What is a Nuclear Medicine Specialist?

A nuclear medicine specialist, also called as nuclear radiologist, is an expert in the usage of radioactive materials (known as Radiopharmaceuticals) to assess the human body and its functions to diagnose diseases and treat them.

Nuclear Medicine and Diagnostic Imaging

In nuclear medicine, radioactive materials called radioactive tracers are injected, ingested or inhaled by the patient depending on which organ of the body is to be examined. These tracers then travel to that particular organ and cause radioactive emissions. Such emissions are captured by the specialist with a special camera that detects this activity. A nuclear radiologist is able to test, read, analyze and interpret these scans for an accurate diagnosis.

Two of the most common 3D modalities are single photon emission computed tomography (SPECT) and positron emission tomography (PET) scans. Scintigraphy is a 2D diagnostic test, a gamma scan, that uses radionuclides that emits gamma radiation which is then captured to create two dimensional images.

Conditions for which such procedures are commonly used

Since nuclear medicine is extensively involved in evaluating organ function, with the help of more than a hundred different examination techniques, Nuclear Medicine Specialist Consultants use tools for the early detection and diagnosis of several diseases. These scan examinations are conducted for various reasons such as assessing the functionality of these below mentioned body organs:

Bones: Evaluation of fractures, infections, bone tumors, arthritis, metastatic bone disease, painful prosthetic joints and identification of biopsy sites

Brain: Investigations of brain abnormalities while experiencing symptoms like memory loss, seizures and abnormal blood flow to the brain. Early detection of neurological disorders like Alzheimer's disease and detection of chemical abnormalities leading to movement disorders like Parkinson's disease. Identification and evaluation of brain tumor recurrence, and areas of the brain causing seizures. Surgical preparation and localization for biopsy

Heart: Evaluation of heart function to examine the blood flow (Eg: myocardial perfusion scan), during chemotherapy (MUGA), for revascularization procedure outcomes, to assess the extent of damage post a heart attack and, for bypass heart surgery and angioplasty like procedures. Also, nuclear medicine evaluation is done for the detection of coronary artery disease, heart transplant rejection and, the level of cardiac stenosis.

Gallbladder: Detection of inflammation in the gallbladder, abnormalities in biliary function and complications post gallbladder surgery

Lungs: For the assessment of blood flow and respiratory issues, for differential lung function (For example for transplant surgery or lung reduction) and for the detection of lung transplant rejection

Renal: Analysis of blood flow and function of native and transplant kidneys, infection versus scar in kidneys, high blood pressure with regard to kidney arteries. And for the detection of kidney tumors or cysts, urinary reflux and urinary tract obstruction.

Others reason where nuclear medicine and diagnostic imaging is suggested are: Identification of bleeding into the colon, any presence of infection, blood cell disorders and its diagnosis. For the evaluation of an overactive parathyroid gland (Hyperparathyroidism), spinal fluid flow and potential leaks and overactive or under-active thyroid, fever of unknown origin and lymph-edema.

The nuclear medicine imaging is also done for the investing tear ducts and their openness, congenital heart disease for shunts, pulmonary blood flow, esophageal abnormalities and reflux, and motility disorders.

What to expect while consulting a nuclear medicine specialist for an examination?

A nuclear medicine specialist may ask you to fast for several hours before the scan might be required. Depending on the type of scan, the radiopharmaceutical can be administered sometimes, hours or even days before the actual scan. The radiopharmaceutical could be an intravenous injection, if not a solid or liquid medicine to be ingested or inhaled as a gas. You would require to wear a comfortable clothing without snaps or zippers can be worn, and in some instances, one might need to change into a gown. It is also advised for women to inform the doctor if they are pregnant or are breastfeeding. In case you have any allergies, herbal or vitamin supplements intake, medical conditions and recent illnesses, better inform the doctor about it. If you have any previous issues that may have occurred during other nuclear medicine examinations must be shared with the medical personnel. Remove metallic jewelry and accessories before the examination. Also inform the specialist beforehand in case one is prone to experience claustrophobia.

One can ask the specialist questions about any health condition or illness they have that might affect the examination. The imaging exam may take somewhere between 20 minutes and several hours. Depending on the type of scan, it may be conducted over a span of several days. For children, gentle wrapping or mild sedation might be needed for them to hold still. Nurses who are specialized in pediatric anesthesia would be present throughout the examination for the child's safety. Usually several positions are to be scanned to capture different views of the organ or body and for better clarity. One would be requested to be motionless during the scan.

Time-wise, the radiopharmaceutical usually is excreted within 24 to 48 hours. Intake of plenty of water will help flush the material out sooner. The images will be studied and the findings will be shared by the doctor. Images or CDs of the scan can be requested for documentation

What are the potential benefits and risk factors associated with nuclear medicine imaging?

All potential treatment risks will be informed by the doctor prior to the treatment. Small doses of radiotracers are used which will have limited radiation exposure, similar to that of a standard X-ray. Allergies to radiotracers are very rare and generally mild. Radiotracers may cause slight redness and pain but will quickly resolve. The procedure in itself will be painless. The images would be accurate, leading to appropriate diagnosis. It is not recommended to inject radioactive material for women who are pregnant or are breastfeeding and therefore, such information is to be shared with the specialist well in advance. Over a span of five decades, no known adverse effects of such low-dose radiation exposure have been found.

Nuclear medicine has come a long way since its introduction in the 1930s. A huge range of illnesses, diseases and disorders can be identified, assessed, diagnosed and accurately treated with the help of nuclear medicine and its specialists. With 'Ask A Doctor' having its own specialists on the panel, one can conveniently consult doctors online for any clarity regarding their health conditions, diagnosis and treatment.