1. Applications of Diagnostic Imaging Nuclear Medicine
Gerald R. Aben, MD FACR
Department of Radiology
College of Osteopathic Medicine
In this presentation, I would like to discuss some of the applications of Nuclear Medicine imaging techniques.
11/8/2018
Department of Radiology

2. Nuclear Medicine / PET Ionizing radiation
Radio-isotopes attached to molecules targeting specific organs or metabolic processes
Spatial resolution limited
Able to evaluate temporal resolution of uptake/ events
Our final ionizing radiation modality is nuclear medicine / PET scanning. Radioisotopes are attached to molecules that target specific organs or metabolic processes. Nuclear medicine and PET imaging tend to have limited spatial resolution. We are not able to very accurately place in space where the abnormal activity is, but we are able to evaluate the temporal course of various events by evaluating the course of uptake of the radionuclide product and assigning that to a time scale.

3. Nuclear Medicine / PET Primary applications:
First line evaluation of biliary function evaluation
First line evaluation of cardiac perfusion
First line evaluation of solid pulmonary nodules
First line evaluation for many neoplasms, staging – treatment response
Some a primary applications in a first line nature of nuclear medicine is in the evaluation of biliary function using the various hida, ida compounds. Also first-line evaluation of cardiac perfusion. This has been the main-stay for many years for cardiac perfusion evaluation. PET scanning provides first-line evaluation for solid solitary pulmonary nodules and also serves a role in first-line evaluation of many neoplasms for the staging and treatment response.

4. Nuclear Medicine / PET Primary applications: Head & Neck Thorax
Brain death evaluation – cerebral blood flow
CSF flow evaluation
Bone abnormality evaluation
Thorax
V-Q Scanning – Ventilation Perfusion scanning for Pulmonary Embolism detection – secondary exam
Pulmonary nodule evaluation (PET)
Cancer staging (PET)
The primary applications of nuclear medicine imaging of the head and neck could include evaluation for brain death by evaluation of cerebral blood flow. CSF flow can be evaluated in an attempt to evaluate for normal pressure hydrocephalus. We can evaluate for abnormalities of bone such as metastases. In the thorax ventilation/perfusion or V/Q scanning still has a role, a secondary role in evaluation of pulmonary embolus. This may be a tool that we will see more use of, as concern about radiation exposure from CT scanning is raised. PET scanning for the evaluation of pulmonary nodules and for cancer staging

5. Nuclear Medicine / PET Primary applications: Abdomen & Pelvis
Liver – spleen scanning
Hepatobiliary scanning
Renal scanning
Bladder & Reflux evaluation
GI bleed evaluation
Cancer staging (PET)
Soft tissues – Bone & Joints
Bone scanning
Tumor scanning (Gallium, PET)
Infection scanning (labeled white cells, Gallium)
In the abdomen and pelvis, liver spleen scanning as well as hepatobiliary scanning allows the evaluation of the liver axis. Renal scanning can be utilized to evaluate for perfusion as well as function. Bladder and reflux evaluation can be performed with nuclear medicine techniques to reduce radiation exposure to the patient. a variety of techniques utilizing nuclear medicine allows evaluation for location of GI bleeds. Cancer staging can be performed with PET scanning. Evaluation of the soft tissues, bone and joints include bone scanning, a variety of tumors scanning technologies including gallium scanning and PET scanning and scanning of a variety of infections with labeled white blood cells or perhaps gallium