Compliance with Gastric-Emptying Scintigraphy Guidelines: An Analysis of the Intersocietal Accreditation Commission Database.

Many variables can influence the results of gastric emptying scintigraphy (GES). A lack of methodologic standardization may cause variability, limit comparisons, and decrease the credibility of the test. To address this, in 2009, the Society of Nuclear Medicine and Molecular Imaging (SNMMI) published a procedure guideline describing a standardized, validated GES protocol for adults.

Endocrine radionuclide scintigraphy with fusion single photon emission computed tomography/computed tomography.

Aim: To review the benefits of single photon emission computed tomography (SPECT)/computed tomography (CT) hybrid imaging for diagnosis of various endocrine disorders.

Methods: We performed MEDLINE and PubMed searches using the terms: "SPECT/CT"; "functional anatomic mapping"; "transmission emission tomography"; "parathyroid adenoma"; "thyroid cancer"; "neuroendocrine tumor"; "adrenal"; "pheochromocytoma"; "paraganglioma"; in order to identify relevant articles published in English during the years 2003 to 2015. Reference lists from the articles were reviewed to identify additional pertinent articles.

Parathyroid adenoma localization with 99mTc-sestamibi SPECT/CT: a meta-analysis.

Purpose: The aim of the study was to determine the diagnostic utility of parathyroid scintigraphy with technetium-99m (99mTc)-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) for localization of parathyroid adenoma.

Materials And Methods: We performed a systematic search of medical databases PubMed and Medline/OVID for literature on 99mTc-sestamibi SPECT/CT parathyroid scintigraphy, using the search terms hyperparathyroidism, parathyroid adenoma/hyperplasia, SPECT/CT, and SPECT-CT. Citations for 981 articles and 128 abstracts of full articles were reviewed by two coauthors for relevance.

Endocrine scintigraphy with hybrid SPECT/CT.

Nuclear medicine imaging of endocrine disorders takes advantage of unique cellular properties of endocrine organs and tissues that can be depicted by targeted radiopharmaceuticals. Detailed functional maps of biodistributions of radiopharmaceutical uptake can be displayed in three-dimensional tomographic formats, using single photon emission computed tomography (CT) that can now be directly combined with simultaneously acquired cross-sectional anatomic maps derived from CT. The integration of function depicted by scintigraphy and anatomy with CT has synergistically improved the efficacy of nuclear medicine imaging across a broad spectrum of clinical applications, which include some of the oldest imaging studies of endocrine dysfunction.

Characterization of changes in total body composition for patients with head and neck cancer undergoing chemoradiotherapy using dual-energy x-ray absorptiometry.

Background: Patients with head and neck cancer experience significant weight loss secondary to concurrent chemoradiotherapy (CCRT). Using dual-energy X-ray absorptiometry (DEXA) scans, we characterize total body composition changes during and after CCRT in order to develop novel clinical care models that will improve the patient's quality of life (QOL).

Methods: Sixty DEXA scans were obtained from 12 patients undergoing CCRT for locally advanced squamous cell head and neck cancer.

Preablation 131-I scans with SPECT/CT in postoperative thyroid cancer patients: what is the impact on staging?

Context: The utility of preablation radioiodine scans for the management of differentiated thyroid cancer remains controversial.

Objective: To determine the contribution of preablation Iodine 131 (131-I) planar with single-photon emission computed tomography/computed tomography (SPECT/CT; diagnostic [Dx] scans) to differentiated thyroid cancer staging.

Design: Prospective sequential series at university clinic.

Adrenal cortical imaging with I-131 NP-59 SPECT-CT.

Purpose: The purpose of this article is to present our initial experience with hypersecretory adrenal syndromes investigated with radioiodinated I-6-B-iodomethyl-19-norcholesterol (NP-59) and SPECT-CT.

Materials And Methods: Illustrative cases are presented of patients being investigated for adrenal hypersecretory syndromes, with or without adrenal nodules, using NP-59 scintigraphy with SPECT-CT imaging, representing a spectrum of diagnoses. Clinical and imaging data are reviewed to evaluate whether additional information derived from near-simultaneous anatomic localization aids study interpretation.

Diffuse skeletal muscle F-18 fluorodeoxyglucose uptake in advanced primary muscle non-Hodgkin's lymphoma.

A 65-year-old man newly diagnosed with primary muscular non-Hodgkin's lymphoma underwent staging F-18 Fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT). This demonstrated striking FDG uptake involving multiple skeletal muscles. Although a variety of factors may result in diffuse skeletal muscle FDG uptake, the heterogeneity and degree of FDG muscle activity, concomitant muscle enlargement, and clinical picture represent an unusual case of advanced primary muscular lymphoma.

Spectrum of 18F-FDG PET/CT findings in oncology-related recurrent laryngeal nerve palsy.

Objective: The objective of our study was to review recurrent laryngeal nerve (RLN) anatomy and describe the typical (18)F-FDG (FDG) PET/CT appearance of vocal cord paresis due to oncology-related RLN injury including a spectrum of presentations, causes, and sites of nerve injury.

Conclusion: Oncology-related RLN palsy may be caused by direct tumor invasion or its therapy. FDG PET/CT findings should be recognized to avoid misdiagnosis.

Contemporary adrenal scintigraphy.

Introduction: High-resolution computed tomography (CT) and magnetic resonance (MR) imaging have replaced scintigraphy as primary imaging modalities for the evaluation of adrenal diseases.

Discussion: Thin-slice CT, CT contrast washout studies and MR pulse sequences specifically designed to identify adrenal lipid content have radically changed the approach to anatomic imaging and provide unique insight into the physical characteristics of the adrenals. With a confirmed biochemical diagnosis, further evaluation is often unnecessary, especially in diagnostic localization of diseases of the adrenal cortex.

Radio-guided surgery for non-131I-avid thyroid cancer.

Objective: In this paper we report in a larger series the use of radio-probe-guided surgery (RGS) in nonradioiodine avid, well-differentiated thyroid cancer (DTC).

Design: Thirty-seven patients with locoregional recurrent, nonradioiodine avid DTC were studied with (99m)Tc-sestamibi directed RGS using a handheld gamma probe as an intraoperative detector.

Outcome: Twenty-three women and 14 men were followed after RGS for 35.

Altered central micro-opioid receptor binding after psychological trauma.

Background: Functional neuroimaging studies have detected abnormal limbic and paralimbic activation to emotional probes in posttraumatic stress disorder (PTSD), but few studies have examined neurochemical mechanisms that underlie functional alterations in regional cerebral blood flow. The mu-opioid neurotransmitter system, implicated in responses to stress and suppression of pain, is distributed in and is thought to regulate the function of brain regions that are implicated in affective processing.

Methods: Here we examined the micro-opioid system with positron emission tomography and the micro-opioid receptor-selective radiotracer [11C] carfentanil in 16 male patients with PTSD and two non-PTSD male control groups, with (n = 14) and without combat exposure (n = 15).

Radioguided surgery of parathyroid adenomas and recurrent thyroid cancer using the "low sestamibi dose" protocol.

Purpose: The aim of this study was to establish the clinical efficacy of the "low sestamibi dose" (LSD) protocol to perform thyroid and parathyroid radioguided surgery in a large series of patients homogeneously studied and operated on by the same surgeon. The LSD protocol was initially developed in our center to cure primary hyperparathyroid (PHPT) patients with a high likelihood of a solitary parathyroid adenoma (PA) by minimally invasive radioguided surgery (MIRS). Since then, the same protocol has been applied to differentiated thyroid cancer (DTC) patients with 131I-negative, but sestamibi-positive, locoregional recurrent disease in order to obtain radical radioguided extirpation of tumoral lesions at reoperation.

Adrenal gland scintigraphy.

There is no question that high-resolution imaging techniques have revolutionized the approach to diagnostic imaging. Computed tomography (CT) and magnetic resonance imaging provide exquisite images of the adrenal glands and offer the best initial imaging approach in the evaluation of patients with suspected adrenal disease. However, an assessment of anatomy is only a portion of the diagnostic effort, which begins with a biochemical evaluation to establish the presence of adrenal gland dysfunction.

Corticolimbic blood flow during nontraumatic emotional processing in posttraumatic stress disorder.

Context: Recent brain imaging studies implicate dysfunction of limbic and paralimbic circuitry, including the amygdala and medial prefrontal cortex (MPFC), in the pathogenesis of posttraumatic stress disorder (PTSD) during traumatic recollection and imagery. However, the relationship between activity in these regions and general emotional processing unrelated to traumatic experience has not been fully examined.

Objective: To investigate activity in the limbic and paralimbic brain regions in PTSD in response to a challenge with emotionally salient generic visual images.

11C-methionine PET/CT in 99mTc-sestamibi-negative hyperparathyroidism in patients with renal failure on chronic haemodialysis.

Purpose: Scintigraphic localisation of parathyroid glands is often unsuccessful in patients with renal failure on chronic haemodialysis who have secondary hyperparathyroidism (HPT). The purpose of this study was to investigate the use of (11)C-methionine PET/CT to detect hyperfunctioning parathyroid glands in patients with renal failure on chronic haemodialysis who had (99m)Tc-sestamibi-negative HPT.

Methods: (11)C-methionine PET/CT was performed in 18 patients (11 women and 7 men, aged 42-79 years; mean age 57.

Corticolimbic blood flow in posttraumatic stress disorder during script-driven imagery.

Background: Functional neuroimaging experiments targeting personal recall of emotional events may help elucidate neural substrates underlying posttraumatic stress disorder (PTSD). Studies suggest that limbic and paralimbic function might be altered in PTSD, as compared with trauma-exposed control subjects; however, little is known about functional changes resulting from traumatic experience itself. The present study examined both PTSD-specific and trauma-specific regional cerebral blood flow (rCBF) patterns during script-driven imagery.

Functional scintigraphy of the adrenal gland.

Over the last 30 years nuclear medicine imaging of the adrenal gland and its lesions has been achieved by the exploitation of a number of physiological characteristics of this organ. By seeking and utilising features which are quantitatively or qualitatively different from those of the adjacent tissues, functional depiction of the adrenal gland and its diseases, which in most cases retain the basic physiology of their tissue of origin, including both the cortex and the medulla, are now a useful clinical reality. Agents widely used in clinical practice include: (a) uptake and storage of radiolabelled cholesterol analogues via the low density lipoprotein (LDL) receptor and cholesterol ester storage pool in the adrenal cortex ((131)I-6-beta-iodomethyl-norcholesterol, (75)Se-selenomethyl-norcholesterol); (b) catecholamine type I, presynaptic, uptake mechanism and intracellular granule uptake and storage mechanism in the adrenal medulla and extra-adrenal paraganglia ((131)I-, (123)I- and (124)I-meta-iodo-benzyl-guanidine (MIBG), (18)F-metafluoro-benzyl-guanidine); (c) cell surface receptor binding of peptides/neurotransmitters/modulators such as for the family of five subtypes of somatostatin receptors ((123)I-tyr-octreotide, (111)In-DTPA-octreotide, (111)In-DOTA-octreotide and many others); (d) although not specific for the adrenal gland, increased glycolysis by tumours, particularly the most malignant varieties, (18)F-2-fluoro-d-deoxyglucose can thus be expected to depict certain malignant lesions such as malignant pheochromocytomas (particularly the minority which are not detected by MIBG) and adrenal incidentalomas (particularly when they occur in patients with known extra-adrenal malignancies).

mu-Opioid receptors and limbic responses to aversive emotional stimuli.

Functional neuroimaging studies implicate limbic and paralimbic activity in emotional responses, but few studies have sought to understand neurochemical mechanisms which modulate these responses. We have used positron emission tomography to measure mu-opioid receptor binding, and cerebral blood flow in the same subjects, and demonstrated that the baseline binding potential and the regional cerebral blood flow in the left inferior temporal pole are functionally related. Higher baseline mu-opioid receptor binding potential was associated with lower regional cerebral blood flow in this region during presentation of emotionally salient stimuli.