Nuclear Medicine Department

Main Activities

Nuclear Medicine Department deals with the use of short-lived radionuclides for diagnosis and treatment of various diseases. These radionuclides are used in doses which are medically safe. Radionuclides producing gamma rays are employed for patient imaging and those producing purely beta particles or beta particles with gamma rays are used for treatment purposes. Commonly used radionuclides include Technetium-99m (99mTc), Iodine-131 (131I) and Thallium-201 (201Tl).

a) DIAGNOSTIC NUCLEAR MEDICINE

After administration, the distribution of radioisotopes in body is detected by hi-tech sophisticated equipment called 'Gamma Camera' and the procedure is called 'Scanning'. Nuclear medicine imaging or radionuclide imaging is also known as physiologic imaging (or imaging of function). Ordinary X-rays, ultrasounds, CAT and MRI scans give details about 'anatomy' of the imaged region whereas a radionuclide scan of an organ tells about its function and diseases affecting that particular function. Another advantage of radionuclide imaging is the determination of quantitative indices of function e.g. glomerular filtration rate (GFR) of the kidneys, ejection fraction (EF %) of the heart, etc. that considerably help the clinicians in diagnosis and management of the patients.

Various scans are routinely carried out in the department, which include:

Cardiac Scan or Myocardial Perfusion Scan (MIBI / Thallium) - to evaluate blood flow to the muscle cells of the heart - helps in detection of angina and myocardial infarction
Gated Myocardial Perfusion Scan - in addition to evaluation of blood flow to the muscle cells of the heart, also helps in determining the function of the heart
MUGA Scan - to detect the function of heart and associated disorders
Renal Scan - several types of renal scans (DTPA, DMSA & MAG3) are available to determine the function of kidneys, detect presence of obstruction due to kidney stones and diagnose renal damage by previous infections
HIDA Scan - to detect function of liver and gall bladder - done in certain types of jaundice and diseases of gall bladder
Bone Scan - a very sensitive test to detect an injury or disease in any bone of the entire skeleton and also helps in determining the spread of cancer in the bones
Thyroid Scan - a commonly done scan to diagnose various disorders of thyroid gland
Lung Perfusion/Ventilation Scan - to detect blood flow abnormalities in the lung and status of respiratory passages respectively, the scan aids in diagnosing a serious emergency medical condition called 'Pulmonary Embolism'
Parathyroid Scan - to detect the presence of disorders of parathyroid gland
GI Bleeding Scan - to diagnose and locate the site of gastrointestinal bleeding
GER Studies - to diagnose gastroesophageal reflux disease in children who have recurrent chest infections
I-131 Scan - to diagnose the presence of differentiated thyroid cancer and monitor treatment response in patients having these cancers
Sentinel lymph node detection - Another important available facility is the detection of sentinel lymph nodes and their resection in patients of breast cancer using Gamma Probe. This is a well-established technique world over and considerably reduces the extent of surgery and post-surgical morbidity of the patient.
Miscellaneous scans like liver and brain scans, radionuclide venography, scintimammography, lymphoscintigraphy, etc. are also performed.

b) THERAPEUTIC NUCLEAR MEDICINE

The Nuclear Medicine Department also provides services for treatment of thyroid gland disorders like hypothyroidism, hyperthyroidism and thyrotoxicosis. Moreover, patients having differentiated thyroid cancers are also managed after the relevant surgery. Less frequently provided services include treatment of refractory joint pains (radiation synevectomy), palliation of bone pains due to malignancy, 131I-MIBG for neural crest tumors and treatment of malignant peritoneal effusions etc.

Equipment

Nuclear medicine department is equipped with a radioisotope-dispensing laboratory for administering radioisotopes to the patients.

1. Gamma Cameras

Gamma Cameras are the mainstay of nuclear medical imaging. The ever-advancing technical developments providing hi-tech gamma cameras, have resulted in performing better planar imaging and SPECT imaging (giving 3-dimensional views of a scanned region), as well as elaborate and sophisticated software for more analytical and conclusive processing of the scans and determination of quantitative parameters.

NORI is currently equipped with following gamma cameras:

Scintronix (1986)
Sophy (1996)
ADAC Argus (2004)

ADAC Argus Spect Gamma Camera

2. Gamma Probe

Gamma Probe (Eurorad, Germany) is a special type of probe that is utilized during the surgery for breast cancer to detect sentinel lymph node(s) and their resection.

Gamma Probe