Nuclear Medicine.pdf
Nuclear Medicine.pdf
V m
William D. Leslie
I. David Greenberg
a d e m e c uV a d e m e c u m
Table of contents
1. An Introduction to Nuclear
Medicine
2. Radiation Effects and Safety
3. Myocardial Perfusion Imaging
4. Equilibrium Radionuclide
Angiography
5. Thromboembolic Disease
6. Bone Densitometry
7. Skeletal Disorders
8. Skeletal Oncology
9. Kidney
10. Gastrointestinal
11. Hepatobiliary Imaging
The Vademecum series includes subjects generally not covered in other handbook
series, especially many technology-driven topics that reflect the increasing
influence of technology in clinical medicine.
The name chosen for this comprehensive medical handbook series is
Vademecum, a Latin word that roughly means “to carry along”. In the Middle
Ages, traveling clerics carried pocket-sized books, excerpts of the carefully
transcribed canons, known as Vademecum. In the 19th century a medical publisher
in Germany, Samuel Karger, called a series of portable medical books
Vademecum.
The Landes Bioscience Vademecum books are intended to be used both in the
training of physicians and the care of patients, by medical students, medical house
staff and practicing physicians. We hope you will find them a valuable resource.
All titles available at
www.landesbioscience.com
LANDES
B I O S C I E N C E
I SBN 1- 57059- 644- 1
9 7 8 1 5 7 0 5 9 6 4 4 5
LANDES
B I O S C I E N C E
Nuclear
Medicine
12. Inflammatory Disorders
13. Thyroid Disorders
14. Radionuclide Therapy
of Thyroid Disorders
15. Tumor Imaging
16. Neuropsychiatric Disorders
17. Pediatric Nuclear Medicine
Appendix
William D. Leslie, MD, FRCPC, ABNM, MSc
University of Manitoba
Winnipeg, Manitoba, Canada
I. David Greenberg, MDCM, FRCPC, ABR, ABNM
University of Manitoba
Winnipeg, Manitoba, Canada
Nuclear Medicine
GEORGETOWN, TEXAS
U.S.A.
v a d e m e c u m
L A N D E S
B I O S C I E N C E
VADEMECUM
Nuclear Medicine
LANDES BIOSCIENCE
Georgetown, Texas U.S.A.
Copyright ©2003 Landes Bioscience
All rights reserved.
No part of this book may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopy, recording, or any
information storage and retrieval system, without permission in writing from the
publisher.
Printed in the U.S.A.
Please address all inquiries to the Publisher:
Landes Bioscience, 810 S. Church Street, Georgetown, Texas, U.S.A. 78626
Phone: 512/ 863 7762; FAX: 512/ 863 0081
ISBN: 1-57059-644-1
Library of Congress Cataloging-in-Publication Data
While the authors, editors, sponsor and publisher believe that drug selection and dosage and
the specifications and usage of equipment and devices, as set forth in this book, are in accord
with current recommendations and practice at the time of publication, they make no
warranty, expressed or implied, with respect to material described in this book. In view of the
ongoing research, equipment development, changes in governmental regulations and the
rapid accumulation of information relating to the biomedical sciences, the reader is urged to
carefully review and evaluate the information provided herein.
Contents
1. An Introduction to Nuclear Medicine ............................... 1
Brian Lentle and Anna Celler
Introduction ............................................................................................... 1
History ....................................................................................................... 1
Comparative Imaging and the Role of Nuclear Medicine ............................ 4
Radionuclide Production ............................................................................ 5
Radionuclide Decay .................................................................................... 8
Detection Systems .................................................................................... 10
Clinical Practice ........................................................................................ 13
A Perspective on the Future ...................................................................... 14
2. Radiation Effects and Safety ........................................... 16
Michael J. Chamberlain
Introduction ............................................................................................. 16
Radiation Dosimetry ................................................................................ 16
Radiation Effects and Carcinogenesis ........................................................ 19
Principles of Radiation Protection ............................................................. 24
Practical Aspects of Radiation Protection .................................................. 25
Frequently Asked Questions (FAQs) ......................................................... 28
3. Myocardial Perfusion Imaging ........................................ 31
Robert Corne and I. David Greenberg
Introduction ............................................................................................. 31
Physiologic and Technical Considerations ................................................. 31
Clinical Role in the Diagnosis of Coronary Artery Disease ........................ 41
Clinical Role in Prognosis and Risk Stratification ..................................... 50
Clinical Role in Defining Myocardial Viability ......................................... 54
Frequently Asked Questions (FAQs) ......................................................... 55
4. Equilibrium Radionuclide Angiocardiography ............... 60
I. David Greenberg and Robert Corne
Introduction ............................................................................................. 60
Technical Considerations .......................................................................... 60
Clinical Applications ................................................................................. 64
Frequently Asked Questions (FAQ)s ......................................................... 72
5. Thromboembolic Disease ............................................... 75
Daniel F. Worsley and Philip S. Wells
Introduction ............................................................................................. 75
Technical Considerations in Lung Scanning ............................................. 75
Diagnosis of Acute Pulmonary Embolism ................................................. 83
Evaluation of Pulmonary Hypertension .................................................... 88
Frequently Asked Questions (FAQs) ......................................................... 88
6. Bone Densitometry ......................................................... 93
William D. Leslie and Bruce E. Roe
Pathophysiology of Bone Loss and Osteoporotic Fractures ........................ 93
Technical Aspects of Bone Densitometry .................................................. 97
Clinical Role of Bone Densitometry ....................................................... 104
Clinical Management of Osteoporosis .................................................... 110
Frequently Asked Questions (FAQs) ....................................................... 117
7. Skeletal Disorders ......................................................... 121
Leonard Rosenthall and Peter MacDonald
Introduction ........................................................................................... 121
Skeletal Anatomy and Physiology ........................................................... 121
Technical Considerations ........................................................................ 121
Trauma ................................................................................................... 122
Osteomyelitis .......................................................................................... 129
Vascular Disorders .................................................................................. 131
Joint Prostheses ....................................................................................... 134
Radionuclide Synovectomy ..................................................................... 137
Frequently Asked Questions (FAQs) ....................................................... 138
8. Skeletal Oncology ......................................................... 141
Leonard Rosenthall and Ralph Wong
Introduction ........................................................................................... 141
Primary Benign Bone Tumors ................................................................. 141
Primary Malignant Bone Tumors ............................................................ 149
Diagnosis and Follow-Up of Skeletal Metastases ..................................... 152
Frequently Asked Questions (FAQs) ....................................................... 159
9. Kidney .......................................................................... 163
Michael Hoskinson and Keevin Bernstein
Introduction ........................................................................................... 163
Renal Physiology ..................................................................................... 163
Technical Considerations ........................................................................ 165
Clinical Role in Acute Renal Failure ........................................................ 172
Clinical Role in Hydronephrosis ............................................................. 174
Clinical Role in Renovascular Hypertension ........................................... 179
Clinical Role in the Renal Transplant Patient .......................................... 188
Frequently Asked Questions (FAQs) ....................................................... 195
10. Gastrointestinal ............................................................. 196
Peter Hollett and Ford Bursey
Introduction ........................................................................................... 196
Clinical Role in Esophageal Motility Disorders ....................................... 196
Clinical Role in Gastric Motility Disorders ............................................. 199
Clinical Role in the Localization of Gastrointestinal Bleeding ................. 203
Clinical Role of Urea Breath Testing ....................................................... 206
Frequently Asked Questions (FAQs) ....................................................... 208
...
