Nuclear medicine

Nuclear medicine is a specialized area of radiology that uses very small amounts of radioactive materials, or radiopharmaceuticals, to examine organ function and structure. Nuclear medicine imaging is a combination of many different disciplines, including chemistry, physics, mathematics, computer technology, and medicine. This branch of radiology is often used to help diagnose and treat abnormalities very early in the progression of a disease, such as thyroid cancer.

Because X-rays pass through soft tissue, such as intestines, muscles, and blood vessels, these tissues are difficult to visualize on a standard X-ray, unless a contrast agent is used, which allows the tissue to be seen more clearly. Nuclear imaging enables visualization of organ and tissue structure as well as function. The extent to which a radiopharmaceutical is absorbed, or "taken up," by a particular organ or tissue may indicate the level of function of the organ or tissue being studied. Thus, diagnostic X-rays are used primarily to study anatomy, whereas nuclear imaging is used to study organ and tissue function.

A tiny amount of a radioactive substance is used during the procedure to assist in the examination. The radioactive substance, called a radionuclide (radiopharmaceutical or radioactive tracer), is absorbed by body tissue. Several different types of radionuclides are available, including forms of the elements technetium, thallium, gallium, iodine, and xenon. The type of radionuclide used will depend on the type of study and the body part being studied.

After the radionuclide has been administered and has collected in the body tissue under study, radiation will be given off. This radiation is detected by a radiation detector. The most common type of detector is the gamma camera. Digital signals are produced and stored by a computer when the gamma camera detects the radiation.

By measuring the behavior of the radionuclide in the body during a nuclear scan, the doctor can assess and diagnose various conditions, such as tumors, abscesses, hematomas, organ enlargement, or cysts. A nuclear scan may also be used to assess organ function and blood circulation.

The areas where the radionuclide collects in greater amounts are called "hot spots." The areas that do not absorb the radionuclide and appear less bright on the scan image are referred to as "cold spots."

In planar imaging, the gamma camera remains stationary. The resulting images are two-dimensional (2D). Single photon emission computed tomography, or SPECT, produces axial "slices" of the organ in question because the gamma camera rotates around the patient. These slices are similar to those performed by a CT scan. In certain instances, such as PET scans, three-dimensional (3D) images can be performed using the SPECT data. 

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