Nuclear medicine can be defined as a medical branch that includes diagnosis and treatment methods using radioactive materials. This technique provides information about the functions of organs, detecting abnormalities and using it in the diagnosis of various diseases by tracking an isotope in the body.
In nuclear medicine, a radioactive substance is injected or swallowed by the patient, and then its movement to a specific area of the body is tracked. In this way, detailed information about the functioning of organs is obtained. In addition, this technique can be used in the diagnosis, treatment and monitoring of certain diseases such as cancer.
Nuclear medicine can be used in conjunction with other imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI). In this way, the structures inside the body can be looked at more clearly and the diagnosis, treatment and monitoring of diseases can be done more effectively.
Nuclear medicine is used in the evaluation of which diseases?
Nuclear medicine can be used in the diagnosis, treatment and monitoring of many diseases. The main areas of use are:
Cancer: Nuclear medicine is used to detect and monitor radioactive materials produced by cancer cells. It can also be used to determine the spread of cancer and to evaluate treatment response.
Heart diseases: Nuclear medicine techniques can be used to measure blood flow to the heart muscle, evaluate the function of the heart vessels, and determine the cause of heart attacks.
Thyroid diseases: Nuclear medicine can be used to evaluate the functioning of the thyroid gland. It can also be used in the treatment of thyroid cancer.
Bone diseases: Bone scans can be used to detect problems in the bones, such as cancer, infections, and fractures.
Neurological diseases: Nuclear medicine can be used in the diagnosis and treatment of neurological diseases such as Alzheimer’s disease, Parkinson’s disease, epilepsy and brain tumors.
Other diseases: Nuclear medicine can be used in the diagnosis and treatment of many diseases such as kidney diseases, lung diseases, liver diseases and infectious diseases.
What are the medical devices used in the nuclear medicine clinic?
Medical devices used in nuclear medicine clinics are often designed to diagnose, treat and monitor diseases using radioisotopes. These devices include:
Gamma camera: Gamma camera creates images by detecting gamma rays emitted by radioactive isotopes. This device is used in many nuclear medicine procedures such as bone scans, thyroid scans, heart imaging and cancer scans.
PET (positron emission tomography) scanner: PET scanners are used to locate cancer cells by injecting a radioactive substance found in a specific area of the body. This device is used for diagnosing cancer, monitoring treatment and determining the spread of cancer.
What is a Pet /CT device?
PET/CT is a medical imaging device that combines positron emission tomography (PET) and computed tomography (CT) imaging methods. PET measures metabolic activity that is injected into specific target areas in the body by injecting a radioactive substance. CT creates cross-sectional images of the body using x-rays.
PET/CT device is used in the diagnosis and treatment of many diseases such as cancer, heart diseases, neurological disorders, infections in the whole body by using these two imaging techniques at the same time. PET/CT device offers the advantages of these two methods together, enabling more precise diagnosis and treatment planning.
What is a gamma camera device?
Gamma camera is one of the nuclear medicine imaging devices. It is a kind of radiological imaging device working with gamma rays. It is a device that displays the function of the target organ in the body by detecting the gamma rays emitted by a radioactive substance after it is injected or swallowed.
The gamma camera is used to detect the radiopharmaceutical substance injected into the patient’s body. When these substances settle in the body, the gamma rays they emit are detected by the gamma camera and processed by the computer into an image.
The gamma camera is used in the diagnosis of cancer, thyroid diseases, bone diseases, cardiovascular diseases and many other diseases. It can also be used in treatment methods such as surgical planning and radiotherapy planning.
What are PET CT indications?
What are the FDG PET/CT Indications?
(Fluorodeoxyglucose Positron Emission Tomography / Computed Tomography) screening is used in many areas such as cancer diagnosis, evaluation of cancer spread and monitoring of treatment response. Some FDG PET/CT indications are:
Cancer diagnosis: FDG PET/CT is used to identify cancerous areas due to the high metabolism of cancer cells. Therefore, it is particularly useful for cancer diagnosis.
Spread of cancer: FDG PET/CT is used to determine whether cancer has spread to other organs.
Evaluation of treatment response: FDG PET/CT is used to evaluate the effectiveness of cancer treatment. Post-treatment scans check whether the cancer cells have decreased or completely disappeared.
Tumor recurrence: FDG PET/CT is used to determine whether tumors recur after cancer treatment.
Diagnosis of other diseases: FDG PET/CT can also be used to diagnose other diseases such as infection, inflammation and neurological disorders.
FDG PET/CT is a useful tool in the diagnosis, treatment and follow-up of cancer. However, the ability of tumors to show small tumors for their size may be limited and in some cases may produce false positive results. Therefore, the interpretation of FDG PET/CT results requires careful examination by a specialist radiologist or nuclear medicine specialist.
What are Gallium 68 PSMA PET/CT indications?
Gallium 68 PSMA PET/CT is an imaging method used in the diagnosis and follow-up of prostate cancer. This method is used to detect prostate cancer cells that have high levels of a protein called PSMA produced.
Gallium 68 PSMA PET/CT can be used in the following situations:
* In the treatment planning of patients diagnosed with high-risk prostate cancer,
* In the detection of the spread of the disease in case of recurrence or progression after prostate cancer treatment,
* In the evaluation of treatment response before or after cancer treatment,
* In the determination of target regions in radiotherapy treatment using radioactive material for prostate cancer,
* It can be used for diagnosis and follow-up in cases where other imaging methods are inconclusive.
What are Gallium 68 DOTA PET/CT indications?
Gallium 68 DOTA PET/CT is an imaging method used for the diagnosis, staging and follow-up of neuroendocrine tumors. This method is a PET scan with a peptide with gallium 68, a radioactive substance that binds to somatostatin receptors labeled with a compound called DOTA.
Gallium 68 DOTA PET/CT can be used in the following situations:
* Diagnosis of neuroendocrine tumors (NET),
* Evaluation of the response of NETs to treatment,
* Detection of the spread of NETs,
* Staging and classification of NETs,
* Monitoring of NETs and determining the risk of their reoccurrence.
Gallium 68 DOTA PET/CT can also be used for the diagnosis and treatment of some other types of cancer, such as pancreatic, breast and prostate cancer. However, its use in these areas is still limited and more studies are needed.
Treatment Methods
Lutetium PSMA therapy is a treatment used in patients with advanced, castration-resistant metastatic prostate cancer. This treatment is administered by targeting a protein called PSMA found in prostate cancer cells. This protein is found in higher than normal amounts in prostate cancer cells. Lutetium PSMA treatment aims to kill cancer cells by giving a radioactive substance to prostate cancer cells by targeting this protein.
Lutetium DOTA therapy is a method used in the treatment of neuroendocrine tumors (NET). This therapy is designed to target neuroendocrine tumors. In these tumors, cells have receptors for a specific protein, somatostatin. Lutetium DOTA therapy targets these cells through the use of DOTA-nocreotides, a substance that can bind to somatostatin receptors. DOTA-ocreotides labeled with lutetium-177 target cells in neuroendocrine tumors, releasing a radioactive substance and causing the death of tumor cells. This treatment may provide benefits such as reducing symptoms, controlling tumor growth, and prolonging life in patients with NET.
Lutetium EDTMP (ethylene-diamine-tetramethylene-phosphonate) therapy is a radionuclide therapy used in the treatment of metastatic bone cancer. The indications for this treatment are:
- Metastatic bone cancer: Lutetium EDTMP therapy is used in the treatment of prostate, breast, lung, thyroid, ovarian, pancreatic, colon and rectum cancers that have metastasized to bones.
- Bone pain: Lutetium EDTMP therapy can be applied for pain control in patients with severe bone pain due to metastatic bone cancer.
Lutetium EDTMP is densely bound to bones, as it has a bone-like structure. Therefore, radiation therapy directly reaches the bones where the cancer cells are located, causing the death of the cancerous cells.
Actinium-225 PSMA therapy is used in the treatment of metastatic castration-resistant prostate cancer (mCRPC). This therapy is a targeted therapy known as prostate specific membrane antigen (PSMA). Since PSMA is a protein found in high amounts in prostate cancer cells, cancer cells can be irradiated using a radioactive substance that binds to PSMA. Actinium-225 PSMA therapy works when radioactive actinium-225 binds to PSMA, delivering a lethal dose of radiation to cancer cells. This treatment may be used in some patients with prostate cancer where other treatments have failed.
Actinium DOTA (Ac-225 DOTATOC) therapy is a nuclear medicine method used in the treatment of somatostatin receptor positive tumors. Indications include:
* Neuroendocrine tumors: Functional and non-functional tumors of the pancreas, stomach
* Prostate cancer metastases
* Breast cancer metastases
* Lung cancer metastases
* Head and neck cancer metastases
However, since Actinium DOTA treatment is a very new treatment method, more research is needed on the selection of patients suitable for this treatment and the treatment process.
Transarterial radioembolization (TARE), also known as Selective Internal Radiation Therapy (SIRT), is a method used in the treatment of liver cancer. In this method, small-sized radioactive particles are sent into the tumor by microembolization and the feeding of the tumor is interrupted and the cancer cells are killed.
TARE indications are:
*Primary liver cancer
* Secondary liver cancer (metastatic liver cancer)
* Surgical procedures that cannot be performed due to liver tumor
* Situations where chemotherapy is insufficient
* Liver cancer not responding or progressing to other treatments
Radioactive iodine therapy is a method used in the treatment of thyroid cancer. Indications are:
- Thyroid cancer: Radioactive iodine therapy is recommended for thyroid cancer patients after removal of the thyroid gland. This is used to detect and destroy cancer cells.
- Benign thyroid diseases: It can be used in the treatment of benign thyroid diseases, especially in the reduction of nodules.
- Thyrotoxicosis: Thyrotoxicosis is a condition that occurs due to overactivity of the thyroid gland. Radioactive iodine therapy can help destroy cells that produce excess thyroid hormone.
- Preoperative and Postop thyroid cancer screening: In people with high risk factors for thyroid cancer, radioactive iodine screening may be recommended.
Note: Radioactive iodine treatment is not applied to women during pregnancy and breastfeeding.
