Nuclear Medicine : Practical Physics, Artifacts, and Pitfalls

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. Cover 1 Nuclear Medicine 4 Copyright 5 Dedication 6 Contents 10 1 Introduction to Nuclear Medicine 16 2 Radiation 20 X-rays 21 Nuclear Nomenclature 23 Nuclear Radiation 24 Electron Capture 24 Beta Emission 25 Positron Emission 25 Alpha Emission 26 Isomeric Transition 26 Gamma Radiation 26 Internal Conversion 27 Auger Electrons 27 Units of Radioactivity 27 3 Radiobiology 30 Units of Radiation Exposure 31 Deterministic Effects 32 Stochastic Effects 33 Radiation Safety 36 4 Radiation Detectors-Ionization Detectors 38 Ionization Chambers 39 Dose Calibrators 40 Survey Meters 43 Proportional Counters 45 5 Radiation Detectors-Single Photon 46 Collimators 47 Scintillators 52 Photomultiplier Tubes 54 The Gamma Camera 56 Static Planar Imaging 57 Dynamic Imaging 60 Gated Imaging 61 Single Photon Emission Computed Tomography 63 SPECT/CT 67 Gamma Probes and Well Counters 69 6 Radiation Detection-Pet 70 PET Principles 71 PET Acquisition and Reconstruction 74 Time of Flight 77 PET/CT 78 PET/MRI 80 7 Ionization Chamber/Dose Calibrator Artifacts 82 Case 1. Altitude 84 Case 2. Geometry 85 Case 3. Materials 86 8 Gamma Camera Artifacts 88 Case 1. Cracked Crystal 90 Case 2. Hygroscopic Crystal 91 Case 3. PMT Malfunction 93 Case 4. Flood Nonuniformity 95 9 Planar Acquisition Artifacts 98 Case 1. Off-peak Acquisition 100 Case 2. Motion Artifact 103 Case 3. Dose Infiltration 106 Case 4. Collimator Penetration 108 10 Spect Acquisition Artifacts 110 Case 1. Center of Rotation Error 112 Case 2. Filtered Back Projection Streak 113 Case 3. Noisy Images 116 Case 4. Iterative Reconstruction Errors 119 Case 5. Motion Artifact 121 11 Pet Acquisition Artifacts 124 Case 1. PMT Malfunction 126 Case 2. Crystal Temperature Instability 128 Case 3. Table Misregistration 129 Case 4. Scatter Correction Errors 131 Case 5. Attenuation Correction Errors 133 Case 6. CT Artifacts Affecting PET Reconstruction 136 12 Dose Calibrator Pitfalls 138 Case 1. Dose Calibrator Contamination 140 Case 2. Wrong Setting used on Dose Calibrator 142 Case 3. High Background Activity 143 13 Single Photon Pitfalls 144 Case 1. Prostheses 146 Case 2. Recent prior Study 148 Case 3. Contamination 150 Case 4. Poor Dynamic Timing 152 Case 5. Background Activity 155 14 Pet Pitfalls 160 Case 1. Infiltration 162 Case 2. Treatment Effect Mimics New Disease 165 Case 3. Misregistration and Attenuation Correction 167 Case 4. Respiratory Motion Artifact 169 15 Therapy Pitfalls 172 Case 1. Empiric Dosing Exceeds Safe Limits 174 Case 2. Gastrointestinal Toxicity 177 Case 3. Radioactive Vomit 178 Case 4. Therapy Infusion via Indwelling Catheter 180 16 Puzzlers 182 Answers 193 Index 196 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 . Nuclear Medicine 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, and "Practical Physics" is a required portion of radiology residency education and a designated area of the board exams. Practical Nuclear Medicine Physics provides a readable explanation of the physics behind radiobiology, radiation detection, and molecular imaging with gamma and PET cameras. Case-based scenarios illustrate common artifacts and pitfalls, and a concluding chapter provides 20 annotated questions and answers.