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Nuclear medicine and the emergency department patient: an illustrative case-based approach

  • EMERGENCY RADIOLOGY
  • Published:
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Abstract

Radiologists are familiar with the use of radiographs, computed tomography, magnetic resonance imaging and ultrasound in the acute clinical setting. However, there are some specific clinical scenarios which may be found in nuclear medicine imaging problem-solving tools. These clinical scenarios and imaging techniques are less frequent, and the referring clinician from the emergency department may not consider these alternatives. It is important for the radiologist to be aware of these techniques to be able to guide the clinician to use those tools, which may result in optimal patient care. In this article, we will discuss those nuclear medicine studies which have application in the setting of an emergency radiology practice.

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References

  1. Berritto D, Somma F, Landi N et al (2011) Seven-Tesla micro-MRI in early detection of acute arterial ischaemia: evolution of findings in an in vivo rat model. Radiol Med 116:829–841

    Article  CAS  PubMed  Google Scholar 

  2. Valentini AL, Gui B, Basilico R et al (2012) Magnetic resonance imaging in women with pelvic pain from gynaecological causes: a pictorial review. Radiol Med 117:575–592

    Article  CAS  PubMed  Google Scholar 

  3. Uliel L, Mellnick VM, Menias CO et al (2013) Nuclear medicine in the acute clinical setting: indications, imaging findings, and potential pitfalls. Radiographics 33:375–396

    Article  PubMed  Google Scholar 

  4. Mannelli L, Yeh MM, Wang CL (2012) A pregnant patient with hypoglycemia. Gastroenterology 143:e3–e4

    Article  PubMed  Google Scholar 

  5. Srichai MB, Lim RP, Donnino R et al (2012) Low-dose, prospective triggered high-pitch spiral coronary computed tomography angiography: comparison with retrospective spiral technique. Acad Radiol 19:554–561

    Article  PubMed  Google Scholar 

  6. Mannelli L, Cherian V, Nayar A et al (2012) Loeffler’s endocarditis in hypereosinophilic syndrome. Curr Probl Diagn Radiol 41:146–148

    Article  PubMed  Google Scholar 

  7. Mannelli L, Caldwell JH, Elman S et al (2013) Multiple-gated acquisition scan with normal left ventricular ejection fraction and LBBB. Clin Nucl Med. doi:10.1097/RLU.0000000000000247

    Google Scholar 

  8. Tabibian JH, Wong Kee Song LM et al (2013) Technetium-labeled erythrocyte scintigraphy in acute gastrointestinal bleeding. Int J Colorectal Dis 28:1099–1105

    Article  PubMed  Google Scholar 

  9. Gutierrez C, Mariano M, Vander Laan T et al (1998) The use of technetium-labeled erythrocyte scintigraphy in the evaluation and treatment of lower gastrointestinal hemorrhage. Am Surg 64:989–992

    CAS  PubMed  Google Scholar 

  10. Zuccaro G Jr (1998) Management of the adult patient with acute lower gastrointestinal bleeding. American College of Gastroenterology. Practice Parameters Committee. Am J Gastroenterol 93:1202–1208

    Article  PubMed  Google Scholar 

  11. Howarth DM (2006) The role of nuclear medicine in the detection of acute gastrointestinal bleeding. Semin Nuc Med 36:133–146

    Article  Google Scholar 

  12. Dusold R, Burke K, Carpentier W et al (1994) The accuracy of technetium-99 m-labeled red cell scintigraphy in localizing gastrointestinal bleeding. Am J Gastroenterol 89:345–348

    CAS  PubMed  Google Scholar 

  13. Goila AK, Pawar M (2009) The diagnosis of brain death. Indian J Crit Care Med 13:7–11

    Article  PubMed Central  PubMed  Google Scholar 

  14. Bonetti MG, Ciritella P, Valle G et al (1995) 99mTc HM-PAO brain perfusion SPECT in brain death. Neuroradiology 37:365–369

    CAS  PubMed  Google Scholar 

  15. Mannelli L, Mosca R, Henry G et al (2011) A case of berry syndrome type 2B. Congenit Heart Dis 6:389–392

    Article  PubMed  Google Scholar 

  16. Zacharias C, Linnau KF, Golub JS et al (2011) Crack cocaine-induced supraglottitis. Emerg Radiol 18:445–447

    Article  PubMed  Google Scholar 

  17. Mannelli L, Mitsumori LM, Ferguson M et al (2013) Changes in measured size of atherosclerotic plaque calcifications in dual-energy CT of ex vivo carotid endarterectomy specimens: effect of monochromatic keV image reconstructions. Eur Radiol 23:367–374

    Article  PubMed  Google Scholar 

  18. de la Riva A, González FM, Llamas-Elvira JM et al (1992) Diagnosis of brain death: superiority of perfusion studies with 99Tcm-HMPAO over conventional radionuclide cerebral angiography. Br J Radiol 65:289–294

    Article  PubMed  Google Scholar 

  19. Ziessman HA (2010) Nuclear medicine hepatobiliary imaging. Clin Gastroenterol Hepatol 8:111–116

    Article  PubMed  Google Scholar 

  20. Alobaidi M, Gupta R, Jafri SZ et al (2004) Current trends in imaging evaluation of acute cholecystitis. Emerg Radiol 10:256–258

    Article  PubMed  Google Scholar 

  21. Hirota M, Takada T, Kawarada Y et al (2007) Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg 14:78–82

    Article  PubMed Central  PubMed  Google Scholar 

  22. Chamarthy M, Freeman LM (2009) Hepatobiliary scan findings in chronic cholecystitis. Clin Nucl Med 35:244–251

    Article  Google Scholar 

  23. MacDonald A, Burrell S (2009) Infrequently performed studies in nuclear medicine: part 2. J Nucl Med Technol 37:1–13

    Article  PubMed  Google Scholar 

  24. Rubini G, Niccoli Asabella A et al (2007) Acute pulmonary embolism: comparison and integration of perfusion lung scintigraphy with multislice spiral CT. Radiol Med 112:174–184

    Article  CAS  PubMed  Google Scholar 

  25. Horlander KT, Mannino DM, Leeper KV (2003) Pulmonary embolism mortality in the United States, 1979-1998: an analysis using multiple-cause mortality data. Arch Intern Med 163:1711–1717

    Article  PubMed  Google Scholar 

  26. Dismuke SE, Wagner EH (1986) Pulmonary embolism as a cause of death. The changing mortality in hospitalized patients. JAMA 255:2039–2042

    Article  CAS  PubMed  Google Scholar 

  27. Dalen JE, Alpert JS (1975) Natural history of pulmonary embolism. Prog Cardiovasc Dis 17:259–270

    Article  CAS  PubMed  Google Scholar 

  28. Anderson FA Jr, Wheeler HB, Goldberg RJ et al (1991) A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study. Arch Intern Med 151:933–938

    Article  PubMed  Google Scholar 

  29. Alikhan R, Peters F, Wilmott R et al (2004) Fatal pulmonary embolism in hospitalized patients: a necropsy review. J Clin Path 57:1254–1257

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Anderson FA Jr, Zayaruzny M, Heit JA et al (2007) Estimated annual numbers of US acute-care hospital patients at risk for venous thromboembolism. Am J Hematol 82:777–782

    Article  PubMed  Google Scholar 

  31. Tapson VF (2008) Acute pulmonary embolism. N Engl J Med 358:1037–1052

    Article  CAS  PubMed  Google Scholar 

  32. Goldhaber SZ, Visani L, De Rosa M (1999) Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 353:1386–1389

    Article  CAS  PubMed  Google Scholar 

  33. Bettmann MA, Baginski SG, White RD et al (2012) ACR Appropriateness Criteria® acute chest pain—suspected pulmonary embolism. J Thorac Imaging 27:W28–W31

    Article  PubMed  Google Scholar 

  34. Sostman HD, Coleman RE, DeLong DM et al (1994) Evaluation of revised criteria for ventilation–perfusion scintigraphy in patients with suspected pulmonary embolism. Radiology 193:103–107

    Article  CAS  PubMed  Google Scholar 

  35. Ghanima W, Nielssen BE, Holmen LO et al (2007) Multidetector computed tomography (MDCT) in the diagnosis of pulmonary embolism. Acta Radiol 48:165–170

    Article  CAS  PubMed  Google Scholar 

  36. Eng J, Krishnan JA, Segal JB et al (2004) Accuracy of CT in the diagnosis of pulmonary embolism: a systematic literature review. AJR Am J Roentgenol 183:1819–1827

    Article  PubMed  Google Scholar 

  37. Rathbun SW, Raskob GE, Whitsett TL (2000) Sensitivity and specificity of helical computed tomography in the diagnosis of pulmonary embolism: a systematic review. Ann Intern Med 132:227–232

    Article  CAS  PubMed  Google Scholar 

  38. Vernet O, Farmer JP, Lambert R et al (1996) Radionuclide shuntogram: adjunct to manage hydrocephalic patients. J Nucl Med 37:406–410

    CAS  PubMed  Google Scholar 

  39. Feng F, Fu HL, Li JN et al (2009) Evaluation of radionuclide cerebrospinal fluid scintigraphy as a guide in the management of patients with hydrocephalus. Clin Imaging 33:85–89

    Article  PubMed  Google Scholar 

  40. Sigg D, Rich R, Ashby S et al (2005) Radionuclide shuntogram demonstrating migration of distal ventriculoperitoneal shunt tubing out of the peritoneal cavity. Clin Nucl Med 30:552–554

    Article  PubMed  Google Scholar 

  41. Lu YY, Lin WY, Wang HY et al (2013) A mass resulting from cerebral spinal fluid collection of ventriculopleural shunt: radiographic and radionuclide findings. Clin Nucl Med 38:215–216

    Article  PubMed  Google Scholar 

  42. Brown ED, Chen MY, Wolfman NT et al (2000) Complications of renal transplantation: evaluation with US and radionuclide imaging. Radiographics 20:607–622

    Article  CAS  PubMed  Google Scholar 

  43. Sfakianaki E, Sfakianakis GN, Georgiou M et al (2013) Renal scintigraphy in the acute care setting. Semin Nucl Med 43:114–128

    Article  PubMed  Google Scholar 

  44. Sfakianakis GN, Cohen DJ, Braunstein RH et al (2000) MAG3-F0 scintigraphy in decision making for emergency intervention in renal colic after helical CT positive for a urolith. J Nucl Med 41:1813–1822

    CAS  PubMed  Google Scholar 

  45. Mannelli L, Gross JA, Medverd JR et al (2013) Symptomatic extraperitoneal bladder perforation following transurethral bladder surgery: imaging with CT urography. Int Braz J Urol 39:599–601

    Article  PubMed  Google Scholar 

  46. Zacharias C, Robinson JD, Linnau KF et al (2012) Blunt urinary bladder trauma. Curr Probl Diagn Radiol 41:140–141

    Article  PubMed  Google Scholar 

  47. Mannelli L, Maki JH, Osman SF et al (2012) Noncontrast functional MRI of the kidneys. Curr Urol Rep 13:99–107

    Article  PubMed  Google Scholar 

  48. Hoang MV, Linnau KF, Gill EA et al (2012) Computed tomography diagnosis of myocardial infarction in a patient with normal initial cardiac biomarkers. Emerg Radiol 19:75–78

    Article  PubMed  Google Scholar 

  49. Mannelli L, Valentino M, Laffi G et al (2010) Functional MRI of the kidney. G Ital Nefrol 27:599–608

    PubMed  Google Scholar 

  50. Dubovsky EV, Russell CD (1998) Advances in radionuclide evaluation of urinary tract obstruction. Abdom Imaging 23:17–26

    Article  CAS  PubMed  Google Scholar 

  51. Kalb B, Sharma P, Salman K et al (2010) Acute abdominal pain: is there a potential role for MRI in the setting of the emergency department in a patient with renal calculi? J Magn Reson Imaging 32:1012–1023

    Article  PubMed  Google Scholar 

  52. Pogatchnik B, Monti S, Lewis DH et al (2014) Intraperitoneal urine leak following prostatectomy confirmed by Tc-99 m MAG3 renogram. Clin Nucl Med 39:744–746

    Article  PubMed  Google Scholar 

  53. Grassi R, Rambaldi PF, Di Grezia G et al (2011) Inflammatory bowel disease: value in diagnosis and management of MDCT-enteroclysis and 99mTc-HMPAO labeled leukocyte scintigraphy. Abdom Imaging 36:372–381

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, University of Washington Medical Center, University of Washington, 1959 NE Pacific Street, Box 357115, Seattle, WA, 98195-7115, USA

    Fatemeh Behnia, Joel A. Gross, Shana Elman, Hubert Vesselle & Lorenzo Mannelli

  2. IRCCS Fondazione SDN, Naples, Italy

    Monica Ragucci, Serena Monti, Marcello Mancini & Lorenzo Mannelli

  3. Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Lorenzo Mannelli

Authors
  1. Fatemeh Behnia
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  2. Joel A. Gross
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  3. Monica Ragucci
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  4. Serena Monti
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  5. Marcello Mancini
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  6. Shana Elman
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  7. Hubert Vesselle
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  8. Lorenzo Mannelli
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Correspondence to Lorenzo Mannelli.

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Behnia, F., Gross, J.A., Ragucci, M. et al. Nuclear medicine and the emergency department patient: an illustrative case-based approach. Radiol med 120, 158–170 (2015). https://doi.org/10.1007/s11547-014-0451-7

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  • DOI: https://doi.org/10.1007/s11547-014-0451-7

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