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A Concise Guide to Nuclear Medicine

Although the risks of low-level radiation exposures are not well understood, a cautious approach has been universally adopted that all human radiation exposures should be kept As Low As Reasonably Practicable, "ALARP".


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Working with the ALARP principle, before a patient is exposed for a nuclear medicine examination, the benefit of the examination must be identified. This needs to take into account the particular circumstances of the patient in question, where appropriate. For instance, if a patient is unlikely to be able to tolerate a sufficient amount of the procedure to achieve a diagnosis, then it would be inappropriate to proceed with injecting the patient with the radioactive tracer.

When the benefit does justify the procedure, then the radiation exposure the amount of radiation given to the patient should also be kept as low as reasonably practicable.

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This means that the images produced in nuclear medicine should never be better than required for confident diagnosis. Giving larger radiation exposures can reduce the noise in an image and make it more photographically appealing, but if the clinical question can be answered without this level of detail, then this is inappropriate. As a result, the radiation dose from nuclear medicine imaging varies greatly depending on the type of study. The effective radiation dose can be lower than or comparable to or can far exceed the general day-to-day environmental annual background radiation dose.

Some nuclear medicine procedures require special patient preparation before the study to obtain the most accurate result.

A concise guide to nuclear medicine - CERN Document Server

Pre-imaging preparations may include dietary preparation or the withholding of certain medications. Patients are encouraged to consult with the nuclear medicine department prior to a scan. The end result of the nuclear medicine imaging process is a "dataset" comprising one or more images. In multi-image datasets the array of images may represent a time sequence i. SPECT single photon emission computed tomography is the process by which images acquired from a rotating gamma-camera are reconstructed to produce an image of a "slice" through the patient at a particular position.

A collection of parallel slices form a slice-stack, a three-dimensional representation of the distribution of radionuclide in the patient. The nuclear medicine computer may require millions of lines of source code to provide quantitative analysis packages for each of the specific imaging techniques available in nuclear medicine. Time sequences can be further analysed using kinetic models such as multi-compartment models or a Patlak plot. Radionuclide therapy can be used to treat conditions such as hyperthyroidism , thyroid cancer , and blood disorders.

In nuclear medicine therapy, the radiation treatment dose is administered internally e. The radiopharmaceuticals used in nuclear medicine therapy emit ionizing radiation that travels only a short distance, thereby minimizing unwanted side effects and damage to noninvolved organs or nearby structures. Most nuclear medicine therapies can be performed as outpatient procedures since there are few side effects from the treatment and the radiation exposure to the general public can be kept within a safe limit. Common nuclear medicine unsealed source therapies. In some centers the nuclear medicine department may also use implanted capsules of isotopes brachytherapy to treat cancer.

Commonly used radiation sources radionuclides for brachytherapy [3]. The history of nuclear medicine contains contributions from scientists across different disciplines in physics, chemistry, engineering, and medicine.

A Concise Guide to Nuclear Medicine

The multidisciplinary nature of nuclear medicine makes it difficult for medical historians to determine the birthdate of nuclear medicine. This can probably be best placed between the discovery of artificial radioactivity in and the production of radionuclides by Oak Ridge National Laboratory for medicine related use, in The origins of this medical idea date back as far as the mids in Freiburg , Germany, when George de Hevesy made experiments with radionuclides administered to rats, thus displaying metabolic pathways of these substances and establishing the tracer principle.

Possibly, the genesis of this medical field took place in , when John Lawrence , known as "the father of nuclear medicine", took a leave of absence from his faculty position at Yale Medical School , to visit his brother Ernest Lawrence at his new radiation laboratory now known as the Lawrence Berkeley National Laboratory in Berkeley , California.


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Later on, John Lawrence made the first application in patients of an artificial radionuclide when he used phosphorus to treat leukemia. The history of nuclear medicine will not be complete without mentioning these early pioneers. Nuclear medicine gained public recognition as a potential specialty on December 7, when an article was published in the Journal of the American Medical Association by Sam Seidlin.

This is considered by many historians as the most important article ever published in nuclear medicine. Among the many radionuclides that were discovered for medical-use, none were as important as the discovery and development of Technetiumm. It was first discovered in by C. Segre as an artificial element to fill space number 43 in the Periodic Table. The development of a generator system to produce Technetiumm in the s became a practical method for medical use. Today, Technetiumm is the most utilized element in nuclear medicine and is employed in a wide variety of nuclear medicine imaging studies.

Widespread clinical use of nuclear medicine began in the early s, as knowledge expanded about radionuclides, detection of radioactivity, and using certain radionuclides to trace biochemical processes. Pioneering works by Benedict Cassen in developing the first rectilinear scanner and Hal O. Anger 's scintillation camera Anger camera broadened the young discipline of nuclear medicine into a full-fledged medical imaging specialty.

By the early s, in southern Scandinavia , Niels A.

Lassen , David H. It allowed them to construct images reflecting brain activation from speaking, reading, visual or auditory perception and voluntary movement. By the s most organs of the body could be visualized using nuclear medicine procedures. In , American Medical Association officially recognized nuclear medicine as a medical specialty. In the s, radiopharmaceuticals were designed for use in diagnosis of heart disease.

The development of single photon emission computed tomography SPECT , around the same time, led to three-dimensional reconstruction of the heart and establishment of the field of nuclear cardiology. More recent developments in nuclear medicine include the invention of the first positron emission tomography scanner PET. The concept of emission and transmission tomography, later developed into single photon emission computed tomography SPECT , was introduced by David E.

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Radiolocical protection in nuclear medicine

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