Nuclear Medicine is a branch of medicine where in small amounts of radioactive isotopes (radionuclides) are used for diagnosis and treatment of disease for various disease states. Unfortunately, it is under developed and underutilized in India.
At Artemis, we have a state-of-the-art Nuclear Medicine Department, complete with state of the art Dual head Gamma Camera, SPECT-CT, Double Gantry PET-CT, Thyroid probe Intraoperational Gamma probe and ‘Hot Lab’. Nuclear imaging aims to detect the disease process before it causes anatomic changes. Conventional imaging modalities like Ultrasound, CT and MRI detect anatomical changes. Metabolic and physiological changes precede the anatomical changes, which happen much later. Some diseases may not even cause anatomic changes.
The studies are safe, easy to perform, non-invasive and impart minimal radiation. Nuclear medicine also has therapeutic aspect. Therapeutic application mainly involves administration of alpha and beta emitting radionuclides which, when localised to the respective target areas, destroys the disease process from within. It is safe as there is minimal damage to the other organs of the body as compared to conventional radiotherapy or chemotherapy. New developments such as ‘labeled micro spheres’ therapy for cancer lesions in liver and radio-labeled targeted antibody therapies hold exciting future!
Positron Emission Tomography (PET):
Positron Emission Tomography (PET) is a cutting edge technology in the armamentarium of the diagnostic field of clinical practice, particularly in cancer management. This modality uses administration of ‘positron emitting isotopes’ which get trapped in specific target areas to accurately stage the disease process. One such radiopharmaceutical FDG is a glucose molecule substituted with F18 Fluorine for an atom of O16. Cancer cells utilize more glucose compared to the normal tissue and so by administering this radiotracer we can study the metabolic behaviour of cancer cells. These changes often predate the conventional radiological modalities and thus diagnose cancers in early stages and also can predict the aggressiveness of malignancies.
PET scan combined with a whole body diagnostic CT scan often serves a purpose of “one stop shop” for the cancer work up and on many occasions avoid the need of multiple investigations and imaging.
Other than cancer, PET can be used to determine the viable myocardium before the revascularisation procedures like CABG or PTCA.
PET can also be useful in brain function evaluation like early diagnosis of Alzheimer’s disease, Parkinson’s disease, various psychiatric disorders as brain exclusively utilises glucose as its metabolic substrate.
There are many more new radiotracers like 18 F-DOPA, 18F-PSMA, 68 Ga DOTANOC, 68 Ga PSMA, some of them are already in clinical use and many others are in pipeline at various stages of clinical trials which can give us better understanding about many a disease process.
Molecular Medicine:This is another promising area of exciting possibilities in both diagnosis and therapeutics. By following the metabolic and physiologic processes by radio-labeling ligands and imaging with both conventional nuclear (gamma) imaging and PET, we can have a better insight in to the disease process at the molecular level and have a better understanding of the natural history of disease using this information, specific cancer can be treated using highly specific targeted radionucleide therapies which attack the specific cancer cells with relative sparing of non cancerous normal tissues. Though many of these techniques are at the developmental level, quite a few have reached clinical practice stage.At Artemis, we constantly endeavour to bring you the latest available technologies to fulfill our commitment towards the art of healthcare.