Skip to main content
SpringerLink
Log in

Emergency Radionuclide Imaging of the Thorax and Abdomen

  • Chapter
  • First Online:
Book cover Emergency Radiology

  • 1720 Accesses

Abstract

Nuclear medicine (NM) can play important primary and secondary roles in diagnosis and management in the emergency setting. Within the radiological armamentarium, selected scintigraphic examinations offer significant value because those negative examinations exclude diagnoses with high certainty, while positive examinations direct appropriate management. Currently, common radionuclide imaging examinations of the thorax and abdomen in the emergency setting are ventilation/perfusion (V/Q) lung scintigraphy, myocardial perfusion imaging (MPI), hepatobiliary scintigraphy (HBS), and gastrointestinal (GI) bleeding including Meckel’s diverticulum scintigraphy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Mansi L, Rambaldi PF, Cuccurullo V, Varetto T. Nuclear medicine in emergency. Q J Nucl Med Mol Imaging. 2005;49:171–91.

    Article  CAS  PubMed  Google Scholar 

  2. Sostman HD, Miniati M, Gottschalk A, Matta F, Stein PD, Pistolesi M. Sensitivity and specificity of perfusion scintigraphy combined with chest radiography for acute pulmonary embolism in PIOPED II. J Nucl Med. 2008;49:1741–8.

    Article  PubMed  Google Scholar 

  3. Amini B, Patel CB, Lewin MR, Kim T, Fisher RE. Diagnostic nuclear medicine in the ED. Am J Emerg Med. 2011;29:91–101.

    Article  PubMed  Google Scholar 

  4. Uliel L, Mellnick VM, Menias CO, Holz AL, McConathy J. Nuclear medicine in the acute clinical setting: indications, imaging findings, and potential pitfalls. RadioGraphics. 2013;33:375–96.

    Article  PubMed  Google Scholar 

  5. Forberg JL, Hilmersson CE, Carlsson M, Arheden H, Bjork J, Hjalte K, et al. Negative predictive value and potential cost savings of acute nuclear myocardial perfusion imaging in low risk patients with suspected acute coronary syndrome: a prospective single blinded study. BMC Emerg Med. 2009;9:12.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Rybicki FJ, Udelson JE, Peacock WF, Goldhaber SZ, Isselbacher EM, Kazerooni E, et al. 2015 ACR/ACC/AHA/AATS/ACEP/ASNC/NASCI/SAEM/SCCT/SCMR/SCPC/SNMMI/STR/STS appropriate utilization of cardiovascular imaging in emergency department patients with chest pain. J Am Coll Radiol. 2015;13:e1–e29.

    Article  Google Scholar 

  7. Kontos MC. Myocardial perfusion imaging in the acute care setting: does it still have a role? J Nucl Cardiol. 2011;18:342–50.

    Article  PubMed  Google Scholar 

  8. Chatziioannou SN, Moore WH, Ford PV, Dhekne RD. Hepatobiliary scintigraphy is superior to abdominal ultrasonography in suspected acute cholecystitis. Surgery. 2000;127:609–13.

    Article  CAS  PubMed  Google Scholar 

  9. Ziessman HA. Hepatobiliary scintigraphy in 2014. J Nucl Med. 2014;55:967–75.

    Article  CAS  PubMed  Google Scholar 

  10. Wahl WL, Brandt MM, Hemmila MR, Arbabi S. Diagnosis and management of bile leaks after blunt liver injury. Surgery. 2005;138:742–7; discussion 747–8.

    Article  PubMed  Google Scholar 

  11. Brunnler T, Klebl F, Mundorff S, Eilles C, Reng M, von Korn H, et al. Significance of scintigraphy for the localisation of obscure gastrointestinal bleedings. World J Gastroenterol. 2008;14:5015–9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Currie GM, Kiat H, Wheat JM. Scintigraphic evaluation of acute lower gastrointestinal hemorrhage: current status and future directions. J Clin Gastroenterol. 2011;45:92–9.

    Article  PubMed  Google Scholar 

  13. Dam HQ, Brandon DC, Grantham VV, Hilson AJ, Howarth DM, Maurer AH, et al. The SNMMI procedure standard/EANM practice guideline for gastrointestinal bleeding scintigraphy 2.0. J Nucl Med Technol. 2014;42:308–17.

    Article  PubMed  Google Scholar 

  14. Spottswood SE, Pfluger T, Bartold SP, Brandon D, Burchell N, Delbeke D, et al. SNMMI and EANM practice guideline for meckel diverticulum scintigraphy 2.0. J Nucl Med Technol. 2014;42:163–9.

    Article  PubMed  Google Scholar 

  15. Swaniker F, Soldes O, Hirschl RB. The utility of technetium 99m pertechnetate scintigraphy in the evaluation of patients with Meckel’s diverticulum. J Pediatr Surg. 1999;34:760–4. discussion 765

    Article  CAS  PubMed  Google Scholar 

  16. Freeman LM, Stein EG, Sprayregen S, Chamarthy M, Haramati LB. The current and continuing important role of ventilation-perfusion scintigraphy in evaluating patients with suspected pulmonary embolism. Semin Nucl Med. 2008;38:432–40.

    Article  PubMed  Google Scholar 

  17. Kontos MC, Tatum JL. Imaging in the evaluation of the patient with suspected acute coronary syndrome. Semin Nucl Med. 2003;33:246–58.

    Article  PubMed  Google Scholar 

  18. Udelson JE, Beshansky JR, Ballin DS, Feldman JA, Griffith JL, Handler J, et al. Myocardial perfusion imaging for evaluation and triage of patients with suspected acute cardiac ischemia: a randomized controlled trial. JAMA. 2002;288:2693–700.

    Article  PubMed  Google Scholar 

  19. Kontos MC, Schmidt KL, McCue M, Rossiter LF, Jurgensen M, Nicholson CS, et al. A comprehensive strategy for the evaluation and triage of the chest pain patient: a cost comparison study. J Nucl Cardiol. 2003;10:284–90.

    Article  PubMed  Google Scholar 

  20. Ziessman HA. Interventions used with cholescintigraphy for the diagnosis of hepatobiliary disease. Semin Nucl Med. 2009;39:174–85.

    Article  PubMed  Google Scholar 

  21. Fleming KW, Lucey BC, Soto JA, Oates ME. Posttraumatic bile leaks: role of diagnostic imaging and impact on patient outcome. Emerg Radiol. 2006;12:103–7.

    Article  PubMed  Google Scholar 

  22. Mittal BR, Sunil HV, Bhattacharya A, Singh B. Hepatobiliary scintigraphy in management of bile leaks in patients with blunt abdominal trauma. ANZ J Surg. 2008;78:597–600.

    Article  PubMed  Google Scholar 

  23. O’Neill BB, Gosnell JE, Lull RJ, Schecter WP, Koch J, Halvorsen RA, et al. Cinematic nuclear scintigraphy reliably directs surgical intervention for patients with gastrointestinal bleeding. Arch Surg. 2000;135:1076–81. discussion 1081–2

    Article  PubMed  Google Scholar 

  24. Mellinger JD, Bittner JG, Edwards MA, Bates W, Williams HT. Imaging of gastrointestinal bleeding. Surg Clin North Am. 2011;91:93–108.

    Article  PubMed  Google Scholar 

  25. Howarth DM. The role of nuclear medicine in the detection of acute gastrointestinal bleeding. Semin Nucl Med. 2006;36:133–46.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, University of Kentucky A.B. Chandler Medical Center, University of Kentucky College of Medicine, 800 Rose Street HX 307, Lexington, KY, 40536, USA

    Cynthia Lumby MD & M. Elizabeth Oates MD

  2. Department of Radiology, Eliza Coffee Memorial Hospital, Florence, AL, USA

    Paul F. von Herrmann MD

Authors
  1. Cynthia Lumby MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul F. von Herrmann MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Elizabeth Oates MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Elizabeth Oates MD .

Editor information

Editors and Affiliations

  1. Division of Emergency Radiology, Department of Radiology, Emergency Radiology Fellowship, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Ajay Singh

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lumby, C., von Herrmann, P.F., Oates, M.E. (2018). Emergency Radionuclide Imaging of the Thorax and Abdomen. In: Singh, A. (eds) Emergency Radiology. Springer, Cham. https://doi.org/10.1007/978-3-319-65397-6_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-65397-6_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65396-9

  • Online ISBN: 978-3-319-65397-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation