CME : Your SA Journal of CPD - Volume 31, Issue 8, 2013
Volume 31, Issue 8, 2013
Source: CME : Your SA Journal of CPD 31 (2013)More Less
Why should an issue of CME, a publication primarily directed at generalists, be devoted to nuclear medicine? I am reminded from time to time of how unfamiliar many of my colleagues are with this specialty, which is not surprising given the minimal coverage the field receives in already full undergraduate medical school programmes - even specialty-specific postgraduate exposure is often limited.
Source: CME : Your SA Journal of CPD 31, pp 279 –283 (2013)More Less
Nuclear medicine provides an opportunity to image pathophysiology, while radiology mainly shows morphology. Over the last few decades hybrid imaging modalities have been developed in which nuclear medicine instrumentation has been combined with computed tomography (CT) and, more recently, with magnetic resonance imaging (MRI). This allows the clinician to combine the imaging of pathophysiology with the anatomical localisation of such lesions.
Conventional nuclear medicine imaging can be performed using various radiopharmaceuticals, mainly labelled with technetium-99m (Tc-99m), e.g. Tc-99m methylene diphosphonate (MDP) for skeletal scanning. In past decades, positron emission tomography combined with CT (PET/CT) has been used routinely for the assessment of solid tumours, including lymphomas, and lung and colorectal cancers. The most frequently used PET radiopharmaceutical is fluorine-18 (F-18) fluorodeoxyglucose (FDG), which reflects cellular glucose metabolism.
Nuclear medicine in oncology 2 : breast, prostate, and cervical cancer, melanoma, and neuro-endocrine tumoursAuthor T. KotzeSource: CME : Your SA Journal of CPD 31, pp 284 –288 (2013)More Less
For 40 years a bone scan has been one of the most sensitive methods for the evaluation of the presence and localisation of skeletal metastases resulting from breast and prostate cancer. The accuracy of conventional bone scans is about 80%. The use of single photon emission computed tomography (SPECT) increases the accuracy to 88%, and by combining SPECT with computed tomography (CT) (SPECT/CT) the overall accuracy rises to 92%.
Author M. SathekgeSource: CME : Your SA Journal of CPD 31, pp 289 –294 (2013)More Less
The goal of targeted radionuclide therapy is to selectively deliver radiation to cancer cells and/or diseased tissue with minimal toxicity to surrounding normal tissues. The basis for successful radionuclide therapy is a theranostic approach that integrates diagnostic testing for the presence of a molecular target for which a specific treatment/drug is intended (Fig. 1). Theranostics is a revolutionary approach that promises improved therapy selection on the basis of specific molecular features of disease, greater predictive power for adverse effects due to improved patient-specific absorbed dose estimates, and new ways to objectively monitor therapy response. Currently, radionuclide therapy remains an important treatment option because ionising radiation from radionuclides can kill cells and inhibit growth in the benign and cancerous lesions that result from proliferative diseases. Radiation kills cells by damaging the DNA in the cell nucleus, thereby inhibiting cellular reproduction. Rapidly developing studies also demonstrate the beneficial effect of combining radionuclide therapy with chemotherapy.
Source: CME : Your SA Journal of CPD 31, pp 298 –303 (2013)More Less
Diagnostic imaging is a dynamic field, which has evolved rapidly during the past few decades. New modalities have developed and research techniques have migrated into clinical practice. Imaging has seen a greater integration of various modalities, defining the entity of diagnostic clinical imaging sciences.
Author C.D. LibhaberSource: CME : Your SA Journal of CPD 31, pp 304 –306 (2013)More Less
During the past three decades, the most rapidly growing areas of nuclear cardiology have been stress myocardial perfusion imaging single photon emission computed tomography (MPI SPECT) and positron emission tomography (PET) for the diagnosis and prognosis of patients with known or suspected coronary artery disease (CAD).
A stress ECG has a relatively low sensitivity and specificity. MPI is both more sensitive and specific than an exercise ECG for diagnosing CAD. Maximal benefit is observed in patients with intermediate probability of the disease, and in those with non-diagnostic ECGs.
Source: CME : Your SA Journal of CPD 31, pp 307 –309 (2013)More Less
Brain single photon emission computed tomography (SPECT) and positron emission tomography (PET) are well validated and relatively widely available modalities for the imaging of brain function or receptor densities. Although structural magnetic resonance imaging (MRI) and computed tomography (CT) provide exquisite anatomical detail, SPECT and PET provide complementary functional information. Frequently, brain pathology will manifest as functional changes before anatomical changes are detectable.
Author A. BrinkSource: CME : Your SA Journal of CPD 31, pp 309 –310 (2013)More Less
Source: CME : Your SA Journal of CPD 31, pp 313 –314 (2013)More Less
Campaigns to circumcise tens of thousands of men in southern Africa are falling victim to lingering acceptability issues six years after the procedure was first recommended to help prevent HIV infection, according to speakers at the 2nd International Conference for the Social Sciences and Humanities in HIV in Paris last week.