-
Seminars in Nuclear Medicine Mar 2017Neuroblastoma is an embryonic tumor of the peripheral sympathetic nervous system, and is metastatic or otherwise high risk for relapse in nearly 50% of cases, with a... (Review)
Review
Neuroblastoma is an embryonic tumor of the peripheral sympathetic nervous system, and is metastatic or otherwise high risk for relapse in nearly 50% of cases, with a long-term survival of <40%. Therefore, exact staging with radiological and nuclear medicine imaging methods is crucial for finding the adequate therapeutic choice. The tumor cells express the norepinephrine transporter, which makes metaiodobenzylguanidine (MIBG), an analogue of norepinephrine, an ideal tumor-specific agent for imaging. On the contrary, MIBG imaging has several disadvantages such as limited spatial resolution, limited sensitivity in small lesions, need for two or even more acquisition sessions, and a delay between the start of the examination and result. Most of these limitations can be overcome with positron emission tomography (PET) using different radiotracers. Furthermore, for operative or biopsy planning, a combination with morphological imaging methods is indispensable. This article would discuss the therapeutic strategy for primary and follow-up diagnosis in neuroblastoma using MIBG scintigraphy and different new PET tracers as well as multimodality imaging.
Topics: 3-Iodobenzylguanidine; Fluorodeoxyglucose F18; Humans; Neuroblastoma; Positron Emission Tomography Computed Tomography; Radioactive Tracers; Radionuclide Imaging
PubMed: 28237003
DOI: 10.1053/j.semnuclmed.2016.10.007 -
Annals of Nuclear Medicine Jan 2024Nuclear cardiology has long been used to identify myocardial ischemia for appropriate treatment strategies for stable coronary artery disease (CAD). After the Ischemia... (Review)
Review
Nuclear cardiology has long been used to identify myocardial ischemia for appropriate treatment strategies for stable coronary artery disease (CAD). After the Ischemia Trial, it is time to reevaluate the significance of ischemia assessment. Functional imaging continues to play pivotal role in detecting microcirculatory disturbances. PET provides a clear image of blood flow distribution and is useful for the quantitative evaluation of myocardial flow reserve (MFR), which plays an important role in predicting treatment strategies and improving prognosis in CAD. Heart failure has become a major area of focus in cardiovascular medicine. Radionuclide imaging has been widely applied in this field. FDG PET is useful in identifying cardiac sarcoidosis and active inflammation. Clinical values of I-123 MIBG and BMIPP SPECT have been reported worldwide from Japan. Additionally, clinical experiences of Tc-99m pyrophosphate imaging have recently gained attention for assessing cardiac amyloidosis. Cardiac PET/CT and PET/MR imaging permit combined assessment of metabolic/functional/structural analyses of various cardiac diseases. While other non-invasive imaging modalities have rapidly been developed, the roles of radionuclide imaging remain to be valuable for early and accurate diagnosis and patient management in most cases of chronic CAD and various cardiovascular diseases.
Topics: Humans; Positron Emission Tomography Computed Tomography; Microcirculation; Coronary Artery Disease; Myocardial Ischemia; Tomography, Emission-Computed, Single-Photon; Cardiology; Ischemia; Myocardial Perfusion Imaging
PubMed: 37891375
DOI: 10.1007/s12149-023-01878-1 -
Seminars in Nuclear Medicine Jul 2022Diuretic scintigraphy includes single-photon emitting radiotracers for planar and single photon emission computed tomography (SPECT) imaging as well as agents for... (Review)
Review
Diuretic scintigraphy includes single-photon emitting radiotracers for planar and single photon emission computed tomography (SPECT) imaging as well as agents for positron emission tomography (PET). These radiotracers provide split-renal functional parameters, including glomerular filtration rate, effective renal plasma flow, tubular function, and/or renal blood flow. Beyond measuring kidney function, the tracer principle also allows for the assessment of various pathophysiological processes in the renal parenchyma, for example ongoing inflammation, activation of angiotensin II type 1 receptor in patients with renovascular hypertension, deterioration of mitochondrial complex I following acute or chronic kidney injury, or characterization of indeterminate renal masses. Providing a whole-body read-out, PET also enables the assessment of kidney-organ interactions, for example cardiorenal crosstalk after primary cardiac injury. This manuscript provides an overview of established clinical applications for single-photon-emitting and PET radiotracers for renal radionuclide imaging. Future perspectives in the field will also be highlighted, such as introduction of PET-guided strategies for drug dose optimization and the recent introduction of radiotracers targeting fibroblast activation protein inhibition, which may allow differentiation between acute inflammatory vs chronic fibrosis in the kidneys.
Topics: Humans; Kidney; Positron-Emission Tomography; Radionuclide Imaging; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon
PubMed: 35058040
DOI: 10.1053/j.semnuclmed.2021.12.003 -
Best Practice & Research. Clinical... Aug 2016In daily clinical practice, conventional radiography is still the most applied imaging technique to supplement clinical examination of patients with suspected... (Review)
Review
In daily clinical practice, conventional radiography is still the most applied imaging technique to supplement clinical examination of patients with suspected osteoarthritis (OA); it may not always be needed for diagnosis. Modern imaging modalities can visualize multiple aspects of the joint, and depending on the diagnostic need, radiography may no longer be the modality of choice. Magnetic resonance imaging (MRI) provides a complete assessment of the joint and has a pivotal role in OA research. Computed tomography (CT) and nuclear medicine offer alternatives in research scenarios, while ultrasound can visualize bony and soft-tissue pathologies and is highly feasible in the clinic. In this chapter, we overview the recent literature on established and newer imaging modalities, summarizing their ability to detect and quantify the range of OA pathologies and determining how they may contribute to early OA diagnosis. This accurate imaging-based detection of pathologies will underpin true understanding of much needed structure-modifying therapies.
Topics: Humans; Magnetic Resonance Imaging; Osteoarthritis; Radionuclide Imaging; Tomography, X-Ray Computed; Ultrasonography
PubMed: 27931960
DOI: 10.1016/j.berh.2016.09.007 -
Journal of Nuclear Medicine Technology Jun 2019
Review
Topics: Gastric Emptying; Humans; Radionuclide Imaging; Stomach
PubMed: 31167827
DOI: 10.2967/jnmt.117.227892 -
Seminars in Nuclear Medicine Jan 2019Ventilation-perfusion scintigraphy is a functional imaging biomarker that has the potential of captivating the heterogeneity of chronic obstructive pulmonary disease... (Review)
Review
Ventilation-perfusion scintigraphy is a functional imaging biomarker that has the potential of captivating the heterogeneity of chronic obstructive pulmonary disease (COPD). It specifically images the distribution of ventilation and perfusion within the lungs, which is a critical pathophysiological component of COPD. The extent of ventilation defects and ventilation inhomogeneity, as well as the ventilation-perfusion ratio distribution thus correlate with severity of disease. Furthermore, specific scintigraphic patterns, such as the "stripe sign" may detect centrilobular emphysematous lesions with a higher sensitivity than other imaging techniques. Although ventilation-perfusion scintigraphy may conceivably detect COPD before any specific changes can be detected by spirometry or high-resolution CT, it is currently mostly used in the workup of lung volume reduction treatment, and for diagnosing various complications and comorbidities of COPD when combined with low-dose CT.
Topics: Comorbidity; Humans; Lung; Organ Size; Pulmonary Disease, Chronic Obstructive; Radionuclide Imaging; Ventilation-Perfusion Scan
PubMed: 30545511
DOI: 10.1053/j.semnuclmed.2018.10.010 -
Seminars in Nuclear Medicine Jan 2015Radionuclide procedures frequently are performed as part of the diagnostic workup of osteomyelitis. Bone scintigraphy accurately diagnoses osteomyelitis in bones not... (Review)
Review
Radionuclide procedures frequently are performed as part of the diagnostic workup of osteomyelitis. Bone scintigraphy accurately diagnoses osteomyelitis in bones not affected by underlying conditions. Degenerative joint disease, fracture, and orthopedic hardware decrease the specificity of the bone scan, making it less useful in these situations. Gallium-67 scintigraphy was often used as an adjunct to bone scintigraphy for diagnosing osteomyelitis. However, now it is used primarily for spinal infections when (18)F-FDG imaging cannot be performed. Except for the spine, in vitro-labeled leukocyte imaging is the nuclear medicine test of choice for diagnosing complicating osteomyelitis. Leukocytes accumulate in bone marrow as well as in infection. Performing complementary bone marrow imaging with (99m)Tc-sulfur colloid facilitates the differentiation between osteomyelitis and normal marrow and improves test overall accuracy. Antigranulocyte antibodies and antibody fragments, such as (99m)Tc-besilesomab and (99m)Tc-sulesomab, were developed to eliminate the disadvantages associated with in vitro-labeled leukocytes. These agents, however, have their own shortcomings and are not widely available. As biotin is used as a growth factor by certain bacteria, (111)In-biotin is useful to diagnose spinal infections. Radiolabeled synthetic fragments of ubiquicidin, a naturally occurring human antimicrobial peptide that targets bacteria, can differentiate infection from sterile inflammation and may be useful to monitor response to treatment. (18)F-FDG is extremely useful in the diagnostic workup of osteomyelitis. Sensitivity in excess of 95% and specificity ranging from 75%-99% have been reported. (18)F-FDG is the radionuclide test of choice for spinal infection. The test is sensitive, with a high negative predictive value, and reliably differentiates degenerative from infectious vertebral body end-plate abnormalities. Data on the accuracy of (18)F-FDG for diagnosing diabetic pedal osteomyelitis are contradictory, and its role for this indication remains to be determined. Initial investigations suggested that (18)F-FDG accurately diagnoses prosthetic joint infection; more recent data indicate that it cannot differentiate infection from other causes of prosthetic failure. Preliminary data on the PET agents gallium-68 and iodine-124 fialuridine indicate that these agents may have a role in diagnosing osteomyelitis.
Topics: Animals; Humans; Osteomyelitis; Radionuclide Imaging; Radiopharmaceuticals
PubMed: 25475377
DOI: 10.1053/j.semnuclmed.2014.07.005 -
Methods in Molecular Biology (Clifton,... 2021Nuclear medicine radionuclide imaging is a quantitative imaging modality based on radioisotope-labeled tracers which emit radiation in the form of photons used for image...
Nuclear medicine radionuclide imaging is a quantitative imaging modality based on radioisotope-labeled tracers which emit radiation in the form of photons used for image reconstruction. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are the two noninvasive tomographic three-dimensional radionuclide imaging procedures for both clinical and preclinical settings. In this review on nuclear medicine imaging procedures in oncology, a variety of standard SPECT and PET tracers including radioiodine, Fluorine fluorodeoxyglucose (F-FDG), and Gallium-labeled small proteins like Prostate Specific Membrane Antigen (PSMA) or somatostatin analogues and their application as targeted molecular imaging probes for improved tumor diagnosis and tumor phenotype characterization are described. Absolute and semiquantitative approaches for calculation of tracer uptake in tumors during the course of disease and during treatment allow further insight into tumor biology, and the combination of SPECT and PET with anatomical imaging procedures like computed tomography (CT) or magnetic resonance imaging (MRI) by hybrid SPECT/CT, PET/CT, and PET/MRI scanners provides both anatomical information and tumor functional characterization within one imaging session. With the recent establishment of novel molecular radiolabeled probes for specific tumor diagnosis, prognosis, and treatment monitoring, nuclear medicine has been able to establish itself as a distinct imaging modality with increased sensitivity and specificity.
Topics: Animals; Humans; Neoplasms; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Single Photon Emission Computed Tomography Computed Tomography
PubMed: 33742410
DOI: 10.1007/978-1-0716-1350-4_21 -
Journal of Nuclear Cardiology :... Feb 2016Non-invasive testing of children with congenital heart disease (CHD) began in the 1950s with the introduction of radionuclide studies to assess shunt fractions,... (Review)
Review
Non-invasive testing of children with congenital heart disease (CHD) began in the 1950s with the introduction of radionuclide studies to assess shunt fractions, pulmonary blood flow, and ventricular contractile function. Echocardiography and cardiac magnetic resonance imaging have since replaced radionuclide imaging in many of these roles. Concurrently, percutaneous and surgical repairs of complex CHD evolved, creating new roles for radionuclide imaging. In this paper on applications of radionuclide imaging in CHD, we review the multiple mechanisms for myocardial ischemia in CHD. We critically compare optimal radionuclide imaging techniques to other imaging modalities for assessing ischemia in CHD. We present the current role of nuclear imaging for assessing viability and pulmonary blood flow. We highlight the value added by advances in dedicated cardiac SPECT scanners, novel reconstruction software, and cardiac PET in performing low-dose radionuclide imaging in CHD. Finally, we discuss the emerging clinical indications for radionuclide imaging in CHD including coronary flow reserve assessment and evaluation of cardiovascular prosthesis and device infections.
Topics: Heart Defects, Congenital; Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Myocardial Ischemia; Myocardial Perfusion Imaging; Positron-Emission Tomography; Reproducibility of Results; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon
PubMed: 26129940
DOI: 10.1007/s12350-015-0185-5 -
British Medical Bulletin Sep 2015Radionuclide imaging for the diagnosis and monitoring of cardiac involvement in sarcoidosis has advanced significantly in recent years. (Review)
Review
INTRODUCTION
Radionuclide imaging for the diagnosis and monitoring of cardiac involvement in sarcoidosis has advanced significantly in recent years.
SOURCES OF DATA
This article is based on published clinical guidelines, literature review and our collective clinical experience.
AREAS OF AGREEMENT
Gallium-67 scintigraphy is among the diagnostic criteria for cardiac involvement in systemic sarcoidosis, and it is strongly associated with response to treatment. However, fluorine-18, 2-fluoro-deoxyglucose (FDG) positron emission tomography (PET) is now preferred both for diagnosis and for assessing prognosis.
AREAS OF CONTROVERSY
Most data are from small observational studies that are potentially biased.
GROWING POINTS
Quantitative imaging to assess changes in disease activity in response to treatment may lead to FDG-PET having an important routine role in managing cardiac sarcoidosis.
AREAS TIMELY FOR DEVELOPING RESEARCH
Larger prospective studies are required, particularly to assess the effectiveness of radionuclide imaging in improving clinical management and outcome.
Topics: Cardiomyopathies; Fluorodeoxyglucose F18; Gallium Radioisotopes; Humans; Myocardial Perfusion Imaging; Positron-Emission Tomography; Prognosis; Sarcoidosis; Tomography, Emission-Computed, Single-Photon
PubMed: 26311504
DOI: 10.1093/bmb/ldv033