Positron emission tomography/computed tomography (PET/CT), as any other imaging modality, is acceptable for routine clinical and research applications only if technical pitfalls can be avoided. Artefacts from incorrect or sub-optimal acquisition procedures should be recognized and, if possible, corrected retrospectively and the resulting image information interpreted correctly, which entails an appreciation of variants of the represented image information. This publication provides guidance on the physics and technical aspects behind PET and PET/CT image distortions. Cases are presented to provide nuclear medicine and radiology professionals with an assortment of examples of possible image distortions and errors in order to support correct image interpretation. Nearly 70 typical PET and PET/CT cases, comprising image sets and case description, have been collected in this volume, all catalogued and augmented with explanations as to the causes of, and solutions to, each individual image problem. The atlas will prove useful to physicists, physicians, technologists, and service engineers in the clinical field.

This publication draws on an IAEA coordinated research project and provides recommendations specific to the measurement and interpretation of radiation dose to children received as a result of undergoing diagnostic radiological examinations. It complements the work of Dosimetry in Diagnostic Radiology: An International Code of Practice (Technical Reports Series No. 457) and extends this work in methodologies for dosimetry in clinical environments to that required for non-adult patients. It includes dosimetry methodologies for general radiography, fluoroscopy and computed tomography for both phantom and patient measurements. Details are given on dose audit strategies that take into account the size of children and on how the results of such audits can be used to indicate or be related to diagnostic reference levels. The effects of radiation on non-adults are also reviewed, as are the factors involved in the management of paediatric dosage in the clinical setting.

Over the last 20 years, PET (positron emission tomography) and PET/CT (positron emission tomography/computed tomography) have revolutionized the care of cancer patients. It is one of the fields in medical imaging with the highest growth rate. Proper cancer management requires highly accurate imaging in order to select the correct treatment that applies to the individual patient. The ability to provide, in a single imaging session, detailed anatomical and metabolic/functional information, has established PET/CT as an indispensable imaging procedure in the management of many types of cancer. The reliability of the images acquired on a PET/CT scanner depends on the quality of the imaging technique. This publication addresses an important aspect of PET/CT imaging, namely how to perform the fluorine-18-FDG PET/CT scan in an adult patient with cancer.

This publication addresses the shortfall of well trained and clinically qualified medical physicists working in radiation medicine. The roles, responsibilities and clinical training requirements of medical physicists have not always been well defined or well understood by health care professionals, health authorities and regulatory agencies. To fill this gap, this publication provides recommendations for the academic education and clinical training of clinically qualified medical physicists, including recommendations for their accreditation, certification and registration, along with continuous professional development. The goal is to establish criteria that support the harmonization of education and clinical training worldwide.

This publication was developed by an international group of experts as an integral part of the IAEA’s efforts to contribute to the transfer of technology and capacity building in this field in order to assist Member States in their efforts to improve the nutrition and health of the most vulnerable population groups, infants and young children. The book provides practical information on the assessment of body composition from birth up to two years of age and is intended for nutritionists, paediatricians and other health professionals. The body composition assessment techniques included in this publication were selected as methodologies with the highest potential for standardization globally — based on considerations such as access to equipment, cost and the training needs of staff — and include stable isotope dilution for total body water assessment, as well as dual energy X ray absorptiometry and air displacement plethysmography. In addition, the book highlights the importance of standardization of anthropometric measurements as basic measurements of body weight and length are crucial for accurate body composition assessment.

This publication provides comprehensive multidisciplinary guidance to promote standardized, effective and safe implementation of best practices for treating neuroendocrine and gastroenteropancreatic tumours through applying peptide receptor radionuclide therapy (PRRNT). Taking into account the latest international classifications of neuroendocrine tumours, both PRRNT as a sole treatment and as a treatment in combination with other options are considered. Comprehensive protocols for employing either yttrium-90 or lutetium-177 tagged somatostatin receptor targeting peptides and clinically tested protocols for renal protection are presented. The publication comprises a comprehensive compilation of medical evidence and experience. Furthermore, it contains clinical presentations, eligibility criteria and means of assessing the effectiveness of therapy utilizing molecular and morphological medical imaging techniques. The publication is a practical reference for specialists in clinical oncology and in nuclear medicine deploying and executing a comprehensive programme for treating patients with neuroendocrine tumours.

This publication on the assessment of iron bioavailability was developed as part of the IAEA’s continuing efforts to transfer knowledge and technology on the use of stable isotope techniques in nutrition. It provides information on the theoretical background and practical application of state of the art methodology to measure human iron absorption and dietary iron bioavailability using stable (non-radioactive) isotopes. These techniques can be used to guide fortification and food based strategies to combat iron deficiency, which remains unacceptably high among infants, children and women of childbearing age in developing countries.

This publication presents a harmonized approach to quality assurance in the field of computed tomography applied to both diagnostics and therapy. It provides a careful analysis of the principles and specific instructions that can be used for a quality assurance programme for optimal performance and reduced patient dose in diagnostic radiology. In some cases, radiotherapy programmes are making a transition from 2-D to 3-D radiotherapy, a complex process which critically depends on accurate treatment planning. In this respect, the authors also provide detailed information about the elements needed for quality assurance testing, including those relating to accurate patient characterization as needed for radiotherapy treatment planning.

This publication, which accompanies Nuclear Cardiology: Its Role in Cost Effective Care (IAEA Human Health Series No. 18), discusses non-invasive imaging modalities with an emphasis on myocardial perfusion imaging (MPI). MPI is one of the most complex nuclear techniques and by far the most widely used for non-invasive detection of coronary artery disease. The book covers all aspects of this modality, from clinical indications to reporting. Chapters describe clinical scenarios and provide examples of good strategies and recommendations of good practice. The aim of the publication is to help strengthen current nuclear cardiology practices, so that they meet accepted standards and that providers can deliver better quality services to the population. Target readers are nuclear medicine physicians, cardiologists and cardiac surgeons, but also all other clinical specialists involved in managing and treating cardiac diseases and particularly coronary artery diseases.

This publication presents a comprehensive overview of cardiovascular disease (CVD) as a public health problem in developing countries, the relative role of nuclear cardiology methods within a scenario of unprecedented technological advances and the evidence behind recommendations. The potential role of non-invasive functional imaging in the diagnosis of obstructive coronary artery disease and more widely in defining the global burden of CVD is also discussed, as well as the need for training, education and quality assurance in nuclear cardiology practice.

This manual provides a harmonized approach to quality assurance (QA) in the emerging area of digital mammography. It outlines the principles of, and specific instructions that can be used for, a QA programme for the optimal detection of early stage breast cancer within a digital environment. Intended for use by Member States that are now using digital mammography or that are assessing the implications of using digital mammography, it addresses major areas such as considerations concerning the transition from screen film to digital mammography, basic principles of QA, clinical image quality, quality control tests for radiographers, and quality control tests for medical physicists, including dosimetry assessment. Instructional materials to supplement the knowledge of professionals already working in the field of diagnostic radiology, as well as quality control worksheets, are also provided.

Bone scintigraphy is a widely accepted method for the evaluation of paediatric bone metabolism. Its strengths are high sensitivity and the capability to investigate the entire skeleton in a single examination. The interpretation of bone scanning in children is challenging and requires knowledge of the appearance of the maturing skeleton. The atlas provides an overview of issues related to bone physiology and variants, and points out pitfalls that might be encountered in daily routine work. Specific suggestions and hints assist in establishing adequate imaging protocols to deliver optimal image quality adjusted to the needs of each age group. The atlas will serve as a valuable reference for nuclear medicine physicians, radiologists and orthopaedic surgeons, and for those involved in teaching and performing paediatric bone scan imaging.