Internet and nuclear medicine.

This paper aims in analyzing the effectiveness of the technological impact of internet technology on nuclear medicine. To make this evaluation we will first determine what we consider is the 'internet technology' and then see how the 'production line' in nuclear medicine benefits from this internet technology, putting both side by side.     

Evaluation of nuclear medicine tests for the diagnosis of breast carcinoma

In this paper, we evaluate nuclear medicine tests used for the diagnosis of breast carcinoma. Breast carcinoma is the most common carcinoma in women in Europe and its early diagnosis and treatment is important for the overall survival of the patients. Scintimammography technique, indications, contraindications and diagnostic procedures for the identification of the sentinel node and the axillary nodes infiltrated by tumour are described. Also, the use of the radiopharmaceuticals, radioactive thallium chloride-201, methylene diphosphonate labelled with technetium-99m, somatostatin receptors labelled with indium-111, diagnostic procedures with the PET camera, the labelled antibodies to CEA with technetium-99m and also the importance of the MRI and the US techniques are mentioned. These tests have greater diagnostic accuracy as compared to X-ray mammography, clinical examination, MRI and the US technique. Tumour markers in vitro are recommended for the follow- up of metastatic breast carcinoma.     

Information for patients and staff concerning nuclear medicine.

Providing information to patients and staff is an important part of the practice of nuclear medicine. To assist in improving the standard of communications, guidance has been prepared covering the content, style and presentation of letters and leaflets for patients and for medical and nursing staff. Examples are provided which describe nuclear medicine procedures and related radiation safety precautions. They also attempt to answer questions frequently put by the various groups to whom they are addressed.     

Considerations for setting up an order entry system for nuclear medicine tests

Integrating the Healthcare Enterprise-Japan (IHE-J) was established in Japan in 2001 and has been working to standardize health information and make it accessible on the basis of the fundamental Integrating Healthcare Enterprise (IHE) specifications. However, because specialized operations are used in nuclear medicine tests, online sharing of patient information and test order information from the order entry system as shown by the scheduled workflow (SWF) is difficult, making information inconsistent throughout the facility and uniform management of patient information impossible. Therefore, we examined the basic design (subsystem design) for order entry systems, which are considered an important aspect of information management for nuclear medicine tests and needs to be consistent with the system used throughout the rest of the facility. METHODS: There are many items that are required by the subsystem when setting up an order entry system for nuclear medicine tests. Among these items, those that are the most important in the order entry system are constructed using exclusion settings, because of differences in the conditions for using radiopharmaceuticals and contrast agents and appointment frame settings for differences in the imaging method and test items. CONCLUSION: To establish uniform management of patient information for nuclear medicine tests throughout the facility, it is necessary to develop an order entry system with exclusion settings and appointment frames as standard features. Thereby, integration of health information with the Radiology Information System (RIS) or Picture Archiving Communication System (PACS) based on Digital Imaging Communications in Medicine (DICOM) standards and real-time health care assistance can be attained, achieving the IHE agenda of improving health care service and efficiently sharing information.     

肿瘤分子核医学

近年来以分子靶向为主导的分子核医学在肿瘤诊断和治疗的研究和应用中发展迅速。许多病变的标志物或其天然配体有不少能直接转换为显像剂。这些显像剂可用于：建立肿瘤诊断方法；指导治疗(因能显示肿瘤中相应靶分子的存在)；证实肿瘤基因治疗制剂的传送；评价肿瘤治疗后的反应；评价肿     

Position paper on the development of a middle level provider in nuclear medicine: the nuclear medicine practitioner

The development of an educational program and credentialing structure to support and recognize an advanced level of the practice of nuclear medicine technology is now underway. This work parallels the efforts in many, if not most, health care disciplines as they seek to achieve the twin goals of developing enhanced career paths and providing the best possible patient care in an environment where science and technology can run roughshod over concepts taught in the classroom a mere decade ago. Education is key to both goals. A master's level degree in nuclear medicine technology, coupled with an advanced practice credential recognizing both the educational achievement and a level of clinical expertise, will give nuclear medicine practitioners the knowledge and the right to practice their profession at a high level of autonomy, leading to more efficient and higher quality health care services. To that end the following position paper was prepared by members of the Advance Practice Task Force of the SNMTS and presented to the SNMTS Executive Council and the SNM Board of Directors. In June 2005, the executive council and the board of directors approved a resolution supporting the establishment of a middle level provider in nuclear medicine known as the nuclear medicine practitioner.     

Nucleology, nuclear medicine, molecular nuclear medicine and subspecialties

Henry N. Wagner Jr started the presentation of the highlights of the 39th Annual Meeting of the Society of Nuclear Medicine by quoting: "The economist JM Keynes said: "the difficult lies not in new ideas but in escaping from the old ones". Many changes have taken place in the actual term describing our specialty during the last 15 years. Cardiologists have adopted an important chapter of nuclear medicine and to describe that they use the term of "nuclear cardiology". Radiologists have proposed the term "radionuclide radiology". "Nuclear endocrinology", "nuclear oncology", "nuclear nephrology" may be considered as terms describing chapters of nuclear medicine related to other specialties. Will that indicate that our specialty will be divided into smaller chapters and be offered to colleagues working in other specialties leaving to us the role of the supervisor or perhaps the radioprotection officer for in vivo studies? Of course this role is now being exercised by our colleagues in medical physics. It is suggested to use the word " nucleology", instead of "nuclear medicine" where "nuclear" is used as an adjective. Thus, we will avoid being part of another specialty and cardiologists would use the term cardiac nucleology where "cardiac" is the adjective. The proposed term "nucleology" as compared to the existing term "nuclear medicine" has the advantage of being simpler, correct from the grammar point of view and not related to combined terms that may seem to offer part of our specialty to other specialties. At present our specialty faces many problems. The term "nucleology" supports our specialty from the point of view of terminology. During the 3rd International Meeting of Nuclear Medicine of N. Greece which was held in Thessaloniki, Macedonia, Greece on 4-6 November 2005, a discussion arose among participants as to whether the name of "nucleology" could replace the existing name of "nuclear medicine". Finally, a vote (between "yes" and "no") for the new proposed term showed that the "yes" votes were 72 and the "no" votes were 49.     

Paediatric nuclear medicine

Until the 1980s no serious attempts were made to develop paediatric nuclear medicine, as for various reasons many centres were reluctant to perform radionuclide examinations on children. Then two books were published on paediatric nuclear medicine in 1984 and 1985, respectively. In 1987, a group of physicians formed an informal club of paediatricians and nuclear medicine specialists in an effort to improve the relationship and cooperation between these specialties. Carrying out nuclear medicine examinations on children requires a completely different approach than on adults. Suggestions are made and tips given, and the specific problems involved are discussed in detail.     

Cardiac nuclear medicine

In this paper, the principal applications of nuclear medicine to studies of the heart are described. First, gated cardiac blood pool imaging is discussed, then thallium-201 myocardial imaging, myocardial infarct scintigraphy with 99mTc pyrophosphate, and evaluation of intracardiac shunts. In gated cardiac blood pool imaging, the patient's red blood cells are labeled with 99mTc. Images of the cardiac blood pool are then obtained in multiple projections and displayed in an endless-loop cine display. Quantitative indices of cardiac function are readily obtained, and a variety of functional images can be generated. Blood pool imaging may also be performed with use of a first-pass technique that yields similar information. Applications of blood pool imaging are discussed. The theory and techniques of planar and tomographic thallium-201 myocardial imaging are described, together with their application in the diagnosis of coronary artery disease. The prognostic value of thallium imaging is also examined. Myocardial infarct imaging with 99mTc pyrophosphate is described, and clinical indications are reviewed. Left-to-right cardiac shunts can be evaluated by following the first transit of a bolus of radiopharmaceutical through the lungs. Right-to-left shunts may be evaluated by injection of 99mTc macroaggregated albumin.