Clinical nuclear medicine
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Clinical nuclear medicine · Feb 2016
Quality and Safety in Health Care, Part VII: Lower Costs and Higher Quality.
The Institute of Medicine report entitled The Health Care Imperative: Lowering Costs and Improving Outcomes discussed numerous ways to decrease costs in the health care system without decreasing quality. The use of evidence-based medicine, eliminating wasteful spending such as needlessly high administrative costs, having more preventive services, having a better reimbursement system that emphasized quality, developing a less fragmented and more efficient medical delivery system, having more transparency for patients on the outcomes of different providers, having greater health care literacy for patients, and eliminating fraud were some of the recommendations. The total savings from eliminating unnecessary health care costs was estimated to be over 3 quarters of a trillion dollars each year.
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Clinical nuclear medicine · Jan 2016
Case ReportsDetection of 18F-FDG PET/CT Occult Lesions With 18F-DCFPyL PET/CT in a Patient With Metastatic Renal Cell Carcinoma.
Renal cell carcinoma (RCC) is common with more than 60,000 new cases in the United States yearly. No curative therapies are available for metastatic RCC. ⋯ A 58-year-old man with known metastatic clear cell RCC was imaged with both 18F-FDG and 18F-DCFPyL PET/CT. 18F-DCFPyL is a small molecule inhibitor of the prostate-specific membrane antigen (PSMA), a target known to be highly expressed on solid tumor neovasculature. Relative to 18F-FDG, 18F-DCFPyL identified more lesions and demonstrated higher tumor radiotracer uptake.
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Clinical nuclear medicine · Jan 2016
Case ReportsCatastrophic Antiphospholipid Syndrome: Scintigraphic Demonstration With Correlated Cross-Sectional Imaging.
We present the case of catastrophic antiphospholipid syndrome occurring in a 44-year-old woman with a recent history of coronary artery bypass surgery. Postoperatively, she was urgently readmitted for a left middle cerebral artery stroke, and during workup she was found with a left ventricular thrombus on echocardiogram. Subsequently, the patient was diagnosed with antiphospholipid syndrome. Multimodality imaging, including bone and myocardial perfusion scintigraphy, CT, and MR, during her hospitalization, depicted all the characteristic features constituting the catastrophic form of antiphospholipid syndrome, also known as Asherson syndrome.
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Clinical nuclear medicine · Dec 2015
Randomized Controlled TrialReducing Perceived Pain Levels During Nonbreast Lymphoscintigraphy.
The aim of this study was to quantify the reduction of perceived pain levels during lymphoscintigraphy for melanoma by altering the pH of the Tc-sulfur colloid to near the physiologic value of 7.40. ⋯ The use of sodium bicarbonate to buffer the pH of Tc-sulfur colloid to near the physiologic value of 7.40 significantly reduced perceived pain levels during nonbreast lymphoscintigraphy.
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Clinical nuclear medicine · Oct 2015
Case ReportsTalc Pleurodesis With Intense 18F-FDG Activity But No 68Ga-DOTA-TATE Activity on PET/CT.
Talc pleurodesis (TP) is a technique, widely employed in the management of patients with persistent pleural effusions or pneumothoraces not amenable to other treatment options. It is well documented that talc deposits produce areas of highly increased F-FDG uptake, because of talc-induced inflammation. We present a case of a patient with history of TP who was evaluated with both F-FDG and Ga-DOTA-TATE. The hypermetabolic area seen on F-FDG-PET-CT in the region of talc placement showed no uptake by Ga-DOTA-TATE, suggesting the potential role of Ga-DOTA-TATE-PET-CT in elucidating F-FDG-postitive lesions in patients with history of both neuroendocrine malignancy and TP.