scholarly journals Functional visualization in diseases of the joints: current status and prospects (clinical lecture)

Author(s):  
M.V. Satyr ◽  
О.І. Solodiannykova ◽  
I.V. Noverko ◽  
О.Yu. Galchenko

Background. Diseases of the musculoskeletal system (MSS), in particular diseases of joints, are a leading factor for reducing the work ability of the population all around the world. The early diagnosis and treatment for them is a high priority task for clinical medicine. Modern nuclear medicine methods can significantly increase the possibilities in differential diagnostics, optimize treatment and improve the prognosis of diseases of the musculoskeletal system (MOP). Purpose – to study and generalize the world experience of application of modern methods of osteoscintigraphy (OSG) for diagnostics of joints diseases, to define possibilities and prospects of various scintigraphic acquisitions for investigation patients with MSS pathology. Materials and methods. Full-text publications in the databases Scopus, Web of Science Core Collection, PubMed (mostly 2015–2021), international standard guidelines for the diagnosis of MSS pathology and monographs for radionuclide examination methods and hybrid imaging technologies in oncology, orthopedics and traumatology. Results. We received the main approaches for radiological diagnostics of pathological changes in joints and the abilities of osteoscintigraphy. We defined the main principles and analyzed the possibilities and advantages of different nuclear medicine protocols: conventional planar examination of the whole body, 3-phase OSG, single-photon emission computed tomography (SPECT) and combined technology with X-ray computed tomography (SPECT/CT). Indications for the use of OSG in various pathological changes of ORA have been determined. We considered different patterns of radiation imaging according to the pathogenesis of various pathological processes – systemic arthritis, diseases of the joints of the spine, upper and lower extremities. The possibilities of different radiological methods for diagnosing and application of different modes of OSG depending on the pathogenesis and localization of lesions were analyzed and compared. Conclusions. Performing 3-phase OSG and tomographic modes (SPECT, SPECT/CT) significantly increases the efficiency of the method for the diagnostics, determination of process activity, staging and prevalence of joint pathology, as well as for monitoring the treatment results. The method detects active metabolic processes at an early stage in the vascular, soft tissue and bone phases and determines the condition of the joints of the whole body without additional radiation exposure.

2021 ◽  
Vol 11 (4) ◽  
pp. 270
Author(s):  
Atia Samim ◽  
Godelieve A.M. Tytgat ◽  
Gitta Bleeker ◽  
Sylvia T.M. Wenker ◽  
Kristell L.S. Chatalic ◽  
...  

Neuroblastoma is the most common extracranial solid malignancy in children. At diagnosis, approximately 50% of patients present with metastatic disease. These patients are at high risk for refractory or recurrent disease, which conveys a very poor prognosis. During the past decades, nuclear medicine has been essential for the staging and response assessment of neuroblastoma. Currently, the standard nuclear imaging technique is meta-[123I]iodobenzylguanidine ([123I]mIBG) whole-body scintigraphy, usually combined with single-photon emission computed tomography with computed tomography (SPECT-CT). Nevertheless, 10% of neuroblastomas are mIBG non-avid and [123I]mIBG imaging has relatively low spatial resolution, resulting in limited sensitivity for smaller lesions. More accurate methods to assess full disease extent are needed in order to optimize treatment strategies. Advances in nuclear medicine have led to the introduction of radiotracers compatible for positron emission tomography (PET) imaging in neuroblastoma, such as [124I]mIBG, [18F]mFBG, [18F]FDG, [68Ga]Ga-DOTA peptides, [18F]F-DOPA, and [11C]mHED. PET has multiple advantages over SPECT, including a superior resolution and whole-body tomographic range. This article reviews the use, characteristics, diagnostic accuracy, advantages, and limitations of current and new tracers for nuclear medicine imaging in neuroblastoma.


2015 ◽  
Vol 17 (1) ◽  
pp. 38-49
Author(s):  
Nasim Khan ◽  
SM Moinul Islam ◽  
Abrar Al Sakib ◽  
Saiyeeda Mahmood ◽  
Gazi Abul Hossian ◽  
...  

The purpose of this study was to investigate the additional benefit of single photon emission computed tomography/computed tomography (SPECT/CT) over whole-body planar bone scintigraphy (planar BS) and SPECT for the detection of bone metastases in breast cancer patients. Materials & methods: Of 112 consecutively examined patients with histologically confirmed breast carcinoma who underwent bone scintigraphy, 39 required further evaluation by SPECT/CT (n= 23) and SPECT alone (n = 16) because a definite diagnosis could not be established using whole body planar BS alone. The 23 SPECT/CT studies were retrospectively evaluated by two nuclear medicine physicians for planar BS and SPECT images, and one nuclear medicine physician and one radiologist for SPECT/CT on consensus. Each focus of abnormal tracer uptake was recorded for differentiating malignant from benign bone lesions. Clinical and imaging follow-up were used as a reference standard. Results: A total of 72 lesions were evaluated in 23 patients examined by three types of imaging modalities. In 57 of the 72 evaluated lesions, the results of planar BS, SPECT and SPECT/CT were concordant; 52 of the 57 lesions were interpreted as malignant and 5 lesions as benign by all modalities. In 15 of the 72 lesions, consensus reading of fused SPECT/CT images changed the image interpretation of 15 planar BS scans and 9 of the 15 SPECT scans: 7 lesions previously interpreted as benign (on both planar BS and SPECT) were re-classified as malignant and 8 lesions (8 by planar BS and 2/8 by SPECT) previously interpreted as malignant were reevaluated as benign. The highest diagnostic gain was in the thoracolumbar spine, thoracic cage & pelvis. The overall accuracy of SPECT/CT was significantly higher on a lesion-based analysis than planar BS and SPECT (100%vs 79%, p < 0.0001 and 100% vs 83%, p = 0.003). Compared to planar BS and SPECT, the results of SPECT/CT changed diagnosis or treatment in 5/23 patients (21.7%). 39 Conclusion: The hybrid imaging system with SPECT/CT is a feasible technique yielding coregistered dual-modality images. The addition of SPECT/CT improves the diagnostic accuracy for the correct interpretation of bony lesions in breast cancer patients undergoing bone scanning for metastases. SPECT/CT should be routinely used in the work up of postoperative breast carcinoma patients with simultaneous CT evaluation to identify metastatic lesions not detected on bone scintigraphy. DOI: http://dx.doi.org/10.3329/bjnm.v17i1.22490 Bangladesh J. Nuclear Med. 17(1): 38-49, January 2014


2018 ◽  
Vol 22 (01) ◽  
pp. 025-045 ◽  
Author(s):  
Ramesh Iyer ◽  
A. Stanescu ◽  
Marguerite Parisi

AbstractThe introduction of diphosphonates in the 1970s revolutionized not only nuclear medicine but musculoskeletal imaging as well, providing functional assessment of entities such as osteomyelitis, trauma, and osseous metastatic disease. Although rarely the first-line imaging modality used today, nuclear medicine procedures continue to play a pivotal role in the evaluation of musculoskeletal diseases in children, providing whole-body assessment of disease involvement. More recently, the introduction of technologies such as single-photon emission computed tomography/computed tomography (SPECT/CT), as well as newer positron-emitting tracers such as 18fluorine-fluorodeoxyglucose and sodium 18F-fluorine, particularly when combined with CT (positron emission tomography/CT), have injected new life into the older established techniques and expanded the application of nuclear medicine imaging into new arenas. This article discusses the utility of standard nuclear medicine procedures as they apply to children with musculoskeletal disorders, focusing on the added value of and indications for SPECT/CT. Subsequently, we discuss the expanding role of positron-emitting agents in infection, trauma, and for the diagnosis, staging, and therapeutic response monitoring of children with malignant bone and soft tissue tumors. Differences between disease processes encountered in children as compared with adults are discussed; developmental variants that can, but should not, be confused with disease are illustrated. The need for pediatric-specific protocols is addressed.


2004 ◽  
Vol 22 (17) ◽  
pp. 3593-3607 ◽  
Author(s):  
Bieke Van Den Bossche ◽  
Christophe Van de Wiele

To date, our understanding of the role of receptors and their cognate ligands in cancer is being successfully translated into the design and development of an arsenal of new, less toxic, and more specific anticancer drugs. Because most of these novel drugs are cytostatic, objective response as measured by morphologic imaging modalities (eg, computed tomography or magnetic resonance imaging) cannot be used as a surrogate marker for drug development or for clinical decision making. Positron emission tomography (PET) can be used to image and quantify the in vivo distribution of positron-emitting radioisotopes such as oxygen-15, carbon-11, and fluorine-18 that can be substituted or added into biologically relevant and specific receptor radioligands. Similarly, single-photon emission computed tomography (SPECT) can be used to image and quantify the in vivo distribution of receptor targeting compounds labeled with indium-111, technetium-99m, and iodine-123. By virtue of their whole-body imaging capacity and the absence of errors of sampling and tissue manipulation as well as preparation, both techniques have the potential to address locoregional receptor status noninvasively and repetitively. This article reviews available data on the in vivo evaluation of receptor systems by means of PET or SPECT for identifying and monitoring patients with sufficient receptor overexpression for tailored therapeutic interventions, and also for depicting tumor tissue and determining the currently largely unknown heterogeneity in receptor expression among different tumor lesions within and between patients.


2021 ◽  
Vol 20 (4) ◽  
pp. 22-32
Author(s):  
E. D. Kireeva ◽  
. Kailash ◽  
T. V. Shamanskaya ◽  
M. Ya. Yadgarov ◽  
D. Yu. Kachanov ◽  
...  

The value of single-photon emission computed tomography combined with computed tomography imaging in ¹²³I-Metaiodobenzylguanidine scintigraphy in children with neuroblastomaWhole body scintigraphy with ¹²³I-Metaiodobenzylguanidine (¹²³I-MIBG) is an important imaging modality for evaluation of patients with neuroblastoma (NB). As the intrinsic nuclear scintigraphic characteristics, the assessment of conventional planar ¹²³I-MIBG images presents some difficulties. The limited resolution of planar images can induce false-negative results for small lesions, whereas the presence of physiologic MIBG uptake is not always easily differentiable from pathologic uptake and can induce false-positive results. Single-photon emission computed tomography combined with computed tomography (SPECT/ CT) hybrid imaging technique, allowing the direct fusion of morphologic and functional information, has been suggested to be more accurate. However, SPECT/CT imaging renders slightly more radiation to patients from CT portion of the study and is time consuming. The aim of our study was to investigate how much SPECT/CT can have additional diagnostic value over planar imaging in NB patients at initial staging. The study was approved by the Independent Ethics Committee and the Scientific Council of the D. Rogachev NMRCPHOI. A total of 251 SPECT/CT scans following by planar ¹²³I-MIBG imaging scans performed in 251 patients with NB were retrospectively analyzed. In 72.1% of the studies, the whole-body planar images and SPECT/CT images showed the same result. In 27.9% of studies, however, SPECT/CT images provided additional very important information. In our study, the diagnosis reached by planar imaging was revised or specified by SPECT/CT in 70 of the 251 patients and was clinically significant. 


Author(s):  
Jamie A. Davies

This chapter addresses muscles. The ultimate result of sensation and thought is usually some kind of action, be it moving the whole body; manipulating an object with the hand; or moving diaphragm, mouth, tongue, and voice-box to speak. All of these depend on muscles which, in their various forms, provide a nearly universal means for the nervous system to control the body and the world. Muscle cells are highly adapted for turning chemical energy into mechanical force. The chapter then looks at skeletal muscle and the musculoskeletal system. Some muscles are arranged circumferentially around a cavity. Two examples of this are the heart and the gut.


Author(s):  
Aleksander Kosmala ◽  
Thorsten Bley ◽  
Bernhard Petritsch

Background Multiple myeloma is a malignant hematological disease characterized by uncontrolled proliferation of monoclonal plasma cells mainly in the bone marrow. Imaging plays a crucial role in diagnosis and follow-up. Method This literature review provides information about multiple myeloma, its precursor diseases, and available imaging techniques. Advantages and limitations as well as possible prognostic and therapeutic implications of the different imaging methods are presented in the context of the current literature. Results and Conclusion Cross-sectional imaging has replaced conventional X-ray skeletal survey. Widely available whole-body computed tomography is routinely used to detect osteolytic lesions. Magnetic resonance imaging is the most sensitive technique to identify bone marrow infiltration and is recommended in multiple myeloma precursor diseases. Positron emission computed tomography combines morphological and functional imaging. It is mainly used for follow-up, therapy monitoring, and response evaluation. Key points:  Citation Format


Sign in / Sign up

Export Citation Format

Share Document