Department of Nuclear Medicine

About the department

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 ¹⁸F-FDG (for metabolic assessment of tumours, detection of unknown primary, staging, re-staging and response assessment of various solid and haematological malignancies), ⁶⁸Ga-DOTANOC (for SSTR expression in neuroendocrine tumours), ⁶⁸Ga-PSMA (for PSMA expressing tumours like prostate cancers) and ¹⁸F / ⁶⁸Ga-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 non oncological indications of PET-CT.

Thyroid scans, renal scans using ^99mTc-DMSA, ^99mTc-LLEC and ^99mTc-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. ¹³¹I, ¹⁷⁷Lu based post therapy scans as well as pre-therapy low dose radioiodine scans are also done using SPECT-CT cameras. erapy response assessment in extra-pulmonary   in the PET-CT and SPECT-CT acquisitions can include the whole body, a limited portion of the body, or an organ.

Radionuclide therapy is being done for post operative management of well differentiated thyroid cancers (using ¹³¹I) with high dose patients requiring admission in isolation wards. OPD based radionuclide therapy includes treatment of hyperthyroidism, bone pain palliation (using ¹⁵³Sm, ¹⁷⁷Lu-EDTMP), metastatic neuroendocrine tumours (¹⁷⁷Lu-DOTATATE), metastatic castrate resistant prostate cancers (¹⁷⁷Lu or ²²⁵Ac-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.