Asunto(s)
Artritis Reumatoide/diagnóstico por imagen , Neovascularización Patológica/diagnóstico por imagen , Oligopéptidos/farmacocinética , Compuestos de Organotecnecio/farmacocinética , Membrana Sinovial/irrigación sanguínea , Ultrasonografía Doppler/estadística & datos numéricos , Artritis Reumatoide/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neovascularización Patológica/etiología , Prueba de Estudio Conceptual , Trazadores Radiactivos , Reproducibilidad de los Resultados , Membrana Sinovial/diagnóstico por imagen , Ultrasonografía Doppler/métodosRESUMEN
Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/publications/guidelines/2015_07_EANM_FINAL_myocardial_perfusion_guideline.pdf .
Asunto(s)
Imagen de Perfusión Miocárdica/métodos , Guías de Práctica Clínica como Asunto , Sociedades Médicas , Tomografía Computarizada por Rayos X/métodos , Adulto , Medios de Contraste , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/fisiopatología , Relación Dosis-Respuesta a Droga , Ejercicio Físico , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Imagen Multimodal , Imagen de Perfusión Miocárdica/efectos adversos , Imagen de Perfusión Miocárdica/instrumentación , Purinas/efectos adversos , Purinas/farmacología , Pirazoles/efectos adversos , Pirazoles/farmacología , Exposición a la Radiación , Seguridad , Programas Informáticos , Tomografía Computarizada por Rayos X/efectos adversos , Tomografía Computarizada por Rayos X/instrumentación , Vasodilatadores/efectos adversos , Vasodilatadores/farmacologíaRESUMEN
This guideline on current good radiopharmacy practice (cGRPP) for small-scale preparation of radiopharmaceuticals represents the view of the Radiopharmacy Committee of the European Association of Nuclear Medicine (EANM). The guideline is laid out in the format of the EU Good Manufacturing Practice (GMP) guidelines as defined in EudraLex volume 4. It is intended for non-commercial sites such as hospital radiopharmacies, nuclear medicine departments, research PET centres and in general any healthcare establishments. In the first section, general aspects which are applicable to all levels of operations are discussed. The second section discusses the preparation of small-scale radiopharmaceuticals (SSRP) using licensed generators and kits. Finally, the third section goes into the more complex preparation of SSRP from non-licensed starting materials, often requiring a purification step and sterile filtration. The intention is that the guideline will assist radiopharmacies in the preparation of diagnostic and therapeutic SSRP's safe for human administration.