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Appropriate imaging is essential in the treatment of children and adolescents with rhabdomyosarcoma. For adequate stratification and optimal individualised local treatment utilising surgery and radiotherapy, high-quality imaging is crucial. The paediatric radiologist, therefore, is an essential member of the multi-disciplinary team providing clinical care and research. This manuscript presents the European rhabdomyosarcoma imaging guideline, based on the recently developed guideline of the European Paediatric Soft Tissue Sarcoma Study Group (EpSSG) Imaging Committee. This guideline was developed in collaboration between the EpSSG Imaging Committee, the Cooperative Weichteilsarkom Studiengruppe (CWS) Imaging Group, and the Oncology Task Force of the European Society of Paediatric Radiology (ESPR). MRI is recommended, at diagnosis and follow-up, for the evaluation of the primary tumour and its relationship to surrounding tissues, including assessment of neurovascular structures and loco-regional lymphadenopathy. Chest CT along with [F-18]2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/CT or PET/MRI are recommended for the detection and evaluation of loco-regional and distant metastatic disease. Guidance on the estimation of treatment response, optimal long-term follow-up, technical imaging settings and standardised reporting are described. This European imaging guideline outlines the recommendations for imaging in children and adolescents with rhabdomyosarcoma, with the aim to harmonise imaging and to advance patient care. Supplementary Information The online version contains supplementary material available at 10.1007/s00247-021-05081-0.

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HISTORY AND CLINICAL FINDINGS: A 25-year-old man working as varnisher near a power transmission line sustained a 110,000 V shock. Immediately cardiopulmonary resuscitation (CPR) of the pulseless and unconscious man by lay personnel was continued after 5 minutes by an emergency physician. Normal cardiac rhythm was established after 25 electrical defibrillating shocks and 25 minutes of CPR. He was then taken to hospital by helicopter. On admission the intubated and ventilated patient was precariously stable on high doses of catecholamines. His blood pressure was 100/60 mm Hg, the heart rate 110/min. There were current marks on both hands and the left foot; part of the right pectoral muscle was contracted bulge-like. Creatine kinase activity in serum was raised to 2070 U/l (MB fraction 174 U/l). The ECG showed significant ST-elevations in V2-V4. TREATMENT AND COURSE: At first most attention was paid to stabilising cardiac function. The activity of serum creatine kinase rose to a maximum of 13,881 U/l during the first 6 hours. To prevent renal failure caused by the marked rhabdomyolysis large fluid volumes were administered while intracardiac pressures were monitored via a right-heart catheter and urinary alkalization obtained. The precordial leads of the ECG showed an evolution of changes as in an anteroseptal infarction, the latter confirmed echocardiographically by hypo- and akinesia of the anterior wall. The patient was successfully extubated after 32 hours and was symptom-free without cerebral impairment after 13 days. As subsequent coronary angiography was normal the previous signs of myocardial infarction were most likely caused by current-induced vasospasms. CONCLUSIONS: Immediate resuscitation measures after high-voltage shock can prevent physical and mental damage. The rare diagnosis of acute myocardial infarction requires careful consideration because the usual diagnostic criteria of enzyme abnormalities and symptoms cannot be used. Language: de

Summary Persisting perfusion defects may still be found in pulmonary perfusion scintigraphy months or years after pulmonary embolism. The aim of this study was to investigate the rate of persisting perfusion defects and the pattern of scintigraphic follow-up of patients after pulmonary embolism. Only those patients were included into our study who received pulmonary perfusion scintigraphy between 1991 and 1999, and who had perfusion defects including at least one whole segment. These perfusion defects were considered as persisting perfusion defects if unchanged over at least 1 year. From 3640 patients examined, 451 (12.4%) had perfusion defects meeting the criteria of this study. Of those, 129 (28.6%) received a scintigraphic follow-up. In 62 patients (48.1%), a reperfusion of the defects was found. In 38 patients (29.5%), the defects persisted within a follow-up period of up to 12 weeks. However, no pulmonary perfusion scintigraphy was performed thereafter. Out of the 129 patients receiving a scintigraphic follow-up, only 29 (22.5%) had a follow-up over more than 1 year, 19 of those had persisting perfusion defects. It is concluded that our data show an inadequate scintigraphic follow-up of patients with pulmonary embolism which may lead to unnecessary anticoagulant treatment if persisting perfusion defects are misinterpreted as fresh pulomary embolism. In many cases, there was no further follow-up even if reperfusion of the defects was lacking in early follow-up. (# 2002 Lippincott Williams & Wilkins)

The technical developments that have taken place in the preceding years (PET, hybrid imaging) have changed nuclear medicine. The future cooperation with radiologists will be challenging as well as positioning nuclear medicine in an European context. It can also be expected that education in nuclear medicine will undergo a harmonization process in the states of the European Union. In this paper, we describe how nuclear medicine education is organized in several European countries. We aim to stimulate constructive discussions on the future development of the specialization in nuclear medicine in Germany.

The technical developments that have taken place in the preceding years (PET, hybrid imaging) have changed nuclear medicine. The future cooperation with radiologists will be challenging as well as positioning nuclear medicine in an European context. It can also be expected that education in nuclear medicine will undergo a harmonization process in the states of the European Union. In this paper, we describe how nuclear medicine education is organized in several European countries. We aim to stimulate constructive discussions on the future development of the specialization in nuclear medicine in Germany., Die technischen Entwicklungen der vergangenen Jahre (PET, Hybridbildgebung) erfordern eine Überarbeitung der Weiterbildung in der Nuklearmedizin. Die zukünftige Zusammenarbeit mit der Radiologie stellt dabei ebenso eine Herausforderung dar wie die Positionierung des Faches Nuklearmedizin im europäischen Kontext. Eine Harmonisierung der Facharztausbildung in den Mitgliedsstaaten der Europäischen Union ist für die Zukunft zu erwarten. Im vorliegenden Artikel beschreiben wir die Ausbildungssituation in der Nuklearmedizin in mehreren europäischen Staaten. Er soll damit Anregungen bieten und eine Diskussionsgrundlage für die Überarbeitung der Weiterbildung in der Nuklearmedizin in Deutschland darstellen.