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DELHI MRI CENTRE JABALPUR

DEPT. OF NUCLEAR MEDICINE. DELHI MRI CENTRE JABALPUR. -DR.PRADEEP DUBEY, M.D DIRECTOR. GAMMA CAMERA. RADIO ISOTOPE SCAN PRINCIPLES. RADIO ACTIVE TRACER SUBSTANCE IS USED. COUPLED WITH SPECIFIC KITS FOR VARIOUS ORGANS.

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DELHI MRI CENTRE JABALPUR

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  1. DEPT. OF NUCLEAR MEDICINE DELHI MRI CENTREJABALPUR -DR.PRADEEP DUBEY, M.D DIRECTOR

  2. GAMMA CAMERA

  3. RADIO ISOTOPE SCAN PRINCIPLES • RADIO ACTIVE TRACER SUBSTANCE IS USED. • COUPLED WITH SPECIFIC KITS FOR VARIOUS ORGANS. • SENSITIVE AND SPECIFIC-PICKS PATHOLIGY AT EARLIEST. • MINIMAL RADIATION.

  4. APPLICATIONS • BONE – METS, AVN, STRESS #,Koch’s • THYROID- HYPO / HYPER THYROID. • G.U.T- Inf.,HN, PUJ.Obs, etc., • CORONARY ARTERY DISEASE • LIVER – BILLIARY ATRESIA ETC. • NUCLEAR HSG & GER, OTHERS. • THERAPY-IODINE 131

  5. PREPARATION • No specific preparation for Bone scan & Renal scan • Cardiac scan- to stop coffee, Chocolate, Ca channel blockers before two days, 6 hrs. fasting • Thyroid scan – To stop Anti thyroid drugs before 2 weeks. • Liver(Hida) scan – NB Phenobarb. for 1wk. • To drink lot of water during the scanning. • To void frequently during test period.

  6. Indication of bone scan All first diagnosed malignancies. Ca. Breast, Cx & Uterus etc. Lung & Prostate cancers. Hodgkin’s lymphoma & other malign. Pathological Fractures. AVN & ? Pelvic girdle pain. Osteomylitis. Stress fracture/ vague boney pain . Unexplained backache .

  7. BONE SCAN (NORMAL)

  8. BONE SCAN (SKELETAL METS)

  9. BONE SCAN (AVN)

  10. BONE SCAN (#NF WITH AVN)

  11. BONE SCAN (ARTHRITIS)

  12. BONE SCAN (METABOLIC BONE DISEASE)

  13. BONE SCAN (MULTIPLE METS)

  14. THYROID SCAN INDICATIONS: • THYROTOXICOSIS • THYROID NODULE • MIDLINE NECK SWELLING • SUSPECTED ECTOPIA • THYROIDITIS • THYROID CYST • Ca. THYROID

  15. MULTINODULAR GOITER

  16. Solitary Toxic Nodule

  17. THYROID SCAN (GRAVE’S DISEASE)

  18. THYROID SCAN (THYROIDITIS)

  19. THYROID SCAN (WARM NODULE LEFT SIDE)

  20. Solitary Cold Nodule Tumor image

  21. Ectopic (Submandibular) Thyroid

  22. Parathyroid tumor

  23. PARATHYROID SCAN

  24. Parathyroid Adenoma

  25. RADIO ISOTOPE RENOGRAM. DTPA / DMSA /EC - Scanning

  26. Indications Recurrent UTI & Growth retardation in children. GUT problems & unexplained Anemia. Primary Hyper tension. Renal donor evaluation Renal Transplant evaluation

  27. Effect of Creatinine If level of S.Creatinine is high then extraction of Tc-99m –DTPA is low and delayed. Background is also very high. GFR is low. In this case it needs to be inject more activity. EC scan is recommended.

  28. DTPA RENOGRAM PUJ OBSTRUCTION

  29. DTPA RENOGRAM RIGHT KIDNEY PUJ- OBST.

  30. Vesico urethral reflux

  31. PYELONEPHRITIS DMSA - SCAN

  32. DMSA cortical imaging DMSA has tubular binding receptor. It binds with tubular protein for a longer period. Imaging is generally done after 3 hours delay to allow time for uptake and slow background clearance. NON-FUNCTIONING RT KIDNEY

  33. Myocardial Perfusion scan(Stress Thallium) • EASY & SAFE:NON-INVASIVE, OUT PATIENT PROCEDURE, NO DYE NOALLERGY • FUNCTIONAL IMAGING:SHOWS BLOOD FLOW & VIABILITY; NOT JUST THE MECHANICAL BLOCK • TRUE FLOW PATTERN:REVEALS COLLATERALS & MICROVASCULAR CIRCULATION & CORONARY STEAL PHENOMENON • VIABILITY:STUNNED MYOCARDIUM, HIBERNATING MYOCARDIUM • MOST COMPREHENSIVE INVESTIGATION OFFERING MAXIMUM INFORMATION FROM SINGLE STUDY

  34. PATIENT PREPARATION • 6 Hrs. FASTING FOR THALLIUM IS ESSENTIAL. • DISCONTINUATION OF BETA-BLOCKERS & FRUSEMIDE FOR 72-48 HRS BEFORE EXERCISE STRESS • NO THEOPHYLLINE AND CAFFEINE BEFORE ADENOSINE STRESS • NO NITRATES PREFERABLY ON THE DAY OF EXERCISE STRESS • DETAILED HISTORY TAKING

  35. INDICATIONS: • EVALUATION OF CAD (Coronary Artery Disease): in cases with equivocal TMT/ECHO and/or chest pain, high risk group prior to non-cardiac surgery • POST ANGIO PLASTY & POST CAG: • CHRONIC H.T. SPLY. WITH D.M. • CHEST PAIN & UNEXPLAINED DYSPNOEA.

  36. MYOCARDIAL PERFUSION IMAGE Normal Vs Abnormal NORMAL ISCHEMIA. INFARCT

  37. STRESS THALLIUM (NORMAL)

  38. STRESS THALLIUM (INDUCIBLE ISCHEMIA)

  39. STRESS THALLIUM (INFARCT)

  40. HIDA SCAN (NORMAL)

  41. HIDA SCAN (NORMAL)

  42. HIPATOBILIARY SCAN (BILIARY ATRESIA)

  43. LUNG PERFUSION SCAN (NORMAL)

  44. GE REFLUX / MILK SCAN

  45. GE REFLUX/MILK SCAN

  46. ISOTOPE HSG

  47. Thank you

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