Radionuclide therapy: An unsung hero in the war against Cancer
Radio-nuclide therapy as the word suggests involves the use of radioactive medic...
As one of the most wide spectrum healthcare providers in India, Manipal Hospitals' through its Department of Nuclear Medicine deals with providing comprehensive, advanced diagnostic imaging andinterventional treatment services to patients. Imaging in nuclear medicine (endoradiology) can be thought of as similar to radiology which uses X-rays, but it is done from the inside out. This allows doctors to view things that are otherwise difficult or impossible to see.
Manipal Hospital is the best Nuclear Medicine hospital Dwarka, Delhi having a dedicated and experienced team of Nuclear Medicine physicians, Radiation safety officers, Technologists and nurses who believe in ethical and efficient patient care. The department is the best imaging centre in Delhi, equipped with cutting edge technology (latest Siemens Time-of-Flight PET CT, GE NM/CT 670 Optima SPECT CT scanners and other allied equipment). The department has the best nuclear medicine physicians in Delhi who are highly motivated, qualified and have sincere staff members who are duly certified by the Atomic energy regulatory board (AERB). Our mantra is “Complete patient care and satisfaction” and the entire team makes lots of effort to achieve this.
PSMA PET-CT Scan
A small dose of radioactive injection is given IV and initial images are acquired for 30mins. Many patients may require a delayed Images after 2 hours(will be decided by the doctor after seeing the initial scan)
A bone scan is a nuclear imaging test used to help diagnose problems with bones. It safely uses a very small amount of radioactive drug called a radiopharmaceutical. This scan is done in case of unexplained skeletal pain, bone infection, the spread of a tumour to bones or any bone injury that can't be seen on a standard X-ray.
Thyroid Scan is a specialized imaging procedure for examining the thyroid, gland that controls metabolism. During this scan radioactive iodine or 99mTc tracer is used to examine the structure and function of the thyroid gland.
A F18 bone scan is a nuclear imaging test used to help diagnose problems with bones. It safely uses a very small amount of radioactive drug called a radiopharmaceutical. This scan is done in case of unexplained skeletal pain, bone infection, the spread of the tumour to bones or any bone injury that can't be seen on a standard X-ray.
This test is mainly to look at the blood supply of the heart, both during exercise and rest. In some cases, if the stress part of the scan looks normal, rest scan may not be performed. Can have light breakfast not later than 6.30 am (2 idlys/sandwich). No coffee /tea/chocolates/caffeine-containing substances for 12-24 hours. Should stop medications…
Radioiodine or Iodine 131 Therapy is a nuclear medicine treatment for an overactive thyroid, a condition called hyperthyroidism and may also be used to treat thyroid cancer.
Our department adheres to all national regulations with regard to the ethical and safe use of radio-isotopes. The department performs all the Nuclear medicine scans & procedures as per the international guidelines. The scan protocols are designed in such a manner so as to obtain the best quality images with minimum radiation exposure to patients.
Dr. Ankur Pruthi is one of the top nuclear medicine doctor in Delhi who is also the Head of the department possesses more than 10 years of experience in the field of clinical Nuclear Medicine. He has worked in many distinguished hospitals across the country. He is well recognised in the national and international Nuclear Medicine community and has multiple research publications in renowned Indian and international journals. He has travelled widely across the world to present his research work and has attained multiple International fellowships.
We are currently performing the entire range of diagnostic nuclear medicine procedures including nuclear oncology, nuclear cardiology applications along with low-dose radio-nuclide therapies. We are about to start high-dose radionuclide therapies including Lutetium-177 & Yttrium-90 therapies in a couple of months. This will help us deliver the entire spectrum of Nuclear Medicine services under one roof.
Currently, the procedures available at our department are:
PET CT scans:
F-18 FDG PET CT scan: Oncology, Infection & Inflammation PET, Brain PET, Cardiac PET CT
F-18 FPSMA PET CT scan (for prostate cancers)
F-18 FDOPA PET CT scan (for Parkinsonism, Brain tumours etc)
SPECT CT scans:
Stress thallium / Sestamibi myocardial Perfusion scan (MPI)
Radio-iodine scan and uptake (RAIU)
Brain perfusion studies
DTPA & DMSA scans (Renal scintigraphy)
Milk scan / Gastro-esophageal reflux scan
GI bleed study
Low-dose Radionuclide therapies:
Radio-iodine (I-131) therapy for hyperthyroidism
Bone pain palliation therapy
Number of successful procedures (Number only): 1400
In endoradiology, radiopharmaceuticals are introduced inside the patient either intravenously or orally. The radiopharmaceutical substances are detected by external gamma cameras to produce diagnostic imaging. - Single photon emission computed tomography (SPECT) - Positron emission tomography (PET) - Myocardial perfusion scan (Brain scans) - Whole body bone scan - Pulmonary ventilation and perfusion (V/Q) scan - Thyroid scan - Parathyroid scanInterventional Nuclear Medicine - Radionuclide therapy (used to treat some cancers and hypothyroidism) - Radioimmunotherapy (RIT) - Chemotherapy
An endoradiologist will intravenously inject a radiopharmaceutical into the bloodstream. This is also known as a contrast material. Once the material has been fully injected, the endoradiologist will be able to use external gamma cameras to produce diagnostic imaging.
Yes, Nuclear Medicine procedures are completely safe. Though there is the use of radioactive medicines the doses of radioactivity is limited to such an extent that they don’t produce any apparent side effects or any increased cancer risk to patients.
The Nuclear Medicine department at Manipal Hospital Dwarka takes special care in limiting the radiation exposure to patients without compromising on scan quality.
Nuclear medicine has been standardized to pose as little risk to patients as possible. However, there is always a component of risk when it comes to radiation, which is why nuclear medical professionals always follow the principle of ALARP (as low as reasonably practicable)
No, they are not invasive or painful procedures. The only pain you will feel is when an injection of radioactive medicine will be administered usually through the veins in your hand or feet. You will remain fully conscious and pain-free during the entire procedure.
In most cases, there is little to no effect on the patient as the exposure levels are maintained well within the safe limit. If any side effects are expected, your endoradiologist will be able to inform you beforehand.
They are normally recommended or prescribed only when there is a lack of alternatives. The advanced imaging techniques may sometimes be the only way to achieve an accurate diagnosis.
It has been widely researched and proven that there are no apparent side effects of Nuclear medicine procedures. Still, to limit radiation exposure to our patients, we administer radioactive medicines in optimal doses which provide best quality images without undue exposure. We follow an important principle for radiation protection of all our patients namely “As low as reasonably achievable” (ALARA).
There are primarily two main differences:
Radiological examinations like X-ray, CT scan and MRI provide structural information regarding the diseased organs. Nuclear medicine scan is functional imaging, which provides functional information of any organ or disease. Hence, both radiology and Nuclear Medicine scans provide complementary information
Both the modalities involve the use of radiation. Whereas in radiological investigations external radiation sources are used. In Nuclear Medicine, radioactive medicines are usually injected inside the body and they emit radiations from the inside, which are then detected with the help of SPECT or PET scanners.
Regular health checkups are an important part of maintaining good health. Routine checkups can help detect any medical issues in their early stages when they are easier to treat.
In most of the diagnostic Nuclear Medicine procedures, we use short-lived radiopharmaceuticals which decay significantly during the scan itself. However, we ask patients to maintain a reasonable distance from children and pregnant ladies usually for one day to avoid any undue radiation exposure to them.
Nuclear Medicine is primarily used for diagnostic purposes. However, radionuclide therapies constitute an important component of Nuclear Medicine. Radionuclide therapies are available for diseases such as hyperthyroidism, thyroid cancer, bone cancers, prostate cancers and neuroendocrine cancers.
PET CT scan is a diagnostic procedure used to visualize the metabolic activity of body tissues using radio-active glucose. The PET CT scanner generates images useful for diagnosis and treatment.
Primarily, the PET CT scans are used for neurological disorders, Cardiac viability determination and evaluation of various cancers.
No, in fact, nuclear medicine scans evaluate functions of multiple organs of the body e.g. Brain, Thyroid, Heart, Liver, Kidneys, Lungs, skeleton and GIT. Some of the tests have been used since many decades like Bone scan, Thyroid scan, Stress thallium etc.
As radioactive medicines are short-lived, hence, we can’t store unnecessary radioactive medicines in the department. Hence, it is imperative that you book your appointments beforehand. You may call the hospital helpline number. Additionally, you may contact the Nuclear Medicine & PET CT department directly for appointments.
As mentioned earlier, both radiology and Nuclear Medicine scans provide complementary information. Hence, PET CT scan may provide additional information in your case, which will be useful for your treating doctor in deciding the appropriate treatment for you.
Yes, we ask patients to bring one attendant with you when coming for the scan. However, please refrain from bringing children or pregnant ladies with you as they may get undue radiation exposure.
Yes, you can. However, we restrict breastfeeding for some time (ranging from hours to few days) depending upon the scan and radioactive medicine used.
Manipal Hospitals is committed to the provision of the best possible care to all its patients and to build long term relationships that foster a stronger and healthier community. The patients served by our nuclear
medicine department are a testament to this.
Contact us to know more about nuclear medicine and book an appointment with one of our specialists
Radio-nuclide therapy as the word suggests involves the use of radioactive medic...