Additional Information
Book Details
Abstract
Master the latest imaging procedures and technologies in Nuclear Medicine! Medicine and PET/CT: Technology and Techniques, 8th Edition provides comprehensive, state-of-the-art information on all aspects of nuclear medicine. Coverage of body systems includes anatomy and physiology along with details on how to perform and interpret related diagnostic procedures. The leading technologies — SPECT, PET, CT, MRI, and PET/CT — are presented, and radiation safety and patient care are emphasized. Edited by nuclear imaging and PET/CT educator Kristen M. Waterstram-Rich and written by a team of expert contributors, this reference features new information on conducting research and managing clinical trials.
- Complete coverage of nuclear medicine eliminates the need to search for information in other sources.
- Foundations chapters cover basic math, statistics, physics and instrumentation, computers, lab science, radiochemistry, and pharmacology, allowing you to understand how and why procedures are performed.
- PET/CT focus with hybrid PET/CT studies provides information that is especially beneficial to working technologists.
- Accessible writing style and approach to basic science subjects simplifies topics, first introducing fundamentals and progressing to more complex concepts.
- Procedure boxes provide step-by-step instructions for clinical procedures and protocols, so you can perform each with confidence.
- CT Physics and Instrumentation chapter provides the knowledge needed for clinical success by introducing CT as it is applied to PET imaging for combined PET/CT studies.
- Key terms, chapter outlines, learning objectives, and suggested readings help you organize your study.
- Table of Radionuclides used in nuclear medicine and PET is provided in the appendix for quick reference.
- More than 50 practice problems in the Mathematic and Statistics chapter let you brush up on basic math skills, with answers provided in the back of the book.
- 12-page, full-color insert includes clear PET/CT scans showing realistic scans found in practice.
- A glossary provides definitions of key terms and important concepts.
- UPDATED content reflects the latest advances and provides the information you need to pass the boards.
- NEW information on conducting research and managing clinical trials prepares you more fully for clinical success.
- New information on administrative procedures includes coverage of coding and reimbursement.
- NEW practice tests on the Evolve companion website help you apply your knowledge.
- NEW! A second color in the design highlights the most important material for easier study and understanding.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Nuclear Medicine and PET/CT: TECHNOLOGY AND TECHNIQUES | i | ||
| Nuclear Medicine and PET/CT: TECHNOLOGY AND TECHNIQUES | iii | ||
| Copyright | iv | ||
| CONTRIBUTORS | v | ||
| REVIEWERS | viii | ||
| PREFACE | ix | ||
| CONTENT | ix | ||
| NEW TO THIS EDITION | ix | ||
| LEARNING ENHANCEMENTS | ix | ||
| INSTRUCTOR ANCILLARIES | ix | ||
| ACKNOWLEDGMENTS | xi | ||
| CONTENTS\r | xii | ||
| 01 - Foundations | 1 | ||
| 1 - Mathematics and Statistics | 1 | ||
| FUNDAMENTALS | 2 | ||
| Scientific Notation | 2 | ||
| Fractions and Percentages | 3 | ||
| Algebraic Equations and Ratios | 3 | ||
| Inverse Square Law | 4 | ||
| Units | 5 | ||
| Exponent Laws and Logarithms | 6 | ||
| Numeric Accuracy: Significance and Rounding | 9 | ||
| Calculators and Computer Programs | 10 | ||
| PRACTICAL APPLICATIONS | 10 | ||
| Radioactive Decay | 10 | ||
| Decay Factor Tables for Radioactive Decay | 12 | ||
| Concentration-Volume Calculations | 13 | ||
| 99Mo-99mTc Radionuclide Generators | 14 | ||
| Half-Life: Biological, Physical, and Effective | 15 | ||
| Attenuation of Radiation | 15 | ||
| Graphs | 17 | ||
| Measurement of Effective Half-Life | 19 | ||
| Least Squares Curve Fitting | 20 | ||
| Other Graphs | 22 | ||
| STATISTICS | 22 | ||
| Mean and Standard Deviation | 22 | ||
| Gaussian Distributions | 24 | ||
| Poisson Distributions and Counting Statistics | 24 | ||
| Chi-Square Tests | 26 | ||
| t-Tests | 28 | ||
| Medical Decision Making | 30 | ||
| SUMMARY | 34 | ||
| 2 - Cell and Molecular Biology | 40 | ||
| EUKARYOTIC CELL STRUCTURE | 41 | ||
| Plasma Membrane | 41 | ||
| Cytoplasm | 41 | ||
| Mitochondria | 41 | ||
| Ribosomes | 42 | ||
| Endoplasmic Reticulum | 42 | ||
| Golgi Body | 42 | ||
| Lysosome | 42 | ||
| Cytoskeleton | 43 | ||
| Centrosome | 43 | ||
| Nucleus | 43 | ||
| CONTROL OF GENE EXPRESSION | 44 | ||
| THE CELL CYCLE | 47 | ||
| Phases of the Cell Cycle | 48 | ||
| Interphase | 48 | ||
| Cell Division | 48 | ||
| Regulation by Cyclins and Cyclin-Dependent Kinases | 49 | ||
| Checkpoints | 49 | ||
| MOLECULAR BASIS OF CANCER | 50 | ||
| What Causes Cancer? | 50 | ||
| Genetics of Cancer | 50 | ||
| Cell Cycle and Cancer | 51 | ||
| Viruses and Cancer | 52 | ||
| Tumor Development | 53 | ||
| SUMMARY | 53 | ||
| 3 - General Chemistry and Biochemistry | 56 | ||
| ELEMENTS, COMPOUNDS, AND MIXTURES | 57 | ||
| Electronic Structure | 57 | ||
| Periodic Table of the Elements | 59 | ||
| Stable Electron Configurations: The Noble Gases | 61 | ||
| Ionic Compounds | 61 | ||
| Covalent Compounds | 62 | ||
| Coordinate Covalent Bonds | 62 | ||
| Complex Ions and Chelates | 63 | ||
| LAWS OF CONSTANT COMPOSITION AND MULTIPLE PROPORTION | 63 | ||
| ATOMIC WEIGHTS, MOLECULAR WEIGHTS, AND THE MOLE CONCEPT | 64 | ||
| SOLUTIONS AND COLLOIDS | 64 | ||
| Molarity | 65 | ||
| Sample Problems | 65 | ||
| Osmolarity | 65 | ||
| Dilution | 65 | ||
| Percent Concentrations | 65 | ||
| Colloids | 66 | ||
| CHEMICAL REACTIONS AND EQUATIONS | 66 | ||
| Stoichiometry | 66 | ||
| Double Displacement Reactions | 67 | ||
| Oxidation-Reduction Reactions | 67 | ||
| Electrolytic Reactions | 68 | ||
| ACIDS AND BASES | 68 | ||
| Concepts of Acids and Bases | 68 | ||
| Neutralization Reactions | 69 | ||
| Calculations | 69 | ||
| Strong versus Weak Acids and Bases | 69 | ||
| EQUILIBRIUMS AND EQUILIBRIUM CONSTANT | 70 | ||
| THE PH CONCEPT | 70 | ||
| BUFFER SOLUTIONS | 71 | ||
| ORGANIC COMPOUNDS | 71 | ||
| Types of Organic Compounds and Nomenclature | 72 | ||
| SUMMARY | 76 | ||
| 4 - Radiochemistry and Radiopharmacology | 77 | ||
| PRODUCTION OF RADIONUCLIDES | 78 | ||
| Nuclear Stability | 78 | ||
| Reactor-Produced Radionuclides | 79 | ||
| Accelerator-Produced Radionuclides | 80 | ||
| Generator Systems | 81 | ||
| TECHNETIUM RADIOPHARMACEUTICALS | 84 | ||
| Oxidized Technetium Complexes | 84 | ||
| Reduced Technetium Complexes | 86 | ||
| Manufacturers’ Package Inserts | 90 | ||
| GALLIUM AND INDIUM RADIOPHARMACEUTICALS | 90 | ||
| THALLIUM CHLORIDE | 92 | ||
| IODINATED RADIOPHARMACEUTICALS | 92 | ||
| PET RADIOPHARMACEUTICALS | 93 | ||
| Oxygen-15 | 93 | ||
| Nitrogen-13 | 93 | ||
| Carbon-11 | 93 | ||
| Fluorine-18 | 94 | ||
| THERAPEUTIC RADIOPHARMACEUTICALS | 97 | ||
| REGULATORY ISSUES: RADIOPHARMACEUTICAL QUALITY ASSURANCE | 98 | ||
| RADIOPHARMACEUTICAL QUALITY CONTROL | 99 | ||
| Radionuclidic Purity | 99 | ||
| Radiochemical Purity | 99 | ||
| Chemical Impurities | 103 | ||
| Microbiological Testing | 103 | ||
| SUMMARY | 105 | ||
| 5 - Radiation Safety in Nuclear Medicine | 108 | ||
| RADIATION SAFETY PROGRAM | 111 | ||
| Personnel Responsible for the Radiation Safety Program | 111 | ||
| Training within the Radiation Safety Program | 111 | ||
| Training and Experience Regulations | 112 | ||
| Radiation-Monitoring Equipment | 113 | ||
| Detection Efficiency | 115 | ||
| Annual Dose Limits | 116 | ||
| Exposure Monitoring | 116 | ||
| Material Inventory and Accountability | 118 | ||
| Safe-Use Guidelines | 119 | ||
| Radiation Area Surveys | 121 | ||
| Posting and Labeling | 121 | ||
| Release of Patients Administered Radioactive Materials | 122 | ||
| Radioactive Waste | 122 | ||
| Radioactive Spill Emergency Procedures | 125 | ||
| Emergency Room Support: Planning and Preparation | 127 | ||
| Program Audits | 128 | ||
| Patient Precautions | 128 | ||
| SOURCES OF RADIATION EXPOSURE | 129 | ||
| RADIATION REGULATIONS | 130 | ||
| Shipping and Receiving of Radioactive Material | 131 | ||
| Notice to Employees | 131 | ||
| RADIATION DOSE | 131 | ||
| Radiation Exposure | 131 | ||
| Absorbed Dose | 131 | ||
| Radiation-Weighted Dose | 131 | ||
| BIOLOGICAL EFFECTS OF IONIZING RADIATION | 135 | ||
| Acute Effects | 135 | ||
| Cataract Induction | 135 | ||
| Fertility Effects | 135 | ||
| Late Effects | 135 | ||
| Genetic Effects | 137 | ||
| Developmental Effects | 138 | ||
| SUMMARY | 138 | ||
| 02 - Patient Care, Management, and Research | 140 | ||
| 6 - Patient Care | 140 | ||
| PATIENT CARE | 142 | ||
| PATIENT PREPARATION | 142 | ||
| PATIENT-CENTERED CARE | 142 | ||
| AGE-SPECIFIC CARE | 143 | ||
| PEDIATRIC CONSIDERATIONS | 145 | ||
| Patient Safety and Care | 145 | ||
| Immobilization Techniques | 146 | ||
| Sedation | 146 | ||
| BODY MECHANICS | 147 | ||
| Concepts of Body Mechanics | 148 | ||
| Lifting Tips | 148 | ||
| Pushing/Pulling Tips | 148 | ||
| Carrying Tips | 148 | ||
| Patient Transfers | 148 | ||
| MEDICATION ADMINISTRATION | 149 | ||
| The Six Rights | 151 | ||
| Routes of Medication Administration | 151 | ||
| Intravenous Equipment | 152 | ||
| Preparation for Venipuncture | 152 | ||
| Venipuncture Procedure | 155 | ||
| Extravasation Precautions | 156 | ||
| Pediatric Considerations for Medication Administration | 156 | ||
| Needle Disposal | 161 | ||
| Withdrawal of Nonradioactive Materials from a Vial | 161 | ||
| Withdrawal of Radioactive Materials from a Vial | 161 | ||
| Syringe Infusion Pumps | 161 | ||
| Intravenous Drip Infusion | 162 | ||
| Intravenous Drip Infusion Pump | 162 | ||
| Medication Administration through Established Lines | 164 | ||
| Charting Medications | 164 | ||
| CONTRAST MEDIA | 164 | ||
| Pharmacology of CT Contrast Media | 164 | ||
| Pharmacology of Magnetic Resonance Contrast Media | 165 | ||
| Adverse Effects of Contrast Media | 166 | ||
| Administration of Contrast Media | 167 | ||
| Extravasation of Contrast Media | 168 | ||
| INFECTION CONTROL | 168 | ||
| Cycle of Infection | 169 | ||
| Standard Precautions (Tier I) | 169 | ||
| Transmission-Based Precautions (Tier II) | 170 | ||
| Housekeeping | 171 | ||
| VITAL SIGNS AND PATIENT ASSESSMENT | 171 | ||
| Body Temperature | 171 | ||
| Pulse-Rate Assessment | 171 | ||
| Respiration-Rate Assessment | 172 | ||
| Blood Pressure Assessment | 172 | ||
| EMERGENCY CARE | 173 | ||
| Asthma | 173 | ||
| Diabetes | 173 | ||
| Cardiopulmonary Resuscitation | 173 | ||
| Myocardial Infarction | 173 | ||
| Syncope | 175 | ||
| Seizures | 175 | ||
| ANCILLARY EQUIPMENT | 175 | ||
| Catheters | 175 | ||
| Electrocardiogram | 175 | ||
| Emergency Code Carts | 176 | ||
| Glucometer | 176 | ||
| Nasogastric Tubes | 177 | ||
| Oxygen Administration | 177 | ||
| Surgical Drains | 179 | ||
| SUMMARY | 179 | ||
| 7 - Department Administration | 181 | ||
| HEALTH CARE LEADERSHIP | 182 | ||
| HEALTH CARE MANAGEMENT | 182 | ||
| CODING AND REIMBURSEMENT | 183 | ||
| Basics of Coding Systems | 183 | ||
| Coding Systems | 183 | ||
| Medical Coverage | 184 | ||
| Billing Compliance | 185 | ||
| QUALITY MEASURES AND IMPROVEMENT | 185 | ||
| Defining Quality | 185 | ||
| Pioneers of Quality Management | 186 | ||
| Quality Terminology and Acronyms | 186 | ||
| Designing and Implementing a Quality Improvement Program | 187 | ||
| QI Methodologies | 188 | ||
| Focus Areas | 192 | ||
| Quality Drivers: The Joint Commission | 193 | ||
| Breaking Down the Process | 194 | ||
| CREDENTIALS AND ACCREDITATION | 197 | ||
| Credentials | 197 | ||
| Accreditation | 197 | ||
| SUMMARY | 199 | ||
| 8 - Clinical Research | 201 | ||
| DEFINING CLINICAL RESEARCH | 201 | ||
| CLINICAL TRIALS AND STUDIES | 202 | ||
| Sponsor | 202 | ||
| Codes and Regulations Associated with Clinical Research | 202 | ||
| Good Clinical Practice | 202 | ||
| Protocol | 203 | ||
| Investigator | 203 | ||
| Informed Consent | 203 | ||
| Institutional Review Board | 203 | ||
| Contract Research Organization | 204 | ||
| Protocol Deviation and Violation | 204 | ||
| Documentation in Clinical Trials | 204 | ||
| Clinical Research Associate (Monitor) | 205 | ||
| CONCLUSION | 206 | ||
| SUMMARY | 206 | ||
| 9 - Health Informatics in Imaging | 207 | ||
| BACKGROUND | 208 | ||
| COMPUTERS IN HEALTH CARE | 208 | ||
| COMPUTER HARDWARE | 209 | ||
| COMPUTER SOFTWARE | 209 | ||
| IMAGE ACQUISITION | 209 | ||
| Camera Interface | 209 | ||
| Matrix Size | 209 | ||
| Pixel Size Calibration | 211 | ||
| Frame versus List Mode | 212 | ||
| IMAGE DISPLAY AND PROCESSING | 212 | ||
| Display Terminals | 212 | ||
| Image Algebra | 213 | ||
| Reframing | 213 | ||
| Interpolation | 214 | ||
| Cinematic Display | 214 | ||
| Three-Dimensional Display | 214 | ||
| Image Smoothing | 214 | ||
| REGION OF INTEREST | 215 | ||
| Image Quantitation | 215 | ||
| Curves | 216 | ||
| Normalization | 217 | ||
| CLINICAL APPLICATIONS | 217 | ||
| HEALTH INFORMATION SYSTEMS | 217 | ||
| ELECTRONIC HEALTH RECORDS | 218 | ||
| RADIOLOGY INFORMATION SYSTEM | 219 | ||
| Picture Archiving and Communication System | 219 | ||
| Compression | 220 | ||
| STANDARD OPERATING PROCEDURES | 220 | ||
| FUTURE ADVANCES | 220 | ||
| Cloud Computing | 220 | ||
| Health Information Exchanges | 220 | ||
| Decision Support Software | 221 | ||
| Teleradiology and Tele-nuclear | 221 | ||
| Mobile Applications | 221 | ||
| 03 - Physics and Instrumentation | 223 | ||
| 10 - Physics of Nuclear Medicine | 223 | ||
| MATTER | 224 | ||
| NUCLEUS OF AN ATOM | 224 | ||
| Nuclides | 225 | ||
| Isotopes | 225 | ||
| Isotones and Isobars | 225 | ||
| Isomers | 226 | ||
| Radioactivity | 226 | ||
| NATURE OF ELECTROMAGNETIC RADIATION | 226 | ||
| Frequency and Wavelength | 226 | ||
| Ionizing Radiation | 227 | ||
| MASS ENERGY EQUIVALENCE | 228 | ||
| UNITS | 228 | ||
| MODES OF RADIOACTIVE DECAY | 229 | ||
| Line of Nuclear Stability | 229 | ||
| Alpha Particle Decay | 230 | ||
| Isobaric Decay | 230 | ||
| Gamma Ray Emission and Internal Conversion | 232 | ||
| Characteristic X-Ray Emission | 232 | ||
| Auger Electron | 233 | ||
| Fluorescent Yield | 233 | ||
| MATHEMATICS OF DECAY | 234 | ||
| UNITS OF RADIOACTIVITY | 235 | ||
| DECAY FACTOR AND PRECALIBRATION FACTOR | 236 | ||
| EFFECTIVE HALF-LIFE | 237 | ||
| PARENT-DAUGHTER RADIONUCLIDE RELATIONSHIPS | 237 | ||
| INTERACTION WITH MATTER | 238 | ||
| Excitation and Ionization | 238 | ||
| Charged Particle Interactions with Matter | 239 | ||
| Photon Interactions with Matter | 240 | ||
| ATTENUATION AND TRANSMISSION OF PHOTONS | 241 | ||
| SUMMARY | 243 | ||
| 11 - Instrumentation | 244 | ||
| RADIATION DETECTION | 246 | ||
| Types of Radiation Detectors and Their Uses | 246 | ||
| Properties of Radiation Detectors | 247 | ||
| System Resolution | 248 | ||
| GAS-FILLED DETECTORS | 250 | ||
| GAS IONIZATION CURVE | 251 | ||
| Recombination Region | 251 | ||
| Ionization Chamber (Saturation) Region | 251 | ||
| Proportional Regions | 251 | ||
| Geiger-Mueller Region | 252 | ||
| Self Discharge | 252 | ||
| SURVEY METERS | 252 | ||
| Geiger-Mueller Detector Survey Meter | 252 | ||
| Portable Ionization Chamber Survey Meter | 252 | ||
| Survey Meter Calibration and Quality Control | 254 | ||
| DOSE CALIBRATOR | 254 | ||
| DOSE CALIBRATOR QUALITY CONTROL | 255 | ||
| Accuracy Test | 255 | ||
| Constancy Test | 255 | ||
| Linearity Test | 255 | ||
| Geometry Test | 256 | ||
| SCINTILLATION DETECTORS | 257 | ||
| GAMMA CAMERAS | 258 | ||
| Early Anger Scintillation Camera | 258 | ||
| Modern Anger Scintillation Camera | 258 | ||
| Non–Anger Scintillation Camera | 259 | ||
| Semiconductor Detectors | 259 | ||
| GAMMA CAMERA DETECTOR COMPONENTS | 260 | ||
| Collimation | 260 | ||
| Scintillating Material | 262 | ||
| Transducers | 263 | ||
| Preamplifier | 263 | ||
| Amplifier | 263 | ||
| Pulse Height Analyzer | 263 | ||
| Multichannel Analyzer | 264 | ||
| Anger Positioning Logic | 264 | ||
| SPECTROSCOPY | 265 | ||
| Photopeak | 265 | ||
| Compton Plateau and Edge | 265 | ||
| Media Scatter and the Backscatter Peak | 266 | ||
| Lead X-Ray Peak | 266 | ||
| Coincidence Sum Peak | 266 | ||
| Escape Peaks | 266 | ||
| GAMMA CAMERA CORRECTIONS | 267 | ||
| Energy Correction | 267 | ||
| Spatial Linearity Correction | 267 | ||
| Uniformity Correction | 268 | ||
| Photomultiplier Stabilization | 268 | ||
| IMAGE ACQUISITION | 268 | ||
| Matrix | 269 | ||
| Zoom | 269 | ||
| Types of Image Acquisition | 269 | ||
| SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY | 269 | ||
| Contrast and Resolution | 269 | ||
| SPECT Instrumentation | 269 | ||
| SPECT/CT Systems | 271 | ||
| Tomographic Acquisitions | 271 | ||
| SPECT Data Acquisition Modes | 271 | ||
| 180-Degree versus 360-Degree Data Acquisition | 272 | ||
| Circular versus Body-Contour Orbits | 272 | ||
| SPECT Reconstruction | 273 | ||
| Filtering of SPECT Images | 276 | ||
| When to Filter: Filtered Back-Projection | 278 | ||
| When to Filter: Iterative Reconstruction | 280 | ||
| SPECT Image Display | 280 | ||
| Image Reorientation | 280 | ||
| Three-Dimensional Displays | 281 | ||
| SPECT Physics and Image Artifacts | 284 | ||
| IMAGE QUALITY | 285 | ||
| Sampling | 285 | ||
| Object and Target Size | 286 | ||
| Contrast | 286 | ||
| Noise | 287 | ||
| Signal-to-Noise Ratio | 287 | ||
| GAMMA CAMERA QUALITY CONTROL | 288 | ||
| Accreditation | 288 | ||
| Acceptance Testing | 288 | ||
| Quality Control Phantoms | 289 | ||
| Routine Gamma Camera Quality Control | 290 | ||
| System Tuning | 292 | ||
| Uniformity Calibrations | 293 | ||
| Annual Gamma Camera Quality Control Tests | 293 | ||
| Gamma Camera Performance Specifications | 294 | ||
| SCINTILLATION COUNTING SYSTEMS | 295 | ||
| Thyroid Probes | 295 | ||
| Well Counters | 295 | ||
| Quality Control for Solid Scintillation Counting Systems | 296 | ||
| Liquid Scintillation Counting Systems | 296 | ||
| SUMMARY | 296 | ||
| 12 - CT Physics and Instrumentation | 299 | ||
| PHYSICS OF X-RAYS | 300 | ||
| Bremsstrahlung Radiation | 300 | ||
| Characteristic X-Rays | 301 | ||
| X-RAY TUBE AND THE PRODUCTION OF X-RAYS | 301 | ||
| X-Ray Tube Design | 301 | ||
| Voltage Variation | 302 | ||
| Current Variation | 302 | ||
| X-Ray Filter | 304 | ||
| PRINCIPLES OF COMPUTED TOMOGRAPHY | 304 | ||
| CT SCANNER DESIGN | 305 | ||
| Collimation | 307 | ||
| Rotation Speed | 308 | ||
| MULTISLICE HELICAL CT SYSTEMS | 310 | ||
| IMAGE DATA ACQUISITION | 311 | ||
| CT IMAGE RECONSTRUCTION | 312 | ||
| CT DISPLAY | 314 | ||
| DISPLAY OF VOLUMETRIC IMAGE DATA | 314 | ||
| IMAGE QUALITY | 315 | ||
| Contrast Resolution | 315 | ||
| Image Noise | 316 | ||
| CT PROTOCOLS | 316 | ||
| Low-Dose CT for PET Attenuation Correction | 317 | ||
| Diagnostic CT | 317 | ||
| Integrated PET/CT Protocols | 318 | ||
| CT ARTIFACTS | 319 | ||
| CT RADIATION SAFETY | 319 | ||
| CT QUALITY CONTROL | 321 | ||
| SUMMARY | 323 | ||
| 13 - PET Instrumentation | 325 | ||
| PHYSICS OF POSITRONS | 326 | ||
| PRODUCTION OF PET RADIOTRACERS | 327 | ||
| PET RADIATION DETECTORS | 327 | ||
| PET SCANNER DESIGN | 328 | ||
| DATA ACQUISITION | 332 | ||
| PET/CT SCANNERS | 337 | ||
| RECONSTRUCTION ALGORITHMS | 338 | ||
| TIME OF FLIGHT PET | 346 | ||
| Characterization and Correction Calibrations | 348 | ||
| Quality Control | 350 | ||
| PARTIAL VOLUME EFFECT | 350 | ||
| QUANTITATIVE IMAGE INFORMATION | 351 | ||
| DISPLAYING PET DATA | 352 | ||
| IMAGE FUSION | 352 | ||
| PET/MRI SCANNERS | 353 | ||
| RADIATION SAFETY IN PET | 354 | ||
| SUMMARY | 355 | ||
| 14 - Principles of Magnetic Resonance Imaging | 357 | ||
| HISTORY | 358 | ||
| INTRODUCTION TO ATOMIC STRUCTURE AND BASIC PRINCIPLES | 358 | ||
| HYDROGEN NUCLEUS | 358 | ||
| PRECESSION | 359 | ||
| RESONANCE AND EXCITATION | 360 | ||
| FREE INDUCTION DECAY | 360 | ||
| T1 AND T2 | 360 | ||
| T1 Recovery | 361 | ||
| T2 Decay | 361 | ||
| T1, T2, and Proton Density Image Contrast | 361 | ||
| INSTRUMENTATION | 362 | ||
| PULSE SEQUENCES AND SCAN PARAMETERS | 362 | ||
| CONTRAST MEDIA | 364 | ||
| SAFETY | 365 | ||
| HYBRID IMAGING: PET/MRI | 367 | ||
| Instrumentation and System Design | 367 | ||
| Attenuation Correction | 368 | ||
| Benefits and Challenges | 368 | ||
| Clinical Applications | 369 | ||
| SUMMARY | 370 | ||
| 15 - Clinical PET/CT in Oncology | 371 | ||
| INTRACELLULAR 18F-FDG METABOLISM | 372 | ||
| PATIENT PREPARATION AND INJECTION | 374 | ||
| PET SCAN ACQUISITION | 376 | ||
| Selecting the Scan Type and Body Area | 376 | ||
| Patient Positioning and Comfort | 377 | ||
| NORMAL WHOLE-BODY FDG DISTRIBUTION | 378 | ||
| NORMAL VARIATIONS IN FDG LOCALIZATION | 379 | ||
| PET ONCOLOGY APPLICATIONS | 381 | ||
| SOLITARY PULMONARY NODULE | 384 | ||
| NON–SMALL-CELL LUNG CARCINOMA | 384 | ||
| OTHER CHEST MALIGNANCIES | 385 | ||
| Small Cell Lung Carcinoma | 385 | ||
| Mesothelioma | 386 | ||
| MELANOMA | 386 | ||
| LYMPHOMA | 387 | ||
| MYELOMA | 388 | ||
| COLORECTAL CANCER | 388 | ||
| HEAD AND NECK CANCER | 389 | ||
| ESOPHAGEAL CANCER | 389 | ||
| BREAST CANCER | 390 | ||
| BRAIN CANCER | 391 | ||
| PROSTATE CANCER | 391 | ||
| CERVICAL CANCER | 392 | ||
| OVARIAN CANCER | 393 | ||
| TESTICULAR CANCER | 394 | ||
| THYROID CANCER | 394 | ||
| PANCREATIC CANCER | 395 | ||
| GASTRIC CANCER | 396 | ||
| HEPATOCELLULAR CARCINOMA | 396 | ||
| ENDOMETRIAL CANCER | 396 | ||
| SARCOMAS | 397 | ||
| LEUKEMIA | 399 | ||
| UNKNOWN PRIMARY | 399 | ||
| FUTURE TRENDS | 402 | ||
| SUMMARY | 405 | ||
| 04 - Imaging Procedures and Protocols | 407 | ||
| 16 - Central Nervous System | 407 | ||
| CHEMISTRY OF THE BRAIN | 408 | ||
| ANATOMY AND PHYSIOLOGY | 408 | ||
| Cerebrum | 409 | ||
| Cerebellum | 410 | ||
| Diencephalon (Thalamus and Hypothalamus) | 410 | ||
| Brain Stem | 410 | ||
| Spinal Cord | 410 | ||
| Ventricular System and Cerebrospinal Fluid | 410 | ||
| Blood Supply | 411 | ||
| Blood-Brain Barrier | 413 | ||
| Neurons and Neuroglia | 413 | ||
| RADIOPHARMACEUTICALS | 414 | ||
| Perfusion Imaging | 415 | ||
| Brain Tumor Imaging | 415 | ||
| PET Radiopharmaceuticals | 416 | ||
| CSF Imaging Radiopharmaceuticals | 416 | ||
| IMAGING TECHNIQUES AND PROTOCOLS | 416 | ||
| Brain Perfusion Imaging: Planar and SPECT | 416 | ||
| Brain Death Study | 417 | ||
| Cerebrospinal Fluid Dynamics | 418 | ||
| Radionuclide Cisternography | 419 | ||
| Cerebrospinal Fluid Shunt Evaluation | 419 | ||
| Cerebrospinal Fluid Leaks | 419 | ||
| Positron Emission Tomography | 421 | ||
| CLINICAL PET AND SPECT STUDIES | 421 | ||
| Normal Distribution of Cerebral Blood Flow and Metabolism | 421 | ||
| Cerebrovascular Disease | 422 | ||
| Tumors | 423 | ||
| Epilepsy | 424 | ||
| Movement Disorders | 425 | ||
| Dementia | 426 | ||
| SUMMARY | 428 | ||
| 17 - Endocrine System | 431 | ||
| THYROID GLAND | 433 | ||
| Anatomy, Physiology, and Pathophysiology | 433 | ||
| Clinical Aspects | 436 | ||
| Nuclear Medicine Procedures | 440 | ||
| Radionuclides | 440 | ||
| Thyroid Iodine Uptake | 441 | ||
| Thyroid Imaging | 443 | ||
| Radionuclide Therapy | 449 | ||
| PARATHYROID GLANDS | 453 | ||
| Anatomy and Physiology | 453 | ||
| Clinical Aspects | 453 | ||
| Radionuclides | 453 | ||
| Nuclear Medicine Procedures | 454 | ||
| NEUROENDOCRINE SYSTEM | 456 | ||
| Anatomy and Physiology | 456 | ||
| Clinical Aspects | 457 | ||
| Radionuclides | 457 | ||
| Nuclear Medicine Procedures | 458 | ||
| ADRENAL GLANDS | 463 | ||
| Adrenal Medulla | 463 | ||
| Radionuclides | 463 | ||
| Nuclear Medicine Procedures | 464 | ||
| SUMMARY | 465 | ||
| 18 - Respiratory System | 469 | ||
| NORMAL ANATOMY AND PHYSIOLOGY | 470 | ||
| PATHOPHYSIOLOGY | 473 | ||
| PERFUSION IMAGING | 475 | ||
| Preparation | 476 | ||
| Dosage | 476 | ||
| Method of Injection | 478 | ||
| Positioning | 479 | ||
| Ventilation Imaging | 479 | ||
| Xenon-133 Ventilation Imaging | 480 | ||
| Aerosol Ventilation Imaging | 482 | ||
| VENTILATION-PERFUSION STUDIES | 483 | ||
| Computer Processing of Ventilation-Perfusion Images | 484 | ||
| Lung Quantification | 484 | ||
| Pulmonary Embolism | 485 | ||
| Chronic Obstructive Pulmonary Disease | 486 | ||
| Lung Cancer | 486 | ||
| SUMMARY | 487 | ||
| 19 - Cardiovascular System | 490 | ||
| ANATOMY, PHYSIOLOGY, PATHOLOGY | 491 | ||
| The Right Heart | 491 | ||
| The Left Heart | 491 | ||
| Circulatory Routes | 491 | ||
| Conduction System | 493 | ||
| Pathology | 493 | ||
| MYOCARDIAL PERFUSION IMAGING | 494 | ||
| Radiopharmaceuticals | 495 | ||
| Imaging Protocols | 495 | ||
| Methods of Stress | 496 | ||
| Exercise Stress Test | 496 | ||
| Image Acquisition | 500 | ||
| Attenuation Correction | 501 | ||
| Image Processing | 501 | ||
| Cardiac SPECT Quantification | 503 | ||
| PET Myocardial Perfusion Tracers | 509 | ||
| Myocardial Viability | 511 | ||
| Myocardial Metabolism | 511 | ||
| Equilibrium Gated Blood-Pool Studies | 512 | ||
| Gated Blood-Pool Stress | 515 | ||
| IMAGING CARDIAC NEUROTRANSMISSION | 516 | ||
| Neurotransmission Assessment | 516 | ||
| Iodine-123–Metaiodobenzylguanidine | 516 | ||
| SUMMARY | 516 | ||
| 20 - Gastrointestinal System | 518 | ||
| SALIVARY GLANDS | 520 | ||
| Imaging Procedure | 520 | ||
| Clinical Aspects | 520 | ||
| OROPHARYNX | 521 | ||
| Imaging Procedure | 521 | ||
| Clinical Aspects | 524 | ||
| ESOPHAGUS | 524 | ||
| Esophageal Transit | 525 | ||
| Gastroesophageal Reflux | 529 | ||
| STOMACH | 532 | ||
| Imaging Procedure | 534 | ||
| Clinical Aspects | 535 | ||
| Compartmental Analysis of the Stomach | 535 | ||
| Pediatric Patients | 537 | ||
| SMALL BOWEL AND COLON | 537 | ||
| Colon Transit | 537 | ||
| Whole-Gut Transit | 538 | ||
| INTESTINAL TRACT | 538 | ||
| Gastrointestinal Bleeding | 538 | ||
| Imaging Procedure | 539 | ||
| Meckel Diverticulum | 540 | ||
| Barrett Esophagus | 541 | ||
| Liver and Spleen Scintigraphy | 541 | ||
| GALLBLADDER | 545 | ||
| Hepatobiliary Imaging | 545 | ||
| Enterogastric Reflux (Bile Reflux) Imaging | 549 | ||
| 14C-Urea Breath Test | 552 | ||
| Liver Function Analysis | 552 | ||
| Fat Absorption Test | 552 | ||
| SUMMARY | 553 | ||
| 21 - Genitourinary System | 556 | ||
| ANATOMY | 556 | ||
| PHYSIOLOGY | 559 | ||
| RADIOPHARMACEUTICALS | 561 | ||
| RADIONUCLIDE PROCEDURES | 563 | ||
| Practical Considerations | 563 | ||
| Common Procedures | 564 | ||
| TESTICULAR IMAGING | 571 | ||
| Anatomy and Physiology | 571 | ||
| Testicular Scintigraphy | 572 | ||
| SUMMARY | 573 | ||
| 22 - Skeletal System | 576 | ||
| COMPOSITION OF BONE | 579 | ||
| GROSS STRUCTURE OF BONE | 579 | ||
| Tubular (Long) Bones | 579 | ||
| Short Bones | 580 | ||
| Flat Bones | 580 | ||
| Irregular Bones | 580 | ||
| JOINTS | 580 | ||
| RADIONUCLIDE IMAGING | 582 | ||
| Past and Present Radiopharmaceuticals | 582 | ||
| Mechanism of Accumulation | 583 | ||
| Technical Considerations | 583 | ||
| Patient Preparation | 584 | ||
| INSTRUMENTATION | 584 | ||
| SPOT VIEWS | 584 | ||
| WHOLE-BODY IMAGING | 585 | ||
| SPECT IMAGING | 585 | ||
| CLINICAL ASPECTS | 586 | ||
| Metastatic Disease | 588 | ||
| Primary Bone Neoplasms | 589 | ||
| Inflammatory Diseases | 589 | ||
| Trauma | 591 | ||
| OTHER USES FOR BONE IMAGING | 592 | ||
| PET Imaging | 593 | ||
| Joint Imaging | 593 | ||
| Radionuclide Therapy of Painful Bone Metastases | 595 | ||
| Gallium-67 and Indium-111 White Blood Cell Imaging in Bone and Joint Disease | 595 | ||
| SUMMARY | 597 | ||
| 05 - Special Considerations | 599 | ||
| 23 - Inflammatory/Tumor/Oncology Imaging and Therapy | 599 | ||
| INFLAMMATORY IMAGING | 600 | ||
| 67Ga-Citrate | 600 | ||
| 111In-Oxine–Labeled White Blood Cells | 601 | ||
| 99mTc Exametazime (Ceretec) | 602 | ||
| TUMOR IMAGING | 603 | ||
| Parathyroid | 603 | ||
| Prostate Cancer | 604 | ||
| Colorectal Cancer | 605 | ||
| Neuroendocrine Tumors | 606 | ||
| Pheochromocytoma and Neuroblastoma | 606 | ||
| Breast Cancer | 607 | ||
| Lung Cancer | 608 | ||
| LYMPHOSCINTIGRAPHY | 609 | ||
| Sentinel Lymph Node Imaging: Melanoma | 609 | ||
| Sentinel Lymph Node Imaging: Breast | 610 | ||
| THERAPY | 611 | ||
| Radioimmunotherapy | 611 | ||
| Standard Patient Preparation | 611 | ||
| 90Y–Ibritumomab Tiuxetan (Zevalin) | 611 | ||
| Patient Preparation | 611 | ||
| Radionuclide Therapy for Bone Pain | 612 | ||
| Additional 32P Therapeutic Protocols | 613 | ||
| 90Y Microspheres for Selective Internal Radiation Therapy | 614 | ||
| SUMMARY | 615 | ||
| 24 - Hematopoietic System | 618 | ||
| BLOOD | 619 | ||
| BLOOD COMPONENTS | 619 | ||
| ISOTOPIC LABELING OF CELLULAR ELEMENTS | 622 | ||
| Cohort (Pulse) Labels | 622 | ||
| Random Labels | 622 | ||
| PLATELET KINETICS | 622 | ||
| ERYTHROKINETICS | 622 | ||
| Measurement of Circulating Red Blood Cell Volume | 622 | ||
| Chromium-51–Ascorbic Acid Method for Labeling Red Blood Cells | 623 | ||
| Plasma Volume | 624 | ||
| Blood Volume Measurements | 624 | ||
| Erythrocyte Survival and Splenic Sequestration Studies | 626 | ||
| Sources of Error | 628 | ||
| MEASUREMENT OF ABSORPTION AND SERUM LEVELS OF ESSENTIAL NUTRIENTS | 628 | ||
| Vitamin B12 (Cyanocobalamin) Absorption | 628 | ||
| Schilling Technique. The Schilling technique is as follows | 629 | ||
| SUMMARY | 631 | ||
| A - Percentage Points and Chi-Square Distribution | 632 | ||
| B - LABORATORY GLASSWARE AND INSTRUMENTATION\r | 633 | ||
| GLASSWARE | 633 | ||
| Beakers, Flasks, and Graduated Cylinders | 633 | ||
| Pipets and Burets | 633 | ||
| INSTRUMENTATION | 634 | ||
| Analytical Balance | 634 | ||
| Centrifuge | 634 | ||
| pH Meter | 634 | ||
| C - Radionuclides and Radiopharmaceutical Form Used in Clinical Nuclear Medicine (Includes Research Radiopharmaceuticals)\r | 636 | ||
| D - APPENDIX | 640 | ||
| Glossary\r | 640 | ||
| E - Answers to Chapter 1 Mathematics and Statistics Review | 659 | ||
| ILLUSTRATION CREDITS | 660 | ||
| INDEX | 663 | ||
| A | 663 | ||
| B | 664 | ||
| C | 665 | ||
| D | 667 | ||
| E | 668 | ||
| F | 669 | ||
| G | 669 | ||
| H | 670 | ||
| I | 671 | ||
| J | 672 | ||
| K | 672 | ||
| L | 672 | ||
| M | 672 | ||
| N | 674 | ||
| O | 674 | ||
| P | 675 | ||
| Q | 676 | ||
| R | 677 | ||
| S | 678 | ||
| T | 680 | ||
| U | 681 | ||
| V | 681 | ||
| W | 682 | ||
| X | 682 | ||
| Y | 682 | ||
| Z | 682 | ||
| Color Plates | ES1 | ||
| IBC\r | ES13 |