Nuclear Medicine and Its History

In its simplest definition, nuclear medicine is the use of radioactive materials in the diagnosisand treatment of diseases.

Currently, function (function) imaging is performed in diseases related to almost every organ system in universities in our country, in state and insurance hospitals in big cities, and in nuclear medicine departments serving in some private centers. The diagnostic tests performedin these centers are the scintigraphic imaging of the thyroid, bone, heart, kidney and manyother organs and diseases, as well as the treatment of some tumors and inflammatory diseases, especially thyroid diseases.

The history of nuclear medicine goes back to the introduction of the atomic theory by theBritish chemist John Dalton in the early 1800s, the discovery of X-rays by the GermanWilheim Konrad Roentgen in 1895, and the cyclotron by Ernest Lawrence in the USA in 1928. The most important step in the development of nuclear medicine was Marie Curie’sdiscovery of artificial radioactivity in 1934. However, many historians point to the realbeginning of nuclear medicine in the 1940s, when radioactive iodine was used in thetreatment of toxic goiter.

Technetium, which is still the most frequently used radioactive substance in nuclear medicineimaging, was produced artificially in 1937, and commercial production, distribution and usestarted after 1965. In the following years, agents used in liver-spleen and brain imaging werefound and nuclear medicine started to develop rapidly until today.

The first experts in the field of nuclear medicine began to grow in the United States in 1972.

 

Terminological Concepts Frequently Used in Nuclear Medicine

Scintigraphy: It is the name given to the operation performed in nuclear medicine.

Radiopharmaceutical: Substances consisting of very low amount of radioactivity andchemical drugs attached to it that can be given to patients in various ways (injection or oral) in nuclear medicine are called.

Planar Method: If the films shot in nuclear medicine are shot in one plane and in 2 directions, it is called the planar method.

• SPECT: Images are taken from the periphery of the organ to be filmed along an angle of 180 or 360 degrees. After shooting, raw images are processed with the help of computer. In thismethod, the extracted organs are examined in 3D.

• PET: The radioactivity used here is positron emitting rays. Other parts are like SPECT.

Uses of Nuclear Medicine

Neurological applications

Diagnosis of paralysis in some paralysis diseases

In the diagnosis of dementia

For the evaluation of brain and neck vascular surgeries

In epilepsy patients whose surgery is planned

Oncological applications

Showing the location of some tumors

Staging of tumors

Evaluation of whether tumors have spread

Treatment of pain in cancerous bones

Orthopedic applications

Display of hidden shards

Bone infections

Kidney applications

Showing obstructions in the urinary tract

Investigating whether there is urine leakage into the kidneys

Investigation of kidney infections

Heart Applications

Diagnosis of coronary artery diseases

Evaluation of those who have bypass surgery

To investigate the cause of the disease in some hypertension patients

Follow-up of patients in kidney transplantations

Lung applications

Diagnosis of pulmonary embolism (blood clot in the lungs)

Other Applications

Goiter diseases

Various esophageal and stomach diseases

Gallbladder diseases

Intestinal bleeding

Suspicion of latent infection

Examination of lymphatic pathways

Examination of tear ducts

Examination of the functions of the salivary glands

Imaging of different tumors with various radiopharmaceuticals

Investigation of hidden infections in the body

Nuclear Medicine Tests

• Tc-99m thyroid scintigraphy

• I-131 thyroid scintigraphy

• I-131 thyroid uptake

• I-131 whole body scan

Parathyroid scintigraphy

Thyroid suppression scintigraphy

• DTPA kidney scintigraphy

• DMSA kidney scintigraphy

• Mag3 kidney scintigraphy

Radionuclide cystoureterogram

• Adrenal cortex scintigraphy

Testicular scintigraphy

Hysterosalpingography

• Bone scintigraphy

• Bone marrow scintigraphy

• Three-Phase Bone Scintigraphy

Myocardial perfusion scintigraphy

Myocardial perfusion scintigraphy (rest)

• Tc-99m PYP myocardial infarction

• I-123 MIBG sympathetic innervation scintigraphy

Radionuclide ventriculography (MUGA)

• First pass angiocardiography

Shunt analysis

Radionuclide venography

lymphoscintigraphy

• Brain perfusion scintigraphy

• Tc-99m HMPAO brain SPECT

• I-123 brain receptor imaging

Cisternography

• CSF leak determination

• CSF shunt evaluation

• GIS bleeding detection

Esophageal transit time and motility study

Gastric emptying time calculation

• Le Veen shunt analysis

Gastroesophageal reflux

Meckel scintigraphy

Liver-Spleen scintigraphy

Hepatobiliary scintigraphy

Lung perfusion scintigraphy

Lung ventilation scintigraphy

• Aerosol inhalation scintigraphy

• TL-201 Tumor screening

• Ga-67 scintigraphy

Radioimmunoscintigraphy

Tumor imaging with Octreotide

Imaging of chemoresistance with Tc-99m sestamibi

• DMSA-V tumor imaging

• MIBG scintigraphy

• I-131 MIBG therapy

• I-131 treatment

Treatment with Sr-89

Salivary gland scintigraphy

Dacryoscintigraphy

• Skin blood flow

Abscess scintigraphy

• RBC scintigraphy

Whole body scanning with Tc-99m HIG

Thrombus scintigraphy with In-111-labeled platelets

• VUR Scintigraphy

• Brain perfusion scintigraphy with Tc-99m DTPA

Scintimammography

Mass localization with gamma probe