Clinical nuclear medicine
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Interpretation of positron emission tomography/computed tomography (PET/CT) studies in the head and neck region is challenging due to the complex anatomy and nonspecific physiologic and inflammatory FDG uptake. We present an atlas of common confounding factors encountered at our institution. ⋯ Knowledge of common variants, pitfalls, and treatment effects is essential in accurate reading of PET/CT in the head and neck region.
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Clinical nuclear medicine · Mar 2011
Case ReportsBone scintigraphy in painful os peroneum syndrome.
Lateral foot pain may be caused by various entities including the painful os peroneum syndrome. A case of a 68-year-old man is presented, who experienced a trauma with distortion of the right foot. ⋯ Bone scintigraphy showed uptake in the area where an os peroneum was located and thus confirmed the clinical assumption of painful os peroneum syndrome. Familiarity with the clinical and imaging findings can prevent undiagnosed lateral foot pain.
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Clinical nuclear medicine · Feb 2011
Case ReportsUnexpected detection of nodular melanoma of the skin on the scalp by I-123 IBZM brain SPECT.
Melanocytes and dopaminergic neurons share the same ectodermal origin and can both produce melanin. Indeed, in vivo studies have shown that the radiopharmaceutical iodine-123-iodobenzamide (I-123 IBZM), which binds in vivo to dopamine D(2/3) receptors, is also able to detect melanoma, and particularly melanotic melanoma. ⋯ The presence of unexpected focal IBZM uptake of the skin justified histologic examination, which revealed nodular melanoma. Melanoma should be considered when one is confronted with atypical focal uptake of benzamide derivatives like IBZM, in or outside the brain.
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Clinical nuclear medicine · Feb 2011
Case ReportsAssessment of cerebral hemodynamics to acetazolamide using brain perfusion SPECT in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary microangiopathy caused by mutations in the Notch3 gene located on chromosome 19, leading to 4 cardinal features with aura, cerebrovascular ischemic events, mood disturbances, and dementia. Acetazolamide (ACZ) has been promoted as a drug to determine cerebral hemodynamics, including cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) in patients with cerebrovascular disease. In CADASIL patients with small-vessel disease, ACZ may be possible to increase CBF. We present that reduced CBF was dramatically improved after administration of ACZ on Tc-99m ECD brain perfusion SPECT in a CADASIL patient.
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Clinical nuclear medicine · Nov 2010
Implications of the CMS final meaningful use information technology rule.
The importance of Health Information Technology and the Electronic Medical Record were discussed in the October issue of Clinical Nuclear Medicine (Henkin and Harolds, Clin Nucl Med. 2010;35). Since that article was written the Final Rule has been issued on what constitutes the meaningful use of certain information technology, such that it would qualify for an incentive payment. Since billions of dollars will be used for such payments, the issuance of the Final Rule has been eagerly anticipated.