Practical Nuclear Medicine PDF
Preview Practical Nuclear Medicine
Peter F. Sharp Howard G. Gemmell Editors Alison D. Murray Practical Nuclear Medicine Third Edition Practical Nuclear Medicine Peter F. Sharp, Howard G. Gemmell and Alison D. Murray (Eds) Practical Nuclear Medicine Third Edition With222Figuresincluding17ColorPlates PeterF.Sharp,PhD,FInstP,FIPEM,FRSE DepartmentofBiomedicalPhysicsandBioengineering AberdeenUniversityandNHSGrampian,UK HowardG.Gemmell,PhD,FIPEM DepartmentofNuclearMedicine AberdeenRoyalInfirmary NHSGrampian,UK AlisonD.Murray,FRCP,FRCR DepartmentofRadiology UniversityofAberdeen,UK TheauthorswishtoacknowledgetheirgratitudetoOUPfortheuseofthefollowingfiguresfromthe secondeditionofthisbook: 1.6,1.7,2.1,2.3,2.4,2.5,2.7,3.1,3.3,3.5,5.1,5.2,5.3,5.4,5.5,5.6,5.7,5.8,5.9,5.10,5.11,5.12,6.1, 6.2,7.1,7.4,7.5,7.6,7.7,10.1,10.2,10.3,10.4,10.8,13.1,13.10,13.14,13.15,13.16,14.1,14.2,14.3, 14.4,14.5,14.9,14.10,14.11,14.12,14.13,14.14,15.1,15.4 BritishLibraryCataloguinginPublicationData AcataloguerecordforthisbookisavailablefromtheBritishLibrary LibraryofCongressCataloguing-in-PublicationData Sharp,PeterF. Practicalnuclearmedicine/PeterF.Sharp,HowardG.Gemmell,AlisonD.Murray.–3rded. p. cm. Includesbibliographicalreferencesandindex. ISBN1-85233-875-X(alk.paper) 1.Nuclearmedicine. I.Gemmell,H.G. II.Murray,AlisonD. III.Title. R895.S452005 616.07(cid:1)575–dc22 2004061448 Apartfromanyfairdealingforthepurposesofresearchorprivatestudy,orcriticismorreview,aspermittedunderthe Copyright,DesignsandPatentsAct1988,thispublicationmayonlybereproduced,storedortransmitted,inanyformor byanymeans,withthepriorpermissioninwritingofthepublishers,orinthecaseofreprographicreproductioninaccordance withthetermsoflicencesissuedbytheCopyrightLicensingAgency.Enquiriesconcerningreproductionoutsidethoseterms shouldbesenttothepublishers. ISBN-10:1-85233-875-X 3rdedition Printedonacid-freepaper ISBN-13:978-1-85233-875-6 Firstpublishedin1996byOxfordUniversityPress;ISBN0199630321 Secondeditionpublishedin1998OxfordUniversityPress;ISBN0192628429 Thirdedition2005 (cid:2)C Springer–VerlagLondonLimited2005 Theuseofregisterednames,trademarks,etc.inthispublicationdoesnotimply,evenintheabsenceofaspecificstatement,that suchnamesareexemptfromtherelevantlawsandregulationsandthereforefreeforgeneraluse. Productliability:Thepublishercangivenoguaranteeforinformationaboutdrugdosageandapplicationthereofcontainedin thisbook.Ineveryindividualcasetherespectiveusermustcheckitsaccuracybyconsultingotherpharmaceuticalliterature. PrintedinSingapore (TB/KYO) 9 8 7 6 5 4 3 2 1 SPIN10931226 SpringerScience+BusinessMedia springeronline.com Foreword Therehavebeenseveralsignificantadvancesinnuclearmedicinesincethepublicationofthe secondeditionofPracticalNuclearMedicine.Thelastsevenyearshaveseengreatstridesin instrumentation,includingnewcoincidencedetectors,thedevelopmentofawidervariety ofcrystals,andtheadventofcombinedanatomical/functionalimagingdevices,including PET/CT and SPECT/CT. PET imaging with 18F-FDG has become a mainstay of many clinicalsettings,andotherradiotracersarefindingtheirwayintotherapidlyexpandingfield ofoncologicPET.However,radiopharmaceuticalbreakthroughsduringthisperiodhave notbeenconfinedtoonesingleimagingmodality.Refinementsindiagnosticapplications ofmonoclonalantibodies,radiolabeledpeptides,neuroreceptors,andawholespectrum ofnewmoleculartargetingagentsaresteadilystrengtheningtheclinicalnuclearmedicine armamentarium. Suchadauntingarrayofchangescanpresentquiteachallengetoeventhemostex- perienced nuclear medicine practitioner. Consider then the magnitude of complexities thatphysicians,physicists,andtechnologistswhoarejustbeginningtheirtraininginour fieldareexpectedtoassimilate!Thatispreciselywhythisbookoffersaneasilyaccessible approachtoboththebasicsciencegroundworkandtheclinicalapplicationsofnuclear medicine.Thethirdeditionpresentsitsmaterialinaverypragmaticmannerbydissemi- natingthevariouscontributors’practicalexperienceviadetailedinstructions.Thebreadth ofthishands-onknowledgeandadvicewilllikelybenefitreadersatalllevelsofexpertise. Thebook’sconcentrationontheactualpracticeofnuclearmedicineisparticularlydis- cernibleinthefirstfewchapters,whichaddressscientificfoundationsofSPECT,PET,ra- diopharmaceuticals,etc.Suchtopicsasinstrumentation,dataprocessing,andnon-imaging radionuclidetestsarecoveredinawaythataccentuatesspecifichumaninteraction;thus, qualityassuranceisanoft-recurringtheme.ToreflectthegrowingimportanceofPETin theclinicalarena,theintroductorychapteronthissubjecthasbeenexpandedandanew chapteroncurrentPETradiopharmaceuticalsandPETimaginginoncology,neurology, andcardiologyhasbeenadded.Inaddition,newcontributorshavepreparedthechapters ontheskeletalsystem,thecardiovascularsystem,andtheurinarytract. ThisthirdeditionofPracticalNuclearMedicinecontinuesthetext’straditionofguiding readersthroughnotonlythemostcommonlyperformedclinicalnuclearmedicinetests butthescientificbasesonwhichtheywerebuilt.Inaddition,theeditorsofthisversionhave skillfullyweededoutcertainproceduresandde-accentuatedotherswhoseusehaslessened intheclinicalsettingoverthelastfewyears.Theseeffortshaveproducedaclinicalmanual thatclearlyaddressesmanyofthediagnosticdilemmasthatcurrentlyappearinnuclear medicine,whichisconstantlyexpandingthelimitsofitsinstrumentation,radiopharma- ceuticals, and diagnostic capabilities. In the future, many aspects of current molecular imagingresearch(suchastargetingoftumorantigens,receptors,andmetabolism;imag- ing of hypoxia and apoptosis; and antisense targeting for both diagnosis and therapy) willfindtheirwayintotheclinicalsetting.Therefore,itisofparamountimportancethat individualsworkinginnuclearmedicineupdatetheirskillstodayinpreparationforthe v vi FOREWORD nextwaveofadvancedknowledgeandclinicaltechniques.Fortunately,thethirdeditionof PracticalNuclearMedicinewillassistmembersofourcommunityinaccomplishingthat task,andtheeditorsandcontributorsaretobecommendedformakingthispossible. MartinP.Sandler,MD CarolD.andHenryP.ProfessorandChairman DepartmentofRadiologyandRadiologicalSciences VanderbiltUniversitySchoolofMedicine Nashville,Tennessee,USA Contents Foreword ................................................................. v MartinP.Sandler...................................................... Contributors ............................................................. ix 1. NuclearMedicineImaging PeterF.SharpandKeithA.Goatman................................... 1 2. SinglePhotonEmissionComputedTomography(SPECT) HowardG.GemmellandRogerT.Staff................................. 21 3. PositronEmissionTomography PeterF.SharpandAndyWelch......................................... 35 4. Non-ImagingRadionuclideInvestigations AlexT.ElliottandThomasE.Hilditch.................................. 49 5. QualityAssurance AlexT.Elliott.......................................................... 65 6. RadiationProtection PhilipP.Dendy,KarenE.Goldstone,AdrianParkin, andRobertW.Barber.................................................. 91 7. TheRadiopharmacy JamesDohertyandDavidGraham...................................... 113 8. TheSkeletalSystem MargaretE.Brooks..................................................... 143 9. TheCardiovascularSystem MalcolmJ.Metcalfe.................................................... 163 10. TheLung HenryW.Gray......................................................... 179 vii viii CONTENTS 11. TheUrinaryTract PhilipS.Cosgriff....................................................... 205 12. TheBrain,SalivaryandLacrimalGlands AlisonD.Murray...................................................... 231 13. Thyroid,Parathyroid,andAdrenalGlandImaging WilliamH.Martin,MartinP.Sandler,andMiltonD.Gross.............. 247 14. GastrointestinalTractandLiver LeslieK.HardingandAlpNotghi....................................... 273 15. InfectionandInflammation A.MichaelPetersandHeokK.Cheow................................... 305 16. TumorImaging AlanC.Perkins........................................................ 333 17. ClinicalPETImaging GaryJ.R.Cook........................................................ 347 Index..................................................................... 365 Contributors RobertW.Barber,MSc,BSc KarenE.Goldstone,BSc,MSc DepartmentofMedicalPhysics,Addenbrooke’s DepartmentofMedicalPhysics,Addenbrooke’s Hospital,Cambridge,UK Hospital,Cambridge,UK MargaretE.Brooks,MBChB,FRCP,DMRD, DavidGraham,MSc,BSc,MRPharmS FRCR PharmacyDepartment,AberdeenRoyal DepartmentofNuclearMedicine,Aberdeen Infirmary,Aberdeen,UK RoyalInfirmary,Aberdeen,UK HenryW.GrayMD,FRCP,FRCR HeokK.Cheow,MBChB,MRCP,FRCR DepartmentofNuclearMedicine, DepartmentofNuclearMedicine, RoyalInfirmary,Glasgow,UK Addenbrooke’sHospital,Cambridge,UK GaryJ.R.Cook,MBBS,MD MiltonD.Gross,MD DepartmentofNuclearMedicineandPET, DepartmentsofRadiologyandInternal RoyalMarsdenHospital,Sutton,UK Medicine,UniversityofMichiganMedical School,NuclearMedicineService, PhilipS.Cosgriff,BSc,MSc DepartmentofVeteransAffairsHealthSystem, MedicalPhysicsDepartment,PilgrimHospital, AnnArbor,MI,USA Boston,UK LeslieK.Harding,MBChB,BSc,FRCP,FRCR PhilipP.Dendy,PhD DepartmentofPhysicsandNuclearMedicine, DepartmentofMedicalPhysics,Addenbrooke’s CityHospitalNHSTrust,Birmingham,UK Hospital,Cambridge,UK ThomasE.Hilditch,BSc,PhD,FInstP JamesDoherty,BSc,MRPharmS DepartmentofClinicalPhysicsand PharmacyDepartment,AberdeenRoyal Bioengineering,WesternInfirmary, Infirmary,Aberdeen,UK Glasgow,UK AlexT.Elliott,BA,PhDDSc,CPhys,FInstP, MalcohmJ.Metcalfe,MD,FRCP FIPEM,ARCP DepartmentofCardiology,AberdeenRoyal DepartmentofClinicalPhysicsand Infirmary,Aberdeen,UK Bioengineering,WesternInfirmary,Glasgow, UK WilliamH.Martin,MD HowardG.Gemmell,BSc,MSc,PhD,FIPEM DepartmentofRadiologyandRadiological DepartmentofNuclearMedicine,Aberdeen Sciences,VanderbiltUniversityMedicalCenter, RoyalInfirmary,NHSGrampian,Aberdeen, Nashville,TN,USA UK AlisonD.Murray,MBChB,FRCP,FRCR KeithA.Goatman,BEng,MSc,PhD DepartmentofRadiology,CollegeofLife DepartmentofBio-MedicalPhysicsand SciencesandMedicine,UniversityofAberdeen, Bio-Engineering,UniversityofAberdeen,UK UK ix x CONTRIBUTORS AlpNotghi,MD,MSc,FRCP MartinP.Sandler,MD DepartmentofPhysicsandNuclearMedicine, DepartmentofRadiologyandRadiological CityHospitalNHSTrust,Birmingham, Sciences,VanderbiltUniversityMedicalCenter, UK Nashville,TN,USA AdrianParkin,DPhil PeterF.Sharp,BSc,PhD,CPhys,FInstP,ARCP, DepartmentofMedicalPhysics,Addenbrooke’s FIPEM,FRSE Hospital,Cambridge,UK DepartmentofBio-MedicalPhysicsand Bio-Engineering,UniversityofAberdeenand NHSGrampian,UK AlanC.Perkins,BSc,MSc,Ph.D,FIPEM,ARCP DepartmentofMedicalPhysics,Medical School,Queen’sMedicalCentre,Nottingham, RogerT.Staff,PhD UK DepartmentofBio-MedicalPhysicsand Bio-Engineering,UniversityofAberdeenand A.MichaelPeters,MA,MD,MSc,FRCPath, NHSGrampain,UK FRCP,FRCR,FMedSci DepartmentofAppliedPhysiology,Brighton AndyWelch,BSc,PhD SussexMedicalSchool,UniversityofSussex, BiomedicalPhysicsandBioengineering,BSc, Brighton,UK PhD,UniversityofAberdeen,UK
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