Nuclear Medicine

Nuclear medicine is an advanced branch of medicine that uses radioactive substances (radiopharmaceuticals) to diagnose and treat diseases. Modern imaging techniques allow for the evaluation not only of the structure of organs but also their functions. It plays a vital role in a wide range of conditions, from cancer and heart disease to thyroid disorders and bone diseases.

What is Nuclear Medicine?

Nuclear medicine is a modern imaging and treatment method that uses low doses of radioactive material to study the functioning of organs and tissues in the body. This method allows for the acquisition of information at the cellular and functional levels.

Radioactive substances used in nuclear medicine applications are called "radiopharmaceuticals." These substances are specifically selected according to the organ or system to be examined. After being administered to the body, they take up space in the relevant area and are visualized using special cameras. The resulting images help doctors detect diseases earlier, assess the spread of the disease, and plan the treatment process.

Nuclear medicine procedures are generally painless and allow patients to return to their daily lives quickly. The amount of radioactive material used is planned in low doses, and the procedure is performed by specialist physicians after evaluating the patient's condition. The imaging process may vary depending on the procedure; some scans are completed quickly, while others may require a certain waiting period for imaging.

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What technologies are used in the Nuclear Medicine Department?

The technological equipment used in the Nuclear Medicine Department consists of advanced systems that enable the structural and functional evaluation of organs in the diagnosis, monitoring, and treatment processes of diseases.

In the Nuclear Medicine Department, imaging devices detect the uptake of radioactive material in the body through special detectors and convert this information into images. These systems play a crucial role in the early diagnosis of diseases and in evaluating the response to treatment.

PET/CT (Positron Emission Tomography/Computed Tomography)

• PET/CT device: Combines PET images, which show metabolic activity, with CT images, which show anatomical structure, in a single system to reveal the location and spread of diseases in detail.
• 18F-FDG PET/CT: Shows glucose utilization by cells, enabling the identification of metabolically active tissues.
• 18F-NAF PET/CT: Images blood supply and structural changes in bone tissue with high sensitivity.
• Ga-68 Dotatate PET/CT: An advanced PET imaging technique that allows visualization of tissues containing somatostatin receptors.
• Ga-68 PSMA PET/CT: Helps in imaging prostate tissue-specific markers.
• TOF PET/CT technology: Its Time of Flight feature allows for clearer images and the use of lower doses of radioactive material.

SPECT/CT and Gamma Camera Systems

• SPECT/CT device: Combines functional scintigraphy data with computed tomography to enable clear anatomical identification of diseased areas.
• Gamma camera: It creates scintigraphy images by detecting the distribution of the radioactive substance administered to the body in organs and tissues.
• The new generation gamma camera (GE 530c): Provides high sensitivity, shortening shooting time and helping to obtain high-quality images with lower radiation.

Cardiac gamma camera: Used in specialized scintigraphy scans that evaluate blood flow to the heart muscle.

Scintigraphy Imaging Systems

• Pulmonary perfusion scintigraphy: Provides information about respiratory system functions by evaluating blood flow in the lungs.
• Ventilation-perfusion scintigraphy: Analyzes both air and blood circulation in the lungs.
• Brain PET imaging: Allows for functional assessment by examining brain metabolism.
• Brain perfusion scintigraphy: Shows the blood supply status of brain tissue.
• Myocardial perfusion scintigraphy: Evaluates the amount of blood reaching the heart muscle.
• MUGA (radionuclide ventriculography): Measures the heart's pumping power to provide information about heart function.
• Three-phase bone scintigraphy: Examines bone blood supply and metabolic activity in stages.
• Whole-body bone scintigraphy: Provides a comprehensive assessment of the entire skeletal system.
• Bone PET/CT (F18-NAF): Provides more precise images of changes in bone tissue.
• Arthroscintigraphy: Provides functional evaluation of intra-articular structures.

Endocrine and Organ Function Imaging Systems

• Thyroid scintigraphy: Evaluates the function and structure of the thyroid gland.
• Parathyroid scintigraphy: Shows the activity and location of the parathyroid glands.
• Dacryoscintigraphy: Examines the patency and function of the tear ducts.
• Salivary gland scintigraphy: Evaluates the functional capacity of the salivary glands.

Gastrointestinal System Imaging Systems

• Gastrointestinal bleeding scintigraphy: Identifies the focus of active bleeding in the digestive system.
• Gastroesophageal reflux scintigraphy: Evaluates the backflow of stomach contents into the esophagus.
• Meckel's diverticulum scintigraphy: Helps detect congenital structures in the small intestine.
• Gastric emptying scintigraphy: Evaluates digestive function by measuring the gastric emptying time.
• Esophageal transit time measurement: Analyzes the speed at which food moves through the esophagus.

Genitourinary System Imaging Systems

• Dynamic renal scintigraphy (DTPA/MAG3): Evaluates the blood supply, filtration, and excretion functions of the kidneys.
• Static renal scintigraphy (DMSA): Detects damage or scarring in kidney tissue.
• ACE inhibitor renal scintigraphy: Helps in the evaluation of renal vessel stenosis.
• Vesicoureteral reflux scintigraphy: Shows the backflow of urine from the bladder to the kidneys.
• Testicular Scintigraphy: Used to assess the blood supply to the testicles.

Infection and Lymphatic System Imaging

• Labeled leukocyte scintigraphy: This imaging method uses the patient's own white blood cells to pinpoint the location of an infection focus.
• Bone marrow scintigraphy: Shows bone marrow activity and distribution.
• 18F-FDG infection imaging: Detects areas of infection with increased metabolic activity.
• Lymphoscintigraphy: Visualizes the flow and drainage pathways of the lymphatic system.

Surgical Assistive Technologies

• Intraoperative gamma probe: Allows surgeons to easily identify tissues or lymph nodes that have absorbed radioactive material during surgery.
• Sentinel lymph node mapping (SPECT/CT): Helps to anatomically identify the first lymph node in the tumor's path of spread.

What treatments are applied in the Nuclear Medicine Department?

Nuclear medicine treatments are modern and effective methods that involve delivering radioactive substances to diseased tissue in a targeted manner. The radiopharmaceuticals used in these treatments selectively bind to specific cells, directly affecting the diseased area and helping to protect healthy tissues.

Nuclear medicine treatments play a significant role, particularly in cancer treatments, thyroid diseases, bone metastases, and some chronic joint diseases.

Treatments Applied in Thyroid Diseases

• Radioactive iodine-131 therapy: This treatment utilizes the thyroid cells' ability to absorb iodine, targeting overactive thyroid tissue or cancer cells.
• Low-dose iodine therapy: Helps suppress overactive thyroid gland in conditions such as hyperthyroidism and hot nodules.
• High-dose iodine therapy (ablation): This is used to destroy cells that may remain after thyroid cancer treatment and to reduce the risk of disease recurrence.

Neuroendocrine Tumor Treatments

Lutetium-177 DOTATATE therapy: Enables targeted radiation by binding to neuroendocrine tumor cells that carry somatostatin receptors.

Prostate Cancer Treatments

• Lutetium-177 PSMA therapy: It directly targets tumor tissue by targeting PSMA receptors found in prostate cancer cells.
• Radium-223 (Xofigo) treatment: Particularly effective in prostate cancer with bone metastases, it targets bone tissue and creates a targeted radiation effect.

Treatments Applied in Bone Metastases

• Samarium-153 treatment: By creating a radioactive effect in areas where bone metastases are located, it helps control symptoms.
• Strontium-89 therapy: A radionuclide therapy agent that accumulates in bone tissue and exerts a targeted effect in metastatic areas.
• Rhenium-186 therapy: Another nuclear medicine treatment option used for bone metastases, providing targeted radiation.

Treatments Used for Liver Tumors

Y-90 microsphere (radioembolization) therapy: This treatment delivers radiation directly to the tumor tissue by injecting radioactive microspheres into the blood vessels that supply the liver tumor.

Treatments Applied in Joint and Rheumatological Diseases

Radiosynovectomy: A local treatment method that helps suppress inflamed synovial tissue by injecting radioactive agents into the joint.

Targeted Radionuclide Therapy Applications

Radionuclide therapies: These are targeted and personalized treatment methods that use radioactive agents selected according to the biological characteristics of diseased cells.