TY - JOUR T1 - Conventional and molecular imaging in sickle cell disease JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 2016 LP - 2016 VL - 62 IS - supplement 1 AU - Raheleh Taghvaei AU - Reza Sirous AU - William Raynor AU - Amir Amanullah AU - Thomas Werner AU - Mona-Elisabeth Revheim AU - Poul Flemming Hoilund-Carlsen AU - Abass Alavi Y1 - 2021/05/01 UR - http://jnm.snmjournals.org/content/62/supplement_1/2016.abstract N2 - 2016Introduction: Sickle cell disease (SCD) is a disorder caused by single gene mutation and has systemic manifestations which include chronic hemolytic anemia, vaso-occlusive episodes throughout the body, recurrent infections, and multi-organ infarctions. Imaging has been established to play a role in detecting and managing SCD complications. In this educational abstract, we discuss and highlight imaging techniques utilized in SCD system-based complications. Objectives: 1) Review the role of CT and MRI in sickle cell disease. 2) Explain the utility of molecular imaging in sickle cell disease. 3) Compare conventional and molecular imaging findings in sickle cell disease. Methods: A comprehensive literature review was conducted using databases including Google Scholar, PubMed, and Scopus. Conclusions: Central nervous system: About 25% of SCD patients are affected by vascular involvement of central nervous system. CT scan has been used to detect cerebral infarction. Subclinical cranial MRI lesions yield important predictive values as a risk factor of stroke, even when detected in asymptomatic patients. SPECT is a useful technique for early detection of deficits in cerebral perfusion in patients with SCD. Decreases in cerebral perfusions may lead to silent infarction, stroke, or neurocognitive diseases. PET may improve sensitivity in detection of impaired metabolism in the area surrounding a major vessel infarct. A study on brain regional alternations with FDG-PET imaging compared SCD patients without prior neurologic abnormalities (and with normal brain CT scans) with healthy controls and showed frontal lobe involvement in SCD patients. Acute chest syndrome (ACS): ACS is the most important cause of death in adult patients with SCD. Chest imaging has an established role in its management. The bedside chest radiograph has > 85% sensitivity and < 60% specificity in ACS diagnosis. Lung CT has an important role in the initial evaluation of ACS in SCD and it is mostly presented as consolidation. Patients with ACS have higher FDG uptake of the lungs compared to non-ACS SCD controls. Moreover, lung apices had lower FDG uptake than lung bases. Patients with higher lung FDG uptake tended to have a longer length of stay in the ICU. Musculoskeletal system: Musculoskeletal involvement in SCD is a serious complication. Vaso-occlusion in SCD may clinically present as osteomyelitis and bone infarction. The clinical presentation of osteomyelitis and bone infarction is similar, which can make it more difficult to choose the proper treatment based solely on clinical findings. Increased uptake in all three phases of triple-phase 99mTc MDP scintigraphy can be seen in acute osteomyelitis. In bone infarction, there are variable patterns of radioisotope uptake, which makes it difficult to distinguish between bone infarction and infection. Further imaging with radiolabled indium 111In or 99mTc hexamethylpropyleneamine oxime (HMPO) allows imaging of leukocytes and helps to make an accurate clinical diagnosis. Increased uptake of 111In or 99mTc is in favor of infection, while photopenia is an indicator for infarction. However, this modality may result in false positive or false negatives. 18F-fluorodeoxyglucose (FDG) (FDG) PET/CT provides a whole-body assessment with an integrated multimodal approach with high spatial resolution and shows the metabolic activity in SCD patients. MRI is a useful imaging modality to diagnose osteomyelitis in SCD. T2-weighted fat-saturated sequences and intravenous gadolinium-enhanced T1-weighted sequences are most useful to distinguish bone infarction from osteomyelitis. However, like other imaging techniques, there is overlap between the observed findings in infection and infarction. ER -