Nuclear imaging, also called molecular imaging, includes positron emission computed tomography (PET) and single photon emission computed tomography (SPECT) imaging. This section includes radiopharmaceuticals and tracers, PET-CT, SPECT-CT, and PET-MRI. Molecular imaging includes the field of nuclear medicine, which uses very small amounts of radioactive materials, or radiopharmaceuticals, to diagnose and treat disease.
Adult male with decades of right neck pain, discomfort and tightening following birth injury. The patient had failed multiple standard therapeutic maneuvers before presenting for 18F-FDG PET/MR imaging. Images shows abnormally elevated FDG uptake (white arrows; SUVmax = 1.2) observed in a linear pattern in the space in the posterolateral right neck, between the oblique capitis inferior and the semispinalis capitis muscles, where the greater occipital nerve resides. By comparison, the same region on the contralateral, asymptomatic side of the neck has an SUVmax = 0.7. This result encouraged a surgeon to explore the area. The surgeon ultimately found a collection of small arteries wrapped around the nerve in this location. The small arteries underwent lysis by the surgeon and the patient reported tremendous relief of symptoms. (A) Coronal thick slab MIP of 18F-FDG PET. (B) Axial LAVA FLEX MRI through the cervical spine. (C) Axial PET at the same slice as the axial MRI. (D) Fused axial PET/MRI. Image courtesy of Cipriano, et al., Stanford University, CA.
Left: Total-body PET/CT in psoriatic arthritis: multiple joints affected, shoulders, elbows, wrists, knees, ankles and small joints of the hands/feet. Arrow: left wrist; arrowhead: right wrist. Middle: Total-body PET/CT in rheumatoid arthritis: multiple joints affected, right shoulder, small joints of the left hand. Arrowhead at the 4th proximal interphalangeal joint shows classic ring-like uptake pattern. Arrow on the foot images demonstrates the hammer toe deformity besides big toe arthritis. Right: Total-body PET/CT in osteoarthritis: affected joints include the left elbow, right knee (arrow) and right big toe (arrowhead). Image courtesy of YG Abdelhafez et al., University of California Davis, Sacramento, CA.
Staging F18FDG PET/CT images of adenocarcinoma in the RUL (right upper lobe) of the lung illustrates the value of Vereos. The primary lesion in the right upper lobe appears in the upper row (PET image is left, CT image is right). A 3 mm synchronous primary or metastatic lesion in the RUL is apparent in the lower row. The precision afforded by Vereos' images provided the basis for the patient to undergo RUL lobectomy instead of thermal ablation of the primary lesion. (Images courtesy of Dr. Jay Kikut and UVMC)
U.S. Army Spc. Jonathon Hyde and Spc. Casymn Harrison from the 1434th Engineer Company, Grayling, Mich., Michigan National Guard, prepare patient rooms at TCF Regional Care Center in Detroit in advance of receiving COVID-19 patients, April 9, 2020. The TCF Center in Detroit has been converted into a 970-bed alternative care facility for COVID-19 patients by the Federal Emergency Management Agency, in partnership with the U.S. Army Corps of Engineers and Michigan National Guard. (Photo courtesy of U.S. Air National Guard photo by Master Sgt. Scott Thompson)
Iva Speck, MD, explains research showing that novel, fully digital, high-resolution positron emission tomography/computed tomography imaging of small brain stem nuclei can provide clinicians with valuable information concerning the auditory pathway in patients with hearing impairment. The research is featured in The Journal of Nuclear Medicine (read more at http://jnm.snmjournals.org/content/current). Video courtesy of Iva Speck, University Hospital Freiburg, Germany.