VQ Scanning: Using SPECT and SPECT/CT
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American Society of Echocardiography Recommendations for Performance, Interpretation, and Application of Stress Echocardiography
GUIDELINES AND STANDARDS American Society of Echocardiography Recommendations for Performance, Interpretation, and Application of Stress Echocardiography Patricia A. Pellikka, MD, Sherif F. Nagueh, MD, Abdou A. Elhendy, MD, PhD, Cathryn A. Kuehl, RDCS, and Stephen G. Sawada, MD, Rochester, Minnesota; Houston, Texas; Marshfield, Wisconsin; and Indianapolis, Indiana dvances since the 1998 publication of the TABLE OF CONTENTS A Recommendations for Performance and Interpreta- tion of Stress Echocardiography1 include improve- Methodology....................................................1021 ments in imaging equipment, refinements in stress Imaging Equipment and Technique............1021 testing protocols and standards for image interpre- Stress Testing Methods...... ............................1022 tation, and important progress toward quantitative Training Requirements and Maintenance analysis. Moreover, the roles of stress echocardiog- of Competency...... .....................................1023 raphy for cardiac risk stratification and for assess- Image Interpretation......................................1024 ment of myocardial viability are now well docu- Table 1. Normal and Ischemic mented. Specific recommendations and main points Responses for Various Modalities are identified in bold. of Stress........................................................1025 Quantitative Analysis Methods.....................1025 Accuracy...... .....................................................1026 False-negative Studies...... ..............................1026 -
A Rare Intravascular Tumour Diagnosed by Endobronchial Ultrasound
Chest clinic IMAGES IN THORAX Thorax: first published as 10.1136/thoraxjnl-2016-208487 on 26 April 2016. Downloaded from A rare intravascular tumour diagnosed by endobronchial ultrasound William T Owen,1 Elena Karampini,2 Ronan A Breen,3 Mufaddal Moonim,4 Arjun Nair,5 Sally F Barrington,6 George Santis1 1Department of Respiratory A 24-year-old man was referred to the haematologists Medicine and Allergy, Kings for investigation of unexplained anaemia on the back- ’ College London, Guy s ground of a 6-month history of exertional breathless- Hospital, London, UK 2Department of Respiratory ness, mild cough and night sweats. Investigations Medicine and Allergy, Kings revealed iron-deficiency anaemia (haemoglobin College London, London, UK 94 g/L), thrombocytosis and markedly elevated 3 Department of Respiratory inflammatory markers (C-reactive protein (CRP) Medicine, Guy’s & St. Thomas’ fi NHS Foundation Trust, London, 235 mg/L). A CT scan of his chest identi ed a large UK expansile filling defect within the left main pul- 4Department of Cellular monary artery, almost entirely occluding the left- Pathology, Guy’s& sided pulmonary circulation, which had high-grade ’ St. Thomas NHS Foundation 18F-fluorodeoxyglucose (FDG) uptake on a subse- Trust, London, UK 5Department of Radiology, quent positron emission tomography (PET) CT ’ ’ (figure 1). Guy s & St. Thomas NHS Figure 2 Endobronchial ultrasound image showing a Foundation Trust, London, UK The lesion was assessed via endobronchial ultra- 6 hyperechoic soft tissue mass (M) within the left main PET Imaging Centre at sound (EBUS), which identified a hyperechoic soft St. Thomas’ Hospital, King’s pulmonary artery (PA). -
PET/CT Lung Ventilation and Perfusion Scanning Using Galligas and Gallium-68-MAA Pierre-Yves Le Roux, MD, Phd,* Rodney J
PET/CT Lung Ventilation and Perfusion Scanning using Galligas and Gallium-68-MAA Pierre-Yves Le Roux, MD, PhD,* Rodney J. Hicks, MBBS, FRACP, MD,†,z Shankar Siva, MBBS, FRANZCR, PhD,z,x and Michael S. Hofman, MBBS, FRACP, FAANMS, FICIS†,z Ventilation/Perfusion (V/Q) positron emission tomography computed tomography (PET/CT) is now possible by substituting Technetium-99m (99mTc) with Gallium-68 (68Ga), using the same carrier molecules as conventional V/Q imaging. Ventilation imaging can be performed with 68Ga-carbon nanoparticles using the same synthesis device as Technegas. Perfusion imaging can be performed with 68Ga-macroaggregated albumin. Similar physiological processes can therefore be evaluated by either V/Q SPECT/CT or PET/CT. However, V/Q PET/CT is inherently a superior technology for image acquisition, with higher sensitivity, higher spatial and temporal resolution, and superior quantitative capability, allowing more accurate delineation and quantification of regional lung function. Additional advantages include reduced acquisition time, respiratory-gated acquisition, and a lower impact on human resources. V/Q PET imaging offers an opportunity to improve the accuracy and util- ity of V/Q imaging in various pulmonary conditions. For pulmonary embolism, V/Q PET/CT scan may improve the diagnostic performance of the test owing to a better characterization of the pattern of defects and allow an accurate quantification of the extent of vascular obstruction. Establishing an accurate functional map of the regional ventilation and perfu- sion in the lungs may be relevant in many other clinical situations, including preoperative assessment of the lung cancer patients, radiotherapy planning, or presurgical evaluation of patients undergoing lung volume reduction surgery. -
Study of Common Artifacts of Myocardial Perfusion Scan in Patients with Chronic Renal Failure and Liver Cirrhosis in Nuclear Medicine Ward of Namazi Hospital in 2019
MedDocs Publishers ISSN: 2637-885X Journal of Radiology and Medical Imaging Open Access | Research Article Study of Common Artifacts of Myocardial Perfusion Scan in Patients with Chronic Renal Failure and Liver Cirrhosis in Nuclear Medicine Ward of Namazi Hospital in 2019 Hossein Akbarialiabad1; Sepideh Hesami1; Seyed Alihossein Zahrayi1; Masoud Vafabin2; Farshid Gheisari3* 1Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran 2Department of general surgery, Shiraz University of medical sciences, Shiraz medical school, Shiraz, Iran 3Nuclear Medicine Department, School of Medicine, Imam Hossein Square, Shiraz, Iran *Corresponding Author(s): Farshid Gheisari Abstract Nuclear Medicine Department, School of Medicine, Background and objective: Myocardial Perfusion Imag- Imam Hossein Square, Shiraz, Iran ing (MPI) is one of the successful techniques for the diagno- sis of cardiovascular disease in both developing and devel- Tel: +98 916 301 1224; Email: [email protected] oped countries. In this imaging technique, like other imaging techniques, there is the possibility of error and unintended side effects such as artifacts that can be associated with the Received: Jun 15, 2020 device, user, and patient factors. Our study aims to assess the prevalence of artifacts in myocardial perfusion scans in Accepted: Jul 17, 2020 patients with chronic renal failure and liver cirrhosis. Published Online: Jul 23, 2020 Methods: In a cross-sectional study in 2019, 90 male pa- Journal: Journal of Radiology and Medical Imaging tients aged 45-65 years, who were referred to the Nuclear Publisher: MedDocs Publishers LLC Medicine Department of Namazi Hospital, were divided Online edition: http://meddocsonline.org/ into three groups of 30. -
Computed Tomography Angiographic Assessment of Acute Chest Pain
SA-CME ARTICLE Computed Tomography Angiographic Assessment of Acute Chest Pain Matthew M. Miller, MD, PhD,* Carole A. Ridge, FFRRCSI,w and Diana E. Litmanovich, MDz Acute chest pain leads to 6 million Emergency Depart- Abstract: Acute chest pain is a leading cause of Emergency Depart- ment visits per year in the United States.1 Evaluation of acute ment visits. Computed tomography angiography plays a vital diag- chest pain often leads to a prolonged inpatient assessment, nostic role in such cases, but there are several common challenges with assessment duration often exceeding 12 hours. The associated with the imaging of acute chest pain, which, if unrecog- estimated cost of a negative inpatient chest pain assessment nized, can lead to an inconclusive or incorrect diagnosis. These 2,3 imaging challenges fall broadly into 3 categories: (1) image acquis- amounts to $8 billion per year in the United States. ition, (2) image interpretation (including physiological and pathologic The main challenge to diagnosis is the broad range of mimics), and (3) result communication. The aims of this review are to pathologies that can cause chest pain. Vascular causes describe and illustrate the most common challenges in the imaging of include pulmonary embolism (PE), traumatic and acute chest pain and to provide solutions that will facilitate accurate spontaneous aortic syndromes including aortic transection, diagnosis of the causes of acute chest pain in the emergency setting. dissection, intramural hematoma, and penetrating athero- sclerotic ulcer, aortitis, and coronary artery disease. The Key Words: acute chest pain, challenges, pulmonary angiography, latter will not be discussed in detail because of the com- aortography, computed tomography plexity and breadth of this topic alone. -
Encyclopedia of Energy, Natural Resource, and Environmental
Respiratory System First and second edition authors: Angus Jeffries Andrew Turley Pippa McGowan Third edition authors: Harish Patel Catherine Gwilt 4 th Edition CRASH COURSE SERIES EDITOR: Dan Horton-Szar BSc(Hons) MBBS(Hons) MRCGP Northgate Medical Practice, Canterbury, Kent, UK FACULTY ADVISOR: Omar S Usmani MBBS PhD FHEA FRCP NIHR Career Development Fellow, Clinical Senior Lecturer & Consultant Physician in Respiratory & Internal Medicine, National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, RespirLondon,a UK tory System Sarah Hickin BSc(Hons) MBBS F2, Heatherwood and Wexham Park Hospitals NHS Trust, Slough, UK James Renshaw BSc(Hons) MBBS F2, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK Rachel Williams BSc(Hons) MBBS F2, West Middlesex University Hospital, London, UK Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2013 Commissioning Editor: Jeremy Bowes Development Editor: Helen Leng Project Manager: Andrew Riley Designer/Design Direction: Christian Bilbow Icon Illustrations: Geo Parkin Illustration Manager: Jennifer Rose © 2013 Elsevier Ltd. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the publisher (other than as may be noted herein). -
Nuclear Imaging in Pulmonary Medicine
Nuclear imaging in pulmonary medicine 14/1/11 • Nuclear medicine as a branch of medicine is relativ ely yongoung • Involves the administration of radiopharmaceuticals into the body and measuring the radioactive decay of these compunds by various instruments, whic h is then converted into digital images • Different from conventional radiology in that there is no external radiation which is passed through the body • Commonly used nuclear medicine techniques in ppyulmonary medicine include ventilation‐ perfusion scanning(V/Q scan) and positron emissision tomography – CT fusion(PET‐CT) PET‐CT • PET (positron emission tomography) is the fastest growing imaging technique worldwide • It was first started in the 1970s • PET‐CT fusion was put into clinical practice in 1998 • Images the uptake and distribution of radiolabelled glucose in the body • PET alone is a functional imaging technique while the addition of CT to it makes PET‐CT both a functional and structural imaging technique Basic ppprinciples PET is based on two principles: 1. The widesprea d dis tr ibu tion of 18 fluoro‐2‐ deoxy‐D‐glucose (FDG) which is a glucose analogue and is tktaken up in altlmost every cell in the body – Within the cell the FDG is phosphorylated and is trapped allowing it to be effectively measured by PET – FDG has a half life of 110 min 2. The radioactive decay of the positron rich fluoride Unstable isotopes(18 F) undergo radioactive nuclear decay Emission of positrons (positively charged particles with the same mass as electrons) Positrons travel through the surrounding tissues and are annihilated by collision with a corresponding electron LdLeads to creation of two 511 kVkeV phthotons trave lling in opposite directions; called as coincidence annihillation Thousands of these annihilations are measured by the PET scanner Scintillation detector absorbs photons and converts them into optical light; Photomultiplier tube converts this into digital signals RddRecorded on a computer • PET images obtained are fused with CT images • Rationale 1. -
Utility of CT Perfusion Scanning in Patient Selection for Acute Stroke
Neurosurg Focus 30 (6):E4, 2011 Utility of CT perfusion scanning in patient selection for acute stroke intervention: experience at University at Buffalo Neurosurgery–Millard Fillmore Gates Circle Hospital PETER T. KAN, M.D., M.P.H.,1,4 KENNETH V. SNYDER, M.D., PH.D.,1,4 PARHAM YAshAR, M.D.,1,4 ADNAN H. SIddIQUI, M.D., PH.D.,1–4 L. NElsON HOpkINS, M.D.,1–4 AND ELAD I. LEVY, M.D.1–4 Departments of 1Neurosurgery and 2Radiology, and 3Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; and 4Department of Neurosurgery, Millard Fillmore Gates Circle Hospital, Kaleida Health, Buffalo, New York Computed tomography perfusion scanning generates physiological flow parameters of the brain parenchyma, allowing differentiation of ischemic penumbra and core infarct. Perfusion maps, along with the National Institutes of Health Stroke Scale score, are used as the bases for endovascular stroke intervention at the authors’ institute, regardless of the time interval from stroke onset. With case examples, the authors illustrate their perfusion-based imaging guide- lines in patient selection for endovascular treatment in the setting of acute stroke. (DOI: 10.3171/2011.2.FOCUS1130) KEY WORDS • computed tomography perfusion • acute stroke • stroke intervention ESPITE advances in pharmacological and mechani- tionale is that by limiting recanalization to patients with cal thrombolytic therapy, acute ischemic stroke large areas of ischemic penumbra, neuronal function may treatment remains -
2019 ESC Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism Developed in Collaboration with the European Respiratory Society (ERS)
ESC GUIDELINES ACUTE PULMONARY EMBOLISM 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC) Authors/Task Force Members: Stavros V. Konstantinides (Chairperson) (Germany/Greece), Guy Meyer (Co-Chairperson) (France), Cecilia Becattini (Italy), Héctor Bueno (Spain), Geert-Jan Geersing (Netherlands), Veli-Pekka Harjola (Finland), Menno V. Huisman (Netherlands), Marc Humbert (France), Catriona Sian Jennings (United Kingdom), David Jiménez (Spain), Nils Kucher (Switzerland), Irene Marthe Lang (Austria), Mareike Lankeit (Germany), Roberto Lorusso (Netherlands), Lucia Mazzolai (Switzerland), Nicolas Meneveau (France), Fionnuala Ní Áinle (Ireland), Paolo Prandoni (Italy), Piotr Pruszczyk (Poland), Marc Righini (Switzerland), Adam Torbicki (Poland), Eric Van Belle (France), and José Luis Zamorano (Spain) @ERSpublications New @ESCardio Guidelines for the Diagnosis and Management of Acute #PulmonaryEmbolism developed in collaboration with @EuroRespSoc now available: #cardiotwitter @erspublications http://bit.ly/2HnrJaj Cite this article as: Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Respir J 2019; in press [https://doi.org/10.1183/13993003.01647-2019]. Correspondence: Stavros V. Konstantinides, Center for Thrombosis and Hemostasis, Johannes Gutenberg University Mainz, Building 403, Langenbeckstr. 1, 55131 Mainz, Germany. E-mail: stavros.konstantinides@ unimedizin-mainz.de; and Department of Cardiology, Democritus University of Thrace, 68100 Alexandroupolis, Greece. E-mail: [email protected]. Correspondence: Guy Meyer, Respiratory Medicine Department, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015 Paris, France. -
Acr–Spr–Str Practice Parameter for the Performance of Pulmonary Scintigraphy
The American College of Radiology, with more than 30,000 members, is the principal organization of radiologists, radiation oncologists, and clinical medical physicists in the United States. The College is a nonprofit professional society whose primary purposes are to advance the science of radiology, improve radiologic services to the patient, study the socioeconomic aspects of the practice of radiology, and encourage continuing education for radiologists, radiation oncologists, medical physicists, and persons practicing in allied professional fields. The American College of Radiology will periodically define new practice parameters and technical standards for radiologic practice to help advance the science of radiology and to improve the quality of service to patients throughout the United States. Existing practice parameters and technical standards will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each practice parameter and technical standard, representing a policy statement by the College, has undergone a thorough consensus process in which it has been subjected to extensive review and approval. The practice parameters and technical standards recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice parameter and technical standard by those entities not providing these services is not authorized. Revised 2018 (Resolution 30)* ACR–SPR–STR PRACTICE PARAMETER FOR THE PERFORMANCE OF PULMONARY SCINTIGRAPHY PREAMBLE This document is an educational tool designed to assist practitioners in providing appropriate radiologic care for patients. Practice Parameters and Technical Standards are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care1. -
AUR 2019 Research Paper Abstracts
AUR 2019 Research Paper Abstracts Research papers are oral educational or scientific presentations that are 8 minutes in length, followed by a 2-minute discussion period. Present- ing author is identified by institution name, city, and state (or country if not United States or Canada). Presentations by trainees (medical students, residents, or 1st-year fellows) are noted in blue. Thursday, April 11, 2019 (SS01-02) 1:10 PM - 1:20 PM The Impact of Additional Tin Filtration on Contrast 1:00–2:30 PM Enhancement, Image Quality, and Radiation Dose Reduction of Renal Lesions at Multidetector Computed SS01: Abdominal, Cardiopulmonary, MSK Tomography: A Phantom Study Location: Holiday Ballrooms 1-2 Tugce Agirlar Trabzonlu, MD★, Northwestern University Feinberg Moderator: Joseph C. Veniero, MD, PhD School of Medicine, Chicago, IL; Amirhossein Mozafarykhamseh★; Va- Diego F. Lemos, MD hid Yaghmai, MD ([email protected]) PURPOSE: Spectral tin filtration technique has been shown to decrease the radiation dose when compared to standard protocols. Our purpose is (SS01-01) 1:00 PM - 1:10 PM to evaluate the effect of the tin filtered based CT protocol on contrast en- Efficacy of Remote, Videoconference Peer Teacher hancement, image quality and radiation dose by using a renal phantom. RESEARCH PAPERS RESEARCH Training for Hands-On Musculoskeletal Ultrasound METHOD AND MATERIALS: A phantom containing 15 tubes embed- Workshops: A Pilot Study ded in a structure resembling kidney was used. The tubes were filled Netanel S. Berko, MD, University of Pennsylvania, Philadelphia, PA; with a serial dilution of iodinated contrast (from 0.156 mg/cc to 6mg/ Andrew C. -
ISSN: 2320-5407 Int. J. Adv. Res. 7(5), 1307-1317
ISSN: 2320-5407 Int. J. Adv. Res. 7(5), 1307-1317 Journal Homepage: -www.journalijar.com Article DOI:10.21474/IJAR01/9166 DOI URL: http://dx.doi.org/10.21474/IJAR01/9166 RESEARCH ARTICLE EVALUATION OF PATIENTS WITH HEMOPTYSIS ATTENDING THE DEPARTMENT OF PULMONOLOGY SANTHIRAM MEDICAL COLLEGE. Dr. S. Anusha Rao. Assistant professor, Department of Pulmonology, SVIMS, Tirupati-517501. …………………………………………………………………………………………………….... Manuscript Info Abstract ……………………. ……………………………………………………………… Manuscript History Objective: To evaluate hemoptysis among patients who attended the Received: 24 March 2019 department of pulmonary medicine, Santhiram medical college and Final Accepted: 26 April 2019 general hospital. Published: May 2019 Material And Methods: This was a descriptive cross sectional study done on patients with at least one episode of hemoptysis attending to the Department of pulmonary medicine, Santhiram medical college and general hospital from January 2015 to August 2016. All the patients are evaluated by -Chest x-ray pa-view, CT-chest, Sputum for culture and sensitivity, Sputum for KOH mount, Sputum for AFB, Bronchoscopy, Upper airway and nasal examination, Complete blood picture, Coagulation profile, ECG, Complete urine examination, ICTC, 2d- Echo (if necessary).The final diagnosis is noted and the data will be statistically analysed. Results: The age of the patients ranged from 21-75 years with a mean age of 49.42 years. Predominant age group was 41-60 years accounting for 49%.48% had history of smoking and all the smokers in the study were males. Hypertension was the most common associated medical condition (27%) followed by Diabetes Mellitus (22%).Tuberculosis was the most common underlying lung disease from the history (36%).Consolidation was the most common radiographic feature in 39% patients.