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PET/CT Reader On Your iPhone June 28, 2008

Posted by tomography in Innovation, Nuclear Medicine, PET, Radiology, SPECT.
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2 comments

When the iPhone came out I said: “I gotta have one of this!” As I am entering the last year of medical school and edging more towards real clinical imaging work in the field of nuclear medicine I say : “I need one of these as soon as possible!”

MIM for iPhone

I wrote about how iPhones could be used in diagnostic imaging and why all radiologist should carry one in their pockets wherever they go, but now PET/CT readers have a reason to do so as well. MimVista has just recently come out with a multi-modality imaging software for the iPhone that is absolutely mind blowing.

You may not only view PET/CT combined data on your phone, but you may use all those tools that you are used to on a workstation. For example:

  • find the contour of the lesion in 3D
  • calculate min. and max. SUV values
  • calculate the volume of the lesion.

And that is just of the many uses of this software that soon may change the way we learn and work!

Take a look at this video to find out more about this emerging technology:

Further reading:

– Andras

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What tomorrow brings? October 22, 2007

Posted by tomography in Nuclear Medicine, PET, Radiology, SPECT, Tomography, What tomorrow brings?.
3 comments

rtgwifehandThe radiologist who sits in a dark room, interpreting films and rendering a report that someone looks at hours later is becoming a thing of the past. Well, does it?
Of course, in this way, it couldn’t work nowadays, in the 2nd millenium – though we should not forget some poor parts of the world, where
some 20-30-40 year old machines are still in use . Basicly Konrad Roentgen’s X-ray was very important in past and shall be in the future, as it started a revolution many years ago, – which we still witness – diagnostic imaging.

 

 

xrayvirt

Since then, his invention went through a great evolution. Just take a look at the latest X-ray machines. They look nice, they work fine…, but they simply do not cover all the basis. As time went by, came new ideas, so we have CT and MRI in our hands (for many years fortunately). CT and MRI are sensitive in defining that disease is present, but they aren’t specific in determining what particular type of disease may be present. PET was the answer as it really brought it’s dramatic change. The increased metabolic activity not only confirms that cancer is present but it also provides evidence of staging or metastasis beyond the primary. Utilization of PET began in the 1990s. (SPECT has been around for decades, and it is preferred over PET in cardiac cases.) PET and SPECT are both basic gadgets in nuclear medicine, which combines chemistry, physics, mathematics, computer technology, and medicine in using radioactivity to diagnose and treat disease. Nuclear medicine procedures are safe, they involve little or no patient discomfort and do not require the use of anesthesia. Finally, CT-MRI and PET-SPECT found each other in a good working marriage, so one of today’s high-end stuff is PET-CT.

Can we go further? What is the next step?

Many say, that the most exciting development is the coming of molecular medicine. By understanding the molecular basis of disease and developing methods to detect and treat changes in the body at the molecular level, physicians will be able to identify diseases in the earliest possible stages. Cancer is one area experts already are seeing progress.

 

Molecular imaging is poised to become the future of nuclear medicine. The role of the nuclear imaging specialist in molecular therapy is to provide detailed information regarding the nature of biologic processes using radiopharmaceuticals in concert with positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging.

How about nanomedicine?

Nanomedicine may be defined as the monitoring, repair, construction and control of human biological systems at the molecular level, using engineered nanodevices and nanostructures. Once nanomachines are available, the ultimate dream of every healer, medicine man, and physician throughout recorded history will, at last, become a reality. Programmable and controllable microscale robots comprised of nanoscale parts fabricated to nanometer precision will allow medical doctors to execute curative and reconstructive procedures in the human body at the cellular and molecular levels. But the ability to direct events in a controlled fashion at the cellular level is the key that will unlock the indefinite extension of human health and the expansion of human abilities.

Nanomedicine FAQsnanomed

to be continued

Stress and Test October 16, 2007

Posted by tomography in Nuclear Medicine, Picture of the week, SPECT.
6 comments

heartvascularstimage1.jpgThe stress test shows if your heart receives enough blood from its own arteries to work harder, safely. Taking the stress test also helps your doctor know what type of exercise and how much is right for you.

The role of nuclear cardiology

The resting heart muscle’s blood supply needs are usually well met even in the presence of blocked arteries. When the heart is stressed either by exercise or chemicals, the demand for blood increases. The blood flow through the blocked arteries – while adequate at rest – may not be able to keep up with the demands of a stressed heart. This can show up on the pictures of the heart taken after stress. This is the principle behind all the stress tests. The word stress test is used for any means used to increase heart muscle’s demand for blood. This can be done by exercise or by chemical means.

The patient either walks on a treadmill, or is given iv. (intravenous) medication which simulates exercise, while connected to an ECG machine, used to record a 12-lead ECG. The level of exercise is increased by 3 minute stages, of progressively increased grade (incline) and speed. The patient’s symptoms, and blood pressure (BP) response are repeatedly checked.

However, some patients cannot exercise adequately. Patients with lung disease, arthritis, or disease in the leg vessels may not be able to walk. Patients with some medical conditions should not walk on the treadmill. For these patients the doctor can use a drug to affect the blood supply to the heart and simulate the effects of exercise.

It is done to identify the cause of chest pain or chest discomfort which can occur with blockages in blood flow to the heart, to monitor heart function in people with known heart disease, and to determine the response to medications or after angioplasty or bypass surgery.

If radioactive isotopes are also used (commonly, Technetium Tc99m Sestamabi and rarely, Thallium-201), then it is usually called a Nuclear Stress Test (NST).stresstest_1.jpg

The most commonly used NST is the Dobutamine Nuclear Stress Test (Cardiolite). (There are four types of cardiolite stress test. Excersize, Persantine, Adenosine and Dobutamine stress test.)

It is similar to excersize stress test except for the fact that a medicine called Dobutamine is used to stress the heart. During this test, Dobutamine is infused at a gradually increasing rate to increase the heart rate to a desired level. This drug has the effect of increasing the force of contraction of the heart, the heart rate and blood pressure. This stresses the heart muscle, which simulates exercise.

“Cardiolite is a short-lived, radioactive element that is absorbed by the heart muscle and allows your heart to be seen by the camera. Cardiolite images allow the physician to indirectly look at the blood flow to your heart.”

Areas that do not have adequate blood supply pick up the tracer very slowly or not at all.

Take a look at one of the “picture of the week”s.

Cardiolite is injected while you are at rest and while your heart is under stress. Rest and stress images are taken to allow doctors to compare how much blood flows through the heart muscle during stress and at rest.
(Most patients experience no side effects.)

Persantine is a coronary vasodilator that is used as a diagnostic agent in nuclear stress testing. Persantine works by increasing the blood vessel circumference of the coronary arteries (arteries that feed the heart) in order to increase blood flow to the heart.”

Adenosine is an antiarrhytmic agent, works as a vasodilatator, similar to Persantine. Side effects include: chest pain/pressure, headache, nausea, dizziness, shortness of breath. Some patients experience a burning or stinging sensation at their IV site because Persantine is more acidic than your blood. Persantine is contraindicated in patients who have a hypersensitivity to this drug. If needed, the antidote Aminophylline is given to the patient.