Nuclear Medicine is a branch of Diagnostic Radiology and Imaging wherein a very small and safe amount of radioactive isotope (usually 99m Technetium) tagged to a pharmaceutical agent is injected intravenously and patient is scanned using specialised equipment called Gamma Camera (with SPECT – Single Photon Emission Computerized Tomography).
Nuclear Medicine scans can be safely carried out in patients with diabetes, hypertension, renal or hepatic dysfunction and in children of all age groups including neonates. There is no risk of any allergic reaction or side effects. A small amount of radiation exposure is involved which is well within permissible and safe limits After scan patient can drive, go back to work or home and carry on his routine tasks.
Specially trained staff: These procedures are performed by specially qualified and highly experienced Nuclear Medicine Technologist and Nuclear Medicine Specialist Physician specially trained and skilled in performing these procedures including handling of Isotopes as per international radiation safety standards.
Utility of Nuclear Medicine: It is a unique and non-invasive Imaging Modality that gives specific functional information regarding physiologic condition of the organ or system (like, perfusion, function metabolism and receptor imaging etc.) rather than anatomic details which are routinely assessed with conventional radiological procedure like Ultrasound, Radiographs (X-Rays) CT Scan and MRI.
- Stress & Rest Myocardial Perfusion Imaging: using 99m Technetium MIBI or Tetrofosmin (using treadmill /pharmacologic
stress eg Adenosine or Dobutamine) – for inducible ischemia.
- Rest myocardial perfusion imaging – to assess Viable Myocardium.
- MUGA scan to assess LV function / LVEF
Orthopedics/ Sports Medicine/Rheumatology (99m Technetium MDP Bone Scan)
- Evaluation & follow up of metastatic bone disease.
- Variety of benign bone conditions/diseases as follows: Evaluation of bone pain/ generalized body/back pain/ joint pains,
metabolic bone diseases, Paget’s disease, stress fractures, complex regional ainsyndrome,polyarthropathies/seronegative
SPA, infections-chronic osteomyelitis/diabetic foot / prosthesis related infection/ loosening, osteoid osteoma etc.
99m Technetium LEUKO SCAN:
- For determining the location and extent of infection/ inflammation in bone in patients with suspected osteomyelitis,
including patients with diabetic Foot ulcers.
- 99m Tc DTPA/MAG 3/EC Dynamic Renal Scan and Renogram – To assess renal function & drainage pattern /rule out PUJ
obstruction. ((with or without diuretic).
- DMSA renal cortical scan – in UTI for documentation of differential function and infective focus/scarring.
- Renal Transplant Evaluation.
- Voiding Cystourethrography (VCUG) – for detection /documentation of VUR in certain cases.
- Renogram with ACE inhibitor challenge – to assess haemodynamic significance of known renal artery stenosis.
- Gastrointestinal Bleeding and Liver Haemangioma- using 99m Tc labeled RBC.
- Meckle’s scan-imaging ectopic gastric mucosa (commonly in children).
- Hepatobiliary scan ( HIDA SCAN) – to assess gallbladder function (GBEF) in suspected GB dyskinesia/dysfunction, acute and chronic cholecystitis, biliary leak.
- Liver & spleen scan (Tc-sulphur colloid) in cases of hepatic (kupffer cell) dysfunction (cirrhosis, NCPH/F)
- Oesophageal transit study.
- Gastric Emptying time.
- 99m Tc Thyroid Scan and Uptake – in evaluation of Thyroid dysfunction, thyroid nodule evaluation (Graves / Thyroiditis
and cold vs hot nodule (AFTN).
- Parathyroid Scan- for detecting and localizing Parathyroid Adenoma in thyroid bed / ectopic location
Pulmonary Perfusion and Ventilation/ VQ Scan
- For probability of pulmonary thromboembolism (NOTE: recent chest x ray and/or HRCT correlation is required).
- Pre OP evaluation of residual lung function prior to pneumonectomy / lobectomy.
- Milk scan- to detect gastroesophageal reflux.
- Meckle’s scan-images ectopic gastric mucosa.
- HIDA / hepatobiliary scan- to rule out biliary atresia in neonates.
- MAG 3 /EC/ DTPA Renal scan and Renogram (with or without diuretic intervention) – to assess renal function & drainage /
rule out PUJ obstruction.
- DMSA scan- for differential function and in UTI to detect infective focus/ scar, documentation of function in multicystic
dysplastic kidney/ assess ectopic kidney.
Miscellaneous procedures / scans
- Sentinel Lymph Node Imaging: To localize and Image sentinel lymph node in various malignancies like Carcinoma Breast, Malignant Melanoma etc.
- Salivary gland scintigraphy – for function and excretion/
- Dacryoscintigraphy – for documentation the level of Functional nasolacrimal duct obstruction.
- Lymphoscintigraphy – to assess patency of lymphatic channels/ differentiate lymphedema from other causes of odema.
- Venography – (dynamic and blood pool) – in veno-occlusive disease/ DVT.
- Scintimammography – may be helpful in the evaluation of breast lesions especially in post-op cases / dense breasts /breast prosthesis.
- Whole body radioiodine (Iodine 131) scan: In a case of Ca Thyroid (DTC) – post-operative status.
- 131 Iodine MIBG scan- in evaluation of suspected neuroendocrine tumors (pheochromocytoma /paraganglioma etc.) for follow up / metastatic work up.
- Testicular scintigraphy- sometimes helpful along with clinical correlation in acute conditions to differentiate torsion from other causes of testicular pain/ swelling.
- 99m Tc Octreotide Scan – Detection and follow-up in Neuroendocrine Tumours.
- Radionuclide Cisternography – to study CSF flow (eg: Normal pressure Hydrocephalus) and CSF leak.
- Therapy for Thyrotoxicosis – Radioactive Iodine 131 therapy for Graves’ Disease and Autonomously functioning Toxic Nodule.