• Diagnostic Imaging: Nuclear Medicine 4th edition provides details on new imaging agents now approved by the FDA, new therapeutic agents not previously discussed, updates to available therapies/procedures with new interval data/guidelines, and new imaging protocols and data on imaging. Both new chapters and updates to existing chapters are included in the 4th ed as well as an expanded reference base for pediatric imaging. • New chapters are included on F-18 PSMA PET, F-18 Fluoroestradiol, and Cu-64 DOTATATE. • New therapeutic agents are covered including •Treatment of pheochromocytoma and paraganglioma using Azedra •Neuroblastoma treatment with I-131 MIBG •Major updates to prostate therapy with interval FDA approval of new drugs • Multiple chapters provide updates on previously available therapies and procedures including for benign and malignant thyroid cancers, sentinel node mapping, and lymphedema.

SECTION 1: CARDIAC

Introduction

Approach to Cardiac Imaging

Function and Coronary Artery Disease

Left Ventricular Function
Myocardial Infarction and Ischemia
Myocardial Viability
Myocardial Blood Flow Quantification
Risk Stratification for Sudden Cardiac Death

Cardiomyopathy

Cardiac Sarcoidosis
Cardiac Amyloidosis

Infection

Endocarditis and Cardiac Device Infection

SECTION 2: CENTRAL NERVOUS SYSTEM

Introduction

Approach to Central Nervous System Imaging

Cerebrospinal Fluid

CSF Leak Evaluation
CSF Shunt Patency
Normal-Pressure Hydrocephalus

Dementia

Alzheimer Disease
Frontotemporal Dementia
Lewy Body Dementia
Multi-Infarct Dementia
Primary Progressive Aphasia

Infection and Inflammation

Brain Abscess and Encephalitis

Movement Disorders

Parkinsonian Syndromes

Vascular

Brain Death
Cerebrovascular Ischemia

Other

Meningioma
Seizure

SECTION 3: GASTROINTESTINAL

Introduction

Approach to Gastrointestinal Imaging

Hepatobiliary

Acute Cholecystitis
Other Biliary Obstruction
Biliary Leak
Functional Gallbladder Disease
Benign Solid Liver Lesions

Gastrointestinal

Gastrointestinal Bleeding
Gastroparesis
Rapid Gastric Transit
Colon Motility Disorders

Infection and Inflammation

Occult Abdominal Infection
Inflammatory Bowel Disease

Spleen

Spleen Localization

SECTION 4: LYMPHATIC AND VASCULAR

Introduction

Approach to Lymphatic and Vascular Imaging

Lymphatic

Lymphedema
Sentinel Lymph Node Mapping

Vascular

Large Vessel Vasculitis
Vascular Graft Infection

SECTION 5: MUSCULOSKELETAL

Introduction

Approach to Musculoskeletal Imaging

Bone Tumors

Bone Neoplasms
Metastatic Bone Tumors
Malignant Peripheral Nerve Sheath Tumor

Bone Dysplasias

Fibrous Dysplasia
Paget Disease

Bone Mineral Density

Osteopenia and Osteoporosis

Infection and Inflammation

Arthroplasty Complication
Inflammatory Arthritis
Osteomyelitis and Septic Arthritis

Metabolic Disease

Metabolic Bone Disease

Trauma

Heterotopic Ossification
Occult Fracture
Stress and Insufficiency Fracture

Vascular

Avascular Necrosis
Complex Regional Pain Syndrome
Sickle Cell Disease

SECTION 6: THYROID AND PARATHYROID

Introduction

Approach to Thyroid and Parathyroid Imaging

Thyroid

Graves Disease
Nodular Thyroid Disease
Subacute Thyroiditis
Thyroid Incidentaloma

Parathyroid

Parathyroid Adenoma

SECTION 7: THORACIC

Introduction

Approach to Thoracic Imaging

Infection and Inflammation

Atypical Infectious Diseases
Granulomatous Disease

Lung Perfusion and Ventilation

Pulmonary Embolism
Quantitative Lung Perfusion
Right-to-Left Shunt

SECTION 8: URINARY TRACT

Introduction

Approach to Urinary Tract Imaging

Infection and Inflammation

Renal Scar and Pyelonephritis

Renal Function

Hydronephrosis
Vesicoureteral Reflux
Renal Transplant Evaluation
Renovascular Hypertension
GFR Analysis

SECTION 9: PEDIATRICS

Introduction

Approach to Pediatric Imaging

Central Nervous System

Seizure

Thyroid

Congenital Hypothyroidism
Pediatric Salivary Function

Gastrointestinal

Gastric Motility
Meckel Diverticulum
Aspiration

Hepatobiliary

Biliary Atresia

Infection and Inflammation

Fever of Unknown Origin
Osteomyelitis and Septic Joint

Musculoskeletal

Avascular Necrosis
Pediatric Lower Extremity Pain
Pediatric Lower Back Pain
Nonaccidental Trauma

SECTION 10: MISCELLANEOUS

DEL_Nasolacrimal Complex Obstruction
Salivary Gland Scintigraphy
Adult Fever of Unknown Origin

SECTION 11: ONCOLOGY

Introduction

Approach to Oncologic Imaging

Breast

Benign Breast Conditions
Breast Malignancy

Central Nervous System

Brain Metastases
Postradiation CNS Evaluation

Cutaneous

Merkel Cell
Melanoma

Gastrointestinal Tract

Esophageal Cancer
Gastric Carcinoma and Gastrointestinal Stromal
Tumor
Colon Cancer
Anal Cancer

Head and Neck

Gland Tumors
Head and Neck Cancer

Hepatobiliary

Hepatocellular Carcinoma
Cholangiocarcinoma and Gallbladder Cancer

Lymphoma

Hodgkin Lymphoma
Non-Hodgkin Lymphoma

Musculoskeletal

Multiple Myeloma

Neuroendocrine

Gastrointestinal Carcinoid Tumor
Pancreatic Neuroendocrine Tumors
Pheochromocytoma and Paraganglioma
Medullary Thyroid Carcinoma

Pancreas

Pancreatic Adenocarcinoma

Reproductive Organs

Uterine and Endometrial Cancers
Ovarian Cancer
Cervical Cancer
Vulvar and Vaginal Cancer
Prostate Cancer
Testicular Cancer

Thoracic

Malignant Pleural Mesothelioma
Non-Small Cell Lung Cancer
Small Cell Lung Cancer
Thymoma and Thymic Carcinoma
Solitary Pulmonary Nodule
Pulmonary Carcinoid Tumor

Thyroid

Papillary and Follicular Thyroid Cancer
Anaplastic Thyroid Cancer

Urinary Tract

Renal Cell Carcinoma
Transitional Cell Carcinoma

Pediatrics

Ewing Sarcoma
Neuroblastoma
Osteosarcoma
Pediatric Somatostatin Receptor-Positive Tumors

Other

Paraneoplastic Syndrome
Carcinoma of Unknown Primary

SECTION 12: NUCLEAR MEDICINE THERAPY

Introduction

Approach to Nuclear Medicine Therapy

Thyroid Therapy

I-131 Thyroid Cancer Therapy
I-131 Hyperthyroid Therapy

Solid Tumor Therapy

Hepatic Tumor Therapy
Pheochromocytoma and Paraganglioma
Neuroendocrine Tumor Therapy
Prostate Cancer Therapy

Bone Tumor Therapy

Metastatic Bone Tumor Therapy

SECTION 13: PHYSICS

Basic Physics and Radionuclides
Nonimaging Detectors
Gamma Camera Imaging
SPECT
PET
Radiation Biology and Dose

SECTION 14: SAFETY

Medical Use of Byproduct Material

Medical Use of Byproduct Material
General Administrative Requirements
General Technical Requirements
Radioactive Spills
Records and Reports
Written Directive Requirements

Standards for Protection Against Radiation

Standards for Protection Against Radiation
Dose Limits
Radiopharmaceutical Administration
Radiopharmaceutical IV Infiltration
Records and Reports

Jennifer Schroeder, MD, Assistant Professor of Nuclear Medicine, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina and Joanna R. Fair, MD, PhD, Regents' Professor and Vice Chair, Department of Radiology, University of New Mexico, Albuquerque, New Mexico