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"Clinical Indications" in Word 97 file. (indicate.doc)

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"Clinical Indications" in Word 97 file. (indicate.doc) "Clinical Indications" in Word 97 file. (indicate.doc) Document Transcript

  • Indications for Nuclear Medicine Study in Orthopedics and Rheumatology Skeletal - Indications Orthopedics & Rheumatology 26029A N29o Whole body bone scan bone metastasis, cancer staging, Tx F/U, osteomyelitis, avascular necrosis of femoral (sensitivity: high) head, infection or loosening of total hip (specificity: moderate) replacement, stress fracture, occult bone trauma, non-union fracture, Paget’s disease, arthritis, ankylosing spondylitis, primary bone tumor, bone graft, fibrous dysplasia, elevated alkaline phosphatase, bone pain of obscure origin. 26057A 26029A Three-phase bone scan & DDx of osteomyelitis & cellulitis, N57o Whole body bone scan vascularity of bone tumor, reflex sympathetic dystrophy syndrome. 26058A N58o Quantitative sacroiliac scan R/O sacroiliitis in systemic disease such as ankylosing spondylitis, psoriatic spondylitis, osteoarthritis, SLE, Crohn’s disease, ulcerative colitis. 26029A 26030A Osteomyelitis study DDx of infection or loosening of THR N29Bo (Tc99mMDP & Ga67) prosthesis, DDx of osteomyelitis & cellulitis. 26013A 26049A Tl201 for bone tumor & malignant bone tumor, osteogenic sarcoma, N13Bo SPECT Ewing’s sarcoma. 26030A 26049A Ga67 for bony inflammation osteomyelitis, infection of prosthesis of N30Do & SPECT total hip replacement. 26059A N59o Muscle scan polymyositis, dermatomyositis, muscle (sensitivity: moderate) trauma, rhabdomyositis (alcoholism), (specificity: moderate) electrical burn, frostbite, overexertion, myositis ossificans, muscular dystrophy. 耕莘醫院核醫科 蕭聿謙醫師 1998.3.14. v5. 1
  • Indications for Nuclear Medicine Study in Cardiovascular System Cardiovascular Indications 26025A 26049A Myocardial perfusion study R/O CAD, angina pectoris, unstable angina, 26024A 1.Stress/Dipyridamole F/U AMI in subacute stage, viable 26049A N25o 2.Tl-201: exercise SPECT myocardium post AMI, F/U PTCA, patency 3.Tl-201: Resting SPECT of CABG graft, CAD with bundle branch block, hyperlipidemia due to hemodialysis, congenital heart disease. 26047A N47o Cardiac function - Resting LV ejection fraction, RV ejection fraction, LV wall motion, pre- & post- chemotherapy, CHF, dilated cardiomyopathy, F/U CAD, apical aneurysm, left-to-right shunt, mitral regurgitation. 26023A N23o Myocardial infarct study R/O AMI (10hr-10days after attack), AMI with equivocal ECG & CPK, AMI with bundle branch block, RV AMI, inferior wall AMI, define areas of AMI, F/U CABG. 26027A N27o Venography deep venous thrombosis, low leg edema. N27o Lung perfusion study pulmonary embolism, F/U anti-coagulant therapy, perfusion change due to lung ca, pre-pneumonectomy evaluation. 26028A N28o Arteriography SVC obstruction, IVC obstruction, Bud- chiari syndrome, hepatoma with IVC thrombosis. Pulmonary System Pulmonary Indications 26014A 26049A Lung perfusion study & pulmonary embolism, F/U pulmonary N14o SPECT embolism after anti-coagulant therapy, perfusion change secondary to lung tumor, pre-operative evaluation for pneumonectomy, post-operative F/U, pulmonary hypertension. 26030A 26049A Ga67 for chest lung abscess, TB, pneumonia, pneumonitis, N30Co inflammation & SPECT pulmonary fibrosis. 2
  • Indications for Nuclear Medicine Study in Nephrology & Urology Nephrology & Urology Indications 26020A 99m 26049A Renal scan Tc DMSA & pyelonephritis, renal scarring, UTI, renal N20o SPECT infarct, renal trauma, horseshoe kidney, ectopic kidney, renal cyst, renal abscess, renal tumor, relative renal function, fetal lobulation, cortical nodular hyperplasia. 26050A 99m N50o Tc DTPA renal function GFR, quantitative renal function, urinary study stone, acute renal failure, R/O ATN, chronic renal failure, acute & chronic rejection, neurogenic bladder, renal transplant. 26020A 26050A Diuresis renography GFR, quantitative renal function, obstructive N20Ao uropathy, ddx of non-obstructive dilatation & mechanical obstruction, urinary stone. 26020A 26050A Captopril renography renovascular hypertension. N20Bo 26020A 26050A Renal scan effective renal plasma flow (ERPF), relative N20Co Renal function study renal function, obstructive uropathy, ATN, transplant renal function. 26019A N19o Scrotal scan scrotal varicocele, hydrocele. 26022A N22o Testicular scan testicular torsion, epididymo-orchitis, DDx of the above, hydrocele, hematocele, abscess, scrotal pain. 26030A 26049A Ga67 for renal tumor/ renal TB, UTI. N30Ao inflammation survey & SPECT 3
  • Indications for Nuclear Medicine Study in Neurology and Psychiatry Neurology & Psychiatry Indications 26063A 99m 26049A Tc HMPAO brain perfusion cerebral infarction, cerebral hemorrhage, N63o scan & SPECT TIA, cerebral ischemia, Alzheimer’s disease, senile dementia, multiple infarct dementia, head injury, AIDS related dementia, SLE vasculitis, epilepsy, encephalitis, cerebellar degeneration, convulsion disorder, Parkinson’s disease, DDx of recurrent brain tumor & radiation necrosis. 26013A 201 26049A Tl for brain tumor & primary brain tumor, residual tumor s/p N13Ao SPECT operation or radiation therapy. 26052A N52o V-P shunt patency study V-P shunt obstruction. 26003A N03o CSF dynamic test normal pressure hydrocephalus (communicating hydrocephalus), CSF leakage. 26030A 26049A Ga67 for brain inflammation brain abscess, meningitis. N30Bo & SPECT Hematology and Ga-67 Imaging Hematology & Ga-67 Indications 26017A N17o Bone marrow scan ectopic hemopoiesis, bone marrow abscess, bone marrow metastasis, bone marrow atrophy, anemia, polycythemia, leukemia. 26036A N36o Spleen scan with Tc99m accessory spleen, autosplenosis, splenic Tagged RBC infarction, spleen trauma, spleen hematoma, spleen abscess, splenic tumor, functional asplenism. 26030A N30o Ga-67 tumor survey Hodgkin’s disease, non-Hodgkin’s lymphoma, melanoma, lung cancer, hepatoma, leukemia, gastric cancer, esophageal cancer. 4
  • Indications for Nuclear Medicine Study in Gastroenterology Gastroenterology Indications 26051A N51o Sialoscintigraphy parotid tumor, sialoadenitis, mumps, salivary obstruction, xerostomia, NPC post radiation therapy, dry mouth. 26053A N53o Esophageal transit study reflux esophagitis, dysphagia, esophageal motor abnormality, achalasia, achalasia post balloon dilatation. 26062A N62o Gastric emptying time DM gastroparesis, s/p vagotomy, delayed gastric emptying, gastrinoma. 26054A N54o Enterogastroesophageal reflux esophagitis, aspiration in children, reflux duodenogastric reflux, gastroesophageal reflux, F/U medical or surgical treatment. 26018A N18o Retained gastric antrum study retained gastric antrum s/p Billroth-II gastrectomy, recurrent ulceration, increased serum gastrin level. 26026A N26o Meckel’s diverticulum scan Meckel’s diverticulum, Barret’s esophagus. Barret’s esophagus 26060A N60o GI bleeding scan lower GI bleeding, internal bleeding. 26060A N60Ao RBC scan for hemangioma & hepatic cavernous hemangioma. SPECT 26016A 26049A Liver and spleen scan & liver cirrhosis, hepatoma, liver metastasis, N16o SPECT chronic hepatitis, liver abscess, liver rupture, focal nodular hyperplasia, splenic infarct, splenomegaly, accessory spleen. 26040A N40Ao HIDA cholescintigraphy acute cholecystitis, chronic cholecystitis, gall bladder ejection fraction, biliary obstruction, gall bladder dyskinesia bile leakage, biliary reflux, DDx of biliary atresia and neonatal hepatitis, choledochal cyst, hepatic adenoma, biliary diversion. 26052A N52Ao Shunt patency study Le-Veen shunt obstruction. (LeVeen) 26060A N60Bo Hepatic hydrothorax hepatic hydrothorax, pleural effusion due to ascites. Indications for Nuclear Medicine Study in Endocrinology 5
  • Endocrine Indications 26004A N04o Tc-99m thyroid scan goiter, nodule goiter, hyperthyroidism, exophthalmos, Graves’ disease, thyroiditis, children with thyroid disease. 26005A N05o I-131 thyroid scan & 24 hrs thyroid cancer, sublingual thyroid, uptake intrathoracic goiter, ectopic thyroid, hypothyroidism, thyroiditis, goiter, nodule goiter, hyperthyroidism, exophthalmos, Graves’ disease. 26011A N11o I-131 neck & chest scan ectopic thyroid, sublingual thyroid, intrathoracic goiter. 26012A N12o I-131 cancer work-up detection of metastasis of thyroid cancer of (sensitivity: high) papillary & follucular types. 26038A N38o I-131 treatment (xx mCi) treatment of metastasis and thyroid cancer of papillary & follucular types, hyperthyroidism in old age. 26013A N13o Tl-201 cancer work-up medullary thyroid cancer, undifferentiated thyroid cancer, breast cancer, osteogenic sarcoma, cancer treatment response. 26055A N55o Parathyroid scan hyperparathyroidism, hypercalcemia, parathyroid hyperplasia, parathyroid adenoma, shorten operation time after one or more previous surgical exploration. 26021A N21o Adrenocortical scan (Np-59) Cushing’s syndrome, aldosteronism, Adrenomedullary scan (I-131 adrenal adenoma, adrenal hyperplasia. MIBG) Pheochromocytoma, extra-adrenal metastasis, medullary thyroid cancer, paraganglioma, neuroblastoma. 6