Nuclear Medicine

Nuclear Medicine is a branch of medicine that makes use of radioactive medicines for diagnosis and treatment of diseases. Small dose of radioactive medicine is introduced into the body (oral route or by injections) and functions of various organs in the body can be imaged.Relatively larger doses of radioactive medicines are used for treatment. It mainly includes treatment for hyper functioning thyroid gland, thyroid cancer, treatment of bone pain, treatment of certain types of cancer like neuroendocrine tumors and prostate cancer. Diagnostic scans and treatment in nuclear medicine is very safe painless and comfortable. Comprehensive nuclear medicine dept includes facilities like gamma camera, PET/CT, low dose and high dose radionuclide therapy and thyroid cancer clinic. All these facilities are available at SGICCC Parumala at reasonable cost. The nuclear medicine department at St Gregorios International cancer cancer care centre is the first comprehensive nuclear medicine department in central Travancore.

PET-CT

The Department of Nuclear Medicine is equipped with the state-of-the-art 16 slice GE Discovery IQ PET-CT scanner (Positron Emission Tomography - Computed Tomography) from GE USA, the first of its kind in the central Travancore. It provides precise diagnostic information in patients with cancer, heart disease and certain neurologic conditions. In addition to 18F-FDG, the department offers the facility to do PET/CT with a number of tracers labeled with 68Ga like 68Ga DOTATATE for neuroendocrine tumors, 68Ga PSMA for prostate cancer, 68Ga Exendin IV for insulinomas, 68Ga Ubi for infection imaging etc.

Gamma Camera

The department is equipped with a gamma camera with SPECT facility (GE Brivo NM 615). Nuclear Medicine imaging using gamma camera is utilized to image functional / metabolic processes in various organs in the body. Unlike computed tomography (CT) or Magnetic Resonance Imaging (MRI) which are anatomic / morphological imaging, nuclear medicine imaging provides insight into functional aspects of various organs in the body. In most diseases, functional changes precede anatomic changes, so scintigraphic evidence of a disease process can be diagnosed at an earlier stage. Nuclear medicine procedures done using a gamma camera are usually non invasive and safe with a small amount of radiation exposure which is very well comparable with diagnostic radiology procedures.

Gamma Camera Procedures Performed

PROCEDURE INDICATIONS
Whole body bone Scan To evaluate skeletal metastases, metabolic bone disease, primary bone malignancy, low backache, tuberculosis of bone, avascular necrosis, stress fracture, osteomyelitis etc.
Renogram To assess differential function, GFR and to evaluate drainage of individual kidneys – Renal donors, neonatal hydronephrosis, PUJ obstructions, obstructed megaureter, duplex systems etc. Also useful in evaluation of transplant kidney and in renal artery hypertension.
DMSA Scan To assess UTI (Renal scars), ectopic kidneys, accurate function assessment of individual kidneys
VUR Scan To assess VU reflux, UTI, hydroureteronephrosis
Thyroid scan Funcational assessment of thyroid diseases - thyrotoxicosis, thyroid nodule evlautaion, ectopic thyroid, congenital hypothyroidism etc.
Parathyroid scan Localization of parathyroid adenoma
Myocardial Perfusion Scintigraphy To evaluate Ischemic Heart Disease, Assess the physiological significance of known coronary artery stenosis. Risk stratification of patients with CAD, positive TMT, Baseline ECG changes like LBBB etc. Presurgical cardiac evaluation, Assessment of myocardial viability before CABG, follow-up of Kawasaki disease etc.
MUGA Scan Accurate objective assessment of LVEF. Assessment of regional wall motion abnormalities. Particularly useful in patients on cardiotoxic anticancer medications.
Lung perfusion & ventilation scan Pulmonary embolism, Assessment of regional functional lung volumes prior to lung surgeries
Liver-spleen Scan Cirrhosis with portal hypertension and Non cirrhotic portal hypertension
Hepatobiliary Scan Differentiate neonatal hepatitis vs biliary atresia, postop bile leak, choledochol cyst, post liver transplant cases, gall bladder dyskinesia, acute/chronic cholecystitis.
Meckel's Scan Evaluation of meckels diverticulum (Ectopic gastric mucosa)
Gastro intestinal bleed Scan To evaluate occult GI bleed and localize the site of bleed
Gastric emptying Scan Suspected gastroparesis especially diabetic gastroparesis
Gastro esophageal reflux (Milk scan) Assessment of gastroesophageal reflux
Dacryo scintigraphyfor eyes To evaluate tear duct atency
Brain scintigraphy Epilepsy, Brain tumors etc

Therapeutic Nuclear Medicine Procedure

Low dose I-131 therapy Treatment of thyrotoxicosis – Graves disease, Toxic MNG, Autonomously functioning thyroid nodule
High dose I-131 therapy Treatment of differentiated thyroid carcinoma and metastatic disease
177Lu DOTATATE therapy Metastatic Neuroendocrine tumor.
177Lu PSMA therapy Metastatic Prostate cancer therapy.
Bone pain palliation (153Samarium) Palliative bone pain therapy for cancer patients
131I - MIBG Therapy Malignant pheochromocytoma, neuroblastoma

Doctors

Dr. Arun Sasikumar

Consultant and Head of the Nuclear Medicine Department