NUCLEAR MEDICINE

NUCLEAR MEDICINE

Diagnostic medical imaging:

In nuclear medicine imaging, radiopharmaceuticals are taken internally, for example intravenously or orally. Then, external detectors (gamma cameras) capture and form images from the radiation emitted by the radiopharmaceuticals. This process is unlike a diagnostic X-ray where external radiation is passed through the body to form an image.

There are several techniques of diagnostic nuclear medicine.

2D: Scintigraphy ("scint") is the use of internal radionuclides to create two-dimensional images.

Nuclear medicine myocardial perfusion scan with Thallium-201 for the rest images (bottom rows) and Tc-Sestamibi for the stress images (top rows). The nuclear medicine myocardial perfusion scan plays a pivotal role in the noninvasive evaluation of coronary artery disease.

The study not only identifies patients with coronary artery disease, it also provides overall prognostic information or overall risk of adverse cardiac events for the patient.

3D: SPECT is a 3D tomographic technique that uses gamma camera data from many projections and can be reconstructed in different planes. Positron emission tomography (PET) uses coincidence detection to image functional processes.

Maximum Intensity Projection (MIP) of a wholebody positron emission tomography (PET) acquisition of a 79 kg weighting female after intravenous injection of 371 MBq of 18F-FDG (one hour prior measurement).

Nuclear medicine tests differ from most other imaging modalities in that diagnostic tests primarily show the physiological function of the system being investigated as opposed to traditional anatomical imaging such as CT or MRI. Nuclear medicine imaging studies are generally more organ or tissue specific (e.g.: lungs scan, heart scan, bone scan, brain scan, etc.) than those in conventional radiology imaging, which focus on a particular section of the body (e.g.: chest X-ray, abdomen/pelvis CT scan, head CT scan, etc.).

In addition, there are nuclear medicine studies that allow imaging of the whole body based on certain cellular receptors or functions. Examples are whole body PET scan or PET/CT scans, gallium scans, indium white blood cell scans, MIBG and octreotide scans.

Hybrid scanning techniques

In some centers, the nuclear medicine scans can be superimposed, using software or hybrid cameras, on images from modalities such as CT or MRI to highlight the part of the body in which the radiopharmaceutical is concentrated. This practice is often referred to as image fusion or co-registration, for example SPECT/CT and PET/CT. The fusion imaging technique in nuclear medicine provides information about the anatomy and function, which would otherwise be unavailable, or would require a more invasive procedure or surgery.

Normal whole body PET/CT scan with FDG-18. The whole body PET/CT scan is commonly used in the detection, staging and follow-up of various cancers.

Abnormal whole body PET/CT scan with multiple metastases from a cancer. The whole body PET/CT scan has became an important tool in the evaluation of cancer.

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