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European Journal of Nuclear Medicine... Aug 2021Nuclear medicine parathyroid imaging is important in the identification of hyperfunctioning parathyroid glands in primary hyperparathyroidism (pHPT), but it may be also...
INTRODUCTION
Nuclear medicine parathyroid imaging is important in the identification of hyperfunctioning parathyroid glands in primary hyperparathyroidism (pHPT), but it may be also valuable before surgical treatment in secondary hyperparathyroidism (sHPT). Parathyroid radionuclide imaging with scintigraphy or positron emission tomography (PET) is a highly sensitive procedure for the assessment of the presence and number of hyperfunctioning parathyroid glands, located either at typical sites or ectopically. The treatment of pHPT is mostly directed toward minimally invasive parathyroidectomy, especially in cases with a single adenoma. In experienced hands, successful surgery depends mainly on the exact preoperative localization of one or more hyperfunctioning parathyroid adenomas. Failure to preoperatively identify the hyperfunctioning parathyroid gland challenges minimally invasive parathyroidectomy and might require bilateral open neck exploration.
METHODS
Over a decade has now passed since the European Association of Nuclear Medicine (EANM) issued the first edition of the guideline on parathyroid imaging, and a number of new insights and techniques have been developed since. The aim of the present document is to provide state-of-the-art guidelines for nuclear medicine physicians performing parathyroid scintigraphy, single-photon emission computed tomography/computed tomography (SPECT/CT), positron emission tomography/computed tomography (PET/CT), and positron emission tomography/magnetic resonance imaging (PET/MRI) in patients with pHPT, as well as in those with sHPT.
CONCLUSION
These guidelines are written and authorized by the EANM to promote optimal parathyroid imaging. They will assist nuclear medicine physicians in the detection and correct localization of hyperfunctioning parathyroid lesions.
Topics: Humans; Hyperparathyroidism, Primary; Nuclear Medicine; Parathyroid Glands; Positron Emission Tomography Computed Tomography; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Sestamibi
PubMed: 33839893
DOI: 10.1007/s00259-021-05334-y -
European Journal of Nuclear Medicine... Nov 2019Scintigraphic evaluation of the thyroid gland enables determination of the iodine-123 iodide or the Tc-pertechnetate uptake and distribution and remains the most...
INTRODUCTION
Scintigraphic evaluation of the thyroid gland enables determination of the iodine-123 iodide or the Tc-pertechnetate uptake and distribution and remains the most accurate method for the diagnosis and quantification of thyroid autonomy and the detection of ectopic thyroid tissue. In addition, thyroid scintigraphy and radioiodine uptake test are useful to discriminate hyperthyroidism from destructive thyrotoxicosis and iodine-induced hyperthyroidism, respectively.
METHODS
Several radiopharmaceuticals are available to help in differentiating benign from malignant cytologically indeterminate thyroid nodules and for supporting clinical decision-making. This joint practice guideline/procedure standard from the European Association of Nuclear Medicine (EANM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) provides recommendations based on the available evidence in the literature.
CONCLUSION
The purpose of this practice guideline/procedure standard is to assist imaging specialists and clinicians in recommending, performing, and interpreting the results of thyroid scintigraphy (including positron emission tomography) with various radiopharmaceuticals and radioiodine uptake test in patients with different thyroid diseases.
Topics: Biological Transport; Europe; Fluorodeoxyglucose F18; Humans; Iodine Radioisotopes; Nuclear Medicine; Positron Emission Tomography Computed Tomography; Practice Guidelines as Topic; Radionuclide Imaging; Societies, Medical; Thyroid Gland
PubMed: 31392371
DOI: 10.1007/s00259-019-04472-8 -
Methods in Molecular Biology (Clifton,... 2021The purpose of this Chapter is to present a detailed description of methods for performing bone Micro-Computed Tomography (microCT) scanning and analysis. MicroCT is an...
The purpose of this Chapter is to present a detailed description of methods for performing bone Micro-Computed Tomography (microCT) scanning and analysis. MicroCT is an x-ray imaging method capable of visualizing bone at the micro-structural scale, that is, 1-100 µm resolution. MicroCT is the gold-standard method for assessment of 3D bone morphology in studies of small animals. As applied to the small bones of mice or rats, microCT can efficiently and accurately assess bone structure (e.g., cortical bone area [Ct.Ar]) and micro-structure (e.g., trabecular bone volume fraction [Tb.BV/TV]). The particular application described herein is for post mortem mouse femur specimens. The material presented should be generally applicable to many commercially available laboratory microCT systems, although some details are specific to the system used in our lab (Scanco mCT 40; SCANCO Medical AG, Bruttisellen, Switzerland).
Topics: Animals; Bone Density; Femur; Humans; Image Processing, Computer-Assisted; Mice; Radionuclide Imaging; Skull; Tibia; X-Ray Microtomography
PubMed: 33197015
DOI: 10.1007/978-1-0716-1028-2_11 -
Nuclear Medicine Communications Sep 2019The purpose of this guideline is to assist specialists in Nuclear Medicine and Radionuclide Radiology in recommending, performing, interpreting and reporting the results...
The purpose of this guideline is to assist specialists in Nuclear Medicine and Radionuclide Radiology in recommending, performing, interpreting and reporting the results of Parathyroid Scintigraphy. This guideline will assist individual departments to formulate their own local protocols. This does not aim to be prescriptive regarding technical aspects of individual camera acquisitions which need to be developed in conjunction with the local medical physics expert. These guidelines pertain only to adult patients. There are numerous techniques for localizing Parathyroid adenomas. This guideline will describe the use of 99mTc-sestamibi dual phase imaging which may be used alone or in combination with other modalities.
Topics: Humans; Image Interpretation, Computer-Assisted; Parathyroid Glands; Practice Guidelines as Topic; Radionuclide Imaging; Radiopharmaceuticals
PubMed: 31365501
DOI: 10.1097/MNM.0000000000001067 -
Cardiology Clinics May 2023The heart and brain have a complex interplay wherein disease or injury to either organ may adversely affect the other. The mechanisms underlying this connection remain... (Review)
Review
The heart and brain have a complex interplay wherein disease or injury to either organ may adversely affect the other. The mechanisms underlying this connection remain incompletely characterized. However, nuclear molecular imaging is uniquely suited to investigate these pathways by facilitating the simultaneous assessment of both organs using targeted radiotracers. Research within this paradigm has demonstrated important roles for inflammation, autonomic nervous system and neurohormonal activity, metabolism, and perfusion in the heart-brain connection. Further mechanistic clarification may facilitate greater clinical awareness and the development of targeted therapies to alleviate the burden of disease in both organs.
Topics: Humans; Heart; Radionuclide Imaging; Heart Failure; Brain; Positron-Emission Tomography
PubMed: 37003682
DOI: 10.1016/j.ccl.2023.01.013 -
Current Opinion in Pediatrics Aug 2019Congenital hypothyroidism is a common worldwide condition. Due in part to increasingly widespread newborn screening, the number of patients with this diagnosis is... (Review)
Review
PURPOSE OF REVIEW
Congenital hypothyroidism is a common worldwide condition. Due in part to increasingly widespread newborn screening, the number of patients with this diagnosis is increasing. In this review, we discuss currently available imaging techniques and the benefits and limitations of these techniques in evaluating congenital hypothyroidism.
RECENT FINDINGS
Recent work has demonstrated an increasing diagnosis of congenital hypothyroidism with normally located glands and mildly decreased thyroid function. Increasingly more genetic abnormalities have been recognized in the hormone synthesis pathways. These cases may have lower or shorter term treatment requirements than the more common severe forms of congenital hypothyroidism, and the ability to distinguish between these situations may become increasingly more important to management and counseling.
SUMMARY
Imaging studies for congenital hypothyroidism may be unlikely to change immediate management in the majority of cases. The common modalities of imaging include thyroid ultrasound and radionuclide uptake scanning with either technetium or iodine. These can help establish an etiology for the condition, and in less-common causes of congenital hypothyroidism may have implications on treatment decisions, prognosis, and counseling.
Topics: Congenital Hypothyroidism; Diagnostic Tests, Routine; Humans; Infant, Newborn; Neonatal Screening; Radionuclide Imaging
PubMed: 31145126
DOI: 10.1097/MOP.0000000000000782 -
PET Clinics Apr 2021This article provides a review of the latest radiotracers for planar/single-photon emission computed tomography (SPECT) and positron emission tomography (PET)/computed... (Review)
Review
This article provides a review of the latest radiotracers for planar/single-photon emission computed tomography (SPECT) and positron emission tomography (PET)/computed tomography (CT) imaging of cardiac amyloidosis, detailing their affinity, specificity, and sensitivity for cardiac amyloidosis. There are several tracers available that have differing affinities for transthyretin (ATTR) and immunoglobulin light chain (AL), and new developments in technology have allowed for disease burden quantification. Bone scintigraphy is an excellent option for visualizing ATTR cardiac amyloidosis. Negative testing does not exclude the possibility of AL cardiac amyloidosis and absolute quantitation of amyloid burden is limited.
Topics: Amyloid; Amyloid Neuropathies, Familial; Heart; Humans; Positron Emission Tomography Computed Tomography; Radionuclide Imaging
PubMed: 33589384
DOI: 10.1016/j.cpet.2020.12.010 -
Frontiers in Bioscience (Landmark... Jun 2016Over the past decades, the diagnostic methods and therapeutic tools for thyroid cancer (TC) have been greatly improved. In addition to the classical method of ingestion... (Review)
Review
Over the past decades, the diagnostic methods and therapeutic tools for thyroid cancer (TC) have been greatly improved. In addition to the classical method of ingestion of radioactive iodine-131 (I131) and subsequent I123 and I124 positron emission tomography (PET) in therapy and examination, I124 PET-based 3-dimensional imaging, Ga68-labeled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI(3)-octreotide (DOTANOC) PET/computed tomography (CT), Tc99m tetrofosmin, pre-targeted radioimmunotherapy, and peptide receptor radionuclide therapy have all been used clinically. These novel methods are useful in diagnosis and therapy of TC, but also have unavoidable adverse effects. In this review, we will discuss the development of nuclear medicine in TC examination and treatment.
Topics: Humans; Iodine Radioisotopes; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radionuclide Imaging; Thyroid Neoplasms
PubMed: 27100499
DOI: 10.2741/4449 -
Seminars in Nuclear Medicine Mar 2018With the exception of radiolabeled monoclonal antibodies, antibody fragments and radiolabeled peptides which have seen little application in the pediatric population,... (Review)
Review
With the exception of radiolabeled monoclonal antibodies, antibody fragments and radiolabeled peptides which have seen little application in the pediatric population, the nuclear medicine imaging procedures used in the evaluation of infection and inflammation are the same for both adults and children. These procedures include (1) either a two- or a three-phase bone scan using technetium-99m methylene diphosphonate; (2) Gallium 67-citrate; (3) in vitro radiolabeled white blood cell imaging (using Indium-oxine or Technetium hexamethyl-propylene-amine-oxime-labeled white blood cells); and (4) hybrid imaging with F-FDG. But children are not just small adults. Not only are the disease processes encountered in children different from those in adults, but there are developmental variants that can mimic, but should not be confused with, pathology. This article discusses some of the differences between adults and children with osteomyelitis, illustrates several of the common developmental variants that can mimic disease, and, finally, focuses on the increasing use of F-FDG PET/CT in the diagnosis and response monitoring of children with infectious and inflammatory processes. The value of and need for pediatric specific imaging protocols are reviewed.
Topics: Child; Humans; Infections; Inflammation; Positron Emission Tomography Computed Tomography; Radionuclide Imaging
PubMed: 29452618
DOI: 10.1053/j.semnuclmed.2017.11.002 -
Seminars in Nuclear Medicine Sep 2015Radionuclide myocardial perfusion imaging (MPI) is an important technique for evaluating the presence and severity of ischemic coronary heart disease that is widespread... (Review)
Review
Radionuclide myocardial perfusion imaging (MPI) is an important technique for evaluating the presence and severity of ischemic coronary heart disease that is widespread in the United States and much of the world. This widely used test has excellent diagnostic accuracy and strong risk-stratification utility and plays an important role in guiding patient management. As with all testing modalities, the clinical utility of MPI relies on proper procedure performance as improper techniques can lead to incorrect test interpretation, and thus misdiagnosis with potential adverse effects on patient management and outcome. A variety of potential pitfalls must be understood and recognized. These include minimizing referral of "rarely appropriate" patients for testing, selecting the best imaging procedure for each patient, properly preparing a patient for the test to be performed, skillful performance of stress testing and image acquisition, careful image processing, understanding the strengths and weaknesses of different image display options, recognition of common artifacts that can lead to misdiagnoses, distinguishing normal anatomy from true pathology, recognizing noncoronary cardiac disease, and not missing extracardiac pathology. It is important that physicians who perform and interpret radionuclide MPI be well versed in published guidelines and potential pitfalls to proper test performance and interpretation.
Topics: Artifacts; Heart; Heart Diseases; Humans; Image Processing, Computer-Assisted; Multimodal Imaging; Radionuclide Imaging
PubMed: 26278852
DOI: 10.1053/j.semnuclmed.2015.02.003