Nuclear medicine deals with unsealed radionuclides labelled with specific compounds / radiopharmaceuticals used for various diagnostic imaging and therapeutic applications. These radiopharmaceuticals or radiotracers provide information regarding perfusion and functional status of various organs as well as provide metabolic status of various cells depending upon the pathophysiology of various disease and target pathway of the radiotracers. Diagnostic applications are classified into imaging (predominantly) and non imaging techniques (like estimation of GFR by plasma sampling method). Imaging studies are done using Single photon emission computed tomography (SPECT) and Positron emission tomography (PET) machines which are used together with in-built computed tomography (CT) scan.

PET-CT is predominantly related to oncology imaging with radiotracers like 18 F-FDG (for metabolic assessment of tumours, detection of unknown primary, staging, re-staging and response assessment of various solid and haematological malignancies), 68 Ga-DOTANOC (for SSTR expressing lesions like neuroendocrine tumours), 68 Ga-PSMA (for PSMA expressing tumours like prostate cancers) and 18 F / 68 Ga-FAPI (fibroblast activated protein inhibitors) targeting cancer associated fibroblasts (CAF) in use. Cardiac viability assessment, evaluation of various types of dementia, neurodegenerative and movement disorders, detection of active focus in pyrexia of unknown origin, evaluation and response assessment of various other infective and inflammatory disorders being various non oncological indications of PET-CT.

Thyroid scans, renal scans using 99m Tc-DMSA, 99m Tc-LLEC and 99m Tc-DTPA as radiotracers, parathyroid scintigraphy for adenoma evaluation, myocardial perfusion study, bone scan, brain perfusion SPECT, lymphoscintigraphy for lymphedema evaluation and sentinel nodal detection, pulmonary scintigraphy, hepatobiliary scans, GI bleed detection using blood-pool  scintigraphy, etc are the routine scans done using SPECT-CT cameras. 131 I, 177 Lu based post therapy scans as well as pre-therapy low dose radioiodine scans are also done using SPECT- CT cameras.

Radionuclide therapy is being done for post operative management of well differentiated thyroid cancers (using 131 I) with high dose patients requiring admission in isolation wards.

OPD based radionuclide therapy includes treatment of hyperthyroidism, bone pain palliation (using 153 Sm, 177 Lu-EDTMP), metastatic neuroendocrine tumours ( 177 Lu-DOTATATE), metastatic castrate resistant prostate cancers ( 177 Lu or 225 Ac-PSMA), etc. All the diagnostic and therapeutic procedures in Nuclear medicine department are done with proper justification and dose optimisation under principle of “as low as reasonably achievable” (ALARA) to avoid excessive radiation exposure.