What is Nuclear Medicine?
NM is a specialized form of medical imaging where small amount of radioactive isotopes are attached to molecules or chemicals which then form “Radiopharmaceuticals”. These radiopharmaceuticals, when once administered to the patient, specifically localize within the organs and organ systems and emit photons which are detected by sophisticated equipment known as Gamma Camera. Nuclear Medicine differs from conventional imaging modalities in that they offer functional information (physiologic, pathologic, molecular and metabolic) of many tissues and organs in the body.
Apart from diagnosis, nuclear medicine also has several therapeutic applications, most importantly in the treatment of hyperthyroidism and thyroid cancers, advanced neuroendocrine tumors, bone pain due to spread from many types of cancer, joint inflammatory disorders etc.
How is the procedure performed?
The radiopharmaceutical is administered intravenously in most of the cases. Depending upon the type of the study you will be taken for scanning immediately or some time later after radiotracer administration; several images / serial scans are needed in some cases.
How to prepare for Nuclear medicine studies?
Women should always inform their physician or technologist if there is any possibility that they are pregnant or if they are breast feeding their baby.
No special preparation like fasting or refraining from passing urine are required for most of the scans; except few, such as myocardial perfusion scan , gall bladder ejection study and PETCT, where overnight fasting is needed; specific instructions will be provided in such cases.
Overall, the scans take between 30 min to 6 hours for completion, depending upon the type of the scan or the additional images required. In some cases a delayed image may have to be taken at 24 hours if necessary.
At the time of the scanning patients have to lie on a couch under the gamma camera. Many scans require different views and each of them can take from 5 to 15 minutes. SPECT studies are needed in some cases where the scanning machine moves around the patient close to the body part but will not touch or hurt you.
SAFETY OF NUCLEAR MEDICINE PROCEDURES
The doses of radiotracer administered are very small, and the resulting small radiation exposure far outweighs the benefits of the procedure. In fact, the amount of radiation from a nuclear medicine procedure is comparable to a few days of back ground radiation which everyone receives and many a times less than conventional imaging modalities like IVP, CT or angiograms.
Allergic reactions to radiopharmaceuticals are extremely rare and very mild if at all they occur.
The patient will not feel any adverse effects of radiotracer administration / scan procedure and can go home and resume normal activities immediately after the test in most of the cases.
Please bring your previous medical records; a nuclear medicine scan acquisitions at times has to be tailored to a particular situation and correlation with other studies may be needed for good interpretation of the findings.
Jewelry and other metallic accessories should be left at home preferably, or removed prior to the exam because they may interfere with the procedure.
We would prefer that you do not bring more than one person with you as an attendant; please do not bring pregnant woman or a small child with you as an attendant.
Results of the study may take 1 to 6 hours before dispatch; may take longer in some cases
What are the different nuclear medicine studies?
Bone scan: Used for detecting bone cancer, tumors, fractures or infection. There are no special preparations for a bone scan. The bone-scanning agent is injected intravenously and a quick image may be taken. Delayed scan is done three to four hours later.
Myocardial Perfusion (Heart) scan: A three-dimensional image of the heart is obtained depicting the blood flow to the heart under stress and resting conditions; useful in depicting whether as obstruction/stenosis as detected in conventional angiogram/ CT is hemodynamically significant and whether it needs revascularization; also useful assessing myocardial viability before revascularization (angioplasty or bypass surgery). Special instructions are given for this study. The patient remains in the department for up to five or six hours.
Brain SPECT/PET: is done to see how blood is flowing through different areas of your brain. It is useful in detection of dementia, stroke and cause of recurrent headaches or to pinpoint the origin of seizures (epileptic fits)
Lung scan: Demonstrates blood supply to your lungs and is useful in detecting obstruction to blood flow by clots (embolism) in the lung.
Kidney and Bladder scan: DTPA and EC scans determine the function of the kidney and relative blood flow to each kidney and whether there is any obstruction to urine outflow.
DMSA scan is done to know whether there is any infection / sequel to infection in the kidneys.
Nuclear micturating cystograms determine whether there is any reflux of urine from bladder to the kidneys.
Thyroid scan: Determines the function of the gland, especially hyperactivity.
I-131 scan: Is done in thyroid cancer patients after thyroid surgery or during follow up. Iodine free salt and diet has to be taken for 3-4 weeks before the scan.
Parathyroid scan: The parathyroid glands (small glands situated in the region of the thyroid) produce parathyroid hormone (PTH). PTH regulates the level of calcium in the blood. If too much PTH is secreted, the bones release calcium into the bloodstream. The purpose of Parathyroid scan is to take pictures of parathyroid glands that may be causing elevated calcium.
GI Bleed (Red Cell) Scan: This study is done to localize the site of gastro-intestinal bleeding and give appropriate treatment as required.
Hepatobiliary Study: This study is done to obtain pictures of liver and gall bladder and is helpful in the diagnosis of liver dysfunction, gall bladder inflammation etc.
In one continuous full-body scan (usually about 30 minutes), PET captures images of miniscule changes in the body’s metabolism caused by the growth of abnormal cells.
NM is a specialized form of medical imaging where small amount of radioactive isotopes are attached to molecules or chemicals which then form “Radiopharmaceuticals”.
Myocardial perfusion imaging (MPI) is a non-invasive procedure used to test for significant coronary artery disease (CAD).
Many radioisotopes, radio labelled conjugates are available for treatment of difficult medical conditions; Some of them are the treatment of choice for the given conditions.
Multi Slice CT
CT Scan or computed tomography is a painless and a non-invasive medical test that helps physicians diagnose and treat medical conditions.
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