Covering both the fundamentals and recent developments in this fast-changing field, Essentials of Nuclear Medicine and Molecular Imaging, 7th Edition, is a must-have resource for radiology residents, nuclear medicine residents and fellows, nuclear medicine specialists, and nuclear medicine technicians. Known for its clear and easily understood writing style, superb illustrations, and self-assessment features, this updated classic is an ideal reference for all diagnostic imaging and therapeutic patient care related to nuclear medicine, as well as an excellent review tool for certification or MOC preparation.
Key Features
Provides comprehensive, clear explanations of everything from principles of human physiology, pathology, physics, radioactivity, radiopharmaceuticals, radiation safety, and legal requirements to hot topics such as new brain and neuroendocrine tumor agents and hybrid imaging, including PET/MR and PET/CT.
Covers the imaging of every body system, as well as inflammation, infection and tumor imaging; pearls and pitfalls for every chapter; and pediatric doses and guidelines in compliance with the Image Gently and Image Wisely programs.
Features a separate self-assessment section on differential diagnoses, imaging procedures and artifacts, and safety issues with unknown cases, questions, answers, and explanations.
Includes new images and illustrations, for a total of 430 high-quality, multi-modality examples throughout the text.
Reflects recent advances in the field, including updated nuclear medicine imaging and therapy guidelines · Updated dosimetry values and effective doses for all radiopharmaceuticals with new values from the 2015 International Commission on Radiological Protection · Updated information regarding advances in brain imaging, including amyloid, dopamine transporter and dementia imaging · Inclusion of Ga-68 DOTA PET/CT for neuroendocrine tumors · Expanded information on correlative and hybrid imaging with SPECT/CT · New myocardial agents · and more.
Contains extensive appendices including updated comprehensive imaging protocols for routine and hybrid imaging, pregnancy and breastfeeding guidelines, pediatric dosages, non-radioactive pharmaceuticals used in interventional and cardiac stress imaging, and radioactivity conversion tables.
Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Author Information
By Fred A. Mettler, Jr., MD, MPH, Emeritus Professor, Department of Radiology, University of New Mexico, School of Medicine, Health Sciences Center, Albuquerque, New Mexico and Milton J. Guiberteau, MD, FACR, FACNM, Professor, Department of Radiology, Baylor College of Medicine, Texas Medical Center, Houston, Texas
Author(s): Fred A. Mettler, Milton J. Guiberteau
Edition: 7th Edition
Publisher: Elsevier
Year: 2018
Language: English
Commentary: TRUE PDF
Pages: 550
Tags: Radiology; Nuclear Medicine
Cover......Page 1
Essentials of Nuclear Medicine and Molecular Imaging......Page 2
Copyright Page......Page 4
Dedication......Page 5
Preface......Page 6
Acknowledgments......Page 7
Nuclear Stability and Decay......Page 8
Radionuclide Production......Page 10
Radioactive Decay......Page 11
Radionuclide Generator Systems......Page 12
Technetium-99m......Page 13
Iodine-123 and -131......Page 15
Indium-111......Page 17
Fluorine-18......Page 18
Adverse Reactions......Page 19
Radiopharmacy Quality Control......Page 20
Generator and Radionuclide Purity......Page 21
Radiochemical Labeling......Page 22
Strontium-89, Samarium-153, Rhenium-186, and Radium-223......Page 24
Suggested Readings......Page 25
Ionization Chamber......Page 26
Sodium Iodide Well Counter......Page 27
Single Probe Counting Systems......Page 28
Dose Calibrator......Page 29
Collimator......Page 30
Crystal and Other Photon Detector Devices......Page 33
Solid-State Photon Detectors......Page 34
Pulse Height Analyzer......Page 35
Resolution......Page 36
Image Acquisition: Memory and Matrix Size......Page 38
Spatial Filters......Page 39
Dedicated Molecular Breast Imaging Cameras......Page 40
Instrumentation......Page 41
Data Acquisition......Page 42
Image Reconstruction......Page 43
SPECT/CT......Page 44
Overview of PET Cameras......Page 45
PET Detector Geometry......Page 49
Attenuation Correction......Page 51
PET Image Acquisition and Processing......Page 52
PET/CT......Page 53
Instrumentation Quality Control......Page 54
Spatial Resolution and Linearity Testing......Page 56
Field Uniformity Assessment......Page 57
SPECT Quality Control......Page 58
Center of Rotation Determination and Correction......Page 59
Normalization Scan......Page 60
Areas of Decreased Activity......Page 61
Areas of Increased Activity......Page 63
Suggested Readings......Page 66
Normal Planar Brain Scan......Page 67
Radiopharmaceuticals......Page 69
Brain Death......Page 70
Carotid Stenosis......Page 73
Brain Tumors......Page 74
Cerebellar Diaschisis......Page 76
Interictal Imaging for Temporal Lobe Epilepsy......Page 78
Alzheimer Disease......Page 79
Alzheimer Disease: Amyloid Imaging in Dementia......Page 81
Frontotemporal Dementia (Pick Disease)......Page 84
Parkinson Disease and Syndromes......Page 85
Normal Examination......Page 86
Cerebrospinal Fluid Leaks......Page 87
Cerebrospinal Fluid Shunt Patency......Page 88
Suggested Readings......Page 91
Iodine-131......Page 92
Principle and Technique......Page 93
Factors Affecting Iodine Uptake......Page 94
Reduced Radioiodine Uptake......Page 95
Normal Images......Page 96
Thyroid Nodules......Page 97
Cold Nodule......Page 98
Indeterminate (“Warm”) Nodule......Page 99
Diffuse Toxic Goiter (Graves Disease)......Page 100
Ectopic Thyroid Tissue......Page 102
Clinical Applications: Thyroid Cancer Imaging......Page 103
Post-Thyroidectomy Imaging of DTC......Page 104
Iodine-131 WBS Interpretation (Box 4.3)......Page 105
Iodine-131 Therapy in Benign Thyroid Disease......Page 107
Principle......Page 109
Patient Preparation and Post-Treatment Expectations for Iodine-131 Hyperthyroid Therapy......Page 110
Diffuse Toxic Goiter......Page 112
Iodine-131 Therapy in Thyroid Cancer......Page 113
Postsurgical Thyroid Remnant Ablation and Adjuvant Therapy......Page 114
Hyperthyroidism Therapy......Page 115
Parathyroid Imaging and Localization......Page 117
Radiopharmaceuticals......Page 118
Salivary Gland Imaging......Page 120
Suggested Readings......Page 122
Anatomy and Physiology......Page 123
Principle......Page 124
Technetium-99m Labeled Radiopharmaceuticals......Page 127
Technetium-99m Sestamibi......Page 128
Thallium-201 Chloride......Page 129
Imaging Protocols......Page 130
Two-Day Protocol......Page 131
Thallium-201 Redistribution Imaging......Page 132
Patient Absorbed Dose Considerations......Page 133
Image Processing......Page 134
Approach to Interpretation......Page 136
Artifacts......Page 137
Attenuation Artifacts......Page 138
Attenuation Correction and SPECT-CT Image Misregistration Issues......Page 140
Nonreversible (Fixed) Defects......Page 141
Lung Activity......Page 143
Semiquantitative Analysis......Page 144
Technique......Page 146
Patient Stress Protocols......Page 147
Physical Exercise......Page 148
Vasodilator Stress Agents......Page 149
Adenosine Stress Imaging......Page 151
Dobutamine Protocol......Page 152
G-SPECT Functional Data......Page 153
G-SPECT Functional Data......Page 154
SPECT Imaging Data......Page 155
SPECT Imaging Data......Page 156
Evaluation of Acute Chest Pain......Page 158
Valvular Lesions......Page 159
PET Cardiac Imaging......Page 160
PET Myocardial Perfusion Imaging......Page 161
Nitrogen-13 Ammonia Imaging Protocol......Page 162
Interpretation......Page 163
Interpretation......Page 164
Cardiac Sarcoidosis......Page 165
Radionuclide Imaging of Cardiac Function......Page 166
Quantitative Data Display......Page 167
Ejection Fraction Image......Page 168
Principle......Page 169
Radiopharmaceuticals......Page 170
Image Interpretation......Page 171
Left-to-Right Intracardiac Shunts......Page 172
Gated Planar Imaging Technique......Page 173
G-SPECT Imaging Technique......Page 175
Systolic Function.......Page 176
Noncoronary Disease......Page 177
Cardiomyopathy......Page 178
Cardiac Valvular Disease......Page 179
Suggested Readings......Page 181
Anatomy and Physiology......Page 182
Perfusion Imaging Agents......Page 184
Radioactive Gases......Page 185
Perfusion Scan......Page 186
Ventilation Scan......Page 187
Clinical Applications......Page 188
Basic Concepts......Page 190
PIOPED: Prospective Investigation of Pulmonary Embolism Diagnosis......Page 197
Perfusion (Q) Only Modified PIOPED II Criteria......Page 198
SPECT Ventilation/Perfusion Interpretation......Page 199
Incorporation of Clinical Information......Page 200
Ancillary Signs......Page 201
Airway Disease (Chronic Obstructive Pulmonary Disease)......Page 202
Lung Scan Follow-Up of Pulmonary Emboli......Page 204
Pulmonary Hypertension......Page 206
Chronic Obstructive Pulmonary Disease......Page 208
Lung Neoplasms......Page 210
Inflammatory Disease......Page 213
Cardiovascular Abnormalities......Page 215
Lung Scanning During Pregnancy......Page 216
Deep Venous Imaging and Thrombus Detection......Page 218
Suggested Readings......Page 219
Planar Imaging and SPECT/CT......Page 220
Abnormal Liver Scan......Page 221
Hepatoma......Page 223
Focal Nodular Hyperplasia......Page 224
Hepatic Blood Pool Imaging......Page 225
Splenomegaly......Page 226
Gastrointestinal Bleeding Studies......Page 227
Interpretation......Page 229
Meckel Diverticulum Imaging......Page 230
Technique......Page 231
Acute Cholecystitis......Page 233
Chronic Cholecystitis......Page 235
Biliary Obstruction......Page 237
Posttraumatic and Postsurgical Biliary Scans......Page 238
Hepatic Neoplasms......Page 242
Esophageal Transit......Page 243
Gastric Emptying......Page 244
Abdominal Shunt Evaluation......Page 247
Suggested Readings......Page 249
Radiopharmaceuticals......Page 250
Technique......Page 251
Normal Scan......Page 252
Clinical Applications......Page 253
Metastatic Disease......Page 254
Malignant Bone Tumors......Page 259
Benign Osseous Neoplasms......Page 260
Soft-Tissue Uptake......Page 263
Trauma......Page 270
Orthopedic Prosthesis Pain......Page 273
Osteomyelitis, Cellulitis, and Septic Arthritis......Page 275
Paget Disease......Page 279
Avascular Necrosis......Page 283
Radiation Therapy......Page 284
Bone Marrow Imaging......Page 285
Bone Mineral Measurements......Page 286
Beta-Emitter Therapy......Page 290
Alpha-Emitter Therapy......Page 291
Suggested Readings......Page 293
Radiopharmaceuticals......Page 294
Functional Renal Imaging......Page 295
Renography......Page 296
Quantitation of Renal Function......Page 298
Diffuse Renal Disease......Page 299
Routine Functional Imaging and Renography......Page 300
Diuretic Renography......Page 302
Pediatric Hydronephrosis......Page 307
Angiotensin-Converting Enzyme Inhibitor (Captopril) Renography......Page 308
Radionuclide Cystography......Page 313
Renal Transplant Evaluation......Page 315
Adrenal Gland Imaging......Page 316
Adrenal Medullary Imaging......Page 317
Pheochromocytoma......Page 318
Neuroblastoma......Page 319
Suggested Readings......Page 320
Chapter Outline......Page 322
Somatostatin (Octreotide) Receptor Imaging......Page 323
Gallium-67 Imaging......Page 325
Brain Neoplasms: Post-Treatment Changes Versus Recurrent Tumor......Page 326
Acquired Immunodeficiency Syndrome-Related Neoplasms......Page 327
Breast Cancer......Page 328
Application in Oncology: Sentinel Lymph Node Biopsy......Page 329
Treatment of Lymphoma With Radioimmunotherapy......Page 331
Treatment of Hepatoma and Liver Metastases With Intravascular Microspheres......Page 332
Suggested Readings......Page 334
Patient Preparation for 18F-FDG Imaging......Page 335
Brain......Page 338
Vocal Cords......Page 342
Muscle and Brown Fat......Page 343
Aorta......Page 344
Gastrointestinal Tract......Page 346
Qualitative Image Interpretation......Page 347
PET Image Quantitation......Page 348
Whole-Body 18F-FDG PET/CT Neoplasm Imaging......Page 349
Head and Neck Cancers......Page 350
Solitary Pulmonary Nodule......Page 351
Primary Lung Cancer......Page 352
Lymphomas......Page 354
Breast Cancer......Page 356
Esophageal Cancer......Page 357
Colorectal Cancer......Page 358
Hepatocellular Carcinoma (Hepatoma)......Page 359
Malignant Melanoma......Page 360
Gynecologic Cancers......Page 361
Prostate and Testicular Cancers......Page 362
Neuroblastoma......Page 364
Bone Metastases......Page 365
68Ga-DOTATATE and 68Ga-DOTATOC......Page 366
68Ga- and 18F-PMSA......Page 367
Suggested Readings......Page 368
Mechanism of Localization......Page 369
Technique......Page 370
General Considerations......Page 371
Fever of Unknown Origin (Occult Fever)......Page 372
Musculoskeletal Infections......Page 373
Osteomyelitis......Page 374
Technetium-99m HMPAO Leukocytes......Page 375
Abdomen/Pelvis......Page 376
Immunocompromised Patients......Page 377
Osteomyelitis......Page 378
Sarcoidosis......Page 379
Abdominal Diseases......Page 380
Vascular Disease......Page 386
Future Inflammation Agents......Page 387
Suggested Readings......Page 388
Overview......Page 389
Radiation Safety Officer......Page 390
Types of Licenses......Page 391
Breastfeeding......Page 392
Determination and Records of Dosages......Page 393
Imaging and Localization Studies (Written Directive Not Required)......Page 394
Related Procedures......Page 395
Medical Events and Required Reporting......Page 396
Transportation of Radioactive Materials......Page 397
Safe Handling and Administration of Radiopharmaceuticals......Page 398
PET Radiation Safety......Page 400
Release of Individuals After Administration of Radionuclides......Page 401
Facility Radiation Survey Policies......Page 403
Radiation Dose Quantities and Units......Page 405
Cancer......Page 406
Modifying Factors......Page 407
Suggested Readings......Page 408
Unknown Case Sets......Page 409
Case 1.1......Page 410
Case 1.2......Page 411
Case 1.3......Page 412
Case 1.5......Page 413
Case 1.7......Page 414
Case 1.8......Page 415
Case 1.10......Page 416
Case 2.1......Page 417
Case 2.2......Page 418
Case 2.3......Page 419
Case 2.5......Page 420
Case 2.6......Page 421
Case 2.8......Page 422
Case 2.10......Page 423
Case 3.1......Page 424
Case 3.2......Page 425
Case 3.3......Page 426
Case 3.4......Page 427
Case 3.6......Page 428
Case 3.7......Page 429
Case 3.8......Page 430
Case 3.9......Page 431
Case 4.1......Page 432
Case 4.2......Page 433
Case 4.3......Page 434
Case 4.4......Page 435
Case 4.5......Page 436
Case 4.6......Page 437
Case 4.7......Page 438
Case 4.8......Page 439
Case 4.9......Page 440
Case 5.1......Page 441
Case 5.2......Page 442
Case 5.3......Page 443
Case 5.4......Page 444
Case 5.5......Page 445
Case 5.6......Page 446
Case 5.7......Page 448
Case 5.8......Page 449
Case 5.9......Page 450
Case 5.10......Page 451
Case 6.1......Page 452
Case 6.2......Page 453
Case 6.3......Page 454
Case 6.4......Page 455
Case 6.5......Page 456
Case 6.6......Page 457
Case 6.7......Page 458
Case 6.8......Page 459
Case 6.9......Page 460
Case 7.1......Page 461
Case 7.2......Page 462
Case 7.3......Page 463
Case 7.4......Page 464
Case 7.5......Page 466
Case 7.7......Page 467
Case 7.8......Page 468
Case 7.9......Page 469
Case 7.10......Page 471
Case 1.6......Page 472
Case 2.2......Page 473
Case 2.8......Page 474
Case 3.5......Page 475
Case 4.2......Page 476
Case 4.10......Page 477
Case 5.7......Page 478
Case 6.3......Page 479
Case 6.10......Page 480
Case 7.5......Page 481
Case 7.10......Page 482
Appendix A Characteristics of Radionuclides for Imaging and Therapy......Page 483
Appendix B.1 Radioactivity Conversion Table for International System (SI) Units (Becquerels to Curies)......Page 485
Appendix B.2 Radioactivity Conversion Table for International System (SI) Units (Curies to Becquerels)......Page 486
Appendix C.1 Technetium-99m Decay and Generation Tables......Page 487
Appendix C.2 Other Radionuclide Decay Tables......Page 489
Appendix D Injection Techniques and Pediatric Dosages......Page 491
SPECT Brain Perfusion Imaging......Page 495
Cisternogram......Page 496
Thyroid Cancer Scan......Page 497
Rest Gated Equilibrium Ventriculography......Page 498
SPECT Myocardial Perfusion Imaging......Page 499
Regadenoson Pharmacologic Stress Procedure......Page 500
Pulmonary Perfusion Scan......Page 501
Liver and Spleen Scan......Page 502
Hepatobiliary Scan......Page 503
Gastrointestinal Bleeding Scan......Page 504
Gastroesophageal Reflux/Aspiration......Page 505
Peritoneovenous (LeVeen) Ascites Shunt Patency......Page 506
Bone Scan (Technetium-99m)......Page 507
Renal Blood Flow Scan......Page 508
Renal Scan (B) Glomerular Filtration......Page 509
Diuretic (Lasix) Renogram......Page 510
Radionuclide Cystogram in Children......Page 511
Gallium Scan for Tumor or Infection......Page 512
Lymphoscintigraphy (Sentinel Node Localization)......Page 513
Leukocyte (White Blood Cell) Scan......Page 514
PET/CT Tumor Imaging With Fluorine-18 Fluorodeoxyglucose (FDG)......Page 515
PET Amyloid Brain Imaging......Page 516
Bone Scan PET/CT (Fluorine-18 Sodium Fluoride)......Page 517
Red Blood Cell Labeling Techniques......Page 518
Suggested Readings......Page 519
Breastfeeding......Page 520
Appendix H.1 General Considerations for Hospitalized Patients Receiving Radionuclide Therapy......Page 523
Nursing Instructions......Page 527
Release From the Hospital......Page 528
Surface Contamination Limits......Page 529
Emergency Autopsy of Patients Who Have Received Therapeutic Amounts of Radionuclides......Page 530
B......Page 531
C......Page 532
D......Page 534
F......Page 535
G......Page 536
H......Page 537
I......Page 538
M......Page 540
N......Page 541
P......Page 542
Q......Page 544
R......Page 545
S......Page 547
T......Page 548
V......Page 549
Z......Page 550
