Bone Scintigraphy

The most frequently requested investigation in any nuclear medicine department remains the technetium-99m (99mTc)-labelled diphosphonate bone scan. Despite rapid advances in all imaging modalities. there has been no serious challenge to the role of bone scanning in the evaluation of the skeleton. The main reason for this is the exquisite sensitivity of the bone scan for lesion detection. combined with clear visualisation of the whole skeleton. In recent years several new diphosphonate agents have become available with claims for superior imaging of the skeleton. Essentially. they all have higher affinity for bone. thus allowing the normal skeleton to be visualised all the more clearly. However. as will be dis cussed. this may occur at some cost to the principal role of bone scanning. lesion detection. The major strength of nuclear medicine is its ability to provide functional and physiological information. With bone scanning this leads to high sensitivity for focal disease if there has been any disturbance of skeletal metabolism. However. in many other clinical situations. and particularly in metabolic bone disease. more generalised alteration in skeletal turnover may occur. and quantitation of diphosphonate uptake by the skeleton can provide valuable clinical information.

I. BASIC PRINCIPLES -- 1. Radiopharmaceuticals -- 2. Nuclear Medicine Physics -- 3. Radiation Detection and Instrumentation -- 4. SPCT and PET -- II. CLINICAL NUCLEAR MEDICINE -- 5. Endocrine System -- 6. Skeletal System -- 7. Hepatobiliary System -- 8. Genitourinary System -- 9. Oncology 6 Single Photon -- 10. Oncology 6 Positron Emission Tomography -- 11. Gastrointestinal System -- 12. Infection and Inflammation -- 13. Central Nervous System -- 14. Cardiac System -- 15. Pulmonary System -- 16. Pearls, Pitfalls and Frequently Asked Questions.

This very practical "how-to" guide comprehensively covers both the common and less common pathologies affecting the paediatric skeleton. It provides clear explanations of the materials and instrumentation, as well as teaching points, technical comments, discussions, and the avoidance of pitfalls. The images presented here have been produced using whole-body scanning, gamma-camera, high-resolution spot images, pinhole and SPECT, as well as three-phase bone scans - each procedure backed by indications for its use. These 350 illustrations thus allow the paediatrician, orthopaedic surgeon, radiologist and nuclear medicine physician a comparison with their own images as well as with the "normal" images presented in the authors' companion volume, Atlas of Bone Scintigraphy in the Developing Paediatric Skeleton.

This book, written by authors with national and international reputations in the field, covers all aspects of radionuclide and hybrid bone imaging. Introductory sections present the basic science and consider the current status and limitations of conventional radiological techniques. The underlying principles of PET-CT and SPECT-CT are carefully explained, and the value of different PET and SPECT tracers, assessed. The role of single- and dual-modality approaches in the imaging of benign bone diseases and malignancies is then discussed in detail in a series of well-illustrated chapters. The pathologies addressed include metabolic bone disease, arthritis, bone and joint infections, primary bone and soft tissue tumors, and metastases from breast and prostate cancer. A further section considers the role of bone scintigraphy in the pediatric patient, and the closing chapters focus on miscellaneous subjects, including bone densitometry and radionuclide targeted therapy.

The British Nuclear Medicine Society celebrates its 50th Anniversary with this booklet, which reflects the research of many of the pioneers in the use of radionuclides for the diagnosis and therapy of human disease. Since 1949 there have been remarkable advances in radionuclide techniques and imaging equipment: from the first devices “home-made” in the many physics departments throughout the UK, to the sophisticated multimodality imagers now in everyday use in Nuclear Medicine. The BNMS has been instrumental in promoting the use of radionuclide techniques in the investigation of pathology by supporting and providing education, research and guidelines on the optimum use of radiation to help patients. The future of Nuclear Medicine is bright, thanks to improved imaging resolution, new radiopharmaceuticals, and new diagnostic and therapeutic techniques and procedures.

In the fifth edition of this highly successful book, the author once again aims to equip the reader with up-to-date information that will facilitate accurate diagnosis of bone and joint diseases by means of combined use of scintigraphy and radiology. Two entirely new chapters have been added, one on the use of 18F-NaF PET/CT and the other on gamma correction scan diagnosis of bone trabecular microfracture and microcontusion as well as bone edema and hemorrhage. Further topics covered for the first time include enthesopathies, myositis, soft tissue diseases, cryptic bones, and differential diagnosis. Individual chapters have been updated and rearranged to reflect the latest advances in imaging diagnosis. As before, a vast number of state of the art gamma correction pinhole bone scans and corroborative conventional radiographs and CT, MRI, and/or ultrasound images are presented side by side. In this new edition, extension of the application of gamma correction to other imaging methods such as MRI and CT and the solution of the halation problem are necessarily addressed. This fifth edition of Combined Scintigraphic and Radiographic Diagnosis of Bone and Joint Diseases will be essential reading for practitioners and researchers in nuclear medicine, radiology, orthopedic surgery, pathology, anatomy, and imaging sciences at large.

Each volume in the Atlases of Clinical Nuclear Medicine covers one anatomic region or system. Each atlas is extensively illustrated with superb quality images and reveals the spectrum of normal scintigraphic findings as well as examples of both common and unusual conditions. Detailed figure legends describe the findings within each image, and most discuss the image's important teaching point. The text, which is descriptive yet concise, covers such topics as procedure technique, dosimetry, physiology, and scan interpretations. Selected Atlases of Bone Scintigraphy is comprised of four individual atlases in the areas of 1) Skeletal Trauma 2) SPECT Cross Sectional Anatomy of the Normal Spine, Pelvis, Hips, and Skull 3) SPECT Quality control 4) Normal Bone Scintigraphy and Indium-11 White Blood Cell Scintigraphy in Porous Coated Hip Prosthesis