[Recommendation on standardization of radionuclide imaging. Subcommittee for Standardization of Radionuclide Imaging, Medical and Pharmaceutical Committee (author's transl)].
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Brain↗
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Results for “Radionuclide Imaging”
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Cardiac ejection fraction: phantom study comparing cine MR imaging, radionuclide blood pool imaging, and ventriculography.
The accuracy and reproducibility of cardiac ejection fraction (EF) measurements based on cine magnetic resonance (MR) imaging, radionuclide multigated acquisition (MUGA) blood pool imaging, and angiographic ventriculography were evaluated by comparing them with a volumetrically determined standard. A biventricular, compliant, fluid-filled heart phantom was developed to mimic normal cardiac anatomy and physiology. Ventricular EFs were measured with cine MR imaging by summation of nine contiguous 10-mm-thick sections in short and long axis, with single-plane ventriculography, and with MUGA. Three measurements were performed with each modality for each of three EFs. Ventriculography was least accurate, with average relative errors ranging from 7.9% for the largest EF to 60.1% for the smallest. Cine MR was most accurate, with average relative errors ranging from 4.4% to 8.5%. MUGA EF measurements showed good correlation, with average relative errors ranging from 7.1% to 22.4%. Comparison of the error variances for the three modalities with the F test revealed that MR and MUGA EF measurements were significantly more accurate than those based on ventriculography (P less than .01). No significant difference was demonstrated between the accuracy of short- and long-axis cine MR acquisitions.
Gated Blood-Pool Imaging↗
Imaging: radionuclides in renal imaging.
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Chromium Radioisotopes↗
Implementation of a digital image superposition algorithm for radionuclide images: an assessment of its accuracy and reproducibility.
An operator-interactive algorithm to achieve superposition of organ images has been used with a dedicated nuclear medicine computer system. Its purpose is to achieve organ registration in 128 X 128 digitized images before a direct numerical comparison of the regional distribution of a deposited radiotracer is performed. The accuracy and reproducibility of the algorithm for myocardial images has been tested by four operators, using a set of 28 image pairs in which the relative position of the heart differed by more than 10 mm for each pair. Comparing their results with the known displacements on two occasions provided an assessment of these two important parameters. The accuracy and reproducibility for superposing myocardial images by this digital technique are found to be well within the spatial resolution (FWHM) of the imaging system of the Tl-201 tracer studied.
Computers↗
The lateral view in radionuclide imaging of the sacrum.
Radionuclide bone images in the anterior and posterior views failed to demonstrate a large metastatic tumor involving the sacrum which was obvious on the lateral view. Evaluation of the sacrum by radionuclide imaging may be incomplete without the lateral projection, particularly when there is a question of false-negative anterior and posterior views or difficulty in interpreting the radionuclide images.
Adult↗
Radionuclide imaging in otolaryngology-head and neck surgery.
Radionuclide imaging provides both qualitative and quantitative information that can have dramatic effects on patient management in diseases of the head and neck. The general concepts of nuclear medicine imaging, including radiopharmaceuticals and radiation effects, are discussed. The principles and techniques of thyroid, parathyroid, bone, and salivary radionuclide imaging studies will be reviewed. The intent of this article is to provide a concise and current review of head and neck radionuclide imaging that will be useful in the day-to-day practice of otolaryngology-head and neck surgery.
Head and Neck Neoplasms↗
The complementary role of computerized axial transmission tomography and radionuclide imaging of the brain.
Computerized axial transmission tomography and radionuclide imaging are complementary procedures, and the following recommendations are made as to their use. Where there is no real clinical suspicion of intracranial disease, either modality can be used for "rule out" screening; the choice can frequently be made on the basis of which modality is cheaper or more quickly available. It should be remembered that "quicker" is often "cheaper". Total cost is determined, not only by the cost of the procedure, but also the per diem costs incurred in waiting for that procedure. Thus the more expensive modality may, in effect, be cheaper if delays are shorter. Screening of the elderly patient, particularly when atrophy or communicating hydrocephalus is of clinical concern, should be by the CT method because of its ability to visualize cerebrospinal fluid spaces. When clinical signs and symptoms point to intracranial abnormality, both modalities should be utilized. If either study done first is normal, use of the other modality is mandatory. When the first study is positive with pathognomonic findings for a specific disease, which totally explains the patient's neurologic problems, the second study need not be employed. Such examples might include the fresh cerebral hemorrhage demonstrated by CT imaging, the AV malformation defined by dynamic-static radionuclide imaging, or multifocal metastatic lesions defined by either. However, when the clinical picture is not totally and satisfactorily explained by the demonstrated disease, the other modality should also be employed. Under many circumstances, neither study will be so reliable, specific, and free of false-negative or false-positive findings as to warrant ignoring the additional information potentially available from the other study.
Astrocytoma↗
Radionuclide imaging in the assessment of primary chronic pyelonephritis.
The diagnostic value of radionuclide imaging as a supplement to excretory urography was assessed in 33 patients with primary chronic pyelonephritis. Both 99mTc-glucoheptonate and 131I-Hippuran were used. Radionuclide imaging did not improve the sensitivity of detection by urography alone (31 of 33 patients). Nevertheless, in one third of cases the radionuclide studies demonstrated certain abnormalities more readily, including focal parenchymal damage, renal functional impairment, and decreased renal perfusion. Radionuclide imaging is useful when minimal or no abnormalities are observed on the excretory urogram or nephrotomogram.
Adolescent↗
Radionuclide imaging and echography of thyroid nodules.
The usefulness of grey scale ultrasonography in association with radionuclide imaging in the evaluation of thyroid nodules is discussed. Nodules were classified in five categories, according to the magnitude of the internal echoes (echogenicity). The assessment of neoplasms in each of these categories is reported in 143 cases in which radionuclide imaging disclosed nonfunctioning or cold nodules. In this study, echography is used principally to clarify the nature of nonfunctioning or cold nodules found on radionuclide imaging.
Adenoma↗
Correlation of computed tomography, gray scale ultrasonography, and radionuclide imaging of the liver in detecting space-occupying processes.
The abilities of computed tomography (CT; scanning time=2.7 min), gray scale ultrasonography, and radionuclide imaging to detect and characterize space-occupying processes in the liver were compared. A numerical rating scale which emphasized detection abilities resulted in ultrasonography scoring 3.5 CT 3.2, and radionuclide imaging 2.9. CT resulted in no false positives and 6 false negatives, caused mainly by motion artifacts. The simplest technique, radionuclide imaging, also had the smallest number (2) of false negatives; it is therefore recommended as the screening procedure of choice. Sonography or CT should be done for those patients with a prior suspicious finding.
Carcinoma, Hepatocellular↗
A comparison of gray scale ultrasound and radionuclide imaging for the detection of focal hepatic lesions: open shutter technique.
A conventional B scan ultrasound unit was modified by the addition of a specially built logarithmic amplifier and a high resolution nonstorage oscilloscope, as suggested by Taylor and Carpenter. One hundred five consecutive patients submitted for radionuclide imaging of the liver were examined with ultrasound using a standardized scanning system. The ultrasound technique produced scans that were technically poor or inadequate in 37 per cent of the patients studied. In the studies in which there has been confirmation, the ultrasound diagnosis was accurate in 73 per cent and the radionuclide diagnosis was correct in 83 per cent. The combined accuracy of the two studies was 93 per cent. In 11 patients, ultrasound more clearly defined the lesions that were demonstrated by both techniques or demonstrated the nature of suspicious or equivocal areas on the radionuclide images. In 48 patients, the radionuclide scan imaged the liver more completely or demonstrated lesions more clearly than did the ultrasound examination. This specific approach to ultrasound gray scale imaging appears to be a valuable supplemental tool to radionuclide imaging, but at its present stage of development cannot replace it as a routine screening technique for hepatic disease.
Diagnostic Errors↗
Bone stress: a radionuclide imaging perspective.
Thirty-five college athletes with lower leg pain underwent radiography and radionuclide studies to rule out a stress fracture. Their asymptomatic extremities and 13 pain-free athletes served as controls. Four main patterns were observed: (a) sharply marginated scintigraphic abnormalities and positive radiographs; (b) sharply marginated scintigraphic abnormalities and negative radiographs; (c) ill-defined scintigraphic abnormalities and negative radiographs; and (d) negative radionuclide images and negative radiographs. Since the patients with the first two patterns were otherwise identical medically, the authors feel that this scintigraphic appearance is characteristic of bone stress in the appropriate clinical setting, regardless of the radiographic findings. A schema is proposed to explain the occurrence of positive radionuclide images and negative radiographs in the same patient, using a broad conceptual approach to the problem of bone stress.
Adolescent↗
Computed tomography and radionuclide imaging of the liver: a comparative evaluation.
The authors retrospectively analyzed the results of radionuclide imaging (RI) and computed tomography (CT) of the liver in 174 patients. RI correctly identified 90% of patients with focal hepatic lesions while CT identified 85%. CT was capable of differentiating tumor, abscess/hematoma, and cyst while RI was more sensitive in the detection of hepatocellular disease. CT distinguished regenerating nodules from other focal lesions. Radionuclide imaging remains the preferred initial screening examination in patients with suspected focal liver disease, while CT is the examination of choice to distinguish obstructive from nonobstructive jaundice.
Diagnostic Errors↗
Computed tomography and 67Ga citrate radionuclide imaging for evaluating suspected abdominal abscess.
A retrospective analysis of the results of 67Ga citrate radionuclide imaging and computed tomography (CT) in 45 patients with suspected abdominal abscess was conducted to determine the mertis of each method. Both techniques were highly sensitive in detecting abdominal abscesses, and often provided complementary and supplementary diagnostic information; their combined use many times offset the limitations of each method used alone. Guidelines are suggested that permit rapid evaluation, while limiting diagnostic errors, when using 67Ga citrate radionuclide imaging and CT in the presence or absence of localizing symptoms and signs.
Abdomen↗
Detection and localization of parathyroid adenomas in patients with hyperparathyroidism using a single radionuclide imaging procedure with technetium-99m-sestamibi (double-phase study)
Dual radionuclide imaging using a combination of 201Tl with either 99mTcO4- or 123I is recognized as a useful procedure in the preoperative localization of parathyroid adenomas. Recently, 99mTc-sestamibi (MIBI) has been introduced for myocardial perfusion imaging as an alternative to 201Tl. The purpose of this prospective study was to evaluate parathyroid scan using early and late imaging following MIBI injection. Twenty-three patients (21 F, 2 M, mean age: 57 yr) with a clinical and biologic diagnosis of hyperparathyroidism were submitted to a MIBI study prior to surgical exploration of the neck. Cervico-thoracic planar imaging (anterior view, 10 min/view) was performed at 15 min and at 2-3 hr after an intravenous injection of 20-25 mCi of MIBI. A positive MIBI scan for parathyroid adenoma was defined as an area of increased focal uptake which persisted on late imaging, contrary to the uptake in the normal thyroid tissue which progressively decreases over time (differential washout). Surgical exploration of the neck, performed between 1 day and 72 days (average: 16 days) after the MIBI study, showed a parathyroid adenoma in 21 patients and hyperplasia in two patients. MIBI scan correctly detected and localized 19/21 adenomas (90%). In conclusion, parathyroid imaging using a single radionuclide with MIBI (early and late study with differential washout analysis) is a promising procedure in the preoperative detection and localization of parathyroid adenomas in patients with primary hyperparathyroidism.
Adenoma↗
Use of radionuclide imaging in the early diagnosis and treatment of renal allograft rejection.
Data are presented on the clinical application of radionuclide imaging to evaluate changes in cadaver transplant function in the immediate postoperative period. The method uses orthoiodohippuric acid (hippuran) administered IV, with scintillation imaging, and curve analysis by a digital computer. An initial study is always obtained 24 hours after transplantation. Serial studies are then obtained, as needed, to interpret the clinical course. Selected cases are presented which illustrate the use of this protocol in various clinical settings. In the oliguric patient serial studies have been of particular value. They have identified ATN so that over-enthusiastic treatment for rejection could be avoided. They have also identified acute rejection complicating ATN so that high dose steroid therapy could be administered appropriately. In the non-oliguric patient they have frequently contributed to the early diagnosis of acute rejection, and they have been useful in monitoring the effect and duration of treatment for severe rejection crisis. It is concluded that radionuclide imaging studies, when carefully applied and interpreted, are a valuable adjunct to the management of patients in this complex clinical setting.
Acute Disease↗
Dosimetry of four heart-imaging radionuclides: 43K, 81Rb, 129Cs, and 201Ti.
In conjunction with research into the relative clinical suitability of radionuclides for heart imaging, estimates of the radiation dosimetry for 43K, 81Rb, 129Cs, and 201Tl were calculated. Estimates of absorbed radiation dose for the heart, kidneys, liver, lungs, testes, and whole body of the standard man were computed from published distribution data in rats via the MIRD method by assuming that the concentration in each organ per initial mean whole-body concentration is the same in rats and humans. The whole-body absorbed radiation doses from 81Rb, 129Cs, 201Tl, and 43K are 0.08, 0.17, 0.24, and 0.60 rads/mCi administered intravenously. In general, the organ doses from the four radionuclides follow the same order.
Animals↗
Radionuclide imaging of intestinal infarction.
An acute small bowel infarction in a 57-year-old male alcoholic produced a dense positive image on a gallium-67 citrate scan. Radionuclide imaging may be useful in the diagnosis of this condition, which has a high mortality rate and is not often diagnosed premortem.
Humans↗