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E2311. Role of Nuclear Medicine in Pediatric Radiology: A Pictorial Review
Authors
  1. Mamta Gupta; Allegheny Health Network
  2. Charanjeet Singh; Allegheny Health Network
Background
Pediatric cases with acute/chronic undifferentiated presentations, including acute abdominal emergencies/gastrointestinal bleeding, cardiovascular and cerebrovascular presentations or injuries as well as neoplastic/tumor cases are common in Pediatric Emergency room (ER) and office. Purpose: To explore various classical imaging modalities for pediatric cases, the findings will be described and teaching points. To teach how to avoid unnecessary investigations or radiation and unwanted interventions by using dedicated imaging.

Educational Goals / Teaching Points
This presentation will discuss various dedicated imaging modalities and their classic appearance, from nuclear medicine imaging modalities in pediatric acute and non-acute cases, to make accurate diagnosis in order to timely resuscitate and stabilize children who are seriously ill or injured. Teaching points: To list and to discuss different Nuclear Medicine scan useful in ER and office. To recognize diagnostic appearance of different radionuclide scans, useful in various conditions encountered in ER and office. Pitfalls.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Gastrointestinal bleeding scan: a brief description, interpretation, imaging appearance, differential diagnosis and pitfalls. Meckel’s scan: a brief description, interpretation, imaging appearance, differential diagnosis and pitfalls. HIDA scan: a brief description, interpretation, imaging appearance, differential diagnosis and pitfalls, biliary atresia, congenital jaundeice, acute vs chronic cholecystitis, and bile leak. V/Q scan: a brief description, interpretation, imaging appearance, differential diagnosis and pitfalls. Myocardial perfusion scan: a brief description, interpretation, imaging appearance, differential diagnosis and pitfalls. Bone scan: a brief description, interpretation, imaging appearance, differential diagnosis and pitfalls. Triple phase vs routine bone scan: particularly in setting of acute fracture and osteomyelitis, and non-accidental trauma. Brain scan: epilepsy, and shunt patency study. Renal Scan: VU reflux, renal perfusion. Thyroid scan: tumor Imaging, pheochromocytoma, neuroblastoma, etc.

Conclusion
Appropriate understanding of diagnostic modalities to make accurate and precise diagnosis of pediatric nuclear medicine scans is necessary for timely initiation of aggressive intervention/surgery to resuscitate and stabilize the patient.