Nuclear Medicine. Practical Physics, Artifacts, and Pitfalls

Description

• The physics behind radiobiology, radiation detection, and molecular imaging is reviewed in a way that can be understood by the non-physicist
• Discusses rational approaches for dose reduction as well as risks from ionizing radiation
• The clinical focus of this book ties in with the American Board of Radiology's exam format

In contrast to most anatomic radiographic imaging techniques, nuclear medicine permits real time, non-invasive imaging of human physiology and pathophysiology and also allows for exquisite targeting of disease with therapeutic radiology. To open this window to the processes of human disease, one must first understand the physical processes behind radioactive decay and emission, as well the principles of radiation detection. Practical Nuclear Medicine Physics provides residents and practitioners in nuclear medicine and radiology a readable explanation of the physics concepts underpinning nuclear imaging and how they impact the utilization and interpretation of those images. Following a brief introductory section, the book provides numerous case examples, illustrating various imaging artifacts and pitfalls that can be recognized and remedied with a solid understanding of the physics behind the procedure. Understanding and applying the physics behind nuclear medicine is essential to maximizing not only diagnostic and therapeutic accuracy for providing optimal patient care, but "Practical Physics" is a required portion of radiology residency education and a designated area of the board exams.

Readership: Radiology residents, practitioners, and technologists; Radiology residents preparing for board examinations and physicians preparing for recertification.

Table of Contents

Radiation
X-rays
Nuclear nomenclature
Nuclear radiation
Electron capture
Beta emission
Positron emission
Alpha emission
Isomeric transition
Gamma radiation
Internal conversion
Auger electrons
Units of radioactivity
Radiobiology
Units of radiation exposure
Deterministic effects
Stochastic effects
Radiation safety
Radiation detectors - ionization detectors
Ionization chambers
Dose calibrators
Survey meters
Proportional counters
Radiation detectors - single photon
Collimators
Scintillators
Photomultiplier tubes
The gamma camera
Static planar imaging
Dynamic imaging
Gated imaging
SPECT
SPECT/CT
Gamma probes and well counters
Radiation detection - PET
PET principles
PET acquisition and reconstruction
Time of flight
PET/CT
PET/MR
Dose calibrator artifacts
Case 1. Altitude
Case 2. Geometry
Case 3. Materials
Gamma camera artifacts
Case 1. Cracked crystal
Case 2. Hygroscopic crystal
Case 3. PMT malfunction
Case 4. Flood nonuniformity
Planar acquisition artifacts
Case 1. Off peak acquisition
Case 2. Motion artifact
Case 3. Dose infiltration
Case 4. Collimator penetration
SPECT acquisition artifacts
Case 1. Center of rotation error
Case 2. Filtered back projection streak
Case 3. Noisy images
Case 4. Iterative reconstruction errors
Case 5. Motion artifact
PET acquisition artifacts
Case 1. PMT malfunction
Case 2. Crystal temperature instability
Case 3. Table misregistration
Case 4. Scatter correction errors
Case 5. Attenuation correction errors
Case 6. CT artifacts affecting PET reconstruction
Dose calibrator pitfalls
Case 1. Dose calibrator contamination
Case 2. Wrong setting used on dose calibrator
Case 3. High background activity
Single photon pitfalls
Case 1. Prostheses
Case 2. Recent prior study
Case 3. Contamination
Case 4. Poor dynamic timing
Case 5. Background activity
PET pitfalls
Case 1. Infiltration
Case 2. Treatment effect mimics new disease
Case 3. Misregistration and attenuation correction
Case 4. Respiratory motion artifact
Therapy pitfalls
Case 1. Empiric dosing exceeds safe limits
Case 2. GI toxicity
Case 3. Radioactive vomit
Case 4. Therapy infusion via indwelling catheter
Puzzlers

Author

Daniel A. Pryma, Assistant Professor of Radiology; Clinical Director of Nuclear Medicine/Molecular Imaging, University of Pennsylvania Perelman School of Medicine, USA

Assistant Professor of Radiology; Clinical Director of Nuclear Medicine/Molecular Imaging, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania