Functional Anatomy
Organ Function Rather Than Morphology | Physiologic Uptake Patterns | Target Organ Distribution
Common Organ Systems
Thyroid Bone Renal Hepatobiliary Cardiac Pulmonary Brain
Radiopharmaceutical Targets
Receptor Binding | Metabolic Activity | Perfusion | Cellular Uptake Mechanisms
Whole Body And Spot Views
Technetium 99m MDP Injection | Early Blood Flow And Blood Pool Phases Optional | Delayed Whole Body Imaging At 2–4 Hours For Metastatic Disease And Fracture Evaluation
Uptake And Imaging
Iodine 123 Or Technetium 99m Pertechnetate | Uptake Measurement And Static Imaging | Evaluate Hyperfunctioning Nodules And Ectopic Tissue
Renal Perfusion And Function
MAG3 Or DTPA Tracers | Dynamic Imaging For Perfusion And Drainage | Differential Renal Function And Postvoid Imaging For Obstruction
Biliary Tree Evaluation
Technetium Labeled IDA Agents | Dynamic Imaging To Assess Biliary Excretion And Cystic Duct Patency | Evaluate Acute Cholecystitis
Stress Rest Myocardial Perfusion
Technetium Or Thallium Tracers | Pharmacologic Or Exercise Stress | Compare Stress And Rest Uptake To Identify Ischemia And Infarction
Metabolic Imaging
FDG PET For Oncology Infection And Inflammation | Combine With CT For Anatomic Correlation | Patient Prep Includes Fasting And Glucose Control
Ventilation Perfusion
Perfusion With Tc99m Macroaggregated Albumin | Ventilation With Inhaled Radiotracer | Evaluate Pulmonary Embolism When CT Contraindicated
Fasting Hydration And Medication Review
Follow Specific Prep For Each Study | For PET Fast 4–6 Hours And Control Blood Glucose | Hydration Encouraged For Renal And Bone Studies
Safe Preparation And Administration
Follow Local Radiation Safety Protocols | Use Shielding And Time Distance Principles | Document Lot Numbers And Activity Administered
Planar SPECT And PET Techniques
Planar Static And Dynamic Imaging | SPECT For Tomographic Functional Imaging | PET For High Sensitivity Metabolic Imaging | Hybrid PET CT For Anatomic Correlation
Daily And Periodic Checks
Camera Uniformity And Energy Window Checks | Dose Calibrator Accuracy | SPECT Reconstruction Parameters And Attenuation Correction Verification
ALARA And Patient Counseling
Minimize Administered Activity While Maintaining Diagnostic Quality | Provide Post Procedure Instructions For Radiation Precautions When Required
Risk Assessment And Guidance
Screen For Pregnancy Prior To Radiopharmaceutical Administration | Provide Breastfeeding Guidance Based On Tracer And Activity | Consider Alternatives If Necessary
Medication Effects On Uptake
Certain Medications And Supplements Can Alter Tracer Uptake | Document Recent Therapies Such As Chemotherapy Or Radioactive Iodine
Recognize Normal Patterns
Differentiate Expected Organ Uptake From Focal Abnormalities | Correlate With Anatomic Imaging And Clinical History
Standardized Uptake Values And Ratios
Use SUV For PET Semi Quantitative Assessment | Use Ratios And Regional Counts For SPECT When Appropriate | Document Acquisition Parameters For Reproducibility
Hybrid Imaging And Multimodality Reports
Combine Functional Findings With CT MRI Or Ultrasound For Precise Localization | Recommend Further Imaging Or Biopsy When Indicated
SPECT
Single Photon Emission Computed Tomography | Tomographic Nuclear Imaging Using Gamma Cameras
PET
Positron Emission Tomography | High Sensitivity Metabolic Imaging Often Combined With CT
Radiopharmaceutical
Radioactive Tracer That Targets Specific Physiologic Processes | Examples FDG Tc99m MDP MAG3 I123
SUV
Standardized Uptake Value | Semi Quantitative PET Metric For Tracer Uptake
Attenuation Correction
Correction For Photon Attenuation Using CT Or Transmission Sources | Improves Quantitative Accuracy