Molecular Imaging

Mechanisms responsible for the course of the rheumatic diseases have not been fully explained. Among the available tools that may help in studies of these mechanisms is molecular imaging—especially techniques emphasized by nuclear medicine. In contrast to CT, MRI or US examination that show only structural pathologies, radionuclide methods allow imaging of functional changes that occur in the course of the disease and usually are featured by a very high specificity. Recent advances in nuclear medicine allowed to develop target-specific agents making it possible to reveal molecular level disturbances that take place on the course of the ongoing disease. The fundamental radionuclide studies include PET, SPECT, and classic scintigraphy. Technological advances (especially hybrid modalities) allow obtaining images of much better resolution and allow combining both structural and functional data

Parathyroid imaging with [99mTc]Tc-MIBI SPECT/CT — unexpected findings of bone marrow involvement of non-Hodgkin’s lymphoma

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Lithium carbonate pre-treatment in 131-I therapy of hyperthyroidism

BACKGROUND: The aim of the present work was to investigate the influence of lithium carbonate on the kinetics of radioiodine in the thyroid gland, and the long-lasting effect of radioiodine therapy pre-treated with lithium carbonate in patients with different types of hyperthyreosis and low baseline 24-h thyroidal radioactive iodine uptake (RAIU). MATERIAL AND METHODS: The examinations were performed in two groups of patients: in a control group with RAIU > 30% and in patients with RAIU < 30%. All groups were comparable with regard to age, sex, duration and type of disease (Graves&#8217; disease, autonomous node, multinodular goitre). The control group was treated (without lithium) according to described protocol. The second group was pre-treated with lithium carbonate in a dose of 1.0 g/day for 6 days before radioiodine and 3 days thereafter. RESULTS: A significant increase in iodide uptake in the thyroid gland was observed during intake of lithium carbonate in 106 out of 128 patients. A decrease of T3, FT3, T4, and FT4 levels and no significant changes in concentration of TSH were observed as an effect of lithium carbonate treatment. Three years of follow-up show that the results of radioiodine therapy with short lasting lithium carbonate intake are better in the first year and are similar in the second and third years in comparison to the control group. CONCLUSIONS: Lithium pre-treatment in hyperthyroid patients with low baseline uptake of radioiodine can increase iodine retention in the thyroid gland independently of the primary disease and permits the use of lower doses of radiation in the therapy. Nuclear Med Rev 2011; 14, 1: 3&#8211;

Diagnosis and treatment of Graves’ disease with particular emphasis on appropriate techniques in nuclear medicine. General state of knowledge

Graves’ disease is an autoimmune disease. It accounts for 50–80% of cases of hyperthyroidism. Antibodies against the TSH receptor (TRAb) are responsible for hyperthyroidism (TRAB). The key role in monitoring and diagnosis of Graves’ disease plays the level of hormones of free thyroxine and triiodothyronine. Helpful is an ultrasound of the thyroid scintigraphy which due to its functional character is both a valuable addition to morphological studies as well as plays an important role in the diagnosis and therapy in patients with Graves’ disease. There is no perfect treatment for Graves’ disease. The reason for this is the lack of therapy directed against primary pathogenic mechanisms. Currently available treatments need to be thoroughly discussed during the first visit as the patient’s understanding of the choice of a treatment constitutes a vital role in the success of therapy. Graves’ disease treatment is based on three types of therapies that have been carried out for decades including: pharmacological treatment anti-thyroid drugs, I131 therapy and radical treatment — thyroidectomy. The purpose of the treatment is to control symptoms and patient to return to euthyreosis. Treatment of Graves’ disease is of great importance because if left untreated, it can lead to long-term harmful effects on the heart, bone and mental well-being of patients

Registry of nuclear medicine procedures in cardiology in Poland in 2019–2021

Background: The purpose of the study was to present the cardiological procedures performed and scintigraphic devices used in Poland in 2019–2021 — based on the results of a nationwide survey. Material and methods: Forty-three (100%) institutions performing scintigraphic cardiology tests responded to the survey: 29 classic nuclear medicine centers (NM), 4 PET centers, and 10 institutions performing NM and PET examinations. Results: In 2021, 51 SPECT devices (including 5 dedicated cardiocentric semiconductor cameras, 12 SPECT gamma cameras, and 39 hybrid SPECT/CT devices) and 15 PET devices (14 PET/CT and 1 PET/MR) were used for cardiological examinations. The total number of cardiological SPECT and PET examinations has reached 33,107; PET shares 0.8%. The most frequently performed NM cardiological examination in 2019–2021 was myocardial perfusion scintigraphy (98–99% of all tests). NM cardiac amyloidosis studies accounted for less than 1% of all studies, and diagnostics of inflammation in the chest using labeled leukocytes — for less than 0.5%. The most frequently performed cardiological heart examination using the PET technique was the diagnostics of inflammation in the chest (166 of 269 examinations, i.e. 61.7%, in 2021), followed by the assessment of cardiac viability (46 examinations, i.e. 17.1%). Conclusions: In Poland, in 2021, cardiac scintigraphy was performed in 39 classic nuclear medicine centers and 14 PET centers, using modern equipment, in approximately 1/1000 inhabitants per year. Polish nuclear cardiology is based on classical nuclear medicine. Almost 99% of the tests are stress and rest myocardial perfusion studies. PET has limited practical use (&lt; 1% of cardiac studies)

Znaczenie metod neuroobrazowania w diagnostyce padaczek

W niniejszym artykule podjęto próbę przeglądu dostępnych obecnie metod neuroobrazowania w diagnostyce padaczek oraz ich oceny pod kątem przydatności w codziennej praktyce neurologa epileptologa. Od wprowadzenia do powszechnego użytku tomografii komputerowej, w latach 70. ubiegłego stulecia, na przestrzeni ostatniego ćwierćwiecza dokonał się gwałtowny rozwój diagnostyki obrazowej, który nie ominął również epileptologii. Nie można sobie wyobrazić warsztatu współczesnego klinicysty bez możliwości korzystania z licznych informacji, oferowanych przez nowoczesne techniki obrazowania. Z praktycznego punktu widzenia można wyróżnić metody obrazujące strukturę (obrazowanie morfologiczne), do których zalicza się tomografię komputerową (CT, computed tomography) i rezonans magnetyczny (MR, magnetic resonance), oraz obrazujące funkcje badanego narządu &#8212; czynnościowy rezonans magnetyczny (fMR, functional magnetic resonance), spektroskopię rezonansową (MRS, magnetic resonance spectroscopy), tomografię emisyjną pojedynczego fotonu (SPECT, single-photon emission tomography) i pozytronową tomografię emisyjną (PET, positron emission tomography). Obecnie zarówno pod względem częstości wykonywanych badań, jak i ich dostępności ekonomicznej i wartości diagnostycznej metodą pierwszoplanową jest rezonans magnetyczny. W dziedzinie epileptologii wyparł on zdecydowanie CT, którą wykonuje się jedynie ze szczególnych wskazań. Wydaje się, że z powodu niedostatecznej rozdzielczości przestrzennej wartość badań SPECT i PET stanowi jedynie uzupełnienie w stosunku do danych uzyskiwanych za pomocą badania MR. W niedalekiej przyszłości obiecującą metodą może się okazać technika MRS pozwalająca na śledzenie in vivo metabolizmu w wybranych niewielkich obszarach mózgowia. Obserwacje wielu autorów skłaniają do wysunięcia wniosku, że jedynie połączenie wielu metod diagnostycznych, pozwalających obrazować i strukturę, i funkcję badanego narządu jest właściwym kierunkiem, w którym powinna podążać współczesna diagnostyka padaczki

Bone metastases diagnosis possibilities in studies with the use of 18F-NaF and 18F-FDG

Scintigraphy of the skeletal system is performed mainly with the use of 99mTc-MDP. There are other radiopharmaceuticals showing affinity to bone lesions: 99mTc-MIBG, 201Tl, 131I (in the case of papillary or follicular thyroid cancers), and 99mTc (V) DMSA (in the case of medullary cancer). Currently, positron emitted radioisotopes are also used in clinical practice. It seems that 18F-NaF/PET is a highly sensitive and specific modality for detection of metastases and other bone lesions. Certain data concerning the role of 18F-FDG, 18F-choline, or 68Ga-DOTATATE can be found. The aim of this article is to review the role of 18F-NaF and 18F-FDG in diagnosis of bone metastases. Nuclear Med Rev 2011; 14, 2: 105&#8211;10