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Nuclear Medicine

Nuclear Medicine. Spring 2013 Week 7-9. NM Team. Nuclear medicine MD Physicist Pharmacist Technologist Patient. Principles of NM. Uses radiopharmaceuticals for diagnosis, therapy and medical research Small amounts of radioactive material used

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Nuclear Medicine

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  1. Nuclear Medicine Spring 2013 Week 7-9

  2. NM Team • Nuclear medicine MD • Physicist • Pharmacist • Technologist • Patient

  3. Principles of NM • Uses radiopharmaceuticals for diagnosis, therapy and medical research • Small amounts of radioactive material used • Sometimes no more than that received in CT or fluoroscopy • Studies physiology • Rather than structural appearance

  4. Tracers • Radioactive material that can be: • Injected, ingested or inhaled • Different tracers for different body parts • organ-, tissue-, or even cell-specific • They produce gamma-ray emissions from within organ being studied • Gamma or scintillation camera transforms emissions into images • Provides information about function

  5. Modality Comparisons • PET and SPECT for physiology • X-ray measures structure, size and position of human anatomy • CT creates cross sectional images of anatomy What do all of these modalities have in common?

  6. Atom Components & Isotopes

  7. Physical Principles of NM • Radioactivity • Radiation of energy from the nucleus of atom • Can be in the form of alpha, beta particles or gamma rays from the nucleus

  8. Basic Nuclear Physics • Nuclide • Atom with a particular arrangement of protons and neutrons in the nucleus • Radionuclide • Unstable nucleus that transmutes by way of nuclear decay (return to ground state) • Decay • Is the atoms attempt to regain stability • By emission of alpha, beta and gamma radiation • Different for each type of radionuclide

  9. Half Life • Physical time it takes for a quantity of radionuclide to decrease to ½ its original activity • Radionuclides half life can range from milliseconds to years • NM radionucldies range from hours to days

  10. Nuclear Pharmacy • Radiopharmaceutical • Radionuclide • Pharmaceutical • Technetium -99 • Short ½ life of 6.04 hours • Low energy gamma photon

  11. Radiation Safety • Radiopharmaceuticals must be sterile • Prep area must have isolated ventilation • Protective measures when administering or handling • Spills must be cleaned immediately • Dosimetry devices • Hands and badges

  12. Modern Day Gamma Camera • Scintillate means: to emit light • Ionizing radiation causes certain materials to glow • Scintillation detector • Detects radiation by observing the emission of light photons emitted by the materials • PMT detect and convert light photons emitted from the crystal into and electronic signal that amplifies the original photon signal • It is then sent to be viewed

  13. Detectors

  14. Collimators • Keep scattered rays from entering the scintillation crystal • Absorbs scattered gamma rays • Resolution and sensitivity • Physical characteristics • Made of material with high atomic number • Lead

  15. Crystals • Sodium iodide Thallium • Thick layer of crystals • High energies • Decreased resolution • Thin layer of crystals • Lower energies • Increased resolution

  16. PhotomultiplierTubes • Attached to the back of the crystals • Detect and convert light photons into and electronic signal that amplifies the original photon signal • About 80-100 in a gamma camera • Light pipe • Like a focusing device

  17. Put it all Together

  18. Computer • Acquires and processes data received from camera • In a time frame • Post-processing • Adjust contrast and density • Records • Dosage • Quality control

  19. Types of Camera Systems • Single detector • Dual head • Triple head

  20. Single Head Detector

  21. Dual Head Detector

  22. Triple Head Detector

  23. Imaging Methods • Static • Whole- Body • Dynamic • SPECT • Co-registration • PET

  24. Static • Single image of a particular structure • Demonstrates radiopharmaceutical distribution • Ex: lung scans, spot bone scans images, thyroid images • Obtained in various orientations, anterior, posterior, and oblique • Low activity levels • Generally 30 seconds to five minutes

  25. Whole Body • Entire body or a large section of body • Primarily used for • Bone scans • Tumor scans • Abscess imaging • Clinical and research applications

  26. Dynamic • Timed record of distribution of radiopharmaceutical • Commonly used for • Cardiac studies • Hepatobiliary studies • Gastric emptying studies

  27. Dynamic Renogram

  28. Dynamic Venogram

  29. SPECT • Images similar to CT & MRI • thin slices through a particular organ • 360 degree rotatator heads allows for: • Coronal, planar and 3D imaging • Ex: cardiac perfusion, brain, liver and bone studies

  30. SPECT and CT combination • Merges SPECT functional testing with CT anatomic landmark images • Statistics show • 25-30% change of treatment options from what would have been done with SPECT alone

  31. PET • Resolution is 2-10 better than SPECT • Radiopharmaceuticals • Minimal alteration in homeostasis • Very small amounts used • Co-registration being done with CT & MRI • Almost all new machines are fused with a CT scanner

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