Nuclear Medicine

Our partner hospitals have been pioneers in the country in the field of Nuclear Medicine, while being the first to introduce nuclear cardiology with multiple-gated acquisition (MUGA) scans for the first time in the country and also the first in the country to get a triple-head gamma camera and the first solid-state dedicated cardiac camera in Asia and recently adding a 5-ring 16-slice PET-CT scanner to the list, one of only 13 that exist in the world. We are one of few to perform brain perfusion imaging in India and also Dopamine transporter (DaT) imaging for Parkinson’s disease for the first time in India.

We have Somatostatin receptor PET-CT imaging in the private sector for the diagnosis and management of Neuroendocrine tumours as well as Peptide receptor radionuclide therapy (PRRT) for treatment of inoperable neuroendocrine tumours such as carcinoids, insulinomas, phaeochromocytomas and pancreatic neuroendocrine tumours. There are only six centers in the country that offer this service. We offer every possible Nuclear Medicine diagnostic scans including myocardial perfusion scan for coronary artery disease, brain scan for Alzheimer’s disease, thyroid scan, salivary scan, lung ventilation and perfusion scan, bone scan, kidney scan, liver and hepatobiliary scan, gastric emptying scan, lymphatic scan, fluorodeoxyglucose (FDG) PET-CT scan for cancer detection, staging and follow up for cardiac viability and neurology applications.We also provide treatment for hyperthyroidism with radioiodine and sentinel-node detection for breast cancer and treatment of hepatic metastases with selective internal radiation therapy (SIRT).

Nuclear Medicine

What is Nuclear Medicine?

Nuclear medicine is a specialised area of ​​radiology that uses small amounts of radioactive materials to examine and evaluate the structure and function of organs. Physicians and medical professionals use the diagnostic procedure to diagnose various conditions in the intestines, lungs, kidneys, gallbladder, heart, tumours, and inflammatory and infectious diseases. Combined with computed tomography (CT) capabilities, which provide images of different anatomical levels, medical professionals can eliminate guesswork, increase diagnostic confidence, and enable better treatment plans.

Use of small trace amounts of radioactive materials (radiotracers) that are normally injected, inhaled, or ingested; A nuclear medicine test can help determine the cause of a medical condition based on tissue, bone, or organ function. A special camera detects the gamma rays produced by the radiotracers to create computer-generated images of molecular information from inside the body that cannot be obtained using other imaging options.

Common Nuclear Medicine Tests

  1. Brain Scans investigate problems within the brain and/or in the blood flow to the brain.
  2. Breast Scans are often used along with mammograms to look for cancerous tissue in the breast.
  3. Bone Scintigraphy evaluates any degenerative and/or arthritic changes in the joints; finds bone diseases and tumors; and/or determines the cause of bone pain or swelling.
  4. Gallium Scans are used to identify malignancies, abscesses, and active infectious and/or inflammatory disorders.
  5. Gastrointestinal (GI) Bleeding Scan: These scans help locate sites of gastrointestinal or non-GI bleeding, including the stomach and small and large intestines.
  6. Cardiac Scans: identify abnormal blood flow to the heart, determine the extent of damage to the heart muscle after a heart attack, and/or measure heart function. Become familiar with the Cardiac Stress Lab.
  7. Hepatobiliary Duct System (Liver, Gallbladder, and Bile Ducts): Your doctor may recommend this scan to diagnose: bile duct obstruction; loss of bile; congenital abnormalities in the bile ducts; inflammation of the gallbladder (cholecystitis); and gallstones.
  8. Renal (kidney) Scan: A renal scan examines the kidneys and looks for abnormalities. These include abnormal function or obstruction of renal blood flow.
  9. Perfusion Scan: Your doctor may recommend this scan to: find a blood clot that is preventing normal blood flow (perfusion) to part of a lung (pulmonary embolism), assess the flow of blood or air through the lungs, or see which parts of the lungs are working and which are damaged.
  10.  Thyroid Scan: Thyroid scans assess thyroid function or to better evaluate a thyroid nodule or mass.

Types of Nuclear Medicine

Common Procedures Include:

  1. Fixed gamma cameras are placed as close to the body as possible. Patients will be standing, sitting, or lying down, depending on the area being scanned.
  2. SPECT, or Single Photon Emission Computed Tomography, uses a rotating gamma camera that can be moved during the scan to provide a more complete image of a particular part of the body.
  3. Patients must recline on a table for the PET, or positron emission tomography, scan. The table is moved through a tube, similar to the process of an MRI.

Nuclear Medicine: What To Expect

Exam preparation will vary depending on the area being tested. Our physician will give patients special instructions prior to their appointment. Please follow them closely.

Patients may be asked to fast for several hours before the scan. For some scans, the radiopharmaceutical is given hours or even days before the imaging portion of the scan.

We ask patients to wear loose-fitting, comfortable clothing, such as a sweatshirt without zippers or snaps. Patients may be required to wear a gown, depending on the area of ​​the body being scanned.

When the patient arrives on the day of the appointment, they will meet with a technologist who will perform the nuclear medicine exam. The technician will ask the patient to lie down or sit on an exam table.

Our nuclear medicine technologist will administer the radiopharmaceutical as an injection or by mouth as a liquid or capsule. Most scans require different positions to capture different views of the body. It is important that patients remain as still as possible during each scan.

Most of the low level radiopharmaceutical will be naturally excreted from the body over the next 24 to 48 hours. Patients should drink plenty of water to eliminate the material faster. Patients do not need to avoid contact with other people during this time, but the doctor may suggest some precautions, such as flushing the toilet twice after using it to reduce radiation exposure in the home.

The nuclear medicine doctor will review the images and send a report to the doctor, who will notify the patient of any findings. A CD of the photographs can also be requested by the patient.

Nuclear Medicine Risks

It is important to note that while the nuclear medicine scan itself is a painless exam, it does involve radiation exposure. However, the benefits of an accurate and early diagnosis far outweigh the risks.

The radioactive materials used in the exam are provided in small amounts with an exposure similar to what a patient would receive with a plain X-ray. They also lose their radioactivity very quickly, passing through the body usually within 24 to 48 hours.

If a patient is pregnant or nursing, notify the technician. Tests using injected radioactive material are generally not recommended for pregnant or lactating women.

A nuclear medicine physician or technologist can answer any questions a patient may have about a health condition that could affect the exam.

FAQs on Nuclear Medicine

Nuclear medicine is a medical specialty used to safely and painlessly diagnose and treat disease. Nuclear medicine procedures allow the determination of medical information that might not otherwise be available, require surgery, or require more expensive and invasive diagnostic tests. Nuclear medicine images are unique in that they provide clinicians with information about structure and function. The procedures often identify abnormalities very early in the progression of a disease, long before certain medical problems are apparent with other diagnostic tests. Early diagnosis allows a disease to be treated earlier in its course when a better prognosis is possible.

Nuclear medicine refers to a medicine (a drug) attached to a small amount of radioactive material (a radioisotope). This combination is called radiopharmaceutical. The body is made up of numerous unique sections. The radiopharmaceutical used will depend on the condition being diagnosed or treated. The radioactive part of the radiopharmaceutical that emits radiation, known as gamma rays (similar to X-rays), is detected by a special type of camera, called a gamma camera, which works with computers to provide very precise images of the area of ​​the body that undergoes exploration.

Radiopharmaceuticals are introduced into the patient’s body by injection, ingestion, or inhalation. The amount given is very small. The medicine is designed to go to a specific place in the body where there may be a disease or abnormality. Then, a specialized camera known as a gamma camera is used to detect the radioactive component of the radiopharmaceutical that releases radiation, known as gamma rays (comparable to X-rays). This type of camera allows the nuclear medicine doctor to see what is happening inside your body.

During this imaging procedure, the patient is asked to lie down on a bed, and then the gamma camera is positioned a few inches from the patient’s body. Photos are taken in the following minutes. These images allow nuclear medicine doctors to diagnose the patient’s disease.

Nuclear medicine procedures are among the safest imaging tests available. The amount of radiation in a typical nuclear imaging procedure is comparable to that received during a diagnostic x-ray, and the amount received in a typical treatment procedure is kept within safe limits. Absolutely, like any medicine, they are prepared very carefully. The risk of reaction is 2-3 accidents for every 100,000 injections of radiological contrast medium.

Although exposure to radioactivity in very high doses can be harmful, radioactivity in radiopharmaceuticals is carefully screened by the nuclear medicine physician to ensure that it is safe. The radiotracer doses administered are small, and nuclear medicine diagnostic procedures involve minimal radiation exposure. Therefore, the risk of radiation is very small compared to the potential benefits.

Nuclear medicine can diagnose many different types of diseases. Without requiring exploratory surgery, it can be utilised to find problematic lesions located far inside the body. Additionally, the procedures might reveal whether or not particular organs are operating normally. For example, nuclear medicine can determine whether or not the heart can pump blood adequately, whether or not the brain is receiving an adequate blood supply, and whether or not brain cells are functioning properly. Nuclear medicine can determine if your kidneys are working normally and if your stomach is emptying properly.

You can determine a patient’s blood volume, lung function, vitamin absorption, and bone density. Nuclear medicine can detect the smallest bone fracture before it can be seen on an x-ray. Additionally, it can locate the epilepsy, Parkinson’s, and Alzheimer’s disease areas. Nuclear medicine can find tumors, determine if they are responding to treatment, and determine if infected bones will heal.

After a heart attack, nuclear medicine procedures can assess damage to the heart. It can also tell doctors how well newly transplanted organs are working.

Yes, for the treatment, the radiopharmaceuticals go directly to the organ to be treated. For example, thousands of hyperthyroid patients are treated each year with nuclear medicine (using radioactive iodine). It can be used to treat certain types of cancer (thyroid, pheochromocytoma) and can treat bone pain caused by cancer.

Nuclear medicine can detect radiation from inside a patient’s body. All of the procedures mentioned above (except nuclear scans) expose the patient to radiation outside the body using machines that send radiation through the body. Consequently, nuclear medicine determines the cause of a medical problem based on the function of an organ, in contrast to other diagnostic tests, which determine the presence of a disease based on anatomical or structural features. A nuclear medicine procedure, called positron emission tomography (PET), identifies many types of disease in the body simply by determining how the disease uses sugar. No other imaging method has the ability to use our body functions to determine disease status.

Absolutely, many patients have had multiple scans as part of their medical evaluation. The best course of action for you will be guided by your doctor.

Before having a thyroid scan, tell your healthcare professionals if:

  • You have allergies to medications, including anesthetics.
  • Take thyroid hormones, antithyroid medications, medications that contain iodine such as iodized salt, seaweed, cough syrups, multivitamins, or the heart medication Amiodarone.
  • You recently (within 4 to 6 weeks) had tests in which you were given radioactive materials or had x-rays that used iodine dye.
  • Before a thyroid scan, you will ingest a dose of radioactive iodine or give you technetium through an When and how to take the radioactive tracer depends on the tracer used.

A lung scan is a nuclear scanning test most commonly used to detect a blood clot that is preventing normal blood flow to part of a lung (pulmonary embolism). The results of a lung scan are usually available within a day.

A cardiac perfusion scan measures the amount of blood in the heart muscle at rest and during exercise. It is often done to find out what might be causing the chest pain. It may be done after a heart attack to see if areas of the heart are not getting enough blood or to find out how much heart muscle has been damaged by the heart attack.

A bone scan is done to determine if a tumor from another area has spread to the bone, the cause or location of unexplained bone pain, to help diagnose bone fractures, such as a hip fracture or stress fracture, that do not show up clearly on X-ray and to detect bone damage caused by infection or other conditions.

A bone mineral density (BMD) test measures the mineral density (such as calcium) in your bones using a special X-ray, computed tomography (CT) scan, or ultrasound. From this information, it is possible to estimate the strength of your bones.

After most nuclear medicine procedures, it is generally best to drink plenty of fluids and urinate as often as possible. This helps remove residual radioactivity from your body. The time required to do this will depend on the radiopharmaceutical being used. Once more, it is better to talk to your doctor.

It is best to stop breastfeeding your baby for a few hours or a few days after studying nuclear medicine. For many therapeutic procedures, nursing care may have to be stopped entirely. This depends on the type of study you are undergoing and the radiopharmaceutical that will be used. You’ll get the greatest guidance from your doctor.

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