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Nuclear Medicine

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nuclear medicine

Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to diagnose and determine the severity of or treat a variety of diseases, including many types of cancers, heart disease, gastrointestinal, endocrine, neurological disorders, and other abnormalities within the body. It’s also called functional imaging or bioimaging.

Because nuclear medicine procedures are able to pinpoint molecular activity within the body, they offer the potential to identify disease in its earliest stages as well as a patient’s immediate response to therapeutic interventions.

It has two arms

  • Diagnosis
  • Therapy

Why do we use Nuclear Scan?

Radionuclide procedures are available for almost all organ systems just like the different X-ray procedures. It is used in the evaluation of the Heart, Lung, Brain, Bone, Kidneys, Liver, etc.

Scans are designed to study various aspects like concentration, excretion, drainage, the flow of tracers in various organs or localize/ characterize the pathology.

Diagnosis

Nuclear medicine imaging procedures are noninvasive and, with the exception of intravenous injections, are usually painless medical tests that help physicians diagnose and evaluate medical conditions. These imaging scans use radioactive materials called radiopharmaceuticals or radiotracers.

Depending on the type of nuclear medicine exam, the radiotracer is either injected into the body, swallowed, or inhaled as a gas and eventually accumulates in the organ or area of the body being examined. Radioactive emissions from the radiotracer are detected by a special camera or imaging device that produces pictures and provides molecular information.

  • PET–CT SCAN
  • SPECT SCAN or GAMMA CAMERA

Therapy

Nuclear medicine also offers therapeutic procedures, such as radioactive iodine (I-131) therapy that use small amounts of radioactive material to treat cancer and other medical conditions affecting the thyroid gland, as well as treatments for other cancers and medical conditions.

I 131 MIBG therapy for neuroendocrine tumour

Bone pain palliation therapy with P 32, Sm 153, Sr 89 extra

Radiation synovectomy

Y90, Lu177 therapy (RIT) is done for lymphoma, neuroendocrine tumour, malignant carcinoid patients who do not respond to chemotherapy. Radio immunotherapy (RIT) is a personalized cancer treatment that combines radiation therapy with the targeting ability of immunotherapy, a treatment that mimics cellular activity in the body’s immune system.

Nuclear Therapy procedures done

  • High dose I- 131 therapy
  • Low dose I-131 therapy
  • Lutetium therapy
  • Bone pain palliation
  • Sentinel node procedures

What is PET-CT scan – GE?

Positron emission tomography (PET) (better known as PET-CT or PET/CT) is a medical imaging technique which uses small amounts of radioactive materials called radiotracers, a special camera and a computer to help evaluate your organ and tissue functions.

  • F-18 FDG scan
  • F-18 PSMA scan
  • Gallium-DOTA scan
  • Gallium-PSMA scan
  • F-18 Bone scan
  • Cardiac viability scan
  • Brain scan

Advantages

  • Early detection
  • Cancer staging
  • Individualize treatment based on unique biological properties
  • Assessing the effectiveness of treatment
  • Modify treatment in response to altered biological behavior
  • Assessing disease progression
  • Checking for disease recurrence

F-18-SODIUM FLUORIDE PET CT

It has gained popularity since its high sensitivity and specificity in differentiating benign from malignant lesions compared to Tc 99m – MDP bone scan.

SPECT/GAMMA CAMERA

  • A single-photon emission computerized tomography (SPECT) scan lets your doctor analyze the function of some of your internal organs. A SPECT scan is a type of nuclear imaging test, which means it uses a radioactive substance and a special camera to create 3-D pictures.
  • While imaging tests like X-rays can show what the structures inside your body look like, a SPECT scan produces images that show how your organs work. For instance, a SPECT scan can show how blood flows to your heart or what areas of your brain are more active or less active.
  • To acquire SPECT images, the gamma camera is rotated around the patient. Projections are acquired at defined points during the rotation, typically every 3–6 degrees. In most cases, a full 360-degree rotation is used to obtain an optimal reconstruction. The time taken to obtain each projection is also variable, but 15–20 seconds is typical. This gives a total scan time of 15–20 minutes.
  • Multi-headed gamma cameras can provide accelerated acquisition. For example, a dual-headed camera can be used with heads spaced 180 degrees apart, allowing two projections to be acquired simultaneously, with each head requiring 180 degrees of rotation. Triple-head cameras with 120-degree spacing are also used. No specific patient preparation is needed for the scans.

Gamma/SPECT procedures done

  • Bone scan
  • Renal (DTPA/DMSA) scan
  • Cardiac scan
  • Thyroid ( Tc, I- 131) scan
  • Parathyroid scan
  • GI bleed scan
  • Meckel’s scan
  • HIDA scan
  • Lung perfusion scan

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