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Lect Theory

Nuclear medicine uses radioactive tracers called radiopharmaceuticals to obtain diagnostic information. Radiopharmaceuticals consist of a radioactive nuclide, a pharmaceutical that localizes in organs of interest, and a biochemical bonding agent. Commonly used radionuclides like technetium-99m have optimal properties including short half-lives and gamma emissions at energies suitable for detection. A gamma camera detects emitted gamma rays and forms images to evaluate the distribution and movements of radiopharmaceuticals in the body over time, providing functional information about organ systems.

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54 views

Lect Theory

Nuclear medicine uses radioactive tracers called radiopharmaceuticals to obtain diagnostic information. Radiopharmaceuticals consist of a radioactive nuclide, a pharmaceutical that localizes in organs of interest, and a biochemical bonding agent. Commonly used radionuclides like technetium-99m have optimal properties including short half-lives and gamma emissions at energies suitable for detection. A gamma camera detects emitted gamma rays and forms images to evaluate the distribution and movements of radiopharmaceuticals in the body over time, providing functional information about organ systems.

Uploaded by

rodelagapito-1
Copyright
© © All Rights Reserved
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Nuclear Medicine

Introduction
What is nuclear medicine?
The use of radioactive tracers (radiopharmaceuticals) to obtain
diagnostic information [and for targeted radiotherapy].
Radiation is emitted from inside the human body cf transmitted
radiation in x-ray imaging.
Tracers : Trace the paths of various biochemical molecules in our body.
Hence can obtain functional information about the bodies workings
(i.e. physiology).

Radiopharmaceuticals

+
Pharmaceutical
Traces physiology /
localises in organs
of interest

Biochemical
Bonding

Radioactive
nuclide
Emits radiation for
detection or therapy

The Pharmaceutical
The ideal tracer/pharmaceutical should follow only
the specific pathways of interest, e.g. there is
uptake of the tracer only in the organ of interest
and nowhere else in the body. In reality this is
never actually achieved.
Typically want no physiological response from the
patient
The mechanism of localisation can be as simple
as the physical trapping of particles or as
sophisticated as an antigen-antibody reaction

Radionuclides in Nuclear Medicine


The ideal radionuclide for in-vivo diagnosis :
Optimum half life
of same order as the length of the test (this minimises the radiation dose to the
patient)

Pure gamma emitter


No alpha or beta particles, these do not leave the body so merely increase the
radiation dose.

Optimum energy for emissions


High enough to exit the body but low enough to be easily detected. Useful range
for gamma cameras is 50 - 500 keV (optimum ~ 150 keV).

Suitable for incorporating into a pharmaceutical without altering


its biochemical behaviour
Readily and cheaply available on the hospital site.

Some Commonly Used Radionuclides in


Nuclear Medicine
Radionuclide

Half-life

Tcm (Technecium)
111
In (Indium)
123
I (Iodine)
131
I
201
Tl (Thallium)

6h
2.8 days
13 h
8 days
73.5 h

99

Pure
emissions ?
y
y
y
n
y

Energy of main
s (KeV)

Source of
production

140
173, 247
160
280, 360, 640
68-80

On site generator

Radionuclide Production:

Neutron Capture
Nuclear Fission
Charged Particle Bombardment
Radionuclide Generator

Cyclotron
Cyclotron
Reactor
Cyclotron

Producing the Radiopharmaceutical


Radiopharmaceutical kits
Most common radiopharmaceuticals are available as kits. These
contain all the necessary freeze-dried ingredients in an air-tight
vial, usually the pharmaceutical, a stannous compound and
stabilizer. On addition of 99Tcm 04- , the stannous reduces the
99Tcm 0 - , makes it charged and "sticky", and Tc forms a bond
4
with the pharmaceutical, labelling it.

For the longer half-life isotopes, the full radiopharmaceutical can be


obtained directly from the manufacturer, e.g. SeHCAT labelled with
75Se.

Detection of the radiopharmaceutical


Non-imaging
In-vitro (measuring radiation levels in bodily fluids outside the body)
e.g. Blood sample counting for GFR analysis:

Inject radioactive
tracer
Measure fluid sample
in sample detector

Extract sample of
bodily fluid
(e.g. blood)

Patient

Electronics and
count-rate meter

Detection of the radiopharmaceutical


Non-imaging
In-vivo (Uptake measurements in organs using a radiation detector probe)
e.g. SeHCAT study for bile salt malabsorption .

Collimator

Scintillation
probe

Electronics and
count-rate meter

Detection of the radiopharmaceutical


In Vivo imaging - the gamma camera
Gamma
rays

Radioactive
tracer

Image

Gamma
camera

Patient

Properties of gamma rays


High energy electromagnetic radiation
Can be scattered and absorbed
Cannot be focused

The Gamma Camera


Collimator

NaI
Crystal
Photo Multiplier
Tubes
Analogue to
Digital Converters
Position
circuitry

X Y Z

Digital
circuitry

Output position
& energy signals

The Collimator

The purpose of the collimator is to project an image of the radioactive distribution in the
patient onto the scintillation crystal.

It is a crude and highly inefficient device, which is required because no gamma-ray lens
exists.
PARALLEL
COLLIMATOR

LENS
Object

Image

Object

Image

In the parallel hole collimator, only incident photons that are normal to the collimator
surface will pass through it.

All other photons should be absorbed by the lead septa between the holes

The collimator defines the field of view, and essentially determines the system spatial
resolution and sensitivity.

Spatial Resolution & Sensitivity


Spatial resolution of an imaging device defines its ability to distinguish between
two structures close together and is characterised by the blurred image
response to a point-source input. For a gamma camera, the overall spatial
resolution in the image depends on the collimator (collimator resolution) and the
other gamma-camera components (intrinsic resolution).

0
Collimator
Radioactive
pt. source

cm

Output from
collimator

5 cm

- important to image with the camera


as close to the patient as possible

10 cm
15 cm
s

Spatial distance

20 cm

To improve collimator resolution


Increase the septa depth (d)
Reduce the size of the holes (s)
Resolution as the source is moved
away from the collimator

Spread of response
to pt. source defines
collimator resolution

To improve collimator sensitivity


Dependent on the number of photons
passing through the collimator
Improved with larger hole sizes and
smaller length septa

resolution and sensitivity are conflicting parameters

Scintillation Crystal
NaI(Tl) Scintillation
crystal
Incident
gamma
ray

Light
Photons (~415nm)

The gamma ray causes an electron release in the


crystal via the Photoelectric Effect, Compton Scattering
or the electronpositron pair production (E > 1.022 MeV),
this excess energy gives rise to subsequent visible light
emission within the crystal (scintillation).

Number of light photons produced is roughly E


Hence, this is an energy discriminating detector
(important feature as we can use this to reject scattered photons)

Image Types
In Nuclear Medicine various forms of data acquisition can be performed:

Static Imaging

The distribution of the radiopharmaceutical is fixed


over the imaging period.
Multiple images can be acquired, viewing from different
angles (e.g. anterior, oblique).
e.g. kidneys (DMSA), thyroids, bone, lung

Tcm Thyroid Scan

99

Whole Body imaging

the camera scans over the whole body to cover more


widespread distributions or unknown locations
e.g. bone scan, infection imaging, tumour imaging

99

Tcm HDP Bone Scan

Dynamic Imaging

Consecutive images are acquired over a period of time


(with the camera in a fixed position) showing the changing
distribution of the radiopharmaceutical in the organ of interest.
e.g. renogram, GI bleed, meckels diverticulum
Tcm labelled red blood cells
GI bleed

99

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