A Concise Guide to Nuclear Medicine

Description

This book, now in an extensively revised second edition, summarizes the basic principles of nuclear medicine and describes the clinical applications of commonly used nuclear medicine procedures and techniques. Readers will find clear explanation of clinical indications, the pathophysiological basis of functional procedures, and the complementary role of nuclear medicine and molecular imaging in relation to diagnostic radiology. Throughout, emphasis is placed on the added diagnostic value offered by the new hybrid imaging modalities. The various therapeutic applications of nuclear medicine are also discussed. Compared with the first edition, technical details have been significantly simplified. The book will be an ideal introduction to nuclear medicine for medical students and will serve as an excellent quick reference for referring physicians, enabling them to utilize this modern medical specialty more efficiently. Preface to Second Edition Acknowledgement Contents 1: Basic Principles of Nuclear Medicine 1.1 Nuclear Medicine and Molecular Imaging 1.2 Historical Background 1.3 Scientific Basis of Nuclear Medicine 1.3.1 Atomic Structure 1.3.2 Isotopes 1.3.3 Radioactivity 1.3.4 Radiopharmaceuticals 1.4 Technical Principles of Nuclear Medicine 1.5 Scope of Nuclear Medicine 1.5.1 Diagnostic Nuclear Medicine 1.5.2 Therapeutic Nuclear Medicine 1.6 Summary Further Reading 2: Nuclear Medicine in the Genitourinary System 2.1 Introduction 2.2 Radiopharmaceuticals 2.3 Dynamic Renal Scintigraphy 2.3.1 Imaging Protocol 2.3.2 Renovascular Hypertension 2.3.3 Urinary Tract Obstruction 2.3.4 Evaluation of Renal Transplant Complications 2.3.4.1 Surgical Complications 2.3.4.2 Medical Complications Acute Tubular Necrosis Rejection 2.4 Cortical Renal Scintigraphy 2.4.1 Imaging Protocol 2.4.2 Urinary Tract Infection 2.5 Vesicoureteral Reflux Study 2.6 Testicular Imaging Study 2.7 Summary Further Reading 3: Nuclear Medicine in the Digestive System 3.1 Introduction 3.2 Clinical Applications 3.3 Evaluation of Esophageal Transit Time 3.4 Detection of Gastroesophageal Reflux 3.5 Evaluation of Gastric Emptying 3.6 Lower Gastrointestinal Bleeding Localization 3.7 Diagnosis of Meckel’s Diverticulum 3.8 Diagnosis and Follow-Up of Inflammatory Bowel Disease 3.9 Diagnosis of Hepatic Hemangioma 3.10 Diagnosis of Hepatobiliary Diseases 3.10.1 Diagnosis of Acute Cholecystitis 3.10.2 Diagnosis of Common Bile Duct Obstruction 3.10.3 Evaluation of Neonatal Hyperbilirubinemia 3.10.4 Diagnosis of Hypokinesis Syndrome 3.10.5 Evaluation of Complications After Hepatobiliary Surgery and Liver Transplantation 3.11 Protein Loss Study 3.12 Scintigraphic Nonimaging Procedures 3.12.1 Carbon-14 Breath Tests 3.13 Summary Further Reading 4: Nuclear Medicine in the Endocrine System 4.1 Introduction 4.2 Thyroid Gland 4.2.1 Clinical Applications 4.2.1.1 Thyroid Imaging Studies 4.2.1.2 Thyroid Radioiodine Uptake 4.2.2 Thyroid Imaging Study 4.2.2.1 Tc-99m Pertechnetate 4.2.3 Thyroid Uptake Measurement 4.2.3.1 Thyroid Cancer Imaging Studies 4.3 Parathyroid Gland 4.3.1 Clinical Applications 4.3.2 Preoperative Parathyroid Localization 4.3.3 Intraoperative Parathyroid Localization 4.4 Adrenal Gland 4.4.1 Clinical Applications 4.4.2 Adrenal Cortex Disorders 4.4.2.1 Adrenal Cortical Imaging Study (NP-59 Study) 4.4.3 Adrenal Medulla Disorders 4.4.3.1 Metaiodobenzylguanidine Study 4.4.3.2 Indium-111 Tc-99m Octreotide Study 4.4.3.3 Positron Emission Tomography (PET) 4.5 Summary Further Reading 5: Nuclear Medicine in Soft-Tissue Infection and Inflammation 5.1 Introduction 5.2 Clinical Applications 5.3 Diagnosis of Infection 5.4 Imaging of Soft-Tissue Infections 5.4.1 Localizing Signs Present 5.4.1.1 Imaging Abdominal Infections 5.4.1.2 Inflammatory Bowel Disease (IBD) 5.4.1.3 Imaging Chest Infections 5.4.1.4 Cardiovascular System Infections 5.4.1.5 Imaging Renal Infections 5.4.2 No Localizing Signs Present 5.5 Algorithm 5.6 Summary Further Reading 6: Nuclear Medicine in the Respiratory System 6.1 Introduction 6.2 Clinical Applications 6.3 Diagnosis of Pulmonary Embolism 6.4 Pulmonary Sarcoidosis 6.5 Idiopathic Pulmonary Fibrosis 6.6 Pneumocystis carinii (jirovecii) Pneumonia 6.7 Alveolar Permeability 6.8 Lung Cancer 6.9 Preoperative Quantitative Ventilation/Perfusion Studies 6.10 Summary Further Reading 7: Nuclear Medicine in the Musculoskeletal System 7.1 Introduction 7.2 Clinical Applications 7.2.1 Non-neoplastic Diseases 7.2.2 Neoplastic Diseases 7.3 Non-neoplastic Disease 7.3.1 Imaging of Skeletal Infections 7.3.1.1 Acute Osteomyelitis 7.3.1.2 Chronic and Vertebral Osteomyelitis 7.3.1.3 Infectious (Septic) Arthritis 7.3.2 Avascular Necrosis (Osteonecrosis) 7.3.3 Trauma and Related Conditions 7.3.3.1 Fractures of Small Bones 7.3.3.2 Stress Fractures 7.3.3.3 Lisfranc Fracture (Tarsometatarsal Fracture) 7.3.3.4 Spondylolysis 7.3.3.5 Growth Plate Injury 7.3.3.6 Complex Regional Pain Syndrome-1 (CRPS-1) 7.3.3.7 Heterotopic Bone Formation 7.3.4 Metabolic Bone Diseases 7.4 Diagnosis of Neoplastic Bone Disease 7.4.1 Imaging of Primary Bone Tumors 7.4.2 Imaging of Metastatic Bone Disease 7.4.2.1 Appearance of Metastases on Bone Scan Typical Pattern Atypical Patterns Solitary Lesion Cold Lesions Diffuse Pattern 7.5 Summary Further Reading 8: Nuclear Medicine in the Cardiovascular System 8.1 Introduction 8.2 Clinical Applications 8.3 Evaluation of Cardiac Function 8.4 Evaluation of Myocardial Perfusion and Metabolism 8.4.1 Diagnosis 8.4.2 Prognosis 8.4.3 Follow-Up After Acute Myocardial Infarction 8.4.4 Follow-Up After Revascularization Procedures 8.4.5 Preoperative Evaluation 8.4.6 Viability Assessment 8.5 Soft-Tissue Hemangioma Study 8.6 Lymphoscintigraphy 8.7 Summary Further Reading 9: Nuclear Medicine in the Nervous System 9.1 Introduction 9.2 Clinical Applications 9.3 Dementia 9.4 Brain Death 9.5 Seizure Localization 9.6 Brain Tumors 9.7 Parkinsonism 9.8 Cerebrospinal Fluid Abnormalities 9.9 Summary Further Reading 10: Nuclear Medicine in Oncology 10.1 Introduction 10.2 Clinical Indications 10.3 Diagnosis of Tumors 10.4 Staging of Malignant Disease 10.5 Detection of Residual or Recurrent Disease 10.6 Evaluating Response to Therapy 10.7 Radiotherapy Planning 10.8 Sentinel Lymph Node Localization 10.9 Summary Further Reading 11: Therapeutic Applications of Nuclear Medicine 11.1 Introduction 11.2 Clinical Uses 11.3 Treatment of Hyperthyroidism and Other Benign Thyroid Conditions 11.4 Treatment of Differentiated Thyroid Cancer 11.5 Treatment of Pain Secondary to Skeletal Metastases 11.6 Treatment of Neuroendocrine Tumors 11.7 Treatment of Prostatic Cancer 11.8 Radioimmunotherapy 11.9 Radionuclide Synovectomy 11.10 Peptide Receptor Radionuclide Therapy 11.11 Treatment of Hepatocellular Carcinoma and Liver Metastases 11.12 Summary Further Reading Glossary