Nuclear Radiology

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SECTION CHIEF
Dr. Kevin Forte

 


WHAT IS NUCLEAR MEDICINE?

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Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive materials called radiopharmaceuticals to diagnose and treat certain illnesses, such as:

  • cancers
  • heart disease
  • gastrointestinal
  • endocrine

Because nuclear medicine procedures are able to pinpoint molecular activity within the body, they offer the potential to identify disease in its earliest stages, as well as a patient’s immediate response to therapeutic interventions.


USES OF PROCEDURE BY RADIOLOGY CONSULTANTS

Physicians use radionuclide imaging procedures to visualize the structure and function of an organ, tissue, bone or system within the body.

IN ADULTS

Heart

  • 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 procedures
  • detect heart transplant rejection
  • evaluate heart function before and after chemotherapy (MUGA)

Lungs

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

Bones

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

Brain

  • investigate abnormalities in the brain, such as seizures, memory loss and abnormalities in blood flow
  • detect the early onset of neurological disorders such as Alzheimer disease
  • plan surgery and localize seizure foci
  • evaluate for abnormalities in a chemical in the brain involved in controlling movement in patients with suspected Parkinson’s disease
  • evaluation of brain tumor recurrence, surgical or radiation planning or localization for biopsy

Other Systems

  • identify inflammation or abnormal function of the gallbladder
  • identify bleeding into the bowel
  • assess post-operative complications of gallbladder surgery
  • evaluate lymphedema
  • evaluate fever of unknown origin
  • locate the presence of infection
  • measure thyroid function to detect an overactive or underactive thyroid
  • help diagnose hyperthyroidism and blood cell disorders
  • evaluate for hyperparathyroidism
  • evaluate stomach emptying
  • evaluate spinal fluid flow and potential spinal fluid leaks

IN CHILDREN

  • investigate abnormalities in the esophagus, such as esophageal reflux or motility disorders
  • evaluate the openness of tear ducts
  • evaluate the openness of ventricular shunts in the brain
  • assess congenital heart disease for shunts and pulmonary blood flow

IN ADULTS AND CHILDREN

Cancer

  • 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

Renal

  • analyze native and transplant kidney function
  • detect urinary tract obstruction
  • evaluate for hypertension related to the kidney arteries
  • evaluate kidneys for infection versus scar
  • detect and follow-up urinary reflux

NUCLEAR MEDICINE THERAPIES PERFORMED BY RADIOLOGY CONSULTANTS

  • Radioactive iodine (I-131) therapy used to treat some causes of hyperthyroidism (overactive thyroid gland, for example, Graves’ disease) and thyroid cancer
  • Radioactive antibodies used to treat certain forms of lymphoma (cancer of the lymphatic system)
  • Radioactive phosphorus (P-32) used to treat certain blood disorders
  • Radioactive materials used to treat painful tumor metastases to the bones
  • I-123 MIBG (radioactive iodine labeled with metaiodobenzylguanidine) used to diagnose adrenal gland tumors in adults and adrenal gland/nerve tissue tumors in children

WHAT TO EXPECT DURING A PROCEDURE

  • During a nuclear medicine imaging procedure, our Radiologic Physicians give patients radiopharmaceuticals. Depending on the type of medical examination they can be breathed in (inhaled), injected, or swallowed.
  • Once the radiopharmaceutical is given, the patient is usually asked to lie down on a table. A special camera that detects radiation is placed over the patient’s body to take pictures. A computer is used to show where the body concentrates the radioactive material. This allows doctors to check if organs are working properly and diagnose diseases.
  • The radioactive materials usually leave the body within hours to months.

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BENEFITS VS RISKS

Benefits

  • Nuclear medicine examinations provide unique information on both function and anatomic structure of the body often unattainable using other imaging procedures.
  • Nuclear medicine scans can yield the most useful information needed to make a diagnosis or to determine appropriate treatment, if any.
  • Nuclear medicine is less expensive than exploratory surgery.
  • Nuclear medicine may yield more precise information than exploratory surgery.
  • Nuclear medicine offers potential to identify disease in its earliest stage, often before symptoms occur or abnormalities detected by other diagnostic tests.
  • By detecting whether lesions are likely benign or malignant, PET scans may eliminate the need for surgical biopsy or identify best biopsy location.
  • PET scans may provide additional information that is used for radiation therapy planning.

Risks

  • Because the doses of radiotracer administered are small, diagnostic nuclear medicine procedures result in relatively low radiation exposure to patient, acceptable for diagnostic exams. Thus, the radiation risk is very low compared with potential benefits.
  • Allergic reactions to radiopharmaceuticals may occur, but are extremely rare and are usually mild.
    • inform the Radiologic Physician of any allergies
    • inform the Radiologic Physician of any problems that may have occurred during a previous nuclear medicine exam.
  • Injection of the radiotracer may cause slight pain and redness which should rapidly resolve.
  • Women should always inform the Radiologic Physician and/or Technologist if there is any possibility that they are pregnant or if they are breastfeeding.

NOTE
The risks of the treatment are always weighed against the potential benefits for nuclear medicine therapeutic procedures. You will be informed of all significant risks prior to the treatment, and have an opportunity to ask questions.


WHO INTERPRETS RESULTS?

weiss_NeuclarOne of our Nuclear Medicine Radiologists will read and interpret your exam. After graduating medical school, our Nuclear Medicine Radiologists completed a four-year Diagnostic Radiology Residency, where they were trained in a wide variety of imaging techniques, including the diagnostic and therapeutic use of radioactive pharmaceuticals. Our Nuclear Radiologists have one or more years of additional nuclear medicine training. All educational programs certified by the Accreditation Council for Graduate Medical Education (ACGME).


HOW WILL I RECEIVE THE RESULTS OF THE TEST?

One of Nuclear Medicine Radiologists will forward your results to your referring Physician along with follow-up recommendations. Your Physician should contact you with the results.


WHAT ABOUT PAYMENT?

Radiology Consultants will file all insurance as a courtesy to you. Depending on the Contractual Agreement with your Insurance Company, you may owe a co-payment and/or deductible at the time of service.

* Please bring your Insurance Card with you *

Please visit our BILLING PAGE for specific information on Insurance, Self-Pay, Motor Vehicle Accident, Cash, Debit or Major Credit Card payment options.

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Important…

Please notify the Radiologic Physician and/or Technologist if there is a possibility you are pregnant. Radiation is potentially harmful to a developing baby during pregnancy.

** All images are for educational purposes only. Consult your physician for a proper diagnosis.**

Source: American College of Radiology
Source: Journal of the American College of Radiology