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Nuclear Medicine & Molecular Imaging

Nuclear Medicine & Molecular Imaging

What is Nuclear Medicine?

Nuclear Medicine is a medical speciality that uses safe, painless, and cost-effective
techniques both to image the body and treat disease.

Nuclear imaging is unique in that it documents both organ function and morphology.Gamma ray emitting radiotracer is injected intravenously and non-invasive imaging is
performed with state-of-the-art Dual Head Gamma Camera (GE Millennium VG)

Why Nuclear Scan?

When we already have X-ray, Ultrasound, CT & MRI, why do we need this?

  • It provides unique functional information from cellular and molecular levels which is not possible with other modalities.
  • It is an extremely sensitive technique
  • It provides dynamic and quantitative information
  • It enables objective and prognostic assessment of disease

When do we use Nuclear Scan?

Radionuclide procedures are available for almost all organ systems just like the different X-ray procedures. It is used in evaluation of Heart, Lung, Brain, Bone, Kidneys, Liver etc.Scans are designed to study various aspects like concentration, excretion, drainage/flow of tracers in various organs or localize/characterize the leison pathology.

Is it safe?

  • Nuclear Scan is very safe
  • There will be no reaction or side effect to the tracer injected
  • Radiation burden to the patient’s body is less than in X-ray Procedures

 PET CT 

Discovery-IQ1

GE/Discovery IQ PET CT – First in South Tamilnadu to have a PET CT 
PET CT is revolutionizing Cancer care
The value of Whole body Positron Emission Tomography–Computed Tomography (PET/CT) for diagnostic imaging in oncology is well established with its capabilities to combine anatomical and functional aspects of the whole body to provide a complete picture of patient’s disease status.
PET CT can help speed up treatment, because metabolic changes in a tumor occur more frequently than structural changes. It is a more accurate and reliable solution that can help clinicians determine how well a treatment is working especially in lymphomas after as few as 1 to 2 cycles of chemotherapy, and they will be able to tailor the treatment according to individual patient’s response and needs. Thus Molecular imaging using PET CT is a decisive tool for early diagnosis, treatment staging as well as monitoring the progress of treatment, while also reducing overall treatment cost.
Most common uses of PET/CT are found in Oncology, Cardiology and Neurology practices.

  • FDG PET/CT is an integral part of cancer management in Evidence Based Practice. PETCT is used for initial staging of various cancers, Radiotherapy planning, treatment response assessment, restaging and surveillance in Oncology practice.It changes treatment decision in significant proportion of cancer patients.
  • In Cardiology practice, FDG PET/CT is the gold standard test for detection of myocardial viability. It provides evidence for selection of heart disease (coronary artery disease) patients for revascularization (stenting / bypass surgery).
  • In Neurology practice, FDG PET/CT is used to provide differential diagnosis for Dementia it helps Neurosurgeons in mapping the brain for surgical resection, in cases of drug resistant Epilepsy.

Gamma Camera – SPECT

GoldSeal-Millenium

GE-Millenium MG

Millennium MG, Multi-Geometry Nuclear Medicine System is used to perform a range of Nuclear Imaging studies. Imaging with Gamma Camera involves preparation and injection of radiopharmaceuticals that specifically trace the function of Organ of Interest. Radiopharmaceuticals are prepared in the well-equipped Hot Lab in the Department of Molecular Imaging. These specific radiopharmaceuticals are administered to patients and images are acquired. Static, dynamic and parametric images can be obtained under a Gamma Camera.
Diagnostic Services:

  • PETCT for initial staging, Detection of Unknown Primary, Radiation therapy Planning, Response assessment, Surveillance
  • Sentinel Lymph Node Lymphoscintigraphy
  • Radio-guided Occult Lesion Localization (ROLL)
  • MDP Bone scan
  • MIBG, HYNICTOC and DMSA (V) Imaging for endocrine tumors
  • Parathyroid Imaging
  • Whole body Iodine Scan for thyroid cancer

Stress Myocardial Perfusion SPECT

(Thallium Scan)

Myocardial Perfusion Scan visualizes the distribution of tracer uptake in the heart muscle, which reflects regional blood flow in different coronary artery territories. This
can be performed with 201T1/ 99m Tc- Sestamibi / Trofosmin.

Rest Injection Scan indicates whether the heart muscle is viable or scarred due to prior attacks. Stress (Exercise/Pharmacological) Scan reveals inducible ischemic perfusion defect corresponding to significant coronary disease.

Advanced Cardiac Analysis with Quantitative Perfusion

SPECT and Gated SPECT software provides the following information:

  • Universal slice review
  • Bullseye plot
  • Cardiac ejection fraction
  • Wall motion abnormality
  • Myocardial viability

Clinical Indications

  • Detection of Coronary Artery Disease
  • Chest Pain Evaluation – Stress Test with uninterpretable ECG
  • Assessment of borderline Coronary Stenosis seen in Angio
  • Assessment of Myocardial Viability
  • Cardiac fitness for non-cardiac surgery

Whole Body Bone Scan

A bone scan is a diagnostic imaging study which records the distribution of a radioactive tracer in the skeletal system. It is the most sensitive study available to pick up any pathology of the skeleton.

Clinical Indications

  • Metastatic Bone leisons
  • Primary Bone leisons
  • Osteoid/Osteoma etc.
  • Infection/Inflammation
  • Osteomyelities
  • Sacroilitis
  • Avascular Necrosis
  • Trauma Stress fracture
  • Metabolic Bone Disease
  • Bone pain evaluation – low back ache evaluation

Renal Scan

Renal scans are performed to evaluate the differential renal function, the extraction and excretion function of the kidneys. Information about Glomerular Filtration Rate (GFR), tubular function and cortical morphology can be obtained by such scans.

Clinical Indications

DTPA Renal Scan:

  • Split renal functions
  • GFR estimation
  • Evaluation of hydronephrosis

PUJ stenosis

  • Renovascular Hypertension
  • Transplant evaluation

DMSA Cortical Scan:

  • Pyelonephritis
  • Urinary tract infection
  • Reflux disease
  • Ectopic Kidney

Voiding Cystography:

  • Detection & follow-up of ureteric reflux

Brain SPECT

Brain Perfusion SPECT with advanced NeuroGam Analysis Package for diagnosing:

    • Assessment of stroke
    • To detect Epileptic focus
    • To evaluate dementia

Other Indications

      • Thyroid Scan to evaluate palpable thyroid nodule, midline neck swelling and thyromegaly & toxic goitres
      • Radio Iodine Scan for post

Operative thyroid cancer

      • Lung Ventilation Perfusion Scan for pulmonary embolism
      • Radionuclide Ventriculography for LV function & Ejection fraction
      • Isotope Venography for DVT
      • Scinti-mammography for doubtful breast leison

Gastro Enterology

Hepatobilliary Scan:

      • To diagnose acute cholecystitis
      • To assess Gall Bladder dysfunction
      • To study bile drainage, atresia and post OP cases

Liver & Spleen Scan:

      • To evaluate cirrhosis
      • Buddchiari, Nodular Hyperplasia and tumors

Other Scans:

      • Hamangioma of the Liver
      • GI bleeding
      • Ectopic Gastric Mucosa

(Meckel’s diverticulum)

      • Oesophageal transit in dysphagia
      • GE Reflux scintigraphy
      • Gastic Emptying in Gastroparesis, post OP states, dysmotility etc.