Diagnostic interventions in nuclear medicine
Diagnostic interventions in nuclear medicine may be defined as the coadministration of a nonradioactive drug or application of a physical stimulus or physiologic maneuver to enhance the diagnostic utility of a nuclear medicine test. The rationale for each interventional maneuver follows from the physiology or metabolism of the particular organ or organ system under evaluation. Diagnostic inference is drawn from the pattern of change in the biodistribution of the tracer in response to the intervention-induced change in metabolism or function. In current practice, the most commonly performed interventional maneuvers are aimed at studies of the heart, genitourinary system, hepatobiliary system, and gastrointestinal tract. The single most commonly performed interventional study in the United States is the stress Thallium-201 myocardial perfusion scan aimed at the diagnosis of coronary artery disease. The stress portion of the study is accomplished with dynamic leg exercise on a treadmill and is aimed at increasing myocardial oxygen demands. Areas of myocardium distal to hemodynamically significant lesions in the coronary arteries become ischemic at peak stress due to the inability of the stenotic vessel to respond to the oxygen demand/blood flow needs of the myocardium. Ischemic areas are readily recognized as photopenic defects on scans obtained immediately after exercise, with normalization upon delayed imaging. Diuresis renography is aimed at the differential diagnosis of hydroureteronephrosis. By challenging the urinary tract collecting structures with an augmented urine flow, dilated, unobstructed systems can be differentiated from systems with significant mechanical obstruction. 137 references.
- Research Organization:
- Massachusetts General Hospital, Boston (USA)
- OSTI ID:
- 6326408
- Journal Information:
- Curr. Probl. Diagn. Radiol.; (United States), Vol. 18:1
- Country of Publication:
- United States
- Language:
- English
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BLOOD FLOW
CARDIOVASCULAR DISEASES
DIAGNOSTIC USES
EXERCISE
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RADIOISOTOPE SCANNING
REVIEWS
THALLIUM 201
TISSUE DISTRIBUTION
UROGENITAL SYSTEM DISEASES
BETA DECAY RADIOISOTOPES
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MEDICINE
NUCLEI
ODD-EVEN NUCLEI
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