Thesis

53 The EANM practice guideline for Bone Scintigraphy Also, any specific patient preparation is reported (analgesics, anxiolytics, catheter, etc), in addition to any incidents during imaging and any technical limitations of the exam. The description of the different images acquired during the exam includes details on early phase images, specific late phase images, and whole-body acquisitions. When multimodality SPECT/CT imaging is performed, the description of osteoarticular structures focuses on the SPECT images and the SPECT/CT fusion images. Findings Abnormal tracer uptake (increased, decreased, pattern of abnormal uptake, bone findings, soft tissue findings) should be clearly stated. In case of repeated examination, data are described in correlation with other diagnostic results and comparison with previous studies. Any skeletal anomalies that are only seen on the CT part of the examination are also reported. Likewise, other relevant non-skeletal pathology detected on the CT images is mentioned. Software based assessment of bone abnormalities can assist in reporting, but should not replace assessment by a nuclear medicine physician. Interpretation The conclusion of the report answers the question posed by the prescriber and mentions any associated diagnoses. A clear diagnosis should be given if possible, accompanied with a description of the study limitations when appropriate. In case of non-specific findings on scintigraphy or multimodality imaging, a differential diagnosis is made, whenever possible mentioning the likelihood of the listed diagnoses. When there is doubt on the diagnosis or further work-up is required, the nuclear medicine physician may recommend additional tests (laboratory, imaging, biopsy, etc), especially if several differential diagnoses, which could lead to different clinical management decisions, are possible. If the scintigraphic findings and/or CT results reveal a life-threatening disease or a condition that requires immediate action, it is the nuclear medicine physician’s responsibility to contact the prescribing physician and organize urgent further care. 2

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