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

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  • 1. Indications for Nuclear Medicine Study in Orthopedics and Rheumatology Skeletal - Orthopedics & Rheumatology Indications 26029A N29ο Whole body bone scan (sensitivity: high) (specificity: moderate) bone metastasis, cancer staging, Tx F/U, osteomyelitis, avascular necrosis of femoral head, infection or loosening of total hip 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 N57ο Three-phase bone scan & Whole body bone scan DDx of osteomyelitis & cellulitis, vascularity of bone tumor, reflex sympathetic dystrophy syndrome. 26058A N58ο Quantitative sacroiliac scan R/O sacroiliitis in systemic disease such as ankylosing spondylitis, psoriatic spondylitis, osteoarthritis, SLE, Crohn’s disease, ulcerative colitis. 26029A 26030A N29Bο Osteomyelitis study (Tc99m MDP & Ga67 ) DDx of infection or loosening of THR prosthesis, DDx of osteomyelitis & cellulitis. 26013A 26049A N13Bο Tl201 for bone tumor & SPECT malignant bone tumor, osteogenic sarcoma, Ewing’s sarcoma. 26030A 26049A N30Dο Ga67 for bony inflammation & SPECT osteomyelitis, infection of prosthesis of total hip replacement. 26059A N59ο Muscle scan (sensitivity: moderate) (specificity: moderate) polymyositis, dermatomyositis, muscle trauma, rhabdomyositis (alcoholism), 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
  • 2. Indications for Nuclear Medicine Study in Cardiovascular System Cardiovascular Indications 26025A 26049A 26024A 26049A N25ο Myocardial perfusion study 1.Stress/Dipyridamole 2.Tl-201: exercise SPECT 3.Tl-201: Resting SPECT R/O CAD, angina pectoris, unstable angina, F/U AMI in subacute stage, viable myocardium post AMI, F/U PTCA, patency of CABG graft, CAD with bundle branch block, hyperlipidemia due to hemodialysis, congenital heart disease. 26047A N47ο 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 N23ο 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 N27ο Venography deep venous thrombosis, low leg edema. N27ο Lung perfusion study pulmonary embolism, F/U anti-coagulant therapy, perfusion change due to lung ca, pre- pneumonectomy evaluation. 26028A N28ο Arteriography SVC obstruction, IVC obstruction, Bud- chiari syndrome, hepatoma with IVC thrombosis. Pulmonary System Pulmonary Indications 26014A 26049A N14ο Lung perfusion study & SPECT pulmonary embolism, F/U pulmonary embolism after anti-coagulant therapy, perfusion change secondary to lung tumor, pre-operative evaluation for pneumonectomy, post-operative F/U, pulmonary hypertension. 26030A 26049A N30Cο Ga67 for chest inflammation & SPECT lung abscess, TB, pneumonia, pneumonitis, pulmonary fibrosis. 2
  • 3. Indications for Nuclear Medicine Study in Nephrology & Urology Nephrology & Urology Indications 26020A 26049A N20ο Renal scan Tc99m DMSA & SPECT pyelonephritis, renal scarring, UTI, renal infarct, renal trauma, horseshoe kidney, ectopic kidney, renal cyst, renal abscess, renal tumor, relative renal function, fetal lobulation, cortical nodular hyperplasia. 26050A N50ο Tc99m DTPA renal function study GFR, quantitative renal function, urinary stone, acute renal failure, R/O ATN, chronic renal failure, acute & chronic rejection, neurogenic bladder, renal transplant. 26020A 26050A N20Aο Diuresis renography GFR, quantitative renal function, obstructive uropathy, ddx of non-obstructive dilatation & mechanical obstruction, urinary stone. 26020A 26050A N20Bο Captopril renography renovascular hypertension. 26020A 26050A N20Cο Renal scan Renal function study effective renal plasma flow (ERPF), relative renal function, obstructive uropathy, ATN, transplant renal function. 26019A N19ο Scrotal scan scrotal varicocele, hydrocele. 26022A N22ο Testicular scan testicular torsion, epididymo-orchitis, DDx of the above, hydrocele, hematocele, abscess, scrotal pain. 26030A 26049A N30Aο Ga67 for renal tumor/ inflammation survey & SPECT renal TB, UTI. 3
  • 4. Indications for Nuclear Medicine Study in Neurology and Psychiatry Neurology & Psychiatry Indications 26063A 26049A N63ο Tc99m HMPAO brain perfusion scan & SPECT cerebral infarction, cerebral hemorrhage, 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 26049A N13Aο Tl201 for brain tumor & SPECT primary brain tumor, residual tumor s/p operation or radiation therapy. 26052A N52ο V-P shunt patency study V-P shunt obstruction. 26003A N03ο CSF dynamic test normal pressure hydrocephalus (communicating hydrocephalus), CSF leakage. 26030A 26049A N30Bο Ga67 for brain inflammation & SPECT brain abscess, meningitis. Hematology and Ga-67 Imaging Hematology & Ga-67 Indications 26017A N17ο Bone marrow scan ectopic hemopoiesis, bone marrow abscess, bone marrow metastasis, bone marrow atrophy, anemia, polycythemia, leukemia. 26036A N36ο Spleen scan with Tc99m Tagged RBC accessory spleen, autosplenosis, splenic infarction, spleen trauma, spleen hematoma, spleen abscess, splenic tumor, functional asplenism. 26030A N30ο Ga-67 tumor survey Hodgkin’s disease, non-Hodgkin’s lymphoma, melanoma, lung cancer, hepatoma, leukemia, gastric cancer, esophageal cancer. 4
  • 5. Indications for Nuclear Medicine Study in Gastroenterology Gastroenterology Indications 26051A N51ο Sialoscintigraphy parotid tumor, sialoadenitis, mumps, salivary obstruction, xerostomia, NPC post radiation therapy, dry mouth. 26053A N53ο Esophageal transit study reflux esophagitis, dysphagia, esophageal motor abnormality, achalasia, achalasia post balloon dilatation. 26062A N62ο Gastric emptying time DM gastroparesis, s/p vagotomy, delayed gastric emptying, gastrinoma. 26054A N54ο Enterogastroesophageal reflux reflux esophagitis, aspiration in children, duodenogastric reflux, gastroesophageal reflux, F/U medical or surgical treatment. 26018A N18ο Retained gastric antrum study retained gastric antrum s/p Billroth-II gastrectomy, recurrent ulceration, increased serum gastrin level. 26026A N26ο Meckel’s diverticulum scan Barret’s esophagus Meckel’s diverticulum, Barret’s esophagus. 26060A N60ο GI bleeding scan lower GI bleeding, internal bleeding. 26060A N60Aο RBC scan for hemangioma & SPECT hepatic cavernous hemangioma. 26016A 26049A N16ο Liver and spleen scan & SPECT liver cirrhosis, hepatoma, liver metastasis, chronic hepatitis, liver abscess, liver rupture, focal nodular hyperplasia, splenic infarct, splenomegaly, accessory spleen. 26040A N40Aο 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 N52Aο Shunt patency study (LeVeen) Le-Veen shunt obstruction. 26060A N60Bο Hepatic hydrothorax hepatic hydrothorax, pleural effusion due to ascites. Indications for Nuclear Medicine Study 5
  • 6. in Endocrinology Endocrine Indications 26004A N04ο Tc-99m thyroid scan goiter, nodule goiter, hyperthyroidism, exophthalmos, Graves’ disease, thyroiditis, children with thyroid disease. 26005A N05ο I-131 thyroid scan & 24 hrs uptake thyroid cancer, sublingual thyroid, intrathoracic goiter, ectopic thyroid, hypothyroidism, thyroiditis, goiter, nodule goiter, hyperthyroidism, exophthalmos, Graves’ disease. 26011A N11ο I-131 neck & chest scan ectopic thyroid, sublingual thyroid, intrathoracic goiter. 26012A N12ο I-131 cancer work-up (sensitivity: high) detection of metastasis of thyroid cancer of papillary & follucular types. 26038A N38ο I-131 treatment (xx mCi) treatment of metastasis and thyroid cancer of papillary & follucular types, hyperthyroidism in old age. 26013A N13ο Tl-201 cancer work-up medullary thyroid cancer, undifferentiated thyroid cancer, breast cancer, osteogenic sarcoma, cancer treatment response. 26055A N55ο Parathyroid scan hyperparathyroidism, hypercalcemia, parathyroid hyperplasia, parathyroid adenoma, shorten operation time after one or more previous surgical exploration. 26021A N21ο Adrenocortical scan (Np-59) Adrenomedullary scan (I-131 MIBG) Cushing’s syndrome, aldosteronism, adrenal adenoma, adrenal hyperplasia. Pheochromocytoma, extra-adrenal metastasis, medullary thyroid cancer, paraganglioma, neuroblastoma. 6
  • 7. in Endocrinology Endocrine Indications 26004A N04ο Tc-99m thyroid scan goiter, nodule goiter, hyperthyroidism, exophthalmos, Graves’ disease, thyroiditis, children with thyroid disease. 26005A N05ο I-131 thyroid scan & 24 hrs uptake thyroid cancer, sublingual thyroid, intrathoracic goiter, ectopic thyroid, hypothyroidism, thyroiditis, goiter, nodule goiter, hyperthyroidism, exophthalmos, Graves’ disease. 26011A N11ο I-131 neck & chest scan ectopic thyroid, sublingual thyroid, intrathoracic goiter. 26012A N12ο I-131 cancer work-up (sensitivity: high) detection of metastasis of thyroid cancer of papillary & follucular types. 26038A N38ο I-131 treatment (xx mCi) treatment of metastasis and thyroid cancer of papillary & follucular types, hyperthyroidism in old age. 26013A N13ο Tl-201 cancer work-up medullary thyroid cancer, undifferentiated thyroid cancer, breast cancer, osteogenic sarcoma, cancer treatment response. 26055A N55ο Parathyroid scan hyperparathyroidism, hypercalcemia, parathyroid hyperplasia, parathyroid adenoma, shorten operation time after one or more previous surgical exploration. 26021A N21ο Adrenocortical scan (Np-59) Adrenomedullary scan (I-131 MIBG) Cushing’s syndrome, aldosteronism, adrenal adenoma, adrenal hyperplasia. Pheochromocytoma, extra-adrenal metastasis, medullary thyroid cancer, paraganglioma, neuroblastoma. 6