Nuclear Medicine and PET Imaging

Abnormalities present as cold spots regardless of etiology (tumor, abscess, cyst, trauma, etc.). The scan can be performed in transplants where regional infarcts occur (wedge shaped)

Preoperative evaluation of future remnant liver function of donor and postoperative confirmation of remnant.

Indications:
•Diagnosis of acute cholecystitis (both calculus and acalculous disease)
•Determination of patency of common bile duct when ultrasound examination not diagnostic (e.g., very early obstruction)
•Evaluation of biliary dyskinesia (gallbladder ejection fraction [GBEF] test) for chronic cholecystitis
•Identification of biliary leaks
•Differentiation of biliary atresia from neonatal hepatitis
•Evaluation of presence, or absence of, spleen (with T-99m SC Liver Scan). •Suspected sphincter of Oddi dysfunction or partial biliary obstruction due to stones or stricture.

The site of the lesion in question must be known in advance, so the appropriate view can be chosen for the flow study. Therefore, the appropriate CT or US must be available at time of approval of study by NM resident or staff. This study is ideal for hemangiomas if a multi-headed scanner is used with lesions greater than 1.4 cm and not located near portal vessels. If lesion is small or near major vessels suggest MRI as primary imaging modality to confirm hemangioma.

Patients with hepatic artery catheters for treatment of hepatic metastases

This test is done differently in infants (see below).

This examination:

Is indicated in patients with diabetes and those with complaints of nausea, vomiting, and early satiety

Can demonstrate abnormal gastric emptying

Serial imaging can demonstrate the response to drug therapy (e.g. metoclopramide)

This examination is performed in an attempt to identify the location of active gastrointestinal hemorrhage.

These studies are indicated to identify esophageal motility disorders, such as:
a) amotility of achalasia or scleroderma;
b) hypomotility of presbyesophagus; or
c) hypermotility of diffuse esophageal spasm