PT  - JOURNAL ARTICLE
AU  - Zamora, Edgar
AU  - Chun, Kwang
AU  - Hari, Adithya
AU  - Ghandili, Saeed
AU  - Zuckier, Lionel
TI  - A new spin on detecting leaks: dynamic scintigraphy with focus on contributive value of SPECT/CT
DP  - 2021 May 01
TA  - Journal of Nuclear Medicine
PG  - 2003--2003
VI  - 62
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/62/supplement_1/2003.short
4100  - http://jnm.snmjournals.org/content/62/supplement_1/2003.full
SO  - J Nucl Med2021 May 01; 62
AB  - 2003Objectives: This exhibit will familiarize the reader with a range of diverse applications of scintigraphy for evaluation of bodily leaks and collections while demonstrating the added value of SPECT/CT for this purpose. Areas covered will include the lymphatic, urinary, CSF, vascular, and hepatobiliary systems. Methods: This case-based image-rich educational exhibit will demonstrate various applications of a multimodal scintigraphic approach for diagnostic evaluation of bodily leakages with emphasis on dynamic imaging and SPECT/CT, based on the experience of a large academic-based institution. We intend to discuss leaks and collections related to CSF, and genitourinary, lymphatic, vascular, and hepatobiliary systems, among others. Our presentation will especially include emphasis on the seminal contribution of SPECT/CT imaging to correlation and the final diagnosis. Discussion: Numerous physiologic processes employ circulation of wanted or efflux of unwanted materials to appropriate locations within or without the body. Homeostasis is heavily reliant on the appropriate functioning and integrity of these systems and their disruption, as may occur from disease, accident, or iatrogenic injury, can lead to intra- or extra-compartmental leakage and collections, serious complications requiring prompt identification and characterization to inform management. While radiologic contrast- and non-contrast based imaging is instrumental in the evaluation of extravascular and intercompartmental collections, radiologic methods may be limited in evaluating dynamic and physiologic processes in given clinical scenarios. Scintigraphic imaging is a well-established modality for evaluation of leaks and collections. While use of dynamic imaging is indispensable for determination and characterization of many types of leak, anatomic correlation of findings on planar scintigraphy may be insufficient. We will illustrate how use of SPECT/CT can overcome limitations of scintigraphy by overlaying and correlating the functional information, portrayed on scintigraphy, onto an anatomic background, as provided by computed tomography. Conclusions: This educational exhibit is an overview of the contribution of scintigraphy and SPECT/CT in the evaluation of an assortment of collections and leaks throughout the body. While clinical examination and other radiologic modalities may be limited, a multimodal scintigraphic approach, including SPECT/CT, can serve as a critical tool for diagnosis and management guidance. Figure 1