Nuclear Medicine Treatments and Clinical Applications

Size: px

Start display at page:

Download "Nuclear Medicine Treatments and Clinical Applications"

Clare Annis Ray
5 years ago
Views:

1 INAYA MEDICAL COLLEGE (IMC) RAD 243- LECTURE 2 Nuclear Medicine Treatments and Clinical Applications DR. MOHAMMED MOSTAFA EMAM

Next Lectures Outlines Introduction to Nuclear Physics Physics of Radioactivity Radiation measurement Units Interaction of Radiation with Matter

2 Next Lectures Outlines Introduction to Nuclear Physics Physics of Radioactivity Radiation measurement Units Interaction of Radiation with Matter Radiation Detectors (Gas-filled and Scintillation Detectors) Imaging Systems Applications of Nuclear Medicine Imaging in Diagnosis and Therapy 2

3 References "Advancing Nuclear Medicine Through Innovation". Committee on State of the Science of Nuclear Medicine, National Research Council, USA. National Academies Press, K. Maher: "Basic Physics of Nuclear medicine". Wikibooks, W.D. Leslie, I.D. Greenberg: Nuclear Medicine. Landes Bioscience, J. D. Bronzino: The Biomedical Engineering HandBook. 2 nd Edn., CRC Press, D.J. Dowsett, P.A. Kenny, R.E. Johnston: The Physics of Diagnostic Imaging. Chapman & Hall Medical,

4 Introduction 4

5 Definition Nuclear medicine is a highly multidisciplinary specialty that develops and uses instrumentation and radiopharmaceuticals to study physiological processes and noninvasively diagnose and treat diseases. 5

6 Radiopharmaceuticals A radiopharmaceutical is either; a radionuclide (also called radioisotope) alone, such as iodine-131 or a radionuclide that is attached to a carrier molecule (a drug, protein, or peptide) or particle, which when introduced into the body by injection, swallowing, or inhalation accumulates in the organ or tissue of interest. 6

7 Radionuclides Radionuclides are chemical elements that are radioactive. 7

8 Radionuclides Radionuclides are chemical elements that are radioactive. As we know, The nucleus of an unstable radionuclide becomes stable by emitting particles, such as alpha or beta. The nucleus may also emit energy in the form of electromagnetic radiation known as gamma rays. 8

9 Radionuclides Although radionuclides can be found in nature, all radionuclides used in nuclear medicine are produced in linear accelerators, cyclotrons, or nuclear reactors. 9

10 Radionuclides Although radionuclides can be found in nature, all radionuclides used in nuclear medicine are produced in linear accelerators, cyclotrons, or nuclear reactors. Each radionuclide has unique properties that make it useful for certain diagnostic and therapeutic tools. 10 EXTRACT

11 Commonly Used Radionuclides in Imaging Radionuclide Carbon-11 Half-Life min Type of Emitted Radiation Positron Imaging Technique Used PET Nitrogen min Positron PET Oxygen min Positron PET Fluorine min Positron PET Technetium-99m 6.02 hours gamma SPECT Indium days gamma SPECT Iodine hours gamma SPECT 11

12 Commonly Used Radionuclides in Therapy Radionuclide Iodine-131 Yttrium-90 Half-Life 8 days 2.7 days Type of Emitted Radiation beta beta 12

13 Nuclear Medicine Scans In a nuclear medicine scan, a radiopharmaceutical is administered to the patient, and an imaging instrument that detects radiation is used to show biochemical changes in the body. 13 EXTRACT

14 Nuclear Medicine Scans Nuclear medicine imaging, in contrast to imaging techniques that mainly show anatomy (e.g., conventional ultrasound, computed tomography [CT], or magnetic resonance imaging [MRI])*, can provide important quantitative functional information about normal tissues or disease conditions in living subjects. * Exceptionally with the emergence of advanced (functional) MRI methods the pure anatomical role of these traditional imaging techniques is slowly reaching an end. 14

15 Nuclear Medicine Treatment For treatment, highly targeted radiopharmaceuticals may be used to deposit lethal radiation at tumor sites. 15

16 The Power of Nuclear Medicine The power of nuclear medicine in clinical diagnosis rests with its ability to detect altered function with great sensitivity. 16

17 The Power of Nuclear Medicine The power of nuclear medicine in clinical diagnosis rests with its ability to detect altered function with great sensitivity. For this reason nuclear medicine has contributed not only to clinical diagnosis but, to an extent unmatched by other imaging methods, to an understanding of disease mechanisms. 17

18 Research and Development (R&D) Activities in the Nuclear Medicine Field Toward improve disease diagnosis Development of new radionuclide production facilities and technologies, such as nuclear reactors particle accelerators Development of chemical processes that synthesize new radiopharmaceuticals used to improve understanding of how specific organs function. for imaging and treatment Development of imaging instruments enabling technologies multimodality imaging devices, such as PET/CT and PET/MRI 18 EXTRACT

19 Research and Development (R&D) Activities in the Nuclear Medicine Field Toward improve disease diagnosis Design and development of instruments which can detect radiation emitted from the radionuclides that accumulate in the human body. Development and use of targeted radionuclide therapeutics that will allow cancer treatments to be tailored for individual patients. Use of nuclear medicine imaging as a tool in the discovery and development of new drugs. 19 EXTRACT

20 Current Clinical Applications of Nuclear Medicine Diagnosis of diseases to permit earlier initiation of treatment as well as reduced morbidity and mortality. Examples include: cancer neurological disorders (e.g., Alzheimer s and Parkinson s diseases), cardiovascular disease in their initial stages Non-invasive assessment of therapeutic response, thus reducing patients exposure to the toxicity of ineffective treatments and allowing alternative treatments to be started earlier. Provision of molecularly targeted treatment of cancer and certain endocrine disorders (e.g., thyroid disease and neuro-endocrine tumors). 20 EXTRACT

21 Emerging Opportunities in Nuclear Medicine Understanding the relationship between brain chemistry and behavior (e.g., addictive behavior, eating disorders, depression). Assessment of the atherosclerotic cardiovascular system. Understanding the metabolism and pharmacology of new drugs. 21 EXTRACT

22 Emerging Opportunities in Nuclear Medicine Assessment of the efficacy of new drugs and other forms of treatments, thus speeding their introduction into clinical practice. Application of targeted radionuclide therapeutics to individualize treatment for cancer patients by tailoring the properties of the targeting vehicle and the radionuclide. Development of new technology platforms (e.g., integrated micro-fluidic chips and other automated screening technologies) that would accelerate and lower the cost of discovering and validating new molecular imaging probes, biomarkers, and radiotherapeutic agents. 22 EXTRACT

Emerging Opportunities in Nuclear Medicine Development of higher resolution, more sensitive imaging instruments to detect and quantify disease faster and more accurately.

23 Emerging Opportunities in Nuclear Medicine Development of higher resolution, more sensitive imaging instruments to detect and quantify disease faster and more accurately. Further development and exploration of hybrid imaging instruments, such as positron emission tomography/magnetic resonance imaging (PET/MRI), to improve disease diagnosis and treatment. Improvement of radionuclide production, chemistry, and automation to lower the cost and increase the availability of radiopharmaceuticals by inventing a new miniaturized particle accelerator and associated technologies to produce short-lived radionuclides for local use in research and clinical programs. 23 EXTRACT

24 A Brief History Henri Becquerel discovered natural radioactivity in February The story was that he placed lumps of pitchblende on sealed photographic film in sunlight, with the intent of finding out if the rays of the sun induced any penetrating fluorescence in the mineral. By chance, on developing the film after a cloudy day he was surprised to find as much blackening of the photographic emulsion as had occurred in bright sunlight. He realized that the pitchblende itself was a source of the energetic rays. 24

25 A Brief History Later Mme. (Dr.) Marie and Dr. Pierre Curie working in Paris described natural radioactivity and discovered radium. Subsequently Mme. (Dr.) Irène Curie was to observe the artificial induction of radioactivity. Rutherford, a British-educated, New Zealand physicist working at McGill University in Montreal went on to discover the structure of the atom. All won Nobel prizes Becquerel and Curie jointly. 25 Next>

26 A stamp commemorating Becquerel s discovery of radioactivity for which 26 he received a Nobel Prize. <Back

27 A Brief History Another important insight came when a Hungarian scientist George de Hevesy (a former student of Rutherford) first used the tracer principle. He experimented with a plant having its roots in a water bath containing a radioactive isotope of lead. Hevesy was able to follow the rate of passage of the tracer through the stem of the plant with an instrument capable of detecting and measuring radioactivity. This use of radioactive atoms, present in minute amounts but acting as a marker of other, non-radioactive atoms came to be called the tracer principle. It only required that Hevesy s insight be translated to people instead of plants, and for the tracer to be administered by injection instead of through a plant s root system, for the power of nuclear medicine to become clear. 27 Next

28 A stamp celebrating the anniversary of the Nobel Prize awarded to de Hevesy for the discovery of the tracer principle. <Back 28

29 A Brief History Without a capacity to image the distribution of radiotracers in the body, the importance of nuclear medicine might be of little value. Dr. Benedict Cassen developed the first rectilinear scanner to image tracers by virtue of the gamma rays they emit. This was followed by the development of the gamma camera, able to image both static and changing distributions of radioactive tracers in the body, by Dr. Hal Anger. Then, Dr. David Kuhl and others went on to develop the concept of tomographic sectional imaging in nuclear medicine. Nuclear medicine, while beginning in the late nineteenth century, gained momentum through the twentieth. Medicine in the twenty-first century will continue to be fundamentally changed by the insights that nuclear medicine provides. 29

30 Comparative imaging and the Role of Nuclear Medicine Classical radiology had been rooted in studies of structure. Another decisive advantage of nuclear medicine is its capacity to be used in whole body imaging. 30

31 Next Lecture PART_II Physics of Radioactivity

32 INAYA MEDICAL COLLEGE (IMC) RAD 243- LECTURE 3 Nuclear Medicine Treatments and Clinical Applications (PART II) DR. MOHAMMED MOSTAFA EMAM

Nuclear Medicine Treatments and Clinical Applications

INAYA MEDICAL COLLEGE (IMC) RAD 243- LECTURE 4 Nuclear Medicine Treatments and Clinical Applications DR. MOHAMMED MOSTAFA EMAM References "Advancing Nuclear Medicine Through Innovation". Committee on State