Nuclear Medicine

What is General Nuclear Medicine?

Nuclear medicine is a branch of medical imaging, which uses small amounts of radioactive materials in order to diagnose, determine the severity and treat various diseases, including many kinds of cancer, cardiac disease and gastrointestinal, endocrine and neurological disorders as well as other anomalies in body.  As the nuclear medicine operations can determine the location of molecular activity inside body, it provides a potential to determine a disease in its early phases stages and define the first response to the interventions for medical purpose.

Diagnosis

Nuclear medicine imaging operations do not have an interventional characteristic, they are mostly painless medical tests which help physicians to diagnose medical problems and evaluate them, except for the intravenous injections. These imaging scans use the radioactive materials, named radiopharmaceutical or radiotracer materials.

Radiotracer materials are either injected to body or swallowed or taken into the respiratory system in the form of gas, depending on the type of nuclear medicine examination, and finally they accumulate in an organ or an examined area of body. Radioactive emissions, created by radiotracer materials, are detected with a special camera or imaging device which create images and provide molecular information.

In many centers, nuclear medicine images can be put on the images of computerized tomography (CT) or magnetic resonance imaging (MRI) or combined with these images by the means of an application, known as image fusion or co-record. These images allow obtaining more accurate information and make more sensitive diagnosis by allowing the correlation and interpretation of information that is obtained through two different examinations through one image. Additionally, today, manufacturers produce single-photon emission computed tomography / computerized tomography (SPECT/BT) and positron emission tomography / computerized tomography (PET/BT) units which can provide both imaging techniques at the same time. Even if PET/MRI cannot be easily used yet, it is a newly developed imaging technology.

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What are the common areas of use for Nuclear Medicine?

Physicians use the radionuclide imaging procedures in order to see the structure and function of a body, tissue, bone or system in body.

Nuclear medicine is used for the following in adults:

Heart

  • Imaging blood flow in heart and cardiac function (such as myocardial perfusion)
  • Determination of the level of coronary artery disease and coronary infarction
  • Evaluation of the damage in heart after a heart attack
  • Evaluation of the treatment options like bypass surgery and angioplasty
  • Evaluation of the results of revascularization processes
  • Diagnosis of heart transplant rejection
  • Evaluation of the cardiac function before and after chemotherapy (MUGA)

Lungs

  • Scanning lungs in terms of respiration and blood flow
  • Evaluation of differential lung function for lung volume reduction or transplantation surgery
  • Determination of the rejection of lung transplantation

Bones

  • Evaluation of bones in terms of fracture, infection and arthritis
  • Evaluation of metastatic bone disease
  • Evaluation of painful prosthetic joints
  • Evaluation of bone tumors
  • Recognition of biopsy areas

Brain

  • Examination of various anomalies in the brains of the patients, having signs or disorders, such as memory loss and suspicious anomalies in blood flow
  • Diagnosis of the neurological diseases, such as Alzheimer disease
  • Determination of aid and seizure focuses in planning operation
  • Evaluation of anomalies in a chemical, which is used for controlling movements in brain, in the patients with suspected Parkinson’s disease or a related movement disorder
  • Evaluation of the suspect of recurrence of brain tumor, operation or radiation planning or the determination of a biopsy location

Other Systems

  • Definition of the inflammation or abnormal function of gallbladder
  • Diagnosis of intestinal bleeding
  • Evaluation of postoperative complications of a gallbladder operation
  • Examination of lymphedema
  • Diagnosis of fever with an unknown reason
  • Identification of the origin of an infection
  • Evaluation of thyroid function to determine hyperactive or hypoactive thyroid
  • Helping the diagnosis of hyperthyroidism and blood cell disorders
  • Evaluation of hyperparathyroidism
  • Evaluation of gastric emptying
  • Examination of spinal fluid flow and potential spinal liquid leak

Nuclear medicine for the following purposes in adults and children:

Cancer

  • Phasing cancer by determining the existence or spread of cancer in various parts of body
  • Determination of the sentinel lymph nodes before operation in the patients, suffering from breast cancer or skin and soft tissue tumors
  • Treatment planning.
  • Evaluation of response to treatment.
  • Diagnosis of the recurrence of cancer.
  • Diagnosis of rare tumors in pancreas and adrenals glands.

Renal

  • Analysis of blood flow and function of a natural and transplanted kidney.
  • Diagnosis of urethral stricture
  • Evaluation of renal artery-related hypertension.
  • Evaluation of renal infections in terms of scarred tissue
  • Diagnosis and following-up urinary reflux

Nuclear medicine is used for the following purposes in children:

  • Examination of anomalies in esophagus, such as esophageal reflux or motility disorders
  • Evaluation of nasolacrimal ducts’ openings
  • Evaluation of ventricular shunts’ openings in brain
  • Examination of congenital heart disease in terms of shunt and pulmonary blood flow

Nuclear medicine treatments include the following:

  • The radioactive iodine therapy (I-131), used for the treatment of some reasons of hyperparathyroidism (hyperactive thyroid gland, for example, Graves’ disease) and thyroid cancer
  • The radioactive antibodies, used for the treatment of some kinds of lymphoma (lymphatic system cancer)
  • The radioactive phosphor (P-32), used for the treatment of specific blood disorders.
  • The radioactive materials, used for the treatment of painful tumor metastasis in bones.
  • I-131 MIBG (radioactive iodine marked with metaiodobenzylguanidine), used for the treatment of adrenal gland tumors and adrenal glands in children / nervous tissue tumors (radioactive iodine marked with metaiodobenzylguanidine)

Diagnostic devices;

They are the Gamma Camera (scintigraphy device) and PET/CT.

The functional disorders of many organs in our body (thyroid, heart, kidney, brain, bone etc.) can be evaluated with the Gamma Camera device.

PET/CT; it is an oncology method, which is indispensable and has no alternative, as it provides an opportunity for the detection of the diagnosis of oncologic (cancer) diseases and the detection of the recurrences as well as the evaluation of the spread (stage) of disease and its response to treatment.

 

Imaging of Prostate Cancer with Ga-68; 

By the means of peptides, connected with Ga-68 (Gallium 68), along with routine PET/CT applications, the diagnosis and staging of the Prostate and Neuroendocrine Cancers can be made.