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  • NUCLEAR

    MEDICINE Radioactivity Assignment

    PHYSICAL SCIENCE

    NUCLEAR

    MEDICINE Radioactivity Assignment

    PHYSICAL SCIENCE

  • Radioactivity Assignment Nuclear Medicine

    2

    Nuclear medicine is a branch of medicine which is generally used to both treat and diagnoses illnesses

    and diseases in a safe/painless way. Nuclear medicine procedures allow the determination of medical

    information which may otherwise be unavailable, require surgery or more expensive tests. The use of

    nuclear medicine generally can make identifications of illnesses or abnormalities extremely early in

    the progression of the illness- long before other practices could identify it. The factor of early

    detection allows a disease/illness to be treated earlier, posing a higher chance of recovery (What Is

    Nuclear Medicine? 2017).

    Nuclear medicine is used for two primary purposes: diagnosis and therapy (ACR, 2017).

    Diagnosis is generally referred to as imaging, and is only used to diagnose and establish what the

    illness the patient is affected by is. Therapy is used to treat a patient from illnesses, again using

    radioactive materials to accomplish said goal.

    Nuclear medicine imaging uses minute amounts of radioactive materials, referred to as radiotracers,

    and they are typically injected into the bloodstream, inhaled or swallowed. (ACR, 2017)

    The radiotracer uses small amounts of radioactive dye to highlight concerning areas (such as cancer

    cells or infection). Pictures can then be taken of the areas for closer analysis and treatment. ("Nuclear

    Medicine Scans" 2017) The radiotracer is introduced to the body either through injection, inhalation

    or consumption. The dye travels through the body, gathering in the area of the body which is under

    examination. When the dye is eventually collected in a tumour or organ, it makes energy in the form

    of gamma rays. In order to identify the gamma rays, a scanner or camera captures images based off

    the gamma ray output. Nuclear medicine scan pictures can detail the function as well as the structure

    of tissues and organs in the body. (ACR, 2017). The radioactive material present in the body will

    decay over time, posing no risk to the patient.

    As with any branch of medicine, there are many smaller sectors and ways to perform nuclear

    medicine. Each type of testing has a different purpose, some working better on different types of

    organs or illnesses to identify the issue.

    Bone or Joint Scans:

    Bone or join scan are utilised to find out if there are any abnormalities within the bones or joints. As

    per usual, a small amount of radioactive material is injected into the vein, which are then taken up by

    the skeletal system. Pictures are captured 2-3 hours’ post injection. ("Full Body Bone Scan | Nuclear

    Medicine | Services & Treatments (Copy) | Premier Radiology" 2017)

    Gallium Scan:

    Gallium scans are used to identify infections or tumour. Small amounts of radioactive gallium are

  • Radioactivity Assignment Nuclear Medicine

    3

    injected into the patient. Pictures are captured using a specialised camera. Dependent on the patients’

    medical history, imaging will generally be at either 24, 48, or 72 hours’ post injection of the

    radioactive material. (Gallium Scan: Medlineplus Medical Encyclopedia". 2017. Medlineplus.Gov.

    https://medlineplus.gov/ency/article/003450.htm.) Gallium scans generally use gallium-67, an isotope

    of gallium, which is commonly found in multiple salts like citrate and nitrate. The gallium-67

    generally releases a spectrum of gamma rays (93, 185, 288, 394 KeV energy), and has a half-life of

    approximately 78 hours. This type of scan has recently been largely replaced by 18-F FDG PET/CT

    imaging which has earlier scans, better image quality and SUV quantification. (Venkatesh 2017)

    Gallium-67 Citrate is used for the scans, and has a chemical structure of:

    The radioactive decay equation for Gallium-67 is:

    67

    31 𝐺𝑎∗ →

    67

    31 𝐺𝑎 +

    0

    0 𝛾 + 𝑒𝑛𝑒𝑟𝑔𝑦

  • Radioactivity Assignment Nuclear Medicine

    4

    The above photo shows the electron capture decay of Ga-67, which occurs in the body throughout

    gallium scans. The isotope slowly decays into Zn-67 which is stable, unlike the radioactive Ga-67.

    A gallium scan is shown above.

  • Radioactivity Assignment Nuclear Medicine

    5

    Gastric Emptying:

    Gastric emptying is used to evaluate the functioning of the stomach and digestive system. The patient

    will either eat a scrambled egg and begin imaging immediately, taking 2 hours, or drink a glass of

    water and then imaging will begin immediately for 60 minutes. ("Gastric Emptying Scan" 2017)

    Oesophageal Reflux Study:

    This test is used to find out if liquid material moves in a reverse direction from the stomach or the

    oesophagus, also commonly known as reflux. In this case, a small amount of the radioactive liquid is

    mixed with a drink the patient must consume. A binder is then placed on the abdomen to place

    pressure on the stomach. Pictures are then captured. ("CT Risks A Hot Topic On Social Media |

    Atlantic Medical Imaging" 2017)

    Hepatobiliary Scan:

    These scans are used to analyse gall bladder function, as well as the bile ducts. The patient is injected

    with radiotracers, which are then taken up by bile-producing glands. Pictures are taken immediately

    for a minimum of one hour, and possibly up to three hours. (“Hepatobiliary (HIDA) Scan | Nuclear

    Medicine”, 2017)

    Liver or Spleen Scan:

    This test is mainly used to find out the size and function of the liver and spleen. A small amount of

    radioactive material is injected into the vein. Pictures of the liver and spleen are taken. ("Liver-Spleen

    Scan" 2017)

    Meckel’s Scan:

    This study is undertaken to discover if the patient has a Meckel’s diverticulum, a slight bulge in the

    small intestine present from birth. This study is frequently performed on children. Pictures are

    captured after the injection for a period of about 45 minutes. ("Test Preparation- Meckel's

    Diverticulum Scan" 2017)

  • Radioactivity Assignment Nuclear Medicine

    6

    Image: A Meckel’s scan result

    MUGA Scan:

    MUGA scans are used to judge the function of the heart, often performed on customers who will be

    receiving chemotherapy. To perform this, the patient generally has a small amount of blood drawn,

    which is taken and mixed with the radioisotope tracker. This mixture is consequently reinjected into

    the patient and imaging begins approximately 10 minutes later. The test then takes about one hour.

    ("Multigated Acquisition Scan (MUGA)" 2017) The imaging takes photos of the heart with each

    pump to find out how well the heart is functioning and how much blood pumps with each beat. It

    generally only captures images of the lower chambers of the heart and reports abnormalities in the

    size of the chambers (ventricles), as well as abnormalities in the movement of blood through the heart.

    It is also taken before chemotherapy to find any pre-existing heart conditions. It is common for cancer

    survivors who have had radiation therapy to the chest, spine or upper abdomen, as well as people who

    have had a bone marrow/stem cell transplant or certain types of chemotherapy. ("MUGA Scan"

    2017). Technetium-99m is generally used for this form of imaging (“Radionuclide

    Angiogram/MUGA Scan”, 2017). Technetium-99m has a gamma decay equation of:

  • Radioactivity Assignment Nuclear Medicine

    7

    𝑇𝑐99𝑚 → 𝑇𝑐99 + 0

    0 𝛾

    Renal Scan:

    Renal scans are used to assess blood flow as well as the level at which kidneys are functioning in the

    patients. A computer is used to graph the level of blood flow and function of the kidneys. Pictures are

    collected for a period of 30 minutes. ("Renal Scan" 2017)

    SPECT Brain Scan:

    This test is unusual in comparison to the others as it’s a two-part test. The first part involves an

    injection. An IV is placed into the patients arm and the medication will be administered through it,

    taking around 30 minutes. The patient can leave between the two tests but must return around an hour

    and a half later for the remainder of the testing (imaging). The imaging portion of the testing takes

    about 45 minutes. ("SPECT Brain Imaging: Background, Indications, Contraindications" 2017)

    SPECT Liver Scan (Red Blood Cell Scan of Liver):

    This is often undertaken as a follow-up of a CT scan, MRI or Ultrasound to rule out a benign (dead)

    liver tumour (haemangioma). This is also a two-part test. The first portion will take approx. 30

    minutes. The technologist will again draw a small sample of blood, and then reinject it into the patient

    after mixing it with the isotope. Again, the patient may leave but must return 1.5 hours afterwards for

    imaging. The imaging will take around 45 minutes. ("Types Of Nuclear Medic