Nuclear Medicine

Radioactive tracers is the form of radiation they use within the human body when doing procedures such as CAT, MIBG, MRI, PET, and Gallium scans. Patients who undergo radioactive procedures are first given a small amount of radioisotope one of two ways oral or by injection. This radioisotope is pertinent to the procedure because it enhances the visualization on vascular structures and organs. The preparation is varies upon ordering physician however are relatively similar in protocol. For vascular patients it is recommended that the patient not have any caffeinated beverages 12 hours prior to the procedure and nothing to eat at least 4 hours before a procedure. Nuclear Vascular stress tests take approximately 3 hours to complete. All patients should wear comfortable lose fitting clothing and tennis shoes for comfort ability due to the nature of the testing which is done on a treadmill. The treadmill however, does not always provide enough information pertaining to the heart and hearts circulation. Nuclear stress tests then become the next phase which includes putting an IV into the arm and injecting a dose of radioisotope. The radiologist will then have you wait approximately 30 minutes and then take you down for pictures of your heart. After this is done the patient will begin walking on the treadmill and right before the procedure is over the radiologist will inject the patient again with radioisotope and then eat. After about a half an hour passes the radiologist will proceed to take some more pictures.
Radionuclide scanning is done for many reasons on patients to give the physicians a more precise location of the effective area and diagnosis. They use them for bone scans, which allow the doctors to detect things such as cancer, infection, or damaged areas. On bone scans when something is visible on the scan it is called a “hot spot” which just means that the radioisotope has detected the affected area. DMSA scanning is a procedure for scanning the kidney to try and locate any scarring, how well your urine is draining from the kidney to the bladder. Lung perfusion scans are done (VQ Scan) to detect pulmonary embolus which is blood clots in the lungs. There are many other usages of radioisotope within scanning the body such as myocardial perfusions and thyroid scans and uptakes.
As for any testing involving nuclear medicine the basic preparation applies to all of these testing’s. However for a PET scan which stands for Positron emission tomography is used as a diagnostic scan that takes images of the entire body and allows for the detection of radiation from the emissions positrons. Preparation for a PET scan includes a limited carbohydrate diet for approximately 24 hours prior to the scanning, nothing to eat or drink with the acceptation of water for at least 6-8 hours prior to the scan. Once you have arrived for the PET scan, the radiology technician will begin a series of questions, identifying you are the patient and all permission forms are completed and then they will insert an IV into your vein. Contrast is then injected into the vein, the radiologist will also inject the isotope and with a warning that it is extremely cold. PET Scans usually last about two hours, and they position you on an exam table. The radiologists will ask you to remain as still as you possibly can for those two hours to get the best results from the scan and to hold your breath periodically throughout the scanning.
After the procedure is over a set of discharge instructions are given to the patients. They prefer if you have small children to avoid them for several hours, drink at least 8 glass of water, breast feeding moms need to wait at least 24 hours before resuming breast feeding. Once the exam is over your kidneys will excrete the contrasts and the isotope through your kidneys when you urinate.
Some advantages and disadvantages of using nuclear medicine is an inexpensive way to detect many different areas of diagnosis, diseases and bone injury or diseases and can gives a more precise diagnosis than going into and operating room and have exploratory surgery or procedures done that may or may not be able to confirm a true diagnosis. Nuclear medicine gives physicians, radiologists and other medical staff the adequate information with precision on both functions of the anatomic structures of whereas the other imaging such as X-rays results in unattainable information because the scanning is not adequate enough to see further into the human body that is necessary for diagnosis of things such as if cancer had metastases and spread throughout the body. Another area of advantage nuclear medicine plays a role in is when a patient receives a PET scan the possibility of an early diagnosis or onset of a disease giving the patient a fighting chance against potentially fatal diseases and diagnosis’s. PET Scans can also detect lesions both benign and malignant and again because of this advancement in technologist within the nuclear medicine field prevent the need for surgical procedures such as biopsies and or to help locate the best biopsy location within the body. Another advantage to using nuclear medicines radiotracers would be in brain scans where it will show parts of the brain and its activity during different parts of the test. The biggest downfall or disadvantage to using these radiotracers is the anatomic detail and the exposure to radiation. There is a lot of new technology and research studies out there that are suggestive that it is now possible to have a PET scan and CT that will show more of the physiologic and anatomic information more so nowadays than in the past. CT scans do see an increase risk in banker from the over exposure to ionizing radiation and this risk increases in children. The injection of contrast can cause and allergic reaction and also kidney problems. PET scan exposures include gamma rays and can also cause an allergic reaction and may become claustrophobic during the procedure and may require a sedative to help them relax.
There many aliments where nuclear medicine is used for treatment and diagnosis. Doctors all over the world use nuclear medicine to find early detection, diagnostics and have become an integral part of patient care. Neurological diseases such as dementias, seizure disorder and Alzheimer’s disease has been diagnosed and treated because of the accessibility to nuclear medicine technology. In addition to these neurological diseases nuclear medicine is used in coronary artery diseases, thyroid, parathyroid, adrenal and many other endocrine diseases. Nuclear medicine is also essential in the early diagnoses, treatments and procedures of all types of cancers. Gastrointestinal disease of the stomach, liver and gallbladder and genitourinary diseases such as testicular, kidney and bladder disease diagnosis also rely on nuclear medicine procedures and treatments. Lastly, infectious, bone and pulmonary diseases also rely on nuclear medicine for detection, diagnoses and treatment.