A Practical Guide for Pediatric Nuclear Medicine

✍ Scribed by Zvi Bar-Sever (editor), Francesco Giammarile (editor), Ora Israel (editor), Helen Nadel (editor)

• Publisher: Springer
• Year: 2023
• Tongue: English
• Leaves: 246
• Category: Library

✦ Synopsis

This open access book will provide a foundation for the understanding of, and knowledge for a successful routine use of diagnostic Nuclear Medicine procedures in children through expertise and cases provided by representative busy pediatric nuclear medicine facilities. The book highlights important aspects of nuclear medicine in children and the differences between adult and pediatric practice where relevant.

An introductory chapter provides general information detailing the advantages and limitations for performing nuclear medicine tests in children, as well as suggestions on how to approach and provide relevant data to the patients, their parents or next of kin. In the remaining 11 chapters, containing over 115 cases of children evaluated for various clinical indications, procedures are presented and subsequently detailed according to their clinical significance or prevalence based on the clinical experience of the contributors. The book is organized by organ systems, and also includes chapter on oncology and infection/ inflammation. Chapters are formatted to provide information regarding clinical indications, preparation including radiopharmaceutical doses and additional medications, study protocol, study interpretation, correlative imaging. Each chapter will include red flags warning and take home messages sections to emphasize important points. The case format is presented with patient history and then study report and impression.

Based on practices explored by experts at the forefront of this field, the publication is directed at Nuclear Medicine physicians, radiologists, oncologists and clinicians in various pediatric specialties, medical physicists, medical technologists, radiopharmacists, laboratory medicine scientists and researchers.

✦ Table of Contents

Foreword
Preface
Contents
List of Contributors
Abbreviations
1: General Principles in Pediatric Nuclear Medicine
1.1 General Information for Referring Physician, Parents, and NM Team [1–5]
Multidisciplinary Care Team
Departmental Workflow—Scheduling the Study
Information to Be Requested at Booking the Study
Information to Be Provided to Parent/Caregiver
Prior to the Study
On the Day of the Study
Radiation Risks [6–9]
Communicating Radiation Risks [10, 11]
Calculating the Administered Activity
Sedation [14–16]
Suggestions for Avoiding Sedation
Options for Distracting and Entertaining the Patient
Assessing the Need for Sedation
Principles and Protocols for Sedation/ General Anesthesia
1.2 Performing and Reporting the Study
Preparing and Administration of Radiopharmaceutical
Setting up the Imaging Device
Positioning the Patient
Performing the Study
Reporting the Study
1.3 Hybrid Imaging [17, 18]
SPECT/CT [19]
PET/CT [21–24]
PET/MRI [25, 26]
Adverse Reactions to Contrast Media [27]
1.4 Correlative Imaging [27–29]
References
2: Central Nervous System: The Brain and Cerebro-Spinal Fluid
2.1 Brain Death Study
Clinical Indications
Pre-exam Information
Study Interpretation [3]
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
2.2 Drug-Resistant Epilepsy—Ictal and Interictal Brain Perfusion Spect
Clinical Indications
Pre-exam Information
Study Interpretation
Correlative Imaging [8–12]
Red Flags
Take Home Messages
Representative Case Examples
2.3 Cerebro-Spinal Shunt Patency Studies
Clinical Indications
Study Interpretation
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
References
3: Cardiovascular System
3.1 First Pass Study
Clinical Indications [1, 2]
Study Interpretation
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
3.2 Myocardial Perfusion Scintigraphy
Clinical Indications [4]
Study Interpretation
Red Flags
Take Home Messages
Representative Case Examples
3.3 Blood Pool Scintigraphy of Vascular Structures
Clinical Indications [11, 12]
Pre-Exam Information
Study Interpretation
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
References
4: Pulmonary System
4.1 Clinical Indications [1–4]
4.2 Pre-Exam Information
4.3 Perfusion and Ventilation Study Interpretation
4.4 Perfusion and Ventilation Differential Lung Function Analysis
4.5 Correlative Imaging
Red Flags
4.6 Take Home Messages
4.7 Representative Case Examples
References
5: Thyroid
5.1 Thyroid Scintigraphy in Congenital Hypothyroidism
Clinical Indications [1–4]
Pre-Exam Information
Study Interpretation
Perchlorate Discharge Test [7]
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
5.2 Thyroid Scintigraphy in Acquired Benign Thyroid Disease
Clinical Indications [8]
Pre-Exam Information
RAIU Test
Study Interpretation (for Thyroid Scan and RAIU) [9–14]
Correlative Imaging [15–17]
Red Flags [18, 19]
Take Home Message
Representative Case Examples
5.3 Thyroid Cancer Imaging
Clinical Indications [20–25]
Pre-Exam Information [26, 27]
Study Interpretation [29]
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
References
6: Digestive Tract
6.1 Gastroesophageal Reflux Scintigraphy (“MILK SCAN”)
Clinical Indications [1, 2]
Pre-Exam Information
Study Interpretation
Correlative Tests and Imaging
Red Flags
Take Home Messages
Representative Case Examples
6.2 Gastric Emptying
Clinical Indications [4]
Pre-Exam Information
Study Processing and Interpretation [6–8]
Study Processing and Interpretation [6–8]
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
6.3 Esophageal Transit Studies
Clinical Indications
Study Interpretation
Correlative Imaging
Red Flags
Take Home Message
Representative Case Examples
6.4 Salivagram
Clinical Indications
Study Interpretation [11]
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
6.5 Gastrointestinal Bleeding
Ectopic Gastric Mucosa (Meckel’s Diverticulum Scan)
Clinical Indications [12, 13]
Pre-Exam Information
Study Interpretation [16]
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
Blood Pool Scintigraphy
Clinical Indications
Pre-Exam Information
Study Interpretation
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
References
7: Liver and Spleen
7.1 Hepatobiliary Scintigraphy
Clinical Indications [1, 2]
Pre-Exam Information
Study Interpretation
Correlative Imaging [11–13]
Red Flags [9]
Take Home Messages
Representative Case Examples
7.2 Liver and Spleen Reticuloendo­thelial System Scintigraphy
Clinical Indications [14]
Study Interpretation (Fig. 7.5)
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
7.3 Spleen Scintigraphy with Denatured (Heat Damaged) Red Blood Cells
Clinical Indications [16]
Study Interpretation
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
7.4 Liver Blood Pool Scintigraphy
Clinical Indications [19]
Study Interpretation
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
References
8: Genitourinary Tract
8.1 Dynamic Renal Scintigraphy
Clinical Indications [1]
Pre-Exam Information
Dynamic Renogram Study Processing and Interpretation [3, 5]
Study Processing
Renogram Processing Quality Control
Processing the Diuretic Response
Study Interpretation
Correlative Imaging
Red Flags [6, 7]
Take Home Messages
Representative Case Examples
8.2 Renal Cortical Scintigraphy
Clinical Indications [11–13]
Pre-Exam Information
Study Interpretation [7, 16]
Correlative Imaging [17, 18]
Red Flags
Take Home Message
Representative Case Examples
8.3 Glomerular Filtration Rate Radionuclide Measurement
Clinical Indications
General Principles for Glomerular Filtration Rate (GFR) Measurements [21]
GFR Step-by-Step: The Single Blood Sample Using the “Weight” Method“
GFR Single Blood Sample Processing
GFR Calculation
GFR Quality Control
Red Flags
Take Home Message
8.4 Direct Radionuclide Cystography (DRC)
Clinical Indications [28, 29]
Pre-Exam Information
Study Interpretation
Correlative Imaging
Red Flags
Take Home Message
Representative Case Examples
8.5 Indirect Radionuclide Cystogram (IRC)
Clinical Indications (in Toilet-Trained Children!) [36–38]
Study Interpretation
Correlative Imaging [1]
Red Flags [1, 38]
Take Home Messages
Representative Case Examples
References
9: Lymphoscintigraphy
9.1 Clinical Indications [1, 2]
9.2 Pre-exam Information
9.3 Study Interpretation
9.4 Correlative Imaging [9, 14]
9.5 Red Flags [15–17]
9.6 Take Home Messages
9.7 Representative Case Examples
References
10: Musculoskeletal System (Non-Oncologic Indications)
10.1 Clinical Indications
10.2 Pre-exam Information
10.3 Bone Scintigraphy
10.4 Study Interpretation [3, 4]
10.5 Correlative Imaging [8]
10.6 Red Flags [4, 6]
10.7 Take Home Message
10.8 Representative Case Examples
10.9 18F-Sodium Fluoride (NAF) Bone PET/CT
10.10 Study Interpretation
10.11 Correlative Imaging
10.12 Red Flags [12, 13]
10.13 Take Home Messages [14, 15]
10.14 Representative Case Examples
References
11: Infection and Inflammation Imaging
11.1 Clinical Indications
11.2 Pre-exam Information
11.3 Study Interpretation of Bone Scintigraphy [12]
11.4 Study Interpretation of Tc-WBC Scan [13]
11.5 Study Interpretation of FDG
11.6 Correlative Imaging [18]
11.7 Red Flags [2]
11.8 Take Home Messages
11.9 Representative Case Examples
References
12: Pediatric Malignancies
12.1 General Tracer-Related Parameters
Radiopharmaceutical and Administered Activity
Study Interpretation for FDG Imaging [8–10]
Study Interpretation for MIBG Imaging [11, 13, 14]
Study Interpretation for FDOPA Imaging [16, 17]
Study Interpretation for 68Ga-Peptide Imaging [18, 19]
Study Interpretation for Bone Imaging
12.2 Lymphoma and Sarcoma
Clinical Indications—Imaging with FDG (see also Box 12.1) [22, 26–29]
Specific Study Interpretation Criteria
Correlative Imaging [34]
Red Flags
Take Home Messages
Representative Case Examples
12.3 Neuroblastoma
Clinical Indications [11]
Correlative Imaging [37, 38]
Specific Study Interpretation Criteria (See also Box 12.2—Imaging with MIBG)
Red Flags [14]
Take Home Messages [14]
Clinical Indications [42, 43]
Red Flags
Take Home Messages [47]
Clinical Indication
Red Flags
Take Home Messages
Relevant Case Examples
12.4 Other Neuroendocrine Tumors
Clinical Indications [15]
Red Flags [50]
Take Home Message
Clinical Indications [51, 52]
Red Flags
Take Home Message
Representative Case Examples
12.5 Musculo-Skeletal Malignancies (see also Box 12.5)
Clinical Indications [21, 23, 54–56]
Correlative Imaging
Red Flags
Take Home Messages
Representative Case Examples
References