How does nuclear medicine differ

from radiologic procedures?

RADIOLOGY
determine the
presence of
disease based on
structural
appearance
(anatomy)

NUCLEAR MEDICINE
Determine the cause
of medical problem
based on organ or
tissue function
(physiology)

RADIOLOGY
- uses sealed
source of
radiation, in the
form of x-rays

NUCLEAR MEDICINE

uses unsealed
source of
radiation in the
form of gamma
rays

Mode of administration

Injection
Swallowing
Inhalation

Nuclear Pharmacy

The radionuclides used in nuclear

medicine are produced in reactors, or
particle accelerators.
Naturally occurring radionuclides have
very long half-lives i.e.,
Carbon-14 = 5760 years
Uranium-235 = 710 million years

Most commonly used radionuclide

in NUCLEAR MEDICINE

Technetium-99m (99mTc) which is

produced in a generator system
Parent and Daughter Nuclide-Principle
Parent is the original nuclide which
undergoes radioactive
Daughter the more stable nuclide
which results from radioactive decay

Technetium-99m

Discovered in 1937 by Perrier and Segre

Named after the Greek word technetos,
meaning artificial
21 isotope of Technetium have been
discovered (all radioactive)
Mo99/Tc99m generator first produced in
1957

Desirable Physical
Properties

TECHNETIUM -99m
6 hour half-life
High photon yield of 140 keV
Pure gamma emitter
Generator availability
Chemically reactive

Ideal properties of diagnostic

radiopharmaceuticals

decay mode: gamma or x-ray only

High yield, photon emission of approx.
150keV
Short T1/2
Ability to form biologically useful
compounds
Easy to produce and distribute
Minimal disposal problems
Economical

Commonly used technetium kits

and their diagnostic indications

DMSA

Morphologic studies of renal cortex

Individual kidney function
Location of ectopic kidney

DTPA

Renal perfusion studies

Glomerular filtration rate estimation
Diuretic washout
Lung aerosol study

MAA

Lung perfusion study

Leg venography

SESTAMIBI

Myocardial perfusion study

Parathyroid study
Breast imaging

PHYROPHOSPHATE

Bone imaging
Myocardial infarct study
Gastrointestinal bleeding study

SULFUR COLLOID

Liver/spleen imaging
Gastroesopageal reflux study
Gastric emptying study

DIPHOSPHONATE DERIVATIVES

Bone mineral study

Bone scintigraphy

IMMINIDIACETATES

Hipatobiliary imaging
Diagnosis of acute/chronic cholecystitis
Gallbladder perforation
Common duct obstruction

PERTECHNETATE

Meckels diverticulum study

Testicular study
Thyroid imaging

Other isotopes used in nuclear

medicine

Thallium-201

Myocardial perfusion study

Tumor viability study

Gallium-67

Inflammatory diseases
Diagnosis and staging lymphomas,
especially Hodgkins disease

Iodine-131

Thyroid uptake study

Thyroid imaging
Therapy for thyroid cancer
Therapy for thyrotoxicosis
Thyroid metastases study

Strontium-89

Therapy for bone metastases

IMAGING METHODS

A wide variety of diagnostic imaging

examinations are performed in nuclear
medicine. These examinations can be
described on the basis of imaging
method used:
Static
Whole-body
Dynamic
SPECT

STATIC IMAGING

Is the acquisition of a single image of a

particular structure.
This image can be thought of a
snapshot of the radiopharmaceutical
distribution within a part of the body.
EXAMPLES

Lung scans
Spot bone scan images
Thyroid images

WHOLE-BODY IMAGING

Uses a specially designed moving

detector system to produce an image of
the entire body or a large body section.
The gamma camera collects data as it
passes over the body.
EXAMPLES

Whole body bone scan

Whole body tumor or abscess imaging
Other clinical and research application

DYNAMIC IMAGING

Display the distribution of a particular

radiopharmaceutical over a specific
period.
A dynamic or flow study of a particular
structure is generally used to evaluate
blood perfusion to the tissue.
EXAMPLES

Renal perfusion study

Hepatobiliary study

Single Photon Emission

Computed Tomography

(SPECT)
Produces images similar to those

scanned be CT or MRI.
The computer creates a thin slices
through a particular organ.
This technique has proved very
beneficial for delineating small lesions
within tissues.
Can be used on virtually any structure or
organ. i.e. cardiac and 3-phase bone
studies.

POSITRON EMISSION
TOMOGRAPHY

PET imaging uses positron emissions

from particular radionuclide to produce
detailed functional images within the
body.
Images show blood flow or metabolic
processes at the cellular level rather
than the more conventional anatomic
images produced by x-ray, CT, MRI or
even SPECT.