General Nuclear Medicine
Nuclear medicine is a subspecialty within radiology. It comprises
diagnostic examinations that result in images of body anatomy
and function. The images are developed based on the detection
of energy emitted from a radioactive substance given to the patient,
either intravenously or by mouth. Generally, radiation to the
patient is similar to that resulting from standard x-ray examinations.
What are some common uses of the procedure?
Nuclear medicine images can assist the physician in diagnosing
diseases. Tumors, infection and other disorders can be detected
by evaluating organ function. Specifically, nuclear medicine
can be used to:
- Analyze kidney function
- Image blood flow and function of the heart
- Scan lungs for respiratory and blood-flow problems
- Identify blockage of the gallbladder
- Evaluate bones for fracture, infection, arthritis or tumor
- Determine the presence or spread of cancer
- Identify bleeding into the bowel
- Locate the presence of infection
- Measure thyroid function to detect an overactive or under-active
thyroid
How should I prepare for the procedure?
Usually, no special preparation is needed for a nuclear medicine
examination. However, if the procedure involves evaluation
of the stomach, you may have to skip the meal immediately before
the test. If the procedure involves evaluation of the kidneys,
you may need to drink plenty of water before the test.
What does the equipment look like?
Positron Emission Tomography (PET)
equipment |
During most nuclear medicine examinations, you will lie down
on a scanning table. Consequently, the only piece of equipment
you may notice is the specialized nuclear imaging camera used
during the procedure. It is enclosed in metallic housing designed
to facilitate imaging of specific parts of the body. It can
look like a large round metallic apparatus suspended from a
tall, moveable post or a sleek one-piece metal arm that hangs
over the examination table. The camera can also be within a
large, doughnut-shaped structure similar in appearance to a
computed tomography (CT) scanner. Sometimes, the camera is
beneath the table out of view.
A nearby computer console, possibly in another room, processes
the data from the procedure.
How does the procedure work?
You are given a small dose of radioactive material, usually
intravenously but sometimes orally, that localizes in specific
body organ systems. This compound, called a radiopharmaceutical
or tracer, eventually collects in the organ and gives off energy
as gamma rays. The gamma camera detects the rays and works with
a computer to produce images and measurements of organs and tissues.
How is the procedure performed?
A radiopharmaceutical is usually administered into a vein.
Depending on which type of scan is being performed, the imaging
will be done either immediately, a few hours later, or even several
days after the injection. Imaging time varies, generally ranging
from 20 to 45 minutes.
The radiopharmaceutical that is used is determined by what part
of the body is under study since some compounds collect in specific
organs better than others. Depending on the type of scan, it
may take several seconds to several days for the substance to
travel through the body and accumulate in the organ under study,
thus the wide range in scanning times.
While the images are being obtained, you must remain as still
as possible. This is especially true when a series of images
are obtained to show how an organ functions over time.
After the procedure, a physician with specialized training in
nuclear medicine checks the quality of the images to ensure that
an optimal diagnostic study has been performed.
What will I experience during the procedure?
Some discomfort during a nuclear medicine procedure may arise
from the intravenous injection, usually done with a small needle.
With some special studies, a catheter may be placed into the
bladder, which may cause temporary discomfort. Lying still
on the examining table may be uncomfortable for some patients.
Most of the radioactivity passes out of your body in urine or
stool. The rest simply disappears through natural loss of radioactivity
over time.
Who interprets the results and how do I get them?
Most patients undergo a nuclear medicine examination because
their primary care physician has recommended it. A physician
who has specialized training in nuclear medicine will interpret
the images and forward a report to your physician. It usually
takes a day or so to interpret, report and deliver the results.
What are the
benefits vs. risks?
Benefits
- The functional information provided by nuclear medicine examinations
is unique and currently unattainable by using other imaging
procedures. For many diseases, nuclear medicine studies yield
the most useful information needed to make a diagnosis and
to determine appropriate treatment, if any.
- Nuclear medicine is much less traumatic than exploratory
surgery, and allergic reaction to the radiopharmaceutical material
is extremely rare.
Risks
- Because the doses of radiopharmaceutical administered are
very small, nuclear medicine procedures result in exposure
to a small dose of radiation. Nuclear medicine has been used
for more than five decades, and there are no known long-term
adverse effects from such low-dose studies.
- As with all radiologic procedures, be sure to inform your
physician if you are pregnant. In general, exposure to radiation
during pregnancy should be kept to a minimum.
- Allergic reactions to the radiopharmaceutical can occur,
but are extremely rare.
What are the limitations of General Nuclear Medicine?
Nuclear medicine procedures are time-consuming. They involve
administration of a radiopharmaceutical, obtaining images,
and interpreting the results. It can take hours to days for
the radiopharmaceutical to accumulate in the part of the body
under study. Imaging can take up to three hours to perform,
though new equipment is available that can substantially shorten
the procedure time.