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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 -
Journal of the American College of... Jun 2020Technetium-labeled cardiac scintigraphy (i.e., Tc-PYP scan) has been repurposed for the diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM). Validated in cohorts... (Review)
Review
Technetium-labeled cardiac scintigraphy (i.e., Tc-PYP scan) has been repurposed for the diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM). Validated in cohorts of patients with heart failure and echocardiographic and/or cardiac magnetic resonance imaging findings suggestive of cardiac amyloidosis, cardiac scintigraphy can confirm the diagnosis of ATTR-CM only when combined with blood and urine testing to exclude a monoclonal protein. Multisocietal guidelines support the nonbiopsy diagnosis of ATTR-CM using cardiac scintigraphy, yet emphasize its use in the appropriate clinical context and the crucial need to rule out light chain amyloid cardiomyopathy. Although increased awareness of ATTR-CM and the advent of effective therapy have led to rapid adoption of diagnostic scintigraphy, there is heterogeneity in adherence to consensus guidelines. This perspective outlines clinical scenarios wherein findings on technetium-labeled cardiac scintigraphy have been misinterpreted, reviews causes of false-negative and false-positive results, and provides strategies to avoid costly and potentially fatal misdiagnoses.
Topics: Amyloidosis; Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; Cardiomyopathies; Heart Failure; Humans; Magnetic Resonance Imaging, Cine; Organotechnetium Compounds; Radioactive Tracers; Radionuclide Imaging; Technetium
PubMed: 32498813
DOI: 10.1016/j.jacc.2020.04.022 -
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 -
Journal of Nuclear Cardiology :... Aug 2021
Topics: Coronary Angiography; Gated Blood-Pool Imaging; Heart Diseases; Humans; Radionuclide Angiography; Reproducibility of Results; Stroke Volume
PubMed: 31482533
DOI: 10.1007/s12350-019-01876-9 -
Seminars in Nuclear Medicine Nov 2023This article discusses the current clinical role and scope of functional radionuclide imaging using testicular perfusion scintigraphy with Tc-pertechnetate in patients... (Review)
Review
This article discusses the current clinical role and scope of functional radionuclide imaging using testicular perfusion scintigraphy with Tc-pertechnetate in patients presenting with an acute hemiscrotum for an early and reliable diagnosis of testicular torsion. The technique of testicular perfusion scintigraphy is described, and the characteristic findings are detailed with examples. The imaging characteristics of the various phases of testicular torsion and its differentiation from epididymitis and/or epididymo-orchitis and the other related conditions presenting as an acute hemiscrotum are detailed. In some cases, further evaluation by SPECT imaging increases the clarity and accuracy of diagnosis and, on occasion, hybrid SPECT/CT in selected complicated cases improves the diagnostic yield of the perfusion scintigraphy. Ultrasonographic and color Doppler findings are described concurrently with the scintigraphic findings. The several case examples presented demonstrate the additional clinical benefit of complementing functional and structural imaging for improving the sensitivity, specificity and accuracy of testicular imaging in the diagnosis.
Topics: Male; Humans; Spermatic Cord Torsion; Diagnosis, Differential; Orchitis; Epididymitis; Radionuclide Imaging
PubMed: 37210316
DOI: 10.1053/j.semnuclmed.2023.04.005 -
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