CONSULTANT & INCHARGE
RADIATION SAFETY OFFICER
DEPT OF NUCLEAR MEDICINE, PET-CT & RADIONUCLIDE THERAPY
KLES DR PRABHAKAR KORE HOSPITAL& MRC
Nuclear Medicine is a rapidly developing branch of medicine which uses radioisotopes for diagnostic imaging and therapy purpose. It is older than CT, MRI and ultrasound, first used on patients over 60 years ago. Nuclear Medicine is part of the hospital’s constant effort to update its services and offer the latest medical technology at economical rates to the needy. The hospital has sophisticated latest generation SPECT gamma camera, PET-CT and therapy wards which constitute backbone of the Department of Nuclear Medicine and PET –CT.
Nuclear Medicine imaging or Scintigraphy utilizes a dual-head gamma camera to record the physiological activity of selected organs or body systems, by using minute quantities of radiopharmaceuticals which are administered by intravenous, oral or inhalation routes. This imaging is fundamentally different from magnetic resonance imaging (MRI) and computed tomography (CT), for these methods only convey anatomic information. In most diseases, physiological changes precede anatomic changes, so scintigraphic evidence of a disease process can be diagnosed at an earlier stage. After administering radiotracers the areas of interest are then imaged by the gamma camera which captures the gamma rays emitting from the patient.
PROCEDURE | INDICATIONS |
THYROID SCAN | To assess thyrotoxicosis, Graves disease, toxic MNG, thyroiditis, thyroid nodule evaluation, lingual thyroid etc |
PARATHYROID SCAN | To assess parathyroid adenoma, hyperplasia, ectopic parathyroid adenomas |
MYOCARDIAL PERFUSION/ THALLIUM SCAN | To evaluate IHD, physiological significance of known coronary stenosis, Risk stratification of CAD, Presurgical cardiac evaluation, to assess myocardial viability before CABG prior to surgery, congenital heart disease, follow-up of Kawasaki disease |
MUGA SCAN | To evaluate accurate LVEF, regional wall motion abnormalities in CAD, prior to adriamycin and other cardiotoxic drug therapy |
RENOGRAM | To assess GFR of individual kidneys esp. in donors, neonatal hydronephrosis, PUJ obstructions, obstructed megaureter, relative function evaluation in patients with renal malignancy prior to nephrectomy, ectopic kidneys, post renal transplant evaluation, renal artery stenosis(pre/post captropril) |
DMSA SCAN | To assess UTI (Renal scars), ectopic kidneys, accurate function assessment of individual kidneys |
DIRECT / INDIRECT RADIONUCLIDE MCU SCAN | To assess VU reflux, UTI, hydroureteronephrosis |
WHOLE BODY BONE SCAN | To evaluate skeletal mets, bone malignancy, low backache, tuberculosis of bone, avascular necrosis, metabolic bone disease, stress fracture, osteomyelitis versus cellulitis. |
GALLIUM SCAN | Assessment of prosthetic infections, evaluation of lymphoma (Hodgkin’s & non Hodgkin’s) |
LUNG PERFUSION & VENTILATION | Pulmonary embolism, lung vascularity assessment in children with congenital heart disease, predict FEV1 in patients planned for pneumonectomy/lobectomy |
LIVER-SPLEEN SCAN | Alcoholic hepatitis, cirrhosis, portal hypertension, hemangioma, jaundice, Budd chiari syndrome |
HEPATOBILIARY SCAN | Differentiate neonatal hepatitis vs biliary atresia, post-op bile leak, choledochol cyst, post-liver transplant cases, gall bladder dyskinesia, acute/chronic cholecystitis |
MECKEL’S SCAN | Evaluation of meckels diverticulum (Ectopic gastric mucosa), malena, GI bleed |
GASTRO INTESTINAL BLEEDING | To evaluate occult GI bleed and localize the site of bleed |
GASTRIC EMPTYING | Diabetic gastroparesis |
GASTRO ESOPHAGEAL REFLUX ( Milk scan) | Recurrent respiratory infections, heart burns |
Lymphangiogram | To evaluate lymphatic duct patency |
Thyroid scan
Renal scan
Bone scan
Myocardial Perfusion Scan
The Department of Nuclear Medicine is equipped with a state-of-the-art PET-CT scanner (Positron Emission Tomography – Computed Tomography). It provides superior diagnostic information for patients with cancer, ischemic heart disease and certain neurologic conditions. In the three decades since its development, PET has been demonstrated to be a clinically proven and safe method for imaging a variety of disorders. PET CT can demonstrate certain pathological changes long before they would be evident on CT or MRI alone.
PET-CT is a noninvasive diagnostic whole-body imaging procedure, cost-effective and is used in the early detection, staging, and follow-up for most cancers, including lymphomas, lung, breast, gastrointestinal, gynecological, cartilaginous, head and neck cancers.
PET CT is also used to evaluate treatment response after chemotherapy and radiotherapy. Mid-cycle PET-CT is useful to ascertain if the patient is responding to chemotherapy so that regimes can be modified.
PET CT is also used in Radiotherapy planning.
PET is able to discover these changes in their earliest stages, often before any symptoms appear. With this information on early developing cancers, effective treatment plans can be initiated sooner. PET can most of the times helps to eliminate the need for other invasive procedures and by correctly staging cancers, may prevent unnecessary surgical procedure.
The Ga-68 scan is not offered at every centre. KLES Dr. Prabhakar Kore hospital and MRC, Belagavi, is the first to start the following services in the entire north Karnataka.
CT Image | PET Image | Fused PET CT Image
LOW DOSE I-131 THERAPY | Treatment of thyrotoxicosis – Graves disease, Toxic MNG, Autonomous toxic nodule |
HIGH DOSE I-131 THERAPY | Treatment of differentiated thyroid carcinoma and metastases |
STRONTIUM /SAMARIUM THERAPY | Palliative bone pain therapy for cancer patients |
MIBG THERAPY | Malignant pheochromocytoma, neuroblastoma |
Peptide Receptor radionuclide therapy(PRRT) | Lu-177 DOTA-NOC/ DOTA-TATE therapy for neuroendocrine tumours |
Radiation Synovectomy | Chronically inflamed joints, refractory to treatment |
Trans Arterial Radio Embolization (TARE) | Y90 TheraSpheres/ SIR-spheres therapy |
LOW DOSE I-131 THERAPY | Treatment of thyrotoxicosis – Graves disease, Toxic MNG, Autonomous toxic nodule |
HIGH DOSE I-131 THERAPY | Treatment of differentiated thyroid carcinoma and metastases |
STRONTIUM /SAMARIUM THERAPY | Palliative bone pain therapy for cancer patients |
MIBG THERAPY | Malignant pheochromocytoma, neuroblastoma |
Peptide Receptor radionuclide therapy(PRRT) | Lu-177 DOTA-NOC/ DOTA-TATE therapy for neuroendocrine tumours |
Radiation Synovectomy | Chronically inflamed joints, refractory to treatment |
Trans Arterial Radio Embolization (TARE) | Y90 TheraSpheres/ SIR-spheres therapy |
Patient information:
Radionuclide imaging is performed only by prior appointment since the isotopes are procured from far places and have to be made ready as they have very short shelf lives. The procedure to be followed is send to either the patient or his attender to the nuclear medicine department where he is given appointment . He is also explained about the procedure and also given necessary instructions in case prior preparations are required.
Several patients have the fear of exposure to radiation. Thanks to intensive research, the radiopharmaceuticals currently available have short half lives, and the biological half lives are even shorter. Therefore, nuclear medicine imaging is quite safe, even for children and the amount of radioactive material used is very small and the radiation dose is similar to that of diagnostic x-ray tests. Most of the radioactive material leaves the body through the urine. Any retained material loses its radioactivity relatively quickly through breakdown (decay). There are little or no side-effects from the radioactive tracer. However, one should be circumspect in the case of pregnant women.
The unique and vital advantage of nuclear medicine scans are its usefulness in providing vital functional information in addition to anatomical details, unlike other imaging modalities like MRI, where patients with metallic prosthesis/implants, aneurysm clips, pacemakers etc are not contraindicated. Therefore radionuclide imaging is an excellent complement to other imaging modalities like CT scan, ultrasonography, MRI etc.
For more information please contact our department of nuclear medicine and PET CT or public relations department.
Dr. Rashmi Angadi is In-charge and Consultant of the dept. of Nuclear Medicine, PET-CT and radionuclide therapy at KLES Dr.Prabhakar Kore Hospital and MRC, Belagavi.
She completed her M.B.B.S from Karnataka Institute of Medical Sciences, Hubballi, achieving five gold medals to her honour.
She completed her Post Graduate Degree in the specialty of Nuclear Medicine, Diplomate of National Board, New Delhi. She underwent her training at Narayana Hrudayalaya Institute of Medical Sciences, Bangalore.
She qualified as a Radiation Safety Officer by Atomic Energy Regulatory Board (AERB), Bhaba Atomic Research Centre (BARC), Mumbai, India.
She received specialized training at AIIMS, New Delhi and PGI Chandigarh towards Radiolabelled Peptide Receptor Therapy for Neuroendocrine cancer, Lu-177 DOTA-NOC therapy, Y90 Synovectomy, Y90 theraspheres therapy and I-131 mIBG therapy etc.
She has gained extensive experience in the speciality of Nuclear Medicine with expertise across wide spectrum of various Nuclear Medicine services including Diagnostic and therapeutic Radionuclide applications.
Her areas of interest includes Nuclear Cardiology, Nuclear Neurology and various other general Nuclear Medicine Procedures.
KLES Dr. Prabhakar Kore Hospital & MRC, in collaboration with the prestigious Jawaharlal Nehru Medical College (JNMC) brings together a dedicated team of physicians, surgeons and healthcare specialists to provide healthcare and hospitality under one roof, thus giving it a perfect academic-and-professional blend.