Sir Ganga Ram Hospital, New Delhi, India

Nuclear Medicine & Bone Densitometry

Nuclear Medicine : Gamma Camera

Nuclear Medicineis a medical speciality that uses small amounts of radioactive materials, known as radiopharmaceuticals, for diagnostic, therapeutic, and research purposes. These radiopharmaceuticals are specific for the organ, tumour or tissue desired to be studied. Once injected into a patient these radiopharmaceuticals localise in the area of interest, which is then imaged using a special camera. Highly simplified, it is something like taking an X-ray from the inside-out.

Nuclear Medicineprovides unique information about both structure and function of nearly every human organ. It is the ability to characterise and quantify physiologic function that makes nuclear medicine different from an X-ray / CT or MRI. As radiopharmaceuticals become more sophisticated, it is becoming possible to see inside of human beings at the molecular level. Nuclear medical procedures are safe, both for the patient and the physicians and technologist performing the tests. Patients experience little or no discomfort and do not require anaesthesia. Exposure to radioactivity is monitored closely, and kept well below safety limits. The radiation exposure is usually as much and often lower than the exposure produced by a similar radiological study such as CT.

Nuclear medicine technology is a highly patient-oriented field. It is a vigorous, dynamic field that has seen dramatic growth over the past two decades and is expected to grow even more in the near future. New radiopharmaceuticals and imagining technologies are continually being developed.

Why is bone scan done?

A bone scan is done to determine whether a cancer from another are has spread to the bone, the cause or location of unexplained bone pain. to help diagnose broken bones such as a hip fracture or a stress fracture, not clearly seen on X-ray and to detect damage tothe bones caused by infection or other conditions.

What is Myocardial Perfusion scan

A cardiac perfusion scan measures the amount of blood supply to your heart muscle at rest and during exercise. It is often done to find out what may be causing chest pain. It may be done after a heart attack to see areas of the heart which are not getting enough blood or to find out how much heart muscle has been damaged from the heart attack.

What is Renal (DTPA) Scan?

This test determines overall kidney function and also relative left and right kidney function. The test is performed using the radiotracer called Tc-99m diethylene-triamine-penta-acetic acid (DTPA). The test is often used in combination with a diuretic drug such as frusemide to determine if a kidney is obstructed. This test is also used in combination with anti-hypertensive drugs (ACEI) to look for narrowing of the renal arteries as a cause of high bloodpressure. The scan is very useful in assessing the function of renal trnasplant grafts.

What is a V/Q lung scan?

This Nuclear Medicine test is a scan of the lungs showing the distribution of air into the lung fields, and also showing the distribution of blood in the lungs. The lungs are made of multiple segments each with its own air and blood supply. The test is most commonly used to diagnose a clot in the lung (pulmonary embolus).

PET-CT?

PET-CT India is a advanced molecular imaging procedure that provides a way to diagnose disease through the measurement of metabolic activity. CT stands for Computerized Tomography. CT is an X-ray test that generates a detailed view of the anatomy of structure of organs and tissues in the body. The CT scan can show the structural details of blood vessels, lymph nodes and organ systems. A PET CT India a combination of a PET scanner and a High Resolution Multi-slice CT which fuses the functional images of PET with the high resolution structural images of CT.

How does PET-CT Technology help?

PET-CT India is a advanced molecular imaging procedure that provides a way to diagnose disease through the measurement of metabolic activity. CT stands for Computerized Tomography. CT is an X-ray test that generates a detailed view of the anatomy of structure of organs and tissues in the body. The CT scan can show the structural details of blood vessels, lymph nodes and organ systems. A PET CT India a combination of a PET scanner and a High Resolution Multi-slice CT which fuses the functional images of PET with the high resolution structural images of CT.

How does PET-CT work?

During a PET scan, the patient is first injected with a radiopharmaceutical compound, usually FDG, a radioactive glucose compound. The compound distributes throughout the body and accumulates in various organs depending on the metabolic activity within the organ or tissue. Because cancer cells usually have a higher metabolic rate than surrounding cells, they absorb more of the tracer and will show up more prominently on the image. The PET CT scanner detects the FDG accumulated in glucose-avid organs or tissues and creates images that are displayed as colour-coded images.

At the Mahajan Imaging, a high resolution 3-dimensional contrast enhanced CT Scan is obtained in most cases. Acquiring 0.625 mm thick slices in all planes, using volume acquisition on a 32 slice/second MDCT, obviates the need for a separate CT scan examination and makes the PET CT very cost-effective. Where necessary, CTAngiographyis also performed in the same sitting.

The Exam

Prior to the exam you will receive a small injection of radioactive sugar (FDG). You will be asked to sit or lie down on a comfortable chair or bed for 30-60 minutes while the FDG travels throughout your body. It is important that you do not talk, read, walk around or chew gum during this period. In some cases you may be asked to drink medicine (oral contrast). This will be at regular intervals before the actual scan is performed. After this short time, the technologist will assist you to the scanner. The CT portion of the exam is completed first followed by the PET portion. An intravenous non-ionic iodinated contrast may be injected for the CT scan. It is important that you don't move for the duration of the scan. The length of the exam is determined by your height and area of interest. Most PET CT scans at our centre are typically completed within 20-30 minutes.

After the exam

Once the scan has been performed you may resume normal daily activity. Even though the FDG and contrast will quickly leave your body, you can expedite the process by drinking plenty of water after your scan is complete. Your PET CT result will not be immediately available, but the reading physician will contact your referring doctor to convey all pertinent information gathered from the scan. You can collect your scan report the next day.

Important

Since the radioactive glucose prepared for you is expensive and has a very short life it is imperative that you keep your appointment on time. In case you need to cancel your appointment please inform us at least 24 hours ahead

List of Publications in 2009-2012

  1. Incremental role of myocardial perfusion imaging in asymptomatic long standing type 2 diabetic patients - "Cardilogical society of India"; December 04, 2009. 
  2. Case report - FDG avid HCCwith cricoid metastasis - "Tropical Gastroentrology" December 20, 2009.
  3. Role of FDG in the evaluatio of vasculitis syndrome "IJNM" - December 11, 2009.
  4. Role of FDGPETCT in detection of occult multifocal tubercular disease in skeletal tuberculosis - "ACNM"January 04, 2010.
  5. Osteoporosis in peri and immediate postmenopausal Indian Women, Osteoporosis in Indian women aged 40-60 years. "International Society for Osteoporosis"January 2010. 
  6. Incremental value of FDG PETCTover CECT in the evaluation of large bowel malignancy - A prospective study - paper SNM 2010.
  7. Role of FDG PETCTin detection of occult multifocal tubercular idsease in patients of skeletal TB-paper - SNM 2012.
  8. Bone mineral density in patients with End stage renal disease and its status after renal transplantation, on going thesis 
  9. Bone mineral density in patients with End stage renal disease and its status after renal transplantation, on going thesis.
  10. Comparision of clinical, biochemical and ultrasonographic parameters with radioactive iodine uptake scan in evaluation of a patient with thyrotoxicosis, on going thesis.