Medical application

APPLICATION OF RADIONUCLIDE
Cardiac performance: This bolus travels to the right side of the heart , The nuclide Tc-99m ( 1 is pumped through the 1.5mci) is tagged with pulmonary system human serum albumin drains into the left in vitro (bolus) and is ventricle from which its injected into an external pumped into the aorta vein such as jugular. and into the bodys arterial system and venous return.

 A crystal detector (NAI) of rays is placed behind a collimator ( a hollow cylinder of lead) and this collimator detector called a probe. Refer the fig

As the radioactive bolus enters the right heart the outer detector records a high level of activity. The bolus is then pumped into the pulmonary circulatory system and very little activity is seen.

 When the bolus return from pulmonary circulation and enters the left ventricle the beat to beat variation seen in the count rate.

Thallium-201 study
When someone Thallium-201 injected exercises strenuously, into the blood binds some part of the particularly strongly to persons heart tissue heart muscle. may not receive Diagnosis of heart sufficient blood because disease depends on the of narrowed arteries. fact that only tissue that These areas do not receives sufficient blood bind thallium-201 and flow binds thallium-201. show up on an image as dark spots.

Heart images

THE GAMMA CAMERA

The instrument used in Nuclear Medicine for the detection of gamma rays is known as the Gamma camera. The components making up the gamma camera are the collimator, detector crystal, photomultiplier tube array, position logic circuits, and the data analysis computer.

ANGER CAMERA
A pin-hole in lead was used to project a gamma ray image of the source distribution in 1953 by Hal Anger. In the late 1950's, Anger replaced the film and screen with a single NaI crystal and PMT array. This formed the basis for the "Anger Camera" which is now the standard clinical nuclear imaging device.

PICTURE OF GAMMA CAMERA

Detector

Nuclear medicine scintillation detector system.

Need for pulse height Analyzer

NaI

Pulse Height Analyzer

COLLIMATOR
The collimator is a pattern of holes through gamma ray absorbing material, usually lead or tungsten, that allows the projection of the gamma ray image onto the detector crystal.

SCINTILLATION DETECTORS
In order to detect the gamma photon we use scintillation detectors. A Thalliumactivated Sodium Iodide [NaI(Tl)] detector crystal is generally used in Gamma cameras. A gamma ray photon interacts with the detector by means of the Photoelectric Effect or Compton Scattering causing the release of electrons which in turn interact with the crystal lattice to produce light, in a process known as scintillation.

PHOTO MULTIPLIER TUBE

The PMT is an instrument that detects and amplifies the electrons that are produced by the photocathode.

BONE SCANS
Bone scans are typically performed in order to assess bone growth and to look for bone tumours. The tumors are the dark areas seen in the picture.

Not included in syllabus (for information)

WHAT IS SPECT?
SPECT is short for Single Photon Emission Computed Tomography. As its name suggests (single photon emission), gamma ray emissions are the source of information, rather than X-ray transmissions as used in conventional Computed Tomography.

PROCEDURE IN SPECT
Internal radiation is administered by means of a pharmaceutical which is labeled with a radioactive isotope. The radioactive isotope decays, resulting in the emission of gamma rays. These gamma rays give us a picture of what's happening inside the patient's body. The gamma camera can be used in planar imaging to acquire 2-dimensional images, or in SPECT imaging to acquire 3dimensional images.

SPECT OF LUNG

DATA ANALYSIS COMPUTER

To deal with the incoming projection data and to process it into a readable 3D image, a processing computer is used. The computer may use various different methods to reconstruct an image, such as filtered back projection or iterative reconstruction.

IMAGE RECONSTRUCTION
The aim of the reconstruction process is to retrieve the radiotracer spacial distribution from the projection data .

SPECT APPLICATIONS
HEART IMAGING. BRAIN IMAGING. KIDNEY/RENAL IMAGING. BONE SCANS.

HEART IMAGING
The following figure is a myocardial scan taken under stress conditions. Regions of the heart that are not being perfused will display as cooler regions .

BRAIN IMAGING
This figure is a transverse SPECT image of the brain.

KIDNEY IMAGING
renal planar scan using MAG3 tracer (a glucose analog).

IMAGES OF STROKES
Ellen, 63, was suddenly paralyzed on the right side of her body. Unable to even speak, she was in a panic and her family was extremely concerned. As drastic as these symptoms were, two hours after the event, her CAT scan was still normal. Suspecting a stroke, the emergency room physician ordered a brain SPECT study that showed a hole of activity in her left frontal lobe caused by a clot that had choked off the blood supply to this part of the brain.