Guidelines on Setting Up Stations for Remote Viewing of Nuclear Medicine and Molecular Imaging Studies During COVID-19.

The current pandemic has created a situation where nuclear medicine practitioners and medical physicists read or process nuclear medicine images remotely from their home office. This article presents recommendations on the components and specifications when setting up a remote viewing station for nuclear medicine imaging.

Fetal Radiation Dose from 18F-FDG in Pregnant Patients Imaged with PET, PET/CT, and PET/MR.

UNLABELLED: The fetal radiation dose from (18)F-FDG was estimated in a series of pregnant women who underwent a PET scan during a clinical workup for malignancies. METHODS: Six pregnant patients were injected with (18)F-FDG (activity range, 296-385 MBq). Three patients were scanned during the first trimester (1 with PET and 2 with PET/CT), 2 were scanned during the second trimester (with PET/MR imaging), and 1 was scanned during the third trimester (with PET). The time-integrated activity coefficients were derived from the fetal radioactivity concentrations measured on the images for all but 1 patient (in early pregnancy [5 wk]), in whom the activity in the uterus was used as a proxy. The coefficients of the mother's organs were derived from standard values (from the International Commission on Radiological Protection). RESULTS: Fetal doses ranged from 6.29E-03 to 2.46E-02 mGy/MBq. An earlier bladder voiding reduced these doses by 25%-45%. The 2 patients who underwent PET/MR imaging--in whom fetal contours could be accurately delineated--displayed the lowest fetal absorbed dose, likely because of more accurate region drawing, with the inclusion of areas of both low and high fetal uptake. Moreover, PET/MR imaging did not necessitate additional radiation for attenuation correction. The placenta, delineated on a PET/MR imaging scan, concentrated 0.27% of the injected activity. CONCLUSION: Fetal radiation doses are higher in early pregnancy than in late pregnancy, and there can be considerable intersubject variability. However, the total absorbed dose is always well below the threshold for noncancer health effects throughout pregnancy. PET/MR imaging is the optimal PET procedure for imaging pregnant women because it is not associated with radiation for attenuation correction and allows more accurate dosimetric calculations.

Use of [18F]fluorodeoxyglucose positron emission tomography in evaluating locally recurrent and metastatic adrenocortical carcinoma.

CONTEXT: Adrenocortical carcinomas are uncommon, and their evaluation by [(18)F]fluorodeoxyglucose positron emission tomography (FDG PET) has not been well evaluated. OBJECTIVE: The purpose of this study was to examine the potential utility of FDG PET in the detection of recurrent or metastatic adrenocortical carcinoma. DESIGN: In patients with known adrenocortical carcinoma who underwent FDG-PET imaging for suspected recurrence or metastasis, FDG activity was compared with other imaging findings, clinical features, and the presence or absence of disease as confirmed by resection, biopsy, or clinical follow-up. SETTING: The study took place at four tertiary referral centers. PATIENTS OR OTHER PARTICIPANTS: Twelve patients (10 females and two males, 5-71 yr of age) were evaluated. MAIN OUTCOME MEASURES: The main outcome measures were FDG activity, other imaging findings, and clinical features. RESULTS: Abnormal FDG uptake correctly indicated tumor recurrence in 10 patients. One patient with no abnormal FDG activity had a morphological abnormality subsequently proven to be a postoperative scar. Two patients, one with very small pulmonary lesions and one with a hepatic metastasis, had false-negative findings. CONCLUSIONS: Most adrenocortical carcinomas accumulate and retain FDG and thus can be visualized by PET. However, false-negative findings are possible, especially with very small lesions.

Systems for remote interpretation of emergency studies.

Telenuclear medicine facilitates a timely expert interpretation of emergency nuclear medicine studies. Current, high-speed Internet connection allows nuclear medicine physicians to be on-call from their homes. Software to support telenuclear medicine is becoming more widely available, although the design of some departments makes implementation difficult. Quality control of the remote monitor requires special attention to ensure correct interpretation. Fortunately, monitor quality control can be performed quickly using relatively simple procedures. Thus, expert interpretation of emergency nuclear medicine studies is practical.