NM bone scan
COMPARISON: []
RADIOPHARMACEUTICALS: []mCi of Tc-MDP was injected I.V.
TECHNIQUE: 3-4hrs after radiotracer injection, whole body bone
scan was performed with selected spot view.
FINDINGS: No suspicious bone uptake. There is degenerative-type
uptake within [site]. Physiologic uptake within kidneys and bladder.
IMPRESSION: No bone scan evidence for
osteoblastic metastasis.
|
NM bone scan 2phase WB
COMPARISON: []
RADIOPHARMACEUTICALS: []mCi of Tc-MDP was injected I.V.
TECHNIQUE: 2-phase whole body bone scan. Whole body blood pool
imaging was performed followed by 3-4hrs delayed whole body imaging with
selected spot views.
FINDINGS: No abnormal periarticular uptake on either blood pool
or delayed whole body imaging. Physiologic uptake within kidneys and
bladder.
IMPRESSION: No bone scan evidence for
synovitis or active inflammatory arthritis.
|
NM bone scan 3phase
COMPARISON: []
RADIOPHARMACEUTICALS: []mCi of Tc-MDP
was injected I.V.
TECHNIQUE: 3 phase bone scan was performed of [site]
FINDINGS: There is [mild/moderate]
abnormal [focal/non-focal/diffuse] peri-articular uptake on all 3 phases of
bone scan within [left/right] [site] which is asymmetric compared to opposite
side consistent with CRPS.
Patient has [left/right] [hip/knee[ arthropasty in
place. There is pmild/moderate[ intensity [focal/non-focal/diffuse]
periprosthetic uptake along site on [flow/blood pool/delayed] imaging. On
delayed imaging there is degenerative vs post-traumatic uptake within
site.
IMPRESSION: No scintigraphic evidence for CRPS
or prosthetic complication.
|
NM bone scan mets FU
COMPARISON: Bone scan []
RADIOPHARMACEUTICALS: []mCi of Tc-MDP
was injected I.V.
TECHNIQUE: 3-4hrs after radiotracer injection, whole body bone
scan was performed with selected spot view.
FINDINGS: Patient has known widespread metastatic disease. In comparison to the prior exam, there is
interval…
no significant change in overall number and intensity of
lesions within axial and proximal appendicular skeleton.
development of [number] new lesion(s) within [location].
remainder of numerous axial skeletal lesions (including
ribs, spine, and pelvis) appear to be stable/slightly improved/slightly
worsened.
IMPRESSION: Known widespread osseous
metastasis with no significant interval change.
|
NM Gallium scan
COMPARISON: []
RADIOPHARMACEUTICAL: []mCi Gallium-67 citrate I.V. on [date]
TECHNIQUE: Whole body infection/inflammation imaging with Gallium
was performed [24/48]hrs after injection along with selected spot views.
FINDINGS: No focal abnormal uptake. There is physiologic uptake within
liver, spleen, bowel, and bone/bone marrow.
IMPRESSION: No site of infection identified.
|
NM GE liquid
COMPARISON: No similar past studies are available for comparison.
RADIOPHARMACEUTICAL: []uCi of Tc-sulfur colloid P.O. in 300cc of water
TECHNIQUE:
Liquid gastric emptying study.
60min of dynamic imaging over abdomen in anterior or LAO position.
FINDINGS: Time to half max (T1/2) gastric activity is
approximately []min (normal less than 23min).
IMPRESSION: Normal liquid gastric emptying study.
|
NM GE oatmeal (semi-solid)
COMPARISON: [none]
RADIOPHARMACEUTICAL: []uCi of Tc-sulfur colloid P.O. in oatmeal (semi-solid
meal). [Patient is unable/unwilling to consume standard egg meal or is
allergic to eggs.]
TECHNIQUE:
[60-90]min of dynamic imaging over
abdomen in anterior or LAO position.
FINDINGS: Time to half max (T1/2) gastric activity is
approximately []min (normal less than equal to 50min).
IMPRESSION: Normal semi-solid gastric emptying
study.
|
NM GE solid
COMPARISON: [none]
RADIOPHARMACEUTICAL: []uCi of Tc-sulfur colloid P.O. in cooked eggs
(standardized solid meal)
TECHNIQUE:
4hr solid gastric emptying study.
After ingestion of radiolabeled standardized solid meal, anterior or LAO
static imaging over the abdomen generally performed at 1hr, 2hr, and 4hr.
FINDINGS: The gastric retention measures []% at 1hr (normal
between 30-90%), []% at 2hr (normal 60% or less), and []% at 4hr (normal
<10%).
IMPRESSION:
Normal solid gastric emptying study.
|
NM GI bleed
COMPARISON: []
RADIOPHARMACEUTICAL: []mCi Tc-RBC
(in-vitro labeling) I.V.
TECHNIQUE: [90]min anterior dynamic imaging was performed over the
abdomen/pelvis after radiotracer injection.
FINDINGS: No abnormal focus of
radiotracer activity was noted during the entire length of study. There is physiologic uptake within blood pool,
spleen, kidneys and bladder.
There is focal abnormal activity
that appears in expected region of [], intensifies over time, and transits
intraluminally in antegrade/retrograde fashion.
IMPRESSION: No scintigraphic evidence for
active GI bleed.
Active X GI bleed within [SMA/IMA]
distribution.
|
NM hemangioma
COMPARISON: []
RADIOPHARMACEUTICAL: []mCi Tc-RBC
I.V.
TECHNIQUE: Flow, blood pool, and [2-3]hr delayed planar imaging of
the abdomen was performed followed by delayed SPECT imaging.
FINDINGS: Hepatic lesion of interest is relatively photopenic on
flow and blood pool imaging with diffuse increased uptake (greater than
hepatic background and equal to blood pool acitivity) on delayed imaging best
evaluated on SPECT imaging consistent with hemangioma.
IMPRESSION:
Scintigraphic findings confirm
[location] hepatic hemangioma.
|
NM HIDA
COMPARISON: []
RADIOPHARMACEUTICALS: []mCi
Tc-choletec IV
TECHNIQUE: [60]min anterior
dynamic imaging over the abdomen was performed after radiotracer injection. [Additional
4hr delayed static imaging was obtained.] [Patient was pretreated with CCK 30
minutes before injection.]
FINDINGS: Normal hepatic uptake and excretion with appropriate
clearance of background blood pool activity. Normal visualization of biliary,
gallbladder and bowel activity.
Normal hepatic uptake with decreased excretion and poor
clearance of background blood pool activity suggestive of hepatocellular
dysfunction.
Normal visualization of biliary and bowel activity.
However, no gallbladder activity on initial or 4hr delayed imaging.
Delayed biliary-to-bowel transit is non-specific but can
be seen with chronic cholecystitis.
Incidental note of enterogastric reflux.
Distended common bile duct with poor clearance of
biliary activity suggestive of partial/high-grade biliary obstruction.
IMPRESSION:
No scintigraphic evidence
for acute cholecystitis. Cannot exclude chronic cholecystitis.
|
HIDA with GBEF
COMPARISON: []
RADIOPHARMACEUTICALS: []mCi Tc-cholectec IV
ANCILLARY
PHARMACEUTICAL: []ug CCK IV
TECHNIQUE: 60min anterior dynamic imaging followed by GB ejection
fraction determination using CCK infusion over [30]min
FINDINGS: Normal hepatic uptake and excretion with appropriate
clearance of background blood pool activity.
Normal visualization of biliary, gallbladder, and small bowel
activity.
After CCK infusion, gallbladder ejection fraction is
calculated to be []% (normal greater
than 35%). [Patient was asymptomatic] during CCK infusion.
60min after oral Ensure/Boost (in lieu of CCK)
administration, gallbladder ejection fraction is calculated to be []% (normal
greater than or equal to 33%).
IMPRESSION:
Depressed gallbladder
ejection fraction consistent with chronic cholecystitis or gallbladder dyskinesia.
|
NM I131 cancer therapy inpatient
COMPARISON:
[]
ADDITIONAL
HISTORY: [cancer pathology]. [social
situation].
RADIOPHARMACEUTICALS: []mCi I-131 P.O.
inpatient therapy for thyroid cancer ablation.
TECHNIQUE: Dose was prescribed by an Authorized user in
conjunction with treatment request by endocrinologist/ENT physician. The
risks, benefits, and potential complications of radioactive I-131 therapy
were discussed in detail with the patient. Verbal and written informed
consent was obtained. [Urine B-hCG was confirmed negative prior to therapy.]
Dose was verified in dose calibrator and patient was given oral I-131 pill
under my direct supervision. Patient will be kept in hospital for next few
days under supervised isolation for radiation safety precautions and
subsequently, discharged to home per release criteria. Take-home written instructions sheet will
be given at discharge for radiation safety precautions to be observed as an
outpatient. Patient has been specifically advised to avoid close contact with
children, pregnant women, and other members for public at time of discharge.
[Also, patient has been advised to use appropriate contraceptive method to
avoid pregnancy for 6 to 12 months following therapy.]
IMPRESSION: Inpatient []mCi I-131 P.O. therapy for thyroid cancer
ablation.
UPDATE: Patient was kept in hospital for
[3]days in supervised isolation for radiation safety precautions. Inpatient
stay was uneventful. Patient was discharged on [date/time] in stable
condition to home per release criteria (exposure rate of []mR/hr at 1m) and was given a take-home
written instructions sheet for radiation safety precautions to be observed
for another [2]days as an outpatient. Patient has been instructed to return
in 7-10 days for post-ablation whole body scan.
|
NM I131 cancer therapy outpatient
COMPARISON:
I-131 post-ablation scan or
Metascan []
ADDITIONAL
HISTORY: [social history]. []TSH (on hormone
withdrawl) on [date].
RADIOPHARMACEUTICALS: []mCi I-131 P.O.
outpatient therapy for thyroid cancer.
TECHNIQUE: Dose was prescribed by an Authorized user in
conjunction with treatment request by endocrinologist/ENT physician. Suitability for outpatient therapy was
determined during in-office consultation on [date] and patient release
calculations were performed using patient-specific factors to ensure
potential dose to public of less than 0.5rem.
The risks, benefits, and potential complications of radioactive I-131
therapy were discussed in detail with the patient. Verbal and written
informed consent was obtained and take-home written instructions were given
for radiation safety precautions to be observed for [5]days as an outpatient.
Patient was specifically advised to avoid close contact with children,
pregnant women, and other members of public. [Also, patient has been advised
to use appropriate contraceptive method to avoid pregnancy for 6 to 12 months
following therapy. Urine B-hCG was confirmed negative prior to therapy.] Dose
was verified in dose calibrator and patient was given oral I-131 pill under
my direct supervision. No immediate complications.
IMPRESSION:
1. Outpatient []mCi I-131 P.O.
therapy for thyroid cancer.
2. Patient will return in 7-10days
for post-ablation scan.
|
NM Pre-I131 consultation
Relevant
medical history: []year-old [F/M] with [type] thyroid cancer
[pathology], status post total thyroidectomy on [date]. [No] prior I-131
therapy or metascan. Patient denies urinary incontinence or renal disease.
Patient is currently on low iodine diet and is currently off thyroid replacement
therapy.
Social
history: Patient lives with [].
Patient will be able to sleep alone and have a bathroom for own exclusive
use. No pregnant female or children
18years or younger at home.
Pertinent
Imaging: []
Pertinent
Labs: [] TGag/TGab with [] TSH on [date]. [] Cr/GFR
on [date].
Pregnancy/Breastfeeding: Patient denies pregnancy or breastfeeding. Pregnancy
test will be obtained prior to therapy.
Discussion:
Pre-therapy consultation with
patient was done to determine suitability of I-131 cancer therapy in an
outpatient setting. Patient's social situation was discussed in detail to
determine whether patient would be able to follow strict radiation safety
precautions at home following therapy without need for hospital stay. The
radiation safety precautions were reviewed in detail and written
documentation was provided for reference.
Risks, benefits and potential complications of I-131 ablation were
also explained and patient had an opportunity to ask questions and have them
answered. 30min was spent in consultation.
PLAN:
Perform high-dose I-131 therapy as
an outpatient. Patient understands and agrees to necessary radiation safety
precautions related to outpatient therapy. Patient's social situation is
conducive to outpatient therapy.
|
NM I131 dosimetric evaluation
RADIOPHARMACEUTICAL: []mCi I-123 P.O.
on [date]
TECHNIQUE: Patient-specific dosimetric evaluation was performed to
determine max tolerated dose ensuring lung/WB retention of less than
80/120mCi at 48hrs. Whole body imaging was performed at 2hrs (pre-voiding)
and 24hrs (post-voiding) after radiotracer administration. Geometric mean of
total anterior and posterior counts derived from ROI over whole body at 2hrs
and over lungs/WB at 24hrs were utilized for determination of WB retention at
48hrs.
FINDINGS: Total Lung/WB retention at 48hrs was calculated to be
[]mCi.
IMPRESSION:
Given total lung/WB
retention at 48hrs of []mCi, recommend therapy with []mCi I-131 PO.
|
NM I131 Hyperthyroid therapy
COMPARISON:
I-123 uptake/scan []
ADDITIONAL
HISTORY: []
RADIOPHARMACEUTICALS: []mCi I-131 P.O.
outpatient therapy for hyperthyroidism.
TECHNIQUE: Dose was prescribed by an Authorized user in
conjunction with treatment request by endocrinologist/ENT physician. The risks, benefits, and potential
complications of radioactive I-131 therapy were discussed in detail with the
patient. Verbal and written informed consent was obtained and take-home
written instructions were given for radiation safety precautions to be observed
for [3]days as an outpatient. Patient was specifically advised to avoid close
contact with children, pregnant women, and other members for public [and also
to use appropriate contraceptive method to avoid pregnancy for 6 months
following therapy]. [Urine B-hCG was confirmed to be negative prior to
therapy]. Dose was verified in dose calibrator and patient was given oral
I-131 pill under my direct supervision. No immediate complications.
IMPRESSION: Outpatient []mCi I-131 P.O.
therapy for hyperthyroidism. Patient to follow-up with [ENT/endocrinologist]
to determine adequacy to treatment.
|
NM I131 Metascan
ADDITIONAL
HISTORY: []
RADIOPHARMACEUTICAL: []mCi I-131 P.O. on [date]
TECHNIQUE: Radioactive iodine was administered under supervision
of an Authorized User. After 48hrs, whole body I-131 Metascan was performed
with spot views of the neck with and without markers.
FINDINGS: There is physiologic uptake within salivary glands,
nasopharynx, stomach, colon and bladder. No suspicious uptake within neck/chest.
IMPRESSION:
No evidence for iodine-avid
thyroid cancer recurrence. Please
correlate with serum thyroglobulin levels.
|
NM I131 post-ablation scan
COMPARISON: []
RADIOPHARMACEUTICAL: []mCi I-131 P.O.
radio-iodine ablation therapy as [outpatient] on [date]
TECHNIQUE: [7-10]days post-ablation I-131 whole body scan with
spot views of neck.
FINDINGS: Post-ablation scan shows expected uptake within the
thyroid bed likely representing remnant thyroid tissue. No other areas of
abnormal uptake. Normal/physiologic uptake within salivary glands,
nasopharynx, stomach, colon and bladder.
IMPRESSION:
1. Expected uptake within thyroid
bed most likely represents remnant thyroid tissue.
2. No regional lymph node uptake or
distant metastatic disease.
|
NM Indium dual-isotope hardware
COMPARISON: 3phase bone scan []
RADIOPHARMACEUTICAL: [0.5]mCi Tc-WBC I.V. on [date] and [10]mCi Tc-SC I.V.
on [date]
TECHNIQUE: Simultaneous dual-isotope imaging of [site] with Indium
labeled WBC (infection imaging) and Tc- Sulfur Colloid (marrow imaging).
Post-processing normalization and subtraction was performed.
FINDINGS:
There is no focal abnormal uptake
on indium scan.
There is concordant [minimal/mild/moderate]
[focal/non-focal/diffuse] periprosthetic uptake on Indium and Sulfur Colloid
scans suggestive of non-infectious etiology like redistributed or reactivated
marrow.
There is [minimal/mild/moderate] [focal/non-focal/diffuse]
periprosthetic uptake along [site] on Indium scan [corresponding to region of
concern on 3phase bone scan] which is discordant with sulfur colloid scan.
IMPRESSION: No dual-isotope
imaging findings to suggest hardware infection.
Given abnormal 3 phase bone scan
hardware loosening cannot be entirely excluded (correlate clinically).
|
NM Indium scan
COMPARISON: []
RADIOPHARMACEUTICAL: []mCi Indium
labeled WBC I.V. on [date]
TECHNIQUE: Whole body infection imaging with Indium-WBC was
performed [24]hrs after injection along with selected spot views.
FINDINGS: No focal
abnormal uptake. There is physiologic uptake within spleen, liver, and bone
marrow.
IMPRESSION:
No site of infection identified.
|
NM injection only
The patient was injected with []mCi
[radiotracer] for [] nuclear medicine study. Due to [patient’s condition] no
imaging could be obtained therefore study was cancelled. The exam code was
changed to [injection only].
|
NM liver spleen scan
COMPARISON: []
RADIOPHARMACEUTICAL: []mCi Tc-Sulfur
Colloid I.V.
TECHNIQUE: Planar imaging of liver/spleen was performed in
multiple projections [including SPECT imaging of abdomen]
FINDINGS: [No] hepatosplenomegaly. [No] abnormal increased splenic uptake or
evidence for colloid shift. [Faint
physiologic] bone marrow uptake is noted.
IMPRESSION: No evidence for colloid shift or sequela of portal
hypertension.
|
NM Lymphoscintigraphy Breast
RADIOPHARMACEUTICAL:
[]mCi [Tc-SC (filtered)/Tc-Lymphoseek]
in [4] equal doses
PROCEDURE:
[Four] peri-areolar intra-dermal
injections were performed for pre-op [left/right] breast sentinel lymph node
localization. Time-out was done prior to procedure. No imaging was requested.
IMPRESSION: [Left/Right] breast injected for
sentinel lymph node localization.
|
NM Lymphoscintigraphy Melanoma
RADIOPHARMACEUTICAL:
[]mCi [Tc-SC (filtered)/Tc-Lymphoseek]
in [2] equal doses
TECHNIQUE: Pre-operative sentinel node mapping for Melanoma. [3]
peritumoral intradermal injections were performed at the [site] followed by
dynamic imaging for [2]hrs. Time-out was done prior to procedure.
FINDINGS/IMPRESSION: [Single] [location] sentinel lymph
node(s) was identified and overlying skin was marked to assist with
intraoperative localization.
|
NM lymphosintigraphy LE
RADIOPHARMACEUTICAL: []mCi [Tc-SC (filtered)/Tilmanocept (Lymphoseek)] intradermal
injections bilateral feet.
TECHNIQUE: Intradermal injection of
radiotracer was performed at first and second web spaces of bilateral feet.
Dynamic and static imaging of bilateral lower extremities was performed from
feet to upper abdomen.
FINDINGS: There is [high grade
obstruction of right lower extremity deep lymphatic channel] located [at the
level of knee with resultant significant dermal backflow (superficial lymphatic
channels) and poor transit distally]. At [2]hrs no significant radiotracer
transit was seen above the knee. [Normal left lower extremity lymphatic
imaging with visualization of inguinal nodes and subsequent physiologic liver
uptake.]
IMPRESSION:
1. High grade obstruction of [right lower extremity deep lymphatics] located
[at the level of the knee]. This correlates with history of lymphedema.
2. Normal left lower extremity lymphatics.
|
NM MPS 1day mibi/mibi
COMPARISON: []
RADIOPHARMACEUTICALS:
[]mCi Tc-Sestamibi IV at rest and
[]mCi Tc-Sestamibi IV at stress
PROCEDURE:
1-day Myocardial Perfusion Scan
with Tc-Sestamibi. SPECT imaging was performed at rest followed by same day
gated SPECT imaging after pharmacological stress with 0.4mg Lexiscan IV.
FINDINGS: [No
significant perfusion defect]. [No] transient ischemic dilation (TID) at
stress. Left ventricular ejection fraction is []% (normal 50% or above).
Normal wall motion.
IMPRESSION:
1. No ischemia or infarct.
2. Ejection fraction of []% with
normal wall motion.
|
NM MPS 2day mibi/mibi
COMPARISON: []
RADIOPHARMACEUTICALS:
[]mCi Tc-Sestamibi IV at stress on [date]
and []mCi Tc-Sestamibi IV at rest on [date]
PROCEDURE:
2-day Myocardial Perfusion Scan
with Tc-Sestamibi. Gated stress SPECT imaging was performed after
pharmacological stress with 0.4mg Lexiscan IV. Rest SPECT imaging was
performed on a separate date.
FINDINGS: [No
significant perfusion defect]. [No] transient ischemic dilation (TID) at
stress. Left ventricular ejection fraction is []% (normal 50% or above).
Normal wall motion.
IMPRESSION:
1. No ischemia or infarct.
2. Ejection fraction of []% with
normal wall motion.
|
NM MPS with thallium
COMPARISON:
[]
RADIOPHARMACEUTICALS:
[3]mCi Thallium-201 IV
PROCEDURE:
Myocardial Perfusion Scan with
Thallium-201. Gated stress SPECT imaging was performed after pharmacological
stress with 0.4mg Lexiscan IV followed [3-4]hr later by rest SPECT imaging.
FINDINGS: [No
significant perfusion defect]. [No] transient ischemic dilation (TID) at
stress. Normal lung-to-heart ratio. Left ventricular ejection fraction is []%
(normal 50% or above). Normal wall motion.
IMPRESSION:
1. No ischemia or infarct.
2. Ejection fraction of []% with
normal wall motion.
|
NM MPS and viability
COMPARISON:
[]
RADIOPHARMACEUTICALS:
[3]mCi Thallium-201 IV at stress and
[1]mCi re-injection at rest for 24hr viability
PROCEDURE:
Myocardial Perfusion and Viability
Scan with Thallium-201. Gated-SPECT imaging was performed after
pharmacological stress with 0.4mg Lexiscan IV followed by 4hr resting SPECT
imaging and 24hr delayed re-distribution (viability) imaging.
FINDINGS:
Myocardial Perfusion and Viability
Scan with Thallium-201. There is [] wall defect which is
demonstrates [no significant viability].
LV ejection fraction is []% (normal 50% or above) with normal wall
motion.
IMPRESSION:
1.
[] wall [partial/complete] viability.
2. [] wall infarct without
significant viability.
3. Depressed LV ejection fraction of []% with
[abnormal] wall motion.
|
NM MPS viability only
COMPARISON: Myocardial
perfusion scan []
RADIOPHARMACEUTICALS:
total [4]mCi Thallium-201 IV [(including 1mCi reinjection after 4hr
imaging)]
PROCEDURE:
Myocardial Viability Scan with
Thallium-201. Resting gated SPECT imaging was performed [10]min after
radiotracer injection followed by [4hr and 24hr] re-distribution SPECT
imaging.
FINDINGS:
There is [] wall defect which
demonstrates [no significant viability]. LV ejection fraction is []% (normal
50% or above) with normal wall motion.
IMPRESSION:
[] wall infarct without
significant viability.
|
NM MPS planar
COMPARISON:
[]
RADIOPHARMACEUTICALS:
[]mCi Tc-Sestamibi IV at stress on
[date] and []mCi IV at rest on [date]
PROCEDURE:
2-DAY PLANAR MYOCARDIAL PERFUSION SCAN. Due to patient's body habitus (beyond camera table
weight-limit), very limited Planar-only (non-SPECT, non-gated) Myocardial
Perfusion Scan was performed at rest and stress in anterior, LAO, and left
lateral projections. Stress imaging was obtained after pharmacological stress
using 0.4mg Lexiscan IV.
FINDINGS/IMPRESSION: Very
limited planar Myocardial Perfusion Scan.
1. [No significant ischemia/infarct].
2. No ventricular function data
available.
|
NM MUGA
COMPARISON: recent MUGA [] and baseline MUGA [].
RADIOPHARMACEUTICALS: []mCi Tc-RBC
(in-vitro labeling) I.V.
TECHNIQUE: Gated dynamic imaging was performed in LAO and
additional projections. Using
end-systolic and end-diastolic ROIs on LAO projection, left ventricular
ejection fraction was calculated.
FINDINGS/IMPRESSION: Left ventricular ejection
fraction is estimated to be []% (normal 50% or more), previously []% on [date].
Normal phase/amplitude and LV wall motion.
|
NM Octreoscan
COMPARISON: []
RADIOPHARMACEUTICAL: []mCi
In-111-Pentreotide (OctreoScan) I.V.
TECHNIQUE: Whole body planar imaging was performed in
anterior/posterior projection at [4hr, 24hr, and 48hr] after radiotracer
injection including SPECT imaging of [abdomen/pelvis] at [24hr and 48hr].
FINDINGS: There is no
focal abnormal uptake. Physiologic uptake is seen within the liver, spleen,
kidneys/bladder, bowel, and thyroid gland.
IMPRESSION: No scintigraphic evidence for metastasis.
|
NM Parathyroid
COMPARISON:
[None]
RADIOPHARMACEUTICAL:
[]mCi Tc-sestamibi IV.
TECHNIQUE:
Dual-phase 20min early and 2hr delayed
Parathyroid scan with Tc-sestamibi. [Delayed SPECT was also obtained].
FINDINGS:
Homogenous thyroid uptake on early and
appropriate thyroid washout on delayed scan. No focal abnormal activity on either
early or delayed parathyroid scan to suggest parathyroid adenoma.
IMPRESSION:
No focal parathyroid adenoma
identified.
|
NM Parathyroid dual-isotope
COMPARISON:
[None]
RADIOPHARMACEUTICAL:
[5]mCi Tc-pertechnetate IV and [20]mCi
Tc-sestamibi IV.
TECHNIQUE:
Dual-isotope imaging with
post-processing subtraction. Thyroid
scan was performed with Tc-pertechnetate followed by early and delayed
Parathyroid scan with Tc-sestamibi.
FINDINGS:
No focal abnormal activity on
thyroid-parathyroid subtraction imaging or delayed parathyroid scan.
On thyroid-parathyroid subtraction
imaging, there is focal residual uptake along [inferior aspect of left
thyroid lobe] suggestive of [left inferior] parathyroid adenoma. This is also
confirmed on delayed parathyroid scan.
IMPRESSION:
No focal parathyroid
adenoma identified.
|
NM Peritoneal scintigraphy
RADIOPHARMACEUTICAL: [5]mCi Tc-MAA intraperitoneal via percutaneous catheter
TECHNIQUE: Approximately [2000]ml of radiolabeled dialysate was
instilled into peritoneal cavity via existing percutaneous catheter in
sterile fashion by [Nephrology nurse]. Anterior/posterior static imaging was
performed at [1hr and 2hr]. Subsequently dialysate fluid was removed.
FINDINGS/IMPRESSION: Normal peritoneal scintigraphy.
There is homogeneous distribution of dialysate within the 4 quadrants of
abdominal cavity without focal fluid collection or evidence for extension
into abdominal/inguinal hernia or within pleural cavity. No significant
retention.
|
NM PET scan
COMPARISON: []
RADIOPHARMACEUTICAL: []mCi of F18-FDG
I.V.
PROCEDURE: Serum glucose of []mg/dl. PET/CT was performed [60]min
following radiotracer injection from [skull base to mid thighs/head to toe (whole
body)/top of head (including brain) to mid thighs]. CT images were acquired
without breathhold and [with/without] [IV/oral contrast].
CT
DOSE: CTDIvol of []mGy and total DLP of
[]mGy-cm (using Body 32cm phantom).
FINDINGS:
BRAIN: []
NECK: []
CHEST/MEDIASTINUM: []
BREAST/AXILLA: []
ABD/PELVIS: []
MSK/MISC: []
IMPRESSION:
No PET/CT evidence for active disease or recurrence.
|
NM PET brain
COMPARISON: []
RADIOPHARMACEUTICAL: []mCi of F18-FDG
I.V.
PROCEDURE: Serum glucose of []mg/dl. Brain PET/CT was performed [30]min
following radiotracer injection from vertex through skull base. Low dose CT
images were acquired without IV for attenuation correction and anatomic
correlation.
CT
DOSE: CTDIvol of []mGy and DLP of []mGy-cm.
FINDINGS:
[Bilateral/unilateral] [symmetric/asymmetric]
decreased FDG uptake within [parietal/temporal/frontal cortices to include
posterior cingulate gyri with sparing of sensorimotor and occipital cortices
and deep gray matter].
There is normal and symmetric FDG
uptake within bilateral cerebral cortices, deep gray nuclei, thalami,
cerebellum and brainstem.
[No focal anatomic abnormality or
atrophy] on noncontrast CT.
IMPRESSION:
No specific PET/CT abnormality to
suggest etiology of MCI/dementia.
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NM PET sarcoidosis
COMPARISON: Myocardial perfusion scan []
RADIOPHARMACEUTICAL: []mCi of F18-FDG
I.V.
PROCEDURE: Serum glucose of []mg/dl. Myocardial PET/CT (including
chest) was performed 90min radiotracer injection. Patient prep included
high-fat, low-carbohydrate diet followed by extended fasting for [12]hrs
before scan. Low dose CT images were acquired without IV and oral contrast,
and were used for attenuation correction and for anatomic correlation.
CT
DOSE: CTDIvol of []mGy and total DLP of []mGy-cm.
FINDINGS:
MYOCARDIUM: []
CHEST/MEDIASTINUM: []
MISC: []
IMPRESSION:
No PET/CT evidence for myocardial
sarcoidosis.
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NM Renal lasix
COMPARISON: []
RADIOPHARMACEUTICAL: []mCi Tc-MAG3 IV via [site]. [No] extravasation at
injection site.
ANCILLARY
PHARMACEUTICAL: [40]mg Lasix IV given at [start
of the exam (within 1 minutes of radiotracer injection)].
TECHNIQUE: Dynamic posterior imaging over bilateral kidneys was
performed for [30]min with Lasix given at the beginning of the study. Static post-void imaging was also
performed.
FINDINGS:
FLOW: There is [prompt/symmetric]
flow to [bilateral kidneys].
SPLIT FUNCTION: Differential
function at 2min is []% on the left and []% on the right.
RENOGRAM AND COLLECTING SYSTEM
CLEARANCE: [Symmetric renal size and normal orientation]. [There is no hydronephrosis or hydroureter]. [There is prompt rise to peak and washout
of bilateral renal activity]. Time to
peak activity is approximately []min on the left and []min on the right
(normal 3-5min). Post-Lasix time to half (T1/2) is []min on the left and []min on the right (normal less than 10
minutes).
POST VOID: [No] significant
persistent collecting system activity is noted on post void imaging. [Progressive clearance of collecting system
activity within upright posture and voiding]. [No significant] post-void
residual bladder volume.
IMPRESSION: Normal bilateral renal flow and function without
obstruction.
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NM Renal captopril
COMPARISON: []
RADIOPHARMACEUTICAL: []mCi Tc-MAG3 IV
on [date] for post-captopril renal scan and
[]mCi Tc-MAG3 IV on [date] for baseline renal scan.
TECHNIQUE: Hypertensive medications were held for at least [48]hrs
prior to study. On day one, post-ACE inhibitor renal scan was performed with [25mg
Captopril PO given 1hr] prior to radiotracer injection. Patient's blood pressure was monitored
throughout the exam with [no adverse reaction]. Dynamic imaging was performed for [30-40]min
in posterior projection. On day two, baseline renal scan was performed
without ACE inhibitor using same imaging parameters. No Lasix was given.
FINDINGS:
Baseline scan: Differential
function is []% left and []% right kidney. Cortical time to peak is []min left and []min right kidney. 20 min/max
activity remaining is []% left and []% right kidney. Renogram curve is grade [] left and grade
[] right kidney.
Post-Captopril scan: Differential
function is []% left and []% right kidney. Cortical time to peak is []min
left and []min right kidney. 20 min/max activity remaining is []% left and []%
right kidney. Renogram curve is grade
[] left and grade [] right kidney.
Misc: Symmetric renal size and
normal orientation. No hydronephrosis. Time to half max (T1/2) of collecting
system activity is []min on the left and []min on the right. This is
unchanged on pre- or post-Captopril scan. Post void images demonstrate []. No
significant extravasation is noted at the injection site.
IMPRESSION:
Low probability for RAS.
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NM thyroid uptake
COMPARISON: Ultrasound thyroid []
RADIOPHARMACEUTICAL: []uCi I-123 P.O.
TECHNIQUE: I-123 uptake and scan performed at 24hrs after
radiotracer ingestion.
FINDINGS: Homogenous thyroid gland uptake without focal hot or
cold nodule. 24hr radioactive iodine uptake is []% (normal 10-30%). No
thyroid enlargement on physical exam.
IMPRESSION: In setting of hyperthyroidism, imaging is suggestive
of [Graves disease] with [elevated] 24hr uptake of []%.
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NM VQ XENON
COMPARISON: chest Xray []
RADIOPHARMACEUTICALS: []mCi Xe-133
gas inhaled and []mCi Tc-MAA IV
TECHNIQUE: Planar ventilation scan was performed in posterior
projection after Xe-133 gas inhalation (wash-in, equilibrium, and wash-out
phases) followed by perfusion scan with Tc-MAA IV in multiple
projections.
FINDINGS:
Normal ventilation with appropriate wash-out
and no significant air-trapping. No mismatched segmental perfusion defect. No
focal opacity on recent chest Xray.
IMPRESSION:
Low probability for acute PE.
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NM VQ AEROSOL
COMPARISON: chest Xray []
RADIOPHARMACEUTICALS: []mCi Tc-DTPA aerosol nebulizer and []mCi Tc-MAA IV
TECHNIQUE: Planar ventilation scan was performed in multiple
projections after Tc-DTPA aerosol nebulizer administration followed by perfusion
scan with Tc-MAA IV in similar projections. [Due to patient's body habitus,
limited ventilation-perfusion imaging was performed in anterior and LAO/RAO
projections only, with patient in hospital gurney.]
FINDINGS:
Normal ventilation scan without defects or
central deposition of radiotracer. No mismatched segmental perfusion defect.
No focal opacity on recent chest Xray.
[Mildly] heterogeneous ventilation
with [multiple/occasional] matched ventilation-perfusion defects [(with
ventilation worse than perfusion)]. No significant mismatched perfusion
defect.
IMPRESSION:
Low probability for acute PE.
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NM VQ shunt
COMPARISON: No previous study available for comparison.
RADIOPHARMACEUTICAL:
[]mCi Tc-MAA IV
TECHNIQUE:
Lung perfusion imaging was performed
for R to L shunt determination. Whole body was imaged from vertex of skull
through mid-thighs. Counts were determined using ROI over region of interest
on both anterior and posterior projections with geometric mean calculation.
FINDINGS:
Whole body (WB) counts= []
Lung counts= []
Systemic counts= WB counts - Lung
counts= []
Right to left shunt= (Systemic counts
/ WB counts) x 100%= []% (normal is <5%)
No significant segmental perfusion
defects.
IMPRESSION: No significant R to L shunt.
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NM VQ split lung
COMPARISON: CXR
RADIOPHARMACEUTICALS: [] mCi Tc-MAA IV
TECHNIQUE: Quantitative lung perfusion study with split lung
analysis. Ventilation was not performed.
FINDINGS:
Focal perfusion defect
corresponding to known lung mass.
Quantitative perfusion analysis
shows total split lung perfusion of []% left lung and []% right lung.
Percent perfusion for left upper
lung zone is []%, left mid lung zone
is []%, left lower lung zone is []%.
Percent perfusion for right upper lung zone is []%, right mid lung
zone is []%, right lower lung zone is [] %.
IMPRESSION: Split lung perfusion as above.
[R/L] lung contributes []% to the total lung perfusion (with [] lung zone
contributing []%).
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