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Objectives
MRI at CCHMC
MRI at CCHMC
MRI at CCHMC
MRI Back-Log Activity FY’04
Pediatric PET
Imaging with Radiotracers
What’s a Positron
FDG
What is the Potential of
FDG
We started using a modified gamma camera
But image resolution
Graphic
Graphic
So we decided
Dedicated PET
Dedicated PET
After 24 Months
PET Oncology
When is PET useful?
Normal
Lymphoma
Hodgkin's Lymphoma
Recurrent Lymphoma
Hodgkin's Disease
Burkitt's Lymphoma
FDG PET
FDG PET
FDG PET
FDG PET
FDG PET
FDG PET
Osteosarcoma
Osteogenic Sarcoma
Ewing Sarcoma
Rhabdomyosarcoma
FDG PET
FDG PET
PET - Sarcomas
PET - Bone Sarcomas (in Children)
Neuroblastoma
Neuroblastoma
Neuroblastoma
PET in Neuroblastoma
Melanoma (Metastasis)
Langerhans Cell Histiocytosis
Renal Cell Carinoma
PET Can Be Non-Specific
Non-Union
Solving the "Brown Fat Problem"
On PET/CT
In mice
Ewing's Sarcoma
Brown Fat
Brown Fat
Brown Fat
Lymphoma
So if you want to get a good
Three Caveats
FDG CNS Tumors
FDG CNS Tumors
PNET
PNET
FDG Epilepsy
Epilepsy
PET Looking Ahead
PET/CT
PET/CT
New Radiopharmaceuticals for PET
New Radiopharmaceuticals for PET
Blank
PET Case of the Day
Chronic Hiccups
How to Get the Wrong Answer
Overview
The Differential for a
The Differential
Two Ways to Get the Wrong Answer
Acute C-Spine Trauma
Spinal Cord Injury Without Radiographic Abnormality (SCIWORA)
A Third Way to get the Wrong Answer
High-Resolution CT for Metastases
High-Resolution CT
Conventional High-Resolution
Be Careful What You Wish for;
A Fourth Way to Get the Wrong Answer
Form
Some Reasons Residents Lie to Radiologists
Rochester Criteria for Low Risk of Sepsis
Medicine is an Art, and Radiologists Know It
A Fifth Way to Get the Wrong Answer
Corollary to #5
Two Clinicians
Two Clinicians
Clinical Situation
Interpretation
Multiple Choice
What’s Missing?
Sensitivity and Specificity
Pretest Probability
Clinical Example
The New Intern
The Chief Resident
US of the Intern’s Patients
US of the Chief Resident’s Patients
RLQ US for These Physicians
Your Choices
RLQ US in Practice
Bayes’ Theorem
Fagan Nomogram
RLQ US
Other Applications
Screening Evaluation
Academic Center vs. Local Practice
The Shotgun
Conclusion

Michael Gelfand, M.D., Alan S. Brody, M.D.

Update on Pediatric Imaging