Nuclear
Medicine...
is
the medical specialty that uses radiopharmaceuticals for
diagnosis and therapy. The radiopharmaceutical is usually
administered intravenously but, depending on the study, it
may also be administered orally or by inhalation.
The radiation dose from a diagnostic study is usually less
than that of a CT scan.
EXAMINATIONS OFFERED:
Bone Scan
•
Skeletal metastates
• Sports injuries (eg shin splints, stress fractures)
• Trauma (eg. scaphoid, sacral & femoral neck
fractures not evident on X-Rays)
• Osteoporotic fractures
• Osteonecrosis (avascular necrosis)
• Osteomyelitis
• Painful prosthesis (loosening or infection)
• Back Pain - spondylolysis, pars interarticularis
fracture
• Paget's disease - presence & extent
• Enthesopathy, sacrolitis
• Reflex sympathetic dystrophy
Myocardial
Perfusion Study
(exercise / dipyridamole /dobutamine)
•
Detection of presence, extent & severity of myocardial
ischaemia
• Gated SPECT permits evaluation of LV wall motion
& thickening & provides LVEF
Gated
Heart Pool Study
•
Evaluation of left & right ventricular size &
systolic function, measurement of LVEF & diastolic
filling parameters
Ventilation
& Perfusion Lung Study
•
Detection of pulmonary embolism
• Significantly less radiation than CTPA
• Preferred over CTPA for chronic pulmonary embolism
Thyroid
Study
•
Evaluation of thyrotoxicosis
• Diagnosis of subacute thyroiditis
• Evaluation of functional status of thyroid nodules
Parathyroid
Study
•
Localisation of parathyroid adenoma / hyperplasia in
hyperparathroidism
Infection
/ Inflammation Study
•
Both used to detect septic foci
Gallium
•
Detection of malignancy as a cause of PUO
Labelled
White Cell
•
Detection of active inflammatory bowel disease
Renal
Cortical Study (DMSA)
•
'Gold standard' test for detection of presence, location
& extent of renal cortical scars
• Detection of acute pyelonephritis
• Measurement of differential renal function
Renal
Study (MAG3 or DTPA) +/- Lasix
•
Evaluation of renal perfusion and excretion
• Diagnosis of pelvi-ureteric junction obstruction
& vesico-ureteric junction obstruction
• Follow-up evaluation after pyeloplasty
• Measurement of differential rela function
GFR
measurement (DTPA)
•
GFR measurement
Captopril
Renal Study
•
Diagnosis of hemodynamically significant renal artery
stenosis
Cerebral
Perfusion Study
•
Evaluation of dementia
• Localisation of focus of complex partial seizures
• Detection of presence and extent of cerebral
infarction not evident on CT
Biliary
Study
•
Chronic cholecystitis, gallbladder dyskinesia, cystic duct
syndrome
• Acute cholecystits
• Post-operative biliary leak
Meckel's
Study
•
Detection of Meckel's diverticulum which contains ectopic
gastric mucosa
Haemangioma
Study
•
Detection of cavernous haemangioma (eg. in liver)
Lymphoscintigraphy
•
Diagnosis of lymphedema
• Evaluation of regional lymphatic drainage prior to
surgery (eg. for skin legions and breast carcinoma)
TUMOUR
STUDIES
•
For tumour staging, evaluation of response to therapy,
detection of residual or recurrent disease
Gallium - Lymphoma (HL and NHL), sarcoma
MIBG (I-123 or I-131) - Phaeochromocytoma, neuroblastoma
In-111 Pentetreotide - Carcinoid tumour, pancreatic islet
cell tumours, medullary thyroid carcinoma, paraganglioma,
glomus tumour
THERAPY
I-131
- Grave's disease, toxic nodules, thyroid carcinoma
Y-90 colloid - Radiation synovectomy (eg for RA)
Samarium-153 EDTMP - Palliation of metastatic bone pain
Strontium-89 - Palliation of metastatic bone pain
Gastrointestinal
Transit Studies
•
Oesophageal transit. Assessment of gastro-oesophageal
reflux
• Gastric emptying. Utilising a labelled egg sandwich
• Colonic transit. Oral gallium-67 is monitored daily
over 5 days
