The establishment of national diagnostic reference levels for adult SPECT-CT in Saudi Arabia.

This study aims to introduce national diagnostic reference levels (NDRLs) for adult hybrid single photon emission computed tomography (SPECT-CT) in nuclear medicine (NM) departments in the Kingdom of Saudi Arabia. The administered activity (AA) of radiopharmaceuticals, volume-weighted computed tomography dose index (CTDIvol) and dose length product (DLP) for ten hybrid SPECT/CT examinations were collected and analysed for one year. The median of AA, CTDIvoland DLP for each dose quantity was derived and the suggested national DRLs were determined based on the 75thpercentile for all identified SPECT-CT examinations. A comparison of the defined adult NDRLs in Saudi Arabia with the published data of other countries was performed. Although there are no significant variations of the proposed NDRL of AA between countries, the proposed NDRLs of the integrated CT metrics exceed the published data in most procedures. NM departments are urged to consider optimisation for both image quality and radiation protection.

99mTc-Pertechnetate in Diagnosis of Meckel Diverticulum in an Adult.

One of the most common malformations of the gastrointestinal tract is Meckel diverticulum (MD). MD complications can range from minor to major, such as intestinal obstruction, intussusception, hemorrhage, ulceration, vesicodiverticular fistulae, and tumors. Bleeding from ectopic gastric mucosa is more common in children than in adults. In the current case, MD in a 25-y-old man was diagnosed by 99mTc-pertechnetate scanning. 99mTc-pertechnetate scanning helps to diagnose MD noninvasively and has a potential role in the evaluation of MD even in adults.

Incidental Pituitary Adenoma on MIBI Parathyroid Imaging.

ABSTRACT: A 77-year-old man with a case of hyperthyroidism with high parathyroid hormone (41 pmol/L), low vitamin D, and normal thyroid-stimulating hormone. The SPECT/CT fused images confirmed the evidence of retrotracheal hyperdense mass approximately 1.0 cm of diameter below the lower pole of the right thyroid lobe with increased uptake, highly suggestive of typical parathyroid adenoma. The most significant point is that there was an incidental finding: high focal uptake in the sellar/suprasellar region corresponding to heterogenous soft tissue lesion suspicious for pituitary adenoma. According to the previous scans, nuclear medicine, CT scan, and the MRI scan indicated pituitary adenoma.

99mTc-Sulfur Colloid SPECT/CT in Diagnosis of Splenogonadal Fusion.

A congenital abnormal connection between an accessory spleen and a gonad is called splenogonadal fusion. The parent of a 3-y-old boy brought him to King Saud Medical City because he had left scrotal swelling that had begun 1 y previously. 99mTc-sulfur colloid (SC) imaging has superior sensitivity and specificity in targeting the liver, spleen, and bone marrow, in that these are the only organs that 99mTc-SC can visualize. Furthermore, if these tissues appear anywhere other than their usual locations, such as in the case of an accessory spleen, 99mTc-SC imaging can identify them even without biopsy or-in the case of splenogonadal fusion-orchiectomy. In the current case, the patient underwent laparoscopy, the masses were removed, and orchiectomy was avoided. Histopathologic examination confirmed normal splenic tissue, matching the imaging results.