()

Thyroid
Gamma camera: I-123, I-131, Tc-99m pertechnetate
Painful thyroiditis: de Quervain thyroiditis
Painless thyroiditis: postpartum lymphocytic thyroiditis
Parathyroid
Dul-tracer: Tl-201: thyroid + parathyroid
Tc-99m: thyroid
Dual-phase: Tc-99m sestamibi(MIBI), early phase: thyroid +
parathyroid
delay phase: parathyroid adenoma
Adrenal gland:
Adrenal medulla (pehochromocytoma)
I-131 MIBG, high dosage can used for therapy
F-18 FDG PET: malignant pheochromocytoma
Tc-99m DTPA??
Adrenal cortex (Conns syndrome)
I-131 NP-59
PET ()
& gamma ray(
)
F18-FDG GLUT 1 , hexokinaseF18-FDG6P
TCA cycle
FDG enhancement: brain & urinary tract
PET anatomical site CT fusion
cancer PET? Head&neck, esophageal cancer, breast
cancer, primary lung cancer, uterine cervical cancer, lymphoma,
melanoma, colorectal cancer
* brain , low grade tumor , urinary tract
* thyroid cancer staging PET, I131 non-sensitive
PET : 18F-Fluoride (bone scan), F18-FDOPA (Parkinson)
GI and respiratory system ()
V/Q scan: secondary pulmonary hypertension, pulmonary
embolism
Sialoscintingraphy: diagnosis of sjogrens syndrome
Esophageal transit study: achalasia, scleroderma
Gastric emptying study: gastroparesis
Colloid liver-spleen scan: accessory spleen
Hepatobiliary scan: biliary leak, biliary atresia, acute
cholecystitis48h
GI bleeding: scope , angio , RBC scan

Skeletal system ()
Skeletal scintingraphy: meta (osteoblastic acitivity)
- High sensitivity (), red marrow infiltration,
fusiform
- Beautiful scan (superscan)severe metastasis
- Flare phenomenon: bone healing (),
()
- Tc-99m MDP false negative? , intra-medullary
growth, osteolytic
* thyroid cancer, multiple myeloma FDG PET
- Three phase bone scintingraphy: osteomyelitis/cellulitis
osteomyelitis
cellulitis
Blood flow
+
+
Blood pool
+
+
Bone phase
++
Complementary
+

Ga-67 scan
- F-18 NaF (Fluoride) PET: ,
Bone mineral density: DXA (low radiation), FRAX fraction risk
- T score:
* postmenopausal women, male age > 50
- Z score: same age group
* females prior to menopause, male < 50
- : Fractures T-score<-2.5
- BMD> least significant change (LSC),
BMD value
Gallium scintiraphy: osteomyelitis
- Fe , kidney & colon
- abdomen In-111 Oxine Leukocyte scan (WBC scan)
, / 1500cc
Neurology ()
Tc-99m ECD: cerebral perfusion
F-18 FDG: metabolic imaging
F-18 ADAM: 5-HT
Pre-synaptic
Post-synaptic
ADDA
D2 receptors
DAT
F-18 DOPA

I-123 IBZM

I-123 B-CIT

C-11

Tc-99m

Raclopride

Trodat
Tc-99m ECD brain SPECT , ? ictal
phase()
BBB? Tc-99m ECD, Tc-99m DTPA, I-123 IMP, Tc-99m

HMPAO
Myocardial perfusion scintigraphy ()
Drugs:
- Tl-201 (1+), , half-life , (), redistribution
- Tc-99m sestamibi (), ,,,
gated SPECT
Rest and stress myocardial perfusion scintigraphy
- Stenosis < 50%: rest/stress image
- Stenosis 50~90%: rest , stress
- Infarction (stenosis>90%): rest/stress
* stress: 1. treadmill (220-age)
2. Persantin (dipyridamole, vasodilatorantidote:
aminophylline)
* Tl-201: exercise
Tc-99m: rest
Interpretation
EKG gated ventricular function study: EKG, ejection
fraction
Genitourinary system ()
Tc-99m DTPAGFR
GFR = CDTPA= UDTPA * V/P
I-131 OIHRPF
Tc-99m MAG3RPF
RPF = COIH or MAG3 = UOIH or MAG3 * V/POIH or MAG3
- renal artery stenosis: ACEI GFR ( efferant
AT II )
Tc-99m DMSAcortex()
Renal transplantrenal scan
- Rejection: decreased perfusion, delayed excretion
- ATN: normal perfusion but delayed excretion
Renal artery stenosisdynamic renal scan with ACEI
- Decreased/increased uptake on the affected side after ACEI
Obstructive hydronephrosisnrenal scan with diuretics (no
response)
APNrenal cortical scan (wedge shape perfusion defects)
VU refluxcystography (Tc-99m DTPA)
Testis torsionscrotal scan (Tc-99m pertechnetate , decreased
perfusion)