Nuclear Medicine

What is Nuclear Medicine?

Nuclear medicine uses very small amounts of radioactive materials (also called radiopharmaceuticals) to diagnose and treat disease. Radiopharmaceuticals are substances that are attracted to specific organs, bones or tissues.

The radiopharmaceuticals used in nuclear medicine emit gamma rays that can be detected externally by special types of cameras. These cameras work in conjunction with computers to form images that provide data about the area of body being imaged.

While X-rays image the body’s anatomy, nuclear medicine shows actual organ function and physiology. For example, Nuclear Cardiology, which involves imaging the heart during vigorous exercise, helps us determine the function and viability of the heart muscle.

When is nuclear medicine used?

Nuclear medicine uses radioactive materials to help diagnose a variety of diseases and disorders, and to assess how different parts of your body are functioning. Typically, it is used to measure or detect hyperthyroidism, heart function, orthopedic injuries, blood clots in the lungs and liver and gall bladder functions.

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What happens during a nuclear medicine procedure?

During the procedure, you are given a low-level radioactive compound, called an isotope, which will be injected, inhaled or swallowed, depending on what type of test you are having. The isotope accumulates in the organ being examined. Depending on the exam, your technologist may ask you to return later, to give the isotope time to process in your body.

The organ to be examined will emit radiation continuously during the exam, radiation which is detected by a special camera and processed through a computer. Patients typically do not experience side effects or allergic reactions since most of the compounds used in nuclear medicine are naturally-occurring substances in the body. The length of the exam varies, depending on type. A technologist will be available throughout the exam to answer questions.

What are the benefits and risks?

Nuclear medicine is non-invasive; it allows clinicians to get medical information that would not be available otherwise, or that would require surgical intervention. It is safe and painless, using very small doses of radioactive materials to diagnose and treat disease. The amount of radiation from a nuclear medicine procedure is comparable to that received during a regular X-ray exam.  Nuclear medicine provides a valuable view of the structure and function of internal organs.

What are my nuclear medicine options?

The diagnostic use of nuclear medicine is increasing, and we provide a range of procedures to meet that need.

The hepatobilliary system includes the liver, gallbladder, cystic bile duct and the common bile duct. A HIDA scan helps clinicians diagnose issues in those organs. The HIDA is used when an ultrasound exam is inconclusive, or when the patient is allergic to iodinated contrast. Generally, the logistics are the same as those described on this page, except if your doctor orders a CCK HIDA. This test reveals gallbladder function and requires a medication (injected) or special solution (which you drink).
A nuclear “stress test” takes images of your heart at rest and after your heart has been “stressed.” The two are compared to reveal if there is any damage to your heart muscle. This procedure helps evaluate coronary artery disease, acute chest pain, hibernating myocardium and cardiomyopathies. Initially, you will be injected with an isotope, and (30 minutes later) resting images will be acquired. The stress portion is next, which involves either a treadmill or injection of medications that mimic physiological stress. A second isotope is injected for this portion of the test. After your heart rate returns to normal and you eat, the technologist takes the final set of images of your heart.
A lung scan helps clinicians examine your lungs using a radionuclide and X-rays. A radionuclide is injected, and a camera can image how that liquid circulates in your bloodstream, specifically the supply to your lungs. You might also be asked to breathe a small amount of radionuclide mixed with oxygen through a face mask. The camera records where the air is going inside your lungs.
Bone imaging helps reveal problems with your bones, such as arthritis, infection, fractures and tumors. The use of radioactive material makes the bone structure visible as it is absorbed by the bones, and the procedure yields much more information than an X-ray. We provide three-phase bone scans (for comparison before and after absorption) and bone spect (which images while the camera is rotating around the body). Both types require several hours, so that the injected isotope has time to process through the body. 
A renogram uses small amounts of radioisotopes to measure the function of the kidneys. This test evaluates the size, position, shape and function of the kidneys. A renal scan is particularly useful when there is a known sensitivity to the contrast media used in an IVP or other X-rays, or when there is underlying kidney insufficiency (reduced kidney function, as after a transplant). A renogram may be used to evaluate kidney function in people with hypertension or to check for rejection after a transplant. 

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