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Introduction
Nuclear Medicine is
a medical specialty that uses safe, painless and cost effective
techniques both to image the body and treat diseases. It involves the
use of minute quantities of radioactive substances combines with
pharmaceuticals to study the functioning of various organs and to some
extent the structure of the anatomy. It is a procedure to gather
medical information, that may be otherwise unavailable with the other
existing modalities which may require surgery. This detection process
allows to disease to be treated early in its course, leading to highly
successful prognosis. In a Nuclear Medicine scan a very small amount of
material or radiopharmaceuticals which is commonly called
the/radiotracer (not the dye) is injected either through the IV route or
orally or by inhalation into the body. They produce gamma ray emission
from the target organ, which is subsequently scanned by a special type
of camera called SPECT.
The other
alternatives of utilizing these radioisotopes are called invitro
technique commonly designated as Radioimmuno Assay. As per this method a
patients blood /plasma is collected in a vial from which the serum is
separated out and tracer antibody tagged with I-125 or cobalt-57 is
added to estimate the particular level of hormone, some of the common
day to day hormones are T3, T4, TSH, FreeT3, FreeT4, and thyroid
antibodies for thyroid function test. Infertility hormones such as FSH,
LH, Prolactin, Progesterone, Oestradiol(E2), Oestradiol(E3),
Testosterone (Total & Free) tumor markers such as CEA, AFP, PSA,
CEA-125, CA-15.3,CA-19.9 etc.
Dynamic Nuclear
Medicine Scans
Invivo Nuclear
Medicine scans are HMPAO Brain SPECT, static brain scan, thyroidscan.
Lung perfuston / ventilation scan, stress MUGA with NG intervention for
LVfunctons. Stress Thallium myocardial perfusion scan. Gated SPECT
tetrofosmin mvocardial scan, static and dynamic liver scan. whole body
bone scan. DTPA renogram to assess kidney function, DMSA cortisol renal
scan, Gl bleeding detection scan, Hepathbiliary imaging scan, Ga-67
whole body scan and 1-131
MIBG scan etc., are also performed routinely.
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1. Whole body
scan using 99mTc - MDP radioisotope shows
physiological distribution of radiotracer throughout the
skeletal system. No localized hot or cold area is seen which is
suggestive of Normal Bone Scan.
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2. Stress
Thallium Myocardial perfusion scan at stress as well as rest
reveals uniform stress perfusion pattern in all the defined
myocardial segment suggestive of uniform & normal blood flow
through the coronary arteries without any evidence of
Coronary Artery Disease.
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3. 99mTc
tetrofosmin myocardial perfusion reveal dilated left ventricle
wit multiple areas of stress perfusion defects involving
anteroseptal & inferior segment of myocardium suggestive of
absence blood supply through LAD &Right Coronary Artery with
evidence of reperfusion with resting reinjection of 99mTc
tetrofosmin involving whole of anteroseptal segment with the
absence of reperfusion involving inferior segment that
suggestive of viable myocardium involving anteroseptal &
almost dead myocardium involving inferior segment |
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4. (a-b).
99mTc DTPA dynamic renal scintigraphy reveal normal sized
both kidneys with uniform cortical uptake. Good excretion by
both kidneys .Individual relative functions are almost normal
.No obstructive hold up pattern suggestive of normal status of
both kidneys. |
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5. 99mTc
radiotracer thyroid scan reveals normal sized both lobs with
uniform uptake pattern .Normal visualization of salivary glands
activity suggestive of Normal
Thyroid Scan. |
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6. 99mTc
radioisotopes static thyroid scan shows diffuse enlargement of
both lobe of thyroid with increased uptake pattern .(13.6% in
right lobe &13.6% in left lobe ). Non visualization of salivary
glands activity suggestive Toxic
Diffuse Goitre. |
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7. (a) 99mTc
Macro Aggregated Albumin radioisotopes lungs perfusion
scintigram in various projection reveals multiple areas of
perfusion defect involving both lobe of lungs region suggestive
of bilateral embolism.
(b) After
administration of thromobolytic therapy the macro Aggregated
Albumin radioisotopes lungs perfusion scintigram was repeated in
the same patient reveals almost re-establishment of normal blood
flow pattern in the form of reperfusion of both the segments of
lungs region suggestive of successful Thromobolytic Therapy. |
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