A version of a chemical element that has an

unstable nucleus and emits radiation during

its decay to a stable form

This is a branch of medicine that

uses radiation to provide information about

the functioning of a person's specific organs

or to treat disease

Material tagged with a radioisotope

Eg

DTPA

DMSA

RBC,WBC,Plt

HIDA

Albumin

EDTA

In isotope studies the radiation (gamma rays)

originates from within a radiopharmaceutical

in the body.

The spontaneous emission of radiation from

atomic nuclei

can consist of alpha, beta, and gamma

radiation

Radioactive tracers emit gamma rays from

within the body.

generally short-lived isotopes linked to

chemical compounds,permit specific

physiological processes to be scrutinized.

Photons are detected by a gamma camera

which can view organs from many different

angles.

The camera builds up an image from the

points from which radiation is emitted; this

image is enhanced by a computer

A nuclear medicine study involves

administration of a radionuclide by

intravenous injection in liquid or aggregate form

ingestion while combined with food

inhalation as a gas or aerosol

rarely, injection of a radionuclide that has

undergone micro-encapsulation

labeled patient's own blood cells with a

radionuclide

leukocyte scintigraphy

red blood cell scintigraphy

Platelet scintigraphy

Diagnostic - radionuclides emit gamma rays,

Therapeutic - cell-damaging properties of

beta particles

Contributions from scientists across different disciplines in physics, chemistry, engineering, and medicine

In 1920s in Freiburg, Germany, George de Hevesy experimented with radionuclidesadministered to rats, displaying metabolic pathways of these substances and establishing the tracer principle

Discovery of artificially produced radionuclides by Frédéric Joliot-Curie and Irène Joliot-Curie in 1934 - the most significant milestone in nuclear medicine

John Lawrence, known as "the father of

nclear medicine“

In 1936, made the first application in

patients of an artificial radionuclide when he

used phosphorus-32 to treat leukemia

Production of radionuclides by Oak Ridge

National Laboratory for medicine related

use, in 1946

December 7, 1946 when an article was

published in the Journal of the American

Medical Association by Samuel Seidlin.

The article described a successful treatment

of a patient with thyroid cancer metastases

using radioiodine (I-131).

The most commonly used intravenous radionuclides Technetium-99m (technetium-99m)

Iodine-123 and 131

Thallium-201

Gallium-67

Fluorine-18 Fluorodeoxyglucose

Indium-111 Labeled Leukocytes

The most commonly used gaseous/aerosol

radionuclides Xenon-133

Krypton-81m

Technetium-99m Technegas a radioaerosol

Technetium-99m DTPA

Thyroid scans

99Tc, 131I, 123I

Uses

Hyperthyroidism

Evaluate nodules

Hot/cold/warm

Detection of LN metastasis

Ectopic thyroid

Follow up of residual tissues

Parathyroid

99Tc Sestamibi

Bone scan

To eveluate Metastasis

Fractures

Infection

Non malignent lesions

Whole body scan

Eg: 123I scan

Myocardial perfusion scan

Thallium-201 (bottom rows)

Tc-Sestamibi for the stress images (top rows)

Noninvasive evaluation of coronary artery

disease.

The study not only identifies patients with

coronary artery disease, it also provides

overall prognostic information or overall risk

of adverse cardiac events for the patient.

Ventillation perfusion scans

Pulmonary embolism

ventilation phase

a gaseous radionuclide such as xenon or

technetium DTPA in an aerosol form

perfusion phase

intravenous injection of radioactive

technetium macro aggregated albumin

(Tc99m-MAA).

HIDA scan

Indications

Acute Cholecystitis

Chronic Cholecystitis

Abnormal biliary leakage

Biliary atresia

Radio labeled RBC scan for GI bleeding

Gastro oesophageal reflux scans

Gastric emptying scans

Colonic transit studies

DTPA

DMSA

MAG 3

VU reflux scan

Lymphatic scintigraphy

WBC scans

Suppurative diseases

Brain perfusion scans

Testicular perfusion scans

Scintimammography

interventional nuclear medicine

To treat

Hyperthyroidism

thyroid cancer

blood disorders.

Radiopharmaceuticals used in therapy emit

ionizing radiation that travels only a short

distance, minimizing

unwanted side effects

damage to noninvolved organs or nearby

structures.

Some nuclear medicine therapies

Iodine-131-sodium iodide hyperthyroidism

and thyroid cancer

Yttrium-90, Iodine-131-refractory lymphoma

131I-MIBG (metaiodobenzylguanidine)

neuroendocrine tumors

Samarium-153 or Strontium-89 for palliative

bone pain

Implanted capsules of isotopes (brachytherapy)

to treat cancer.

Commonly used radiation sources

(radionuclides) for brachytherapy

Caesium-137

Cobalt-60

Iridium-192

Iodine-125

Palladium-103

Ruthenium-106

Women must not be pregnant or

breastfeeding.

Patients who are incontinent should have a

urinary catheter.

Stop antithyroid drugs for one week before

your treatment.

For 7 days before should follow a low

iodine diet.

Only have a light meal 2 hours before

treatment.

Low levels of radioactivity in body will disappear within 3 weeks.

Wash hands before preparing food and after visiting the toilet.

Toilets should be flushed twice after use. Better to use separate toilet

( males….)

Avoid pregnancy for at least 6 months following the start of treatment and must not be breast feeding.

Male patients should avoid fathering a child for at least 4 months following the start of their treatment.

Avoid going to places of entertainment for 1 week.

Avoid close and prolonged contact with adults for 1 week.

Avoid close and prolonged contact with children and pregnant women for 3 weeks.