Advertisement

Nuclear Medicine Imaging Techniques

  • Walter NoordzijEmail author
  • Andor W. J. M. Glaudemans

Abstract

Nuclear medicine is a rapidly developing field which focuses on the imaging of physiological processes and the evaluation of treatment of specific diseases. It involves the use of radiopharmaceuticals for both purposes. Different radiopharmaceuticals have different kinetics and can therefore be used to image processes in the body, the function of an organ or the presence of a specific cellular target. In sports medicine, bone scintigraphy and leukocyte scintigraphy play important roles. Radiopharmaceuticals in bone scintigraphy are diphosphonate complexes which are absorbed onto the hydroxyapatite crystal of newly formed bone and therefore represent osteoblast activity. When combined with the radionuclide technetium-99 m (99mTc), it is very suitable for imaging. Bone scintigraphy, especially combined with additional single-photon emission computed tomography and conventional computed tomography (SPECT/CT), can, e.g. discriminate a (stress) fracture from osteoarthritis. In leukocyte scintigraphy, autologous white blood cells are labelled with 99mTc and reinjected in the patient. In case of an active infection, the leukocytes accumulate at the location within 24 h after administration. The combination of three-phase bone scintigraphy with leukocyte scintigraphy has the best test characteristics for identifying infectious processes in the peripheral skeleton. The positron emission tomography (PET) radiopharmaceutical fluor-18-labelled fluorodeoxyglucose (18F-FDG) is indicated for infectious processes of the axial skeleton (osteomyelitis and spondylodiscitis). Its uptake mechanism is distinct from that of diphosphonate complexes; it represents the glycolytic activity of cells. 18F sodium fluoride is another PET tracer to image the skeleton. However, at the moment it has no role in sports medicine.

Keywords

Positron Emission Tomography Bone Scintigraphy Blood Pool Image Medial Tibial Stress Syndrome Leukocyte Scintigraphy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Bombardieri E, Aktolun C, Baum RP et al (2003) Bone scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging 30:BP99–BP106PubMedGoogle Scholar
  2. Bridges RL, Wiley CR, Christian JC et al (2007) An introduction to Na18F bone scintigraphy: basic principles, advanced imaging concepts, and case examples. J Nucl Med Technol 35:64–76CrossRefPubMedGoogle Scholar
  3. de Vries EFJ, Roca M, Jamar F et al (2010) Guidelines for the labeling of leucocytes with 99mTc HMPAO. Eur J Nucl Med Mol Imaging 37:842–848PubMedCentralCrossRefPubMedGoogle Scholar
  4. Drzezga A, Souvatzoglou M, Eiber M et al (2012) First clinical experience with integrated whole-body PET/MR: comparison to PET/CT in patients with oncologic diagnoses. J Nucl Med 53:845–855CrossRefPubMedGoogle Scholar
  5. Glaudemans AWJM, Signore A (2010) FDG-PET/CT in infections: the imaging method of choice? Eur J Nucl Med Mol Imaging 37:1986–1991PubMedCentralCrossRefPubMedGoogle Scholar
  6. Glaudemans AW, Galli F, Pacilio M et al (2012) Leukocyte and bacteria imaging in prosthetic joint infection. Eur Cell Mater 25:61–77Google Scholar
  7. Godart G, Durez M, Bevilacqua M et al (1986) Technetium-99 m MDP vs technetium-99 m dicarboxypropane diphosphonate. A clinical comparison in various pathologic conditions. Clin Nucl Med 11:92–97CrossRefPubMedGoogle Scholar
  8. Goerres GW, Ziegler SI, Burger C et al (2003) Artifacts at PET and PET/CT caused by metallic hip prosthetic material. Radiology 226:577–584CrossRefPubMedGoogle Scholar
  9. Grant FD, Fahey FH, Packard AB et al (2008) Skeletal PET with 18F-fluoride: applying new technology to an old tracer. J Nucl Med 49:68–78CrossRefPubMedGoogle Scholar
  10. International Commission on Radiological Protection (1998) Radiation dose to patients from radiopharmaceuticals (addendum to ICRP publication 53). ICRP Publication 80. Ann ICRP 28(3)Google Scholar
  11. Israel O, Keidar Z (2011) PET/CT imaging in infectious conditions. Ann N Y Acad Sci 1228:150–166CrossRefPubMedGoogle Scholar
  12. Li Y, Schiepers C, Lake R et al (2012) Clinical utility of 18F-fluoride PET/CT in benign and malignant bone disease. Bone 50:128–139CrossRefPubMedGoogle Scholar
  13. Melcher CL (2000) Scintillation crystals for PET. J Nucl Med 41:1051–1055PubMedGoogle Scholar
  14. Nekolla SG, Martinez-Moeller A, Saraste A (2009) PET and MRI in cardiac imaging: from validation studies to integrated applications. Eur J Nucl Med Mol Imaging 36(Suppl 1):S121–S130CrossRefPubMedGoogle Scholar
  15. Segall G, Delbeke D, Stabin MG et al (2010) SNM practice guideline for sodium 18F-fluoride PET/CT bone scans 1.0. JNM 51:1813–1820CrossRefPubMedGoogle Scholar
  16. Sheth S, Colletti PM (2012) Atlas of sodium fluoride PET bone scans. Clin Nucl Med 37:e110–e116CrossRefPubMedGoogle Scholar
  17. Signore A, Glaudemans AWJM (2011) The molecular imaging approach to image infections and inflammation by nuclear medicine techniques. Ann Nucl Med 25:681–700CrossRefPubMedGoogle Scholar
  18. Signore A, Mather SJ, Piaggio G et al (2010) Molecular imaging of inflammation/infection: nuclear medicine and optical imaging agents and methods. Chem Rev 110:3112–3145CrossRefPubMedGoogle Scholar
  19. Signore A, Glaudemans AWJM, Malviya G et al (2012) Development and testing of a new disposable sterile device for labelling white blood cells. Q J Nucl Med Mol Imaging 56:200–208Google Scholar
  20. Subramanian G, McAfee JG (1971) A new complex of Tc-99 m for skeletal imaging. Radiology 99:192CrossRefPubMedGoogle Scholar
  21. Vorne M, Vähätalo S, Lantto T (1983) A clinical comparison of 99mTc-DPD and two 99mTc-MDP agents. Eur J Nucl Med 8:395–397CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of Nuclear Medicine and Molecular ImagingUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands

Personalised recommendations