[en] Peripheral vascular occlusive disease is an extremely common clinical problem. The conventional examination of the patient with known or suspected peripheral arteriosclerosis usually includes contrast arteriography and, in fact, studies of the peripheral circulation were among the first efforts that led to the development and clinical acceptance of arteriography. In view of the acknowledged clinical value of contrast angiography and the fact that an arteriogram is virtually a mandatory requirement before any surgical or interventional radiology procedure, it is logical to ask what role, if any, radionuclide studies can or should play in the evaluation of peripheral vascular disease. Part of the answer to this question is necessarily philosophical and will be dependent on the diagnostic and therapeutic goals within a particular institution. Although radionuclide studies have not become routinely or widely implemented in the evaluation of peripheral vascular disease they do afford a means of: (1) quantitatively measuring blood flow, (2) analyzing the regional distribution of flow within an extremity, (3) assessing the functional significance of collaterals, (4) predicting the healing potential of peripheral ulcers, and (5) assessing the functional outcome of therapy both quantitatively and qualitatively. A number of different radionuclide studies have been developed for the evaluation of peripheral vascular disease, including several that require interventional maneuvers. For purposes of classification the available radiotracers and procedures may be divided into the following groups: (1) intravascular tracers used for radionuclide angiography, (2) particulate and ionic tracers used for assessment of regional flow distribution, and (3) freely diffusable radioactive indicators used for quantitative measurement of flow per unit mass of skeletal muscle or skin. The author discusses each of these

[en] The diuretic renogram has become a useful clinical procedure during the past five years. The major strength of the study is its ability to noninvasively place the majority of patients into unequivocally nonobstructed or obstructed categories. The technique remains limited in the face of marked hydronephrosis or impaired renal function. Future improvements in the technique will be forthcoming if more knowledge can be developed regarding the interrelationship between murine flow rate, volume of the collecting system, and pressure within the collecting system

[en] This book contains 14 chapters. Some of the chapter titles are: Radionuclide Techniques in Peripherral Vascular Disease; Central Nervous System Studies; Hepatic Artery Perfusion Imaging; Drug-Radiopharmaceutical Interactions; and Formulary; Pharmacologic Interventions in Nuclear Medicine

[en] Thallium-201 myocardial imaging is of value in the early detection and evaluation of patients with suspected acute infarction. Thallium imaging may have a special value in characterizing patients with cardiogenic shock and in detecting patients at risk for subsequent infarction or death or death or both, before hospital discharge. Approximately 95 percent of pateints with transmural or nontransmural myocardial infarction can be detected with technetium-99m pyrophosphate myocardial imaging if the imaging is performed 24 to 72 hours after the onset of symptoms. Pyrophosphate imaging may have an important role in the evaluation of patients during the early follow-up period after hospital discharge from an episode of acute infarction. The finding of a persistently positive pyrophosphate image suggests a poor prognosis and is associated with a relatively large incidence of subsequent myocardial infarction and death

No abstract available

[en] We studied 37 children soon after ureteroneocystostomy using diuretic radionuclide urography to assess the patency of the ureterovesical junction. Postoperative obstruction was excluded correctly in 90 per cent of the patients. Transient ureterovesical obstruction occurred in 5 patients, identification of which was useful in assigning risk and in guiding followup studies. Because it is a safe, noninvasive and relatively low radiation test the diuretic radionuclide urogram proves to be an attractive alternative to the excretory urogram in the early and late followup of patients undergoing a ureterovesical junction operation

[en] With IDA hepatobiliary imaging, interventional studies are now playing a major role in the clinical diagnosis and treatment of patients. It is clear that the pharmacological manipulation of physiology with cholecystokinetic agents yields information not obtainable without the pharamacologic interventions. Cholecystokinetic agents improve the diagnostic accuracy in identifying acute cholecystitis, and in allowing greater distinction between patients with acute cholecystitis, acalculus cholecystitis, and biliary colic symptoms with cystic duct patency

[en] Short communication

[en] Conventional radionuclide renography has been modified to include a pharmacologic intervention by administration of intravenous furosemide. The procedure is applied in patients with hydroureteronephrosis to distinguish dilated, nonobstructed systems from those with significant mechanical obstruction. Diagnostic patterns are derived from computer-generated time-activity histograms that depict the accumulation of radiotracer prior to diuresis and in response to diuresis. In dilated, nonobstructed systems, increased urine flow following diuresis causes a decline or washout of activity. In significantly obstructed systems, there is a failure of tracer activity to decrease in response to diuresis. The procedure is applied most commonly in suspected ureteropelvic junction and ureterovesical junction obstruction. The significance of residual urinary tract dilatation following corrective surgery also can be readily assessed. The major current limitation to the technique is poor renal function with inadequate response of urine flow to diuresis

[en] Organ and region-selective intra-arterial chemotherapy have been used for more than two decades to treat malignant neoplasms in the extremities, head and neck region, pelvis, liver, and other areas. Substantial evidence of improved response to regional chemotherapy now exists, but there are stringent requirements for successful application of the regional technique. First, the chemotherapeutic agent employed must have appropriate pharmacokinetic and pharmacodynamic properties. Second, the drug must be reliably delivered to the tumor-bearing area. This typically requires an arteriographic assessment of the vascular supply of the tumor, followed by placement of a therapeutic catheter and confirmation that the ''watershed'' perfusion distribution from the catheter truly encompasses the tumor. Optimal catheter placement also minimizes perfusion of nontarget organs. Radionuclide perfusion imaging with technetium 99m-labeled particles, either microspheres or macroaggregates of albumin, has become the method of choice for making these assessments. Catheter placement itself is considered by many to represent a type of ''therapeutic'' intervention. However, once the catheter is in the hepatic artery the radionuclide perfusion technique can be used to assess adjunctive pharmacologic maneuvers designed to further exploit the regional approach to chemotherapy. This chapter presents the technetium Tc 99m macroaggregated albumin method for assessing catheter placement and the pharmacokinetic rationale for regional chemotherapy, and discusses two promising avenues for further intervention