The Economic Value of Hybrid Single-photon Emission Computed Tomography With Computed Tomography Imaging in Pulmonary Embolism Diagnosis.

Objective: The objective was to quantify the potential economic value of single-photon emission computed tomography (SPECT) with computed tomography (CT; SPECT/CT) versus CT pulmonary angiography (CTPA), ventilation-perfusion (V/Q) planar scintigraphy, and V/Q SPECT imaging modalities for diagnosing suspected pulmonary embolism (PE) patients in an emergency setting.

Methods: An Excel-based simulation model was developed to compare SPECT/CT versus the alternate scanning technologies from a payer's perspective. Clinical endpoints (diagnosis, treatment, complications, and mortality) and their corresponding cost data (2016 USD) were obtained by performing a best evidence review of the published literature.

Drug injection-related fat necrosis of the breast with FDG PET-CT uptake.

A 52-year-old woman was found to have a lung mass and bilateral breast lesions on computed tomography (CT). Subsequent positron emission tomography/CT demonstrated marked uptake in the lung mass and mild uptake within the breast lesions. A diagnostic mammogram and targeted ultrasound were performed to exclude primary breast malignancy or metastases from presumed pulmonary malignancy.

Improved prediction of lobar perfusion contribution using technetium-99m-labeled macroaggregate of albumin single photon emission computed tomography/computed tomography with attenuation correction.

Objective: Lung cancer resection can require removal of an entire lobe and, at times, bilobectomy or pneumonectomy. Many patients will also have significantly compromised lung function that requires limiting the extent of surgery or could preclude surgery altogether. The preoperative assessment should include predicted postoperative forced expiratory volume in 1 second (ppoFEV1), because a ppoFEV1 of <40% predicts significantly increased perioperative morbidity.

Neural networks for nodal staging of non-small cell lung cancer with FDG PET and CT: importance of combining uptake values and sizes of nodes and primary tumor.

Purpose: To evaluate the effect of adding lymph node size to three previously explored artificial neural network (ANN) input parameters (primary tumor maximum standardized uptake value or tumor uptake, tumor size, and nodal uptake at N1, N2, and N3 stations) in the structure of the ANN. The goal was to allow the resulting ANN structure to relate lymph node uptake for size to primary tumor uptake for size in the determination of the status of nodes as human readers do.

Materials And Methods: This prospective study was approved by the institutional review board, and informed consent was obtained from all participants.

Ventilation/Perfusion scanning for acute pulmonary embolism: effect of direct communication on patient treatment outcomes.

Purpose Of The Report: Although the synthesis of ventilation-perfusion (V/Q) scan result and clinical pretest probability is vital to the diagnostic accuracy of V/Q scanning, there is no updated pretest/posttest tabular decision tool since that presented in the Prospective Investigation of Pulmonary Embolism Diagnosis I data. Because this verbal communication between the nuclear medicine physician and referring clinician is indispensable in this process, we sought to study the relationship between documentation of such communication (DCOMM) of the result of a V/Q scan and patient treatment outcome in patients with suspected acute pulmonary embolus (PE).

Methods: Electronic medical records were searched for patients who underwent V/Q scan for the workup of acute pulmonary embolism from 2000 through 2009 at Harborview Medical Center in Seattle, Washington.

Nuclear medicine in cerebrovascular disease.

Stroke and cerebrovascular diseases are major causes of mortality, morbidity, and disability. Nuclear Medicine, primarily via tomographic methods, has made significant contributions to the understanding of the hemodynamic and metabolic consequences of cerebrovascular diseases. In this review, the findings in acute, subacute, and chronic cerebrovascular diseases are described.

Nuclear medicine imaging in dementia: a practical overview for hospitalists.

Dementia is a clinical syndrome with diverse presentation, a challenging differential diagnosis, and time-sensitive therapy. The most common cause of dementia in patients aged > 65 years is Alzheimer's disease, which now affects 4 million people in the United States, but is often underrecognized, especially in the inpatient population. The hospitalist may have the opportunity to evaluate a patient's initial presentation of dementia.