Nuklearmedizin in Deutschland

2011 ◽  
Vol 50 (02) ◽  
pp. 53-67 ◽  
Author(s):  
A. Grgic ◽  
J. Kotzerke ◽  
C.-M. Kirsch ◽  
D. Hellwig
Keyword(s):  
Nuclear Medicine ◽  
Cross Sectional ◽  
Lengths Of Stay ◽  
Health Care Structure ◽  
Pet Ct ◽  
Care Structure ◽  
Cross Sectional Imaging ◽  
Nuclear Medicine Procedures ◽  
Bone Scans

SummaryAim: To explain the spectrum and number of in-vivo nuclear medicine examinations and therapies based on official statistics about out-patient and in-patient care. Trends in time of the frequency and spectrum of procedures as well as data on the health care structure for nuclear medicine in Germany should be collected. Methods: Data from the Gesundheitsberichterstattung des Bundes, from the frequency statistics of the statutory health insurance for out-patients and from the Bundes - ärztekammer were used. Customized queries were performed to analyse temporal changes. Results: Nuclear medicine physicians are more frequently consulted by out-patients over the last years (2008: 2 024 498; 2009: 2 164 664) and the number of colleagues in private practice increased. For in-patients, the frequency of conventional nuclear medicine procedures (mainly for brain, lymphatic system, lung and heart) increased since 2008 after a decline in previous years (2009: 323 515; +4.6%) and the number of PET(/CT) examinations continued to rise (2009: 25 123; +18%), even if changes in OPS keys may hamper comparisons. Nearly 600 gamma cameras and 76 PET(/CT) scanners were installed in hospitals in 2008. Nuclear medicine procedures are increasingly performed as cross sectional imaging like SPECT(/CT) and PET(/CT). With the supply shortfall with 99Mo, the frequency of thyroid scans with 123I iodine increased as well as the use of 18F PET as a substitute for conventional bone scans. The number of radionuclide therapies, in particular non-thyroid treatments, increased since the mid-nineties and stabilized at nearly 50 000 cases per year with shorter lengths of stay. Conclusion: The details of the present analysis may help to understand the positive evolution of key numbers for nuclear medicine.

VP69 Mapping Brazilian Nuclear Medicine Installed Capacity And Perspectives

2017 ◽  
Vol 33 (S1) ◽  
pp. 180-181
Author(s):  
Lorena Pozzo ◽  
Evelinda Trindade
Keyword(s):  
Nuclear Medicine ◽  
Regional Analysis ◽  
Reticuloendothelial System ◽  
Myocardial Scintigraphy ◽  
National Commission ◽  
The South ◽  
North East ◽  
Pet Ct ◽  
Nuclear Medicine Procedures

INTRODUCTION:Guidelines compliance, with a priori non-invasive and earlier tests and interventions, depends on access. This study investigates the Brazilian Unified Health System (SUS) outpatient access to nuclear medicine procedures through SUS data comparison with those from the National Commission of Nuclear Energy (CNEN: Comissão Nacional de Energia Nuclear).METHODS:Data provided by the SUS outpatient database (SIA-DATASUS) regarding procedures performed from 2013 to 2016 was compared with data from institutions (Nuclear Medicine Services and Cyclotron Facilities) and radioprotection supervisors with numbers certified by CNEN.RESULTS:CNEN has authorized 420 nuclear medicine institutions (.20 per million inhabitants) and certified 294 radioprotection supervisors (.14 per million inhabitants), and 1.4 services per supervisor. There are 457 graduated professionals qualified for radioactive sources preparation, use and handling for diagnostic and therapeutic radiopharmaceuticals (.9 professionals / installation). During the last four years, 08 new nuclear medicine facilities were authorized by CNEN. The number of nuclear medicine procedures performed slightly increased in the South, but remained constant in other regions. Annual SUS reimbursements increased by 21.2 percent on average for the 03 PET/CT (Positron emission tomography–computed tomography) adopted procedures: regional analysis showed the Central-West as the highest growth area (70.8 percent), compared to the South (53.4 percent), North-East region (30.8 percent), and the South-East (5 percent). Currently, thirteen Cyclotron Facilities operate in Brazil: South-East (six), South (three), North-East (three) and Central-West (one). Some nuclear medicine procedures largely outnumber the average increase: for example, reticuloendothelial system scintigraphy (513.9 percent), gastric transit scintigraphy (112.8 percent), and thyroid screening with suppression/stimulation test (100.6 percent). However, myocardial scintigraphy (stress and rest) and bone scintigraphy with or without blood flow still correspond to 82 percent of total nuclear medicine in vivo procedures.CONCLUSIONS:Regional disparity is quantitatively depicted in Brazil and reflects access to SUS nuclear medicine procedures. This denotes a potential for improvements related to nuclear medicine areas, for example developments concerning new PET/CT coverage, new radiopharmaceuticals research, and national and international training.

Patient Exposure and Radiation Risk in Bulgarian Diagnostic Nuclear Medicine I. Survey of Diagnostic Nuclear Medicine Procedures in Bulgaria in 1980

1982 ◽  
Vol 21 (03) ◽  
pp. 85-91 ◽  
Author(s):  
R. Poppitz
Keyword(s):  
Nuclear Medicine ◽  
Radiation Risk ◽  
Patient Exposure ◽  
Diagnostic Nuclear Medicine ◽  
Nuklearmedizinische Diagnostik ◽  
Nuclear Medicine Procedures

Um die Strahlenexposition und das Strahlenrisiko für die Bevölkerung durch die nuklearmedizinische Diagnostik in Bulgarien zu ermitteln, wurde eine Erhebung für das Jahr 1980 über die Arten und Anzahl der Applikationen von Radiopharmaka, über die verwendeten Aktivitäten und über die Geschlechts- und Altersverteilung der untersuchten Patienten durchgeführt. Die Gesamtzahl diagnostischer in vivo Applikationen betrug 116418 (davon 40,5% bei Männern und 59,5% bei Frauen), d.h. 13,1 Applikationen per 1000 Einwohner. Die applizierte Gesamtaktivität aller 44 verwendeter Radiopharmaka betrug ca. 2,1 TBq (56 Ci). Die Geschlechts- und Altersverteilung der untersuchten Patienten war ähnlich jener in anderen Ländern: nur 17,4% aller Patienten waren im reproduktionsfähigen Alter, 52,7% waren über 45 Jahre alt. Im Vergleich zu anderen entwickelten Ländern war in Bulgarien im Jahr 1980 der Anteil der 131J-Jodid-Untersuchungen verhältnismäßig hoch.

Comparison between anatomical cross-sectional imaging and 18F-FDG PET/CT in the staging, restaging, treatment response, and long-term surveillance of squamous cell head and neck cancer

2014 ◽  
Vol 35 (2) ◽  
pp. 123-134 ◽  
Author(s):  
Laura Evangelista ◽  
Anna Rita Cervino ◽  
Sotirios Chondrogiannis ◽  
Maria Cristina Marzola ◽  
Anna Margherita Maffione ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Fdg Pet ◽  
Cross Sectional ◽  
Pet Ct ◽  
Cross Sectional Imaging ◽  
18F Fdg ◽  
Sectional Imaging ◽  
Fdg Pet Ct

Imaging

2017 ◽  
Author(s):  
Robert Laureno
Keyword(s):  
Resonance Imaging ◽  
Cross Sectional ◽  
Advantages And Disadvantages ◽  
Mri Scans ◽  
Cross Sectional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Cellular Pathology ◽  
Brain And Spinal Cord ◽  
The Brain

This chapter on “Imaging” examines the relative advantages and disadvantages of computed tomography (CT) and magnetic resonance imaging (MRI) scans. It compares the modalities to each other and to gross neuropathology. For several decades, neurologists have been able to view cross-sectional images of living patients. Analogous to gross neuropathology, cross-sectional imaging displays the brain as an entire organ but does not demonstrate microscopic tissue or cellular pathology. By allowing practitioners to view sections of brain and spinal cord in vivo, imaging has improved neurologic practice and facilitated clinical research. This chapter deals with imaging topics that are important to the neurologist. The timing of scans, the effects of gravity, and the importance of plane of section are considered. Imaging is compared to gross neuropathology, and MRI is compared to CT.

scholarly journals Optical coherence tomography of the pancreatic and bile ducts: are we ready for prime time?

2020 ◽  
Vol 08 (05) ◽  
pp. E644-E649
Author(s):  
Amy Tyberg ◽  
Isaac Raijman ◽  
Aleksey A. Novikov ◽  
Divyesh V. Sejpal ◽  
Petros C. Benias ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Pancreatic Duct ◽  
Imaging System ◽  
Biliary Duct ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Reflective Surface ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Abstract Background and study aims First-generation optical coherence tomography (OCT) has been shown to increase diagnostic sensitivity for malignant biliary and pancreatic-duct strictures. A newer OCT imaging system, NVision Volumetric Laser Endomicroscopy (VLE), allows for in vivo cross-sectional imaging of the ductal wall at the microstructure level during endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to identify and evaluate characteristics on OCT that are predictive of benign and malignant strictures. Patients and methods Consecutive patients from six centers who underwent OCT between September 2016 and September 2017 were included in a dedicated registry. OCT images were analyzed, and nine recurring characteristics were further assessed. Final diagnosis was based on histology and/or surgical pathology. Results 86 patients were included (49 % male, mean age 64.7). OCT was performed in the bile duct in 79 patients and the pancreatic duct in seven. Nine OCT characteristics were identified: dilated hypo-reflective structures (n = 7), onion-skin layering (n = 8), intact layering (n = 17), layering effacement (n = 25), scalloping (n = 20), thickened epithelium (n = 42), hyper-glandular mucosa (n = 13), prominent blood vessels (n = 6), and a hyper-reflective surface (n = 20). Presence of hyper-glandular mucosa, hyper-reflective surface and scalloping significantly increased the odds of malignancy diagnosis by 6 times more (P = 0.0203; 95 % CI 1.3 to 26.5), 4.7 times more (P = 0.0255; 95 % CI 1.2 to 18.0) and 7.9 times more (P = 0.0035; 95 % CI 1.97 to 31.8) respectively. Conclusion By providing in-vivo cross-sectional imaging of the pancreatic and biliary duct wall, OCT technology may improve sensitivity in diagnosing malignant strictures and provide standardizable criteria predictive of malignancy.

The value of lymph node ultrasound and whole body PET/CT in stage IIB/C patients prior to SLNB.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e22079-e22079
Author(s):  
Emma H.A. Stahlie ◽  
Bernies Van Der Hiel ◽  
Annemarie Bruining ◽  
Michel W.J.M. Wouters ◽  
Yvonne Schrage ◽  
...  
Keyword(s):  
Lymph Node ◽  
High Risk ◽  
Whole Body ◽  
Preoperative Imaging ◽  
Cross Sectional ◽  
Primary Tumors ◽  
Pet Ct ◽  
Cross Sectional Imaging ◽  
Melanoma Patients ◽  
Sectional Imaging

e22079 Background: Stage IIB/IIC (pT3b-T4N0) patients are known to have high-risk primary tumors, even higher risk than some stage IIIA/B melanomas (AJCC Staging System 8th edition), however they follow the same routine to sentinel lymph node biopsy (SLNB) as more low-risk tumors. A priori the risk of finding SLNB or other metastases is much higher for these thick and/or ulcerated primary melanomas compared to the thinner ones. Guidelines are not conclusive regarding the use of preoperative imaging in these cases. Recently, a trend to more frequently use cross-sectional imaging has been noticed. However, others have previously shown that preoperative ultrasound was the most sensitive. The aim of this pilot study was to assess the value of ultrasound (US) and Positron Emission Tomography/Computerized Tomography (PET/CT) prior to SLNB for stage IIB/C (pT3b-T4N0) melanoma patients. Methods: Starting 2019-04, all patients with a pT3b melanoma or higher (8th AJCC) were included. All patients underwent US and PET/CT before their planned lymphoscintigraphy and routine SLNB. Suspected metastases were confirmed with cytologic puncture. Results: A total of 20 patients were screened. Seven patients (35%) had metastases detected by imaging: one by PET/CT, three by US and three by both imaging modalities. Three of these metastases were detected by US as well as PET/CT. All metastases were nodal. For all seven patients treatment was altered to lymph node dissection with adjuvant therapy. Of the 13 patients in whom no metastases were identified by imaging, six (46%) still had a positive sentinel node (SN). Conclusions: This study showed that this select group of patients had a high risk of metastases prior to SLNB and that all recurrences except one, were detected by ultrasound. This suggests that nodal staging with US is sufficient and can replace the need for SLNB when metastases is proven with cytology. Despite negative imaging, SLNB cannot be foregone for pT3b-pT4N0 melanoma patients, as many still have an involved SN. Cross-sectional imaging can be reserved for patients after positive cytology or SN to confirm the absence of distant visceral metastases.

Noninvasive cross-sectional imaging of proximal caries using swept-source optical coherence tomography (SS-OCT)in vivo

2013 ◽  
Vol 7 (7) ◽  
pp. 506-513 ◽  
Author(s):  
Yasushi Shimada ◽  
Hisaichi Nakagawa ◽  
Alireza Sadr ◽  
Ikumi Wada ◽  
Masatoshi Nakajima ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
Proximal Caries ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

scholarly journals Imaging in head and neck cancer: United Kingdom National Multidisciplinary Guidelines

2016 ◽  
Vol 130 (S2) ◽  
pp. S28-S31 ◽  
Author(s):  
H Lewis-Jones ◽  
S Colley ◽  
D Gibson
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Residual Disease ◽  
Ct Imaging ◽  
Cross Sectional ◽  
Positron Emission ◽  
Pet Ct ◽  
Cross Sectional Imaging ◽  
The Uk

AbstractThis guideline is endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper summarises the current imaging modalities in use for head and neck cancer evaluation. It highlights their role in the management with recommendations on modality choice for each cancer subsite.Recommendations• Offer appropriate radiological imaging, based on tumour extent, site and local expertise, to stage tumours and plan treatment for patients diagnosed with head and neck cancer. (G)• Consider positron emission tomography combined with computed tomography (PET–CT) imaging if conventional cross-sectional imaging identifies no primary site. (R)• Offer PET–CT imaging 12 weeks after non-surgical treatment to detect residual disease. (R)

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