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At least 19 recordsLinked to original sources
PubMedDate not supplied

Nucleology, nuclear medicine, molecular nuclear medicine and subspecialties.

Henry N. Wagner Jr started the presentation of the highlights of the 39th Annual Meeting of the Society of Nuclear Medicine by quoting: "The economist JM Keynes said: "the difficult lies not in new ideas but in escaping from the old ones". Many changes have taken place in the actual term describing our specialty during the last 15 years. Cardiologists have adopted an important chapter of nuclear medicine and to describe that they use the term of "nuclear cardiology". Radiologists have proposed the term "radionuclide radiology". "Nuclear endocrinology", "nuclear oncology", "nuclear nephrology" may be considered as terms describing chapters of nuclear medicine related to other specialties. Will that indicate that our specialty will be divided into smaller chapters and be offered to colleagues working in other specialties leaving to us the role of the supervisor or perhaps the radioprotection officer for in vivo studies? Of course this role is now being exercised by our colleagues in medical physics. It is suggested to use the word " nucleology", instead of "nuclear medicine" where "nuclear" is used as an adjective. Thus, we will avoid being part of another specialty and cardiologists would use the term cardiac nucleology where "cardiac" is the adjective. The proposed term "nucleology" as compared to the existing term "nuclear medicine" has the advantage of being simpler, correct from the grammar point of view and not related to combined terms that may seem to offer part of our specialty to other specialties. At present our specialty faces many problems. The term "nucleology" supports our specialty from the point of view of terminology. During the 3rd International Meeting of Nuclear Medicine of N. Greece which was held in Thessaloniki, Macedonia, Greece on 4-6 November 2005, a discussion arose among participants as to whether the name of "nucleology" could replace the existing name of "nuclear medicine". Finally, a vote (between "yes" and "no") for the new proposed term showed that the "yes" votes were 72 and the "no" votes were 49.

Greece↗
PubMed2006

Position paper on the development of a middle level provider in nuclear medicine: the nuclear medicine practitioner.

The development of an educational program and credentialing structure to support and recognize an advanced level of the practice of nuclear medicine technology is now underway. This work parallels the efforts in many, if not most, health care disciplines as they seek to achieve the twin goals of developing enhanced career paths and providing the best possible patient care in an environment where science and technology can run roughshod over concepts taught in the classroom a mere decade ago. Education is key to both goals. A master's level degree in nuclear medicine technology, coupled with an advanced practice credential recognizing both the educational achievement and a level of clinical expertise, will give nuclear medicine practitioners the knowledge and the right to practice their profession at a high level of autonomy, leading to more efficient and higher quality health care services. To that end the following position paper was prepared by members of the Advance Practice Task Force of the SNMTS and presented to the SNMTS Executive Council and the SNM Board of Directors. In June 2005, the executive council and the board of directors approved a resolution supporting the establishment of a middle level provider in nuclear medicine known as the nuclear medicine practitioner.

Credentialing↗
PubMed1992

Uronephrologic nuclear medicine.

Nuclear medicine offers a rapid noninvasive means of evaluating suspected urinary tract disorders. Over the years, radionuclide scintigraphy has gained an important role in the evaluation of the renal transplant, possible obstruction, infection, and renovascular hypertension. During the past year, the importance of nuclear medicine within these areas has been confirmed. The diagnostic value of both diuresis and angiotensin-converting enzyme inhibitor renography is now generally accepted, whereas there is still disagreement about the optimal protocol. Renal scintigraphy is useful in patients with renal infection. Nuclear medical examinations have assumed a dominant role in the control and monitoring of renal transplants owing to their ability to quantify perfusion and function, but they do not obviate graft biopsy.

Humans↗
PubMed1988

Evaluation of metallic osseous implants with nuclear medicine.

Nuclear medicine has proven to have a valuable role in the evaluation of osseous metallic implants, particularly with joint prostheses, but can assist with evaluation of other appliances as well. The nuclear arthrogram has become an invaluable adjunct to simultaneously performed radiographic contrast arthrography. This application has been best evaluated in what is one of the most common of orthopedic prosthesis problems, namely, loosening of total hip prostheses. Experience indicates that both sensitivity and specificity of loosening of the femoral component can be increased to over 90% through combined use of nuclear with radiographic contrast arthrography. Furthermore the combination of routine skeletal scintimaging with the nuclear arthrogram adds a significant dimension to precise localizing of the nuclear arthrographics agent In-111 chloride. Nuclear medicine also plays an important role in further evaluating the presence of infection associated with metallic implants with In-111 WBC preparations being superior to Ga-67 as the radiopharmaceutical tracer. Infection has been detected with a sensitivity of 73% and a specificity of 93% in our series using combined In-111 WBC and simultaneous skeletal imaging with conventional Tc-99m MDP. Acute infections are more readily identifiable than chronic in association with prostheses.

Hip Prosthesis↗
PubMed2006

Benign thyroid disease: what is the role of nuclear medicine?

Nuclear medicine is directly involved in both the diagnosis and treatment of benign thyroid disease, which requires an understanding of the pathophysiology and management of thyroid disorders in addition to expertise in nuclear methodology. Thyroid uptake and imaging, the principal nuclear tests in thyroid disease, may be used as follows: (1) Differential diagnosis of hyperthyroidism: A very low thyroid uptake suggests destructive ("subacute") thyroiditis, a self-limited disorder, whereas a normal or elevated uptake is consistent with toxic nodular goiter and Graves' disease. Scintigraphic characteristics also help differentiate between nodular and Graves' disease. (2) Function of thyroid nodules: Fine-needle aspiration biopsy with cytological examination (FNAB) is used routinely to assess for malignancy in thyroid nodules. Scintigraphy may be of assistance before FNAB. "Hot" nodules are generally benign and do not require FNAB, while "cold" nodules may be malignant. (3) Differential diagnosis of congenital hypothyroidism: Scintigraphy combined with ultrasound examination may be used to identify such conditions as thyroid agenesis, dyshormonogenesis, and incomplete thyroid descent. Treatment of Graves' disease and toxic nodular disease with (131)I may require greater clinical involvement and decision analysis compared with thyroid uptake and imaging. The following aspects of treatment are particularly important: (1) Risk: Radioiodine treatment may occasionally aggravate hyperthyroidism, Graves' ophthalmopathy, and airway obstruction caused by large, nodular goiters. Alternative treatments, including the temporary use of antithyroid drugs, and surgery for nodular goiters, may be considered. (2) Radioiodine dose: Cure of hyperthyroidism with a single (131)I treatment is desirable, though not always possible. Such factors as a large goiter, severe hyperthyroidism, and prior propylthiouracil therapy, may contribute to treatment failure. (3) Informed consent: A detailed discussion with the patient regarding the clinical risks, outcomes, and side effects of (131)I is a critical component of successful management.

Adult↗
PubMed1998

Selected topics in orthopedic nuclear medicine.

Nuclear medicine provides information about bone physiology that complements anatomic imaging modalities. Following a review of the principles of bone scintigraphy, scintigraphic imaging of orthopedic problems, such as primary and secondary neoplastic disease of the skeleton, occult fracture, stress fracture, and osteomyelitis are discussed.

Bone Diseases↗
PubMed1977

Instrumentation trends in nuclear medicine.

Nuclear medicine instrumentation requires use of various configurations of photon detectors for the purpose of in vivo and in vitro measurements of flow and metabolism. Computed tomography has solved a previous limitation of an ambiguous volume of interest intrinsic to projection images. Selection of instruments involves first, a definition of the medical problem to be solved; then an evaluation of the following characteristics of the candidate instruments: sensitivity, spatial resolution, saturation performance, dead time, uniformity of resolution, uniformity of sensitivity, data processing capabilities, and cost. New developments include dynamic imaging in transverse section with either single photon or positron annihilation photons, and whole-body quantitative imaging of sequential changes in radiopharmaceutical concentration.

Evaluation Studies as Topic↗
PubMedDate not supplied

Advances in pulmonary nuclear medicine.

Nuclear medicine plays a major role in the diagnosis of pulmonary embolism as well as in other lung diseases. Important innovations have concerned in recent years the equipment and radiopharmaceuticals. In ventilation studies the use of technegas, a monodisperse aerosol able to supply images of the same quality or even superior to gas images, is widespread in the clinical practice. Significant clinical results in the evaluation of acute thromboembolism have been achieved with antifibrin monoclonal antibodies and radioactive peptides specific for activated platelet receptors. Primary lung cancer and its metastases can now be visualized with tracers used for the study of myocardial perfusion (sestaMIBI, tetrofosmin) or labeled ocreotide, a molecule able to recognize lung tumors with somatostatin receptors. 99mTc-NR-LU-10 Fab immunoscintigraphy was shown to be very sensitive for tumors, while the major role of PET in the differential diagnosis of solitary pulmonary nodule, in the initial staging and in the response assessment to lung cancer therapy, is confirmed. SPECT is widespread in the clinical field with the use of 2-3 head gamma cameras and the possible combined imaging with CT or MRI. The use of PET with common gamma cameras with appropriate collimation systems or coincident recording without collimation is being studied. PET is used in the study of tumor metabolism as well as in the evaluation of intra-and extravascular lung water, regional blood flow and pulmonary vascular permeability. PET studies of vascular lung physiology as well as of receptor physiology, amine accumulation and clearance and drug transport to the areas of healthy or impaired lung, were also shown to be fundamental.

Humans↗
PubMed1991

Pulmonary applications of nuclear medicine.

Nuclear medicine techniques have a long history in pulmonary medicine, one that has been continually changing and growing. Even longstanding methods, such as perfusion scanning for embolic disease or for pretherapy pulmonary function evaluation, have largely withstood the test of recent careful scrutiny. Not only have these techniques remained an important part of the diagnostic armamentarium, but we have learned how to use them more effectively. Furthermore, because of technical advances, we are in a phase of expanding roles for nuclear imaging. Gallium citrate scanning for the mediastinal staging and follow-up of lymphoma has been recognized as a valuable adjunct to the anatomic information provided by CT and MRI. With the growth of PET technology in areas that have been explored in a limited fashion until now, such as noncardiogenic pulmonary edema and lung carcinoma, evaluation and management of these patients may substantially improve. Finally, in the field of radiolabeled monoclonal antibodies, attention is now being turned to both the diagnostic and the therapeutic problems presented by lung carcinoma. As radiolabeling methods are refined and as new and better antibodies are developed, radioimmunodetection and therapy in lung carcinoma may begin to make inroads on this common and hard to control disease.

Gallium Radioisotopes↗
PubMed2004

Complementary alternative medicine and nuclear medicine.

Complementary alternative medicines (CAMs), including food supplements, are taken widely by patients, especially those with cancer. Others take CAMs hoping to improve fitness or prevent disease. Physicians (and patients) may not be aware of the potential side-effects and interactions of CAMs with conventional treatment. Likewise, their known physiological effects could interfere with radiopharmaceutical kinetics, producing abnormal treatment responses and diagnostic results. Nuclear medicine physicians are encouraged to question patients on their intake of CAMs when taking their history prior to radionuclide therapy or diagnosis. The potential effect of CAMs should be considered when unexpected therapeutic or diagnostic results are found.

Complementary Therapies↗