Nuclear Medicine is a medical specialty which uses safe, painless and cost-effective techniques both to image the body and treat disease. It is unique in that it documents organ functions, structure and quantitation, in contrast to diagnostic radiology which is based upon anatomy by using very small amount of radioactive material. These procedures often identify abnormalities very early in the progression of a disease long before some medical problems are apparent with other diagnostic tests.
An estimated 10-12 million nuclear medicine imaging and therapeutic procedures are performed each year in the United States. Nuclear medicine plays a vital role in:Cardiology
Detection of coronary artery disease and its prognosis. If the perfusion images are normal, there may be no need for coronary angiography.Pulmonary
Detection of blood clots in the lungs.Neurology
Detection of transient ischaemic attacks, epilepsy and stroke. Differentiating dementia of different types.Breast
Detection of cancer (Scintimammography) and the avoidance of unnecessary biopsies.Thyroid
Differentiating causes of thyrotoxicosis.
Differentiating between types of nodules (hot/cold).
Assessment and treatment of thyroid cancer and thyrotoxicosis with radio-active iodine.
Detection of pheochromocytoma (adrenal and extra adrenal sites), neuroblastoma, carcinoid, paragangliomas, etc.Nephro-urology
Dynamic renal images portray differential parenchymal functions, glomerular filtration rate, effective renal plasma flow and the excretion of each kidney. Detection of infective foci and vesico-ureteric reflux (low and high pressure).Gastrointestinal
Gastrointestinal bleeding - detects lower rate (0.05 to 0.1 ml/min) of bleeding than by other tests, Meckle's diverticulum bleeding, etc. Biliary leaks, biliary atresia, Quantitative Cholecystokinin (CCK) cholescintigraphy for acalculous biliary disease and parenchymal liver functions, gastroesophageal reflux, esophageal transit time and gastric emptying.Skeletal
Bone scanning is commonly used to detect metastases from tumours. The technique allows visualisation of the entire skeleton in a short time and enables staging of the disease and evaluating response to treatment. It is also used to diagnose sports injuries (stress fractures, shin splints, etc.), avascular necrosis of hips and knees, to differentiate between loosening and infection of joint prostheses, metabolic bone disease, and in the investigation of bone pain of unknown origin.Lymphatics
Sentinel lymph node (SLN) detection in carcinoma breast, melanoma, etc. to avoid unnecessary lymph node dissection and morbidity. Upper and lower limb lymphatic scans to rule out any lymphatic flow obstruction.Infection/Inflammation and Tumours
Gallium 67 citrate imaging is useful where diagnostic dilemma exist. Nuclear scans are employed for the diagnosis of osteomyelitis, fever of unknown origin, Adult Respiratory Distress Syndrome (ARDS), and sarcoidosis, as well as in cases of Hodgkins/Non Hodgkins lymphoma, melanoma, testicular, bronchogenic and hepatocelluar carcinomas.
Detailed information can be obtained from Dr. Shekhar V. Shikare , Nuclear Medicine Specialist, on Tel: 06-5619999 ext. 7061.