4.1 Interventional Radiology Ultrasound/Nuclear Magnetic Resonance Imaging Angiography 19.4.2 Radiotherapy Urinary Bladder Carcinoma Prostate Carcinoma (Carcinoma of the Glandular Tissue of the Prostate Gland) Testicular Tumors (Seminoma, Non-Seminoma) 20: Musculoskeletal Diseases 20.1 General 20.2 Anatomical Structures 20.2.1 Bone Structure 20.3 Clinical Pictures 20.3.1 Fractures Long Bong Bones, Short Bones Vertebral Body Cranial Bones Child Fractures Greenwood Fracture Bead Breakage Injuries to the Epiphyseal Fossa 20.3.2 Luxation 20.3.3 Inflammatory Diseases Spondylodiscitis/Spondylitis Osteomyelitis/Osteitis Rheumatoid Arthritis (RA) 20.3.4 Degenerative Diseases Herniated Discs Arthrosis 20.3.5 Tumors and Tumor-like Lesions Examples of Benign Tumors and Tumor-like Lesions Juvenile Bone Cyst/Single Bone Cyst Osteoid Osteoma Examples of Malignant Bone Tumors Classic Osteosarcoma Chondrosarcoma Osseous Metastases 20.3.6 Congenital Disorders of the Skeletal System Congenital Hip Dysplasia Congenital Foot Deformities 20.3.7 Diseases of the Infantile Skeleton Perthes’ Disease/Legg-Calvé-Perthes’ Disease Epiphysiolysis Capitis Femoris Coxitis Fugax 20.4 Diagnostics 20.4.1 Diagnostic Radiology Services Sonography Conventional X-ray Diagnostics Fluoroscopy/Angiography Computed Tomography Magnetic Resonance Imaging 20.4.2 Nuclear Medicine Diagnostics Skeletal Scintigraphy Inflammatory Scintigraphy of the Skeleton 20.4.3 Valence 20.5 Therapy 20.5.1 Interventional Radiology Tumor Embolization Computed Tomography-Guided Bone Tumor Treatment Pain Management 20.5.2 Nuclear Medicine Radiosynoviorthesis (RSO) Palliative Therapy of Bone Metastases 20.5.3 Radiotherapy Soft Tissue Sarcomas Bone Sarcomas 21: Cardiovascular Diseases 21.1 Anatomical Structures 21.2 Disease Patterns 21.2.1 Heart Acute Myocardial Infarction Cardiomyopathies Dilated Cardiomyopathy (DCM) Hypertrophic Cardiomyopathy (HCM) HCM with Hypertrophied Left Ventricular Myocardium Restrictive Cardiomyopathy (RCM) Unclassified Cardiomyopathies Myocarditis Cardiac Tumor Atrial Myxoma 21.2.2 Vessels Aortic Dissection Aortic Aneurysm Traumatic Aortic Rupture Acute Mesenteric Ischemia Peripheral Arterial Occlusive Disease (PAVD) Leriche Syndrome Deep Vein Thrombosis of the Leg 21.3 Diagnostics 21.3.1 Radiological Diagnosis Sonography Conventional X-ray Diagnostics Fluoroscopy/Angiography Computed Tomography Magnetic Resonance Imaging 21.3.2 Nuclear Medicine SPECT Cardiac and PET Cardiac Ergometric Load Pharmacological Exposure Polar Tomograms 21.3.3 Valence 21.4 Therapy 21.4.1 Interventional Radiology Angiography 22: Endocrinological System 22.1 Anatomical Structures 22.2 Disease Patterns 22.2.1 Thyroid Goiter 22.2.2 Thyroid Carcinoma 22.2.3 Adrenal Adenoma 22.2.4 Adrenocortical Carcinoma 22.2.5 Pituitary Adenoma 22.3 Diagnostics 22.3.1 Diagnostic Radiology Sonography Conventional X-ray Diagnostics Fluoroscopy/Angiography Computer Tomography Magnetic Resonance Imaging 22.3.2 Nuclear Medicine Thyroid Scintigraphy Parathyroid Glands (Glandulae Parathyroideae) 22.3.3 Valence 22.4 Therapy 22.4.1 Radiotherapy Thyroid Carcinoma 22.4.2 Nuclear Medicine Radioiodine Therapy 23: Lymphatic System 23.1 Anatomical Structures 23.2 Disease Patterns 23.2.1 Systemic Diseases 23.2.2 Hodgkin’s Disease 23.2.3 Non-Hodgkin’s Lymphoma 23.2.4 Lymph Node Metastases 23.2.5 Splenic Cysts 23.2.6 Spleen Abscess 23.2.7 Splenic Infarction 23.2.8 Splenic Rupture 23.2.9 Thymoma 23.3 Diagnostics 23.3.1 Radiological Diagnosis Sonography Conventional X-ray Diagnostics Fluoroscopy/Angiography Computer Tomography Magnetic Resonance Imaging 23.3.2 Nuclear Medicine Introduction to Sentinel Lymph Node Scintigraphy Sentinel Lymph Node Scintigraphy Using the Example of Breast Carcinoma PET in Lymphoma Diagnostics Indication for PET Special Features in Pediatrics Possible Sources of Error 23.3.3 Valence 23.4 Therapy 23.4.1 Interventional Radiology CT-Guided Biopsy 23.4.2 Radiotherapy Hodgkin’s Disease Non-Hodgkin’s Lymphoma (NHL) 24: Pediatrics 24.1 Thorax 24.1.1 Respiratory Distress Syndrome (ANS) 24.1.2 Meconium Aspiration 24.1.3 Oesophageal Atresia 24.1.4 Catheter in the Thoracic Region Wash-in Catheter Umbilical Vein Catheter (NVK) Umbilical Artery Catheter 24.2 Gastrointestinal Tract 24.2.1 Necrotising Enterocolitis (NEC) 24.2.2 Duodenal Atresia 24.2.3 Invagination 24.3 Urogenital Tract 24.3.1 Vesicourethral Reflux (VUR) 24.4 Musculoskeletal 24.4.1 Child Abuse (Battered Child) 24.4.2 Osteomyelitis 24.4.3 Hip Dysplasia 24.5 Oncology 24.5.1 Neuroblastoma 24.5.2 Nephroblastoma (Wilms’ Tumor) 24.5.3 Medulloblastoma III: Testing 25: MC Questions and Answers 25.1 MC Questions 25.2 MC Responses 26: Clinical Cases 26.1 Pulmonary Embolism or … 26.2 Swollen Hands 26.3 Pain in the Lower Leg 26.4 Chest Pain and Circulatory Problems 26.5 A Swollen Leg 26.6 Hematuria 26.7 Frequent Urination 26.8 Riding Accident 26.9 Laceration to the Forehead 26.10 Persistent Headache 27: Solutions