The usefulness of SPECT/CT in characterization of skeletal and soft tissue lesions — report of two cases

SPECT/CT imaging provides detailed information on the radiotracer distribution and enables simultaneous lesion morphology evaluation. This hybrid imaging delivers complementary information about patient’s disease. We present two cases in which SPECT/CT imaging and cooperation between the nuclear medicine physician and radiologist quickly clarified the diagnosis, sparing patient unnecessary diagnostic procedures or treatment

Complex Regional Pain Syndrome type I with atypical scintigraphic pattern — diagnosis and evaluation of the entity with three phase bone scintigraphy. A case report

Complex Regional Pain Syndrome (CRPS) is a neurological disorder of unknown etiology which may lead to severe disability. Its diagnosis is very difficult and based on diagnostic criteria which have been changing over last years. Still, there is no golden standard in diagnosis of this entity. Three-phase bone scan is a widely used diagnostic modality which has been proved useful in CRPS evaluation. The syndrome may present various scintigraphic patterns. Different diagnostic modalities can also be helpful when CRPS is suspected including plain film radiography, magnetic resonance imaging and ultrasonography. Multidisciplinary approach is necessary for proper and quick diagnosis. We present a case of CRPS in 12-year-old girl in whom the diagnosis was based on the bone scan

Myocardial blood flow assessment with myocardial perfusion scan in patients with coronary artery chronic total occlusion

Introduction and purpose: Coronary artery disease (CAD) is a leading cardiological problem in modern society. A special form of CAD is the Chronic Total Occlusion (CTO), which affects about 20% of visible coronary artery lesions. The aim of the study is to present the role of myocardial perfusion scintigraphy performed on patients with CTO, and scintigraphic findings in these patients.Material and method: It was a retrospective study. We analized studies in patients with CTO reported in medical history. We included studies performed between 2016 and 2019. 119 cases were found with the majority of men (M = 95, W = 24). The patients’ mean age was 65 years (M = 65, W = 66). In order to assess ischemia in these patients, the stress test was applied by means of physical exercise (cycloerometer) or pharmacological test. If patient's clinical condition did not allow a stress test, only a rest test was performed.Results: In the analyzed group the most common occluded vessel was the right coronary artery (59%). In this case, mean ischaemia was found to cover 18% of the myocardium. The second most frequent obstructed vessel was the circumflex (16%) with ischaemia of 15%. The next artery was left anterior descending artery with ischaemia of 30% and other vessel - 7%. 9 patients had more than one vessel closed.Conclusions: Myocardial perfusion imaging helps to choose optimal treatment in patients with CTO.</p

Nuclear cardiology: an overview of radioisotope techniques used in the diagnostic workup of cardiovascular disorders

Cardiovascular diseases are the most common cause of death in patients over 60 years old. Pivotal imaging modalities in cardiac diagnostic workup are echocardiography, magnetic resonance, multi‑row detector computed tomography, coronary angiography, and radioisotope tests. In this study, we summarize the techniques of nuclear medicine (positron emission tomography, single‑photon emission computed tomography, radionuclide ventriculography) that could be implemented in the cardiovascular diagnostic algorithms. Despite being acknowledged in a few cardiology guidelines, these imaging methods are still underestimated by practitioners. Nevertheless, noninvasive diagnostic tools are of increasing potential and should be implemented whenever possible. We discuss the usefulness of particular techniques in the management of patients with obstructive and nonobstructive coronary artery disease, including assessment of myocardial perfusion, contractility, viability, and detection of unstable atherosclerotic plaques. Radioisotope imaging can also be valuable in the diagnostic workup of infective endocarditis, as well as cardiac sarcoidosis and amyloidosis. Apart from theoretical principles of nuclear cardiology, we also provide 3 case reports illustrating a practical implementation of these imaging modalities