Nuclear medicine

Nuclear medicine imaging uses small amounts of radioactive radiotracers that are typically injected into the bloodstream, inhaled, or swallowed. The radiotracer travels through the area being examined and gives off energy in the form of gamma rays which are detected by a special camera and a computer to create images of the inside of your body. Nuclear medicine imaging provides unique information that often cannot be obtained using other imaging procedures and offers the potential to identify disease in its earliest stages.

Nuclear medicine is noninvasive. Except for intravenous injections, it is usually painless. These tests use radioactive materials called radiopharmaceuticals or radiotracers to help diagnose and assess medical conditions.

Radiotracers are molecules linked to, or "labeled" with, a small amount of radioactive material. They accumulate in tumors or regions of inflammation. They can also bind to specific proteins in the body. The most common radiotracer is F-18 fluorodeoxyglucose (FDG), a molecule similar to glucose. Cancer cells are more metabolically active and may absorb glucose at a higher rate. This higher rate can be seen on PET scans. This allows a doctor to detect disease before it may be seen on other imaging tests. FDG is just one of many radiotracers in use or in development.

Many imaging centers combine nuclear medicine images with computed tomography (CT) or Single-photonmagnetic resonance imaging (MRI) to produce special views. Doctors call this image fusion or co-registration. Image fusion allows the doctor to connect and interpret information from two different exams on one image. This leads to more precise information and a more exact diagnosis. Single photon emission CT/CT (SPECT/CT) and positron emission tomography/CT (PET/CT) units can perform both exams at the same time.

Nuclear medicine offers many therapeutic procedures, such as radioactive iodine (I-131) therapy that use small amounts of radioactive material to treat cancer and other medical conditions affecting the thyroid gland, as well as treatments for other cancers and medical conditions.

• visualize heart blood flow and function (such as a myocardial perfusion scan)
• detect coronary artery disease and the extent of coronary stenosis
• assess damage to the heart following a heart attack
• evaluate treatment options such as bypass heart surgery and angioplasty
• evaluate the results of revascularization (blood flow restoration) procedures
• detect heart transplant rejection
• evaluate heart function before and after chemotherapy (MUGA)

• scan lungs for respiratory and blood flow problems
• assess differential lung function for lung reduction or transplant surgery
• detect lung transplant rejection

• evaluate bones for fractures, infection and arthritis
• evaluate for metastatic bone disease
• evaluate painful prosthetic joints
• evaluate bone tumors
• identify sites for biopsy

• investigate abnormalities in the brain in patients with certain symptoms or disorders, such as seizures, memory loss and suspected abnormalities in blood flow
• detect the early onset of neurological disorders such as Alzheimer's disease
• assist in surgical planning and identify the areas of the brain that may be causing seizures
• evaluate for abnormalities in a chemical in the brain involved in controlling movement in patients with suspected Parkinson's disease or related movement disorders
• evaluation for suspected brain tumor recurrence, surgical or radiation planning or localization for biopsy

• stage cancer by determining the presence or spread of cancer in various parts of the body
• localize sentinel lymph nodes before surgery in patients with breast cancer or skin and soft tissue tumors plan treatment
• evaluate response to therapy
• detect the recurrence of cancer
• detect rare tumors of the pancreas and adrenal glands