21 Ekim 2019 Pazartesi

Nuclear Medicine

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Department Identification
Suleyman Demirel Universty, Medicine Faculty, Nuclear Medicine was established with the assignment of Assistant Professor Doctor Mustafa YILDIZ in 2001.
The proficiency education of nuclear medicine started in the department in 2003 and 7 doctors have completed their proficiency education till now. Our department takes place on the first floor of Süleyman Demirel Investigation and Education Hospital. There are two gamma cameras one of which is SPECT, the other one is planar gamma, one PET-CT, one DEXA, one uptake, 1 gamma probe, one gamma counter, one ventilation unit, one infusion pump, one treadmill exercise ECG in our department. The daily, weekly and monthly quality control of the equipment is made sure by a physicist. In Nuclear Medicine Department there are on the average of 5000 actions such as; Nuclear Cardiology, Nuclear Oncology, Nuclear Nephrology and Endocrine System have been taken per year.
Diagnostic and Treatment Procedures in our department
By scintigraphic methods, it could be possible to monitor the organs using radioactive substances. Radioactive substances can be given to the patients either severely or in the radiopharmaceutical form with other chemical substances which ensures the involvement of organs. It is decided by the nuclear medicine doctor which agent to be used and which method to be applied to the patient by; and it is bound to the organ being monitored. Monitorization is recorded by the cameras. With these recordings, it becomes possible to get information about organs at physiologic, metabolic and molecular levels which is impossible to get by the any of the methods.
Diagnostic procedures in our department
- Lung perfusion – ventilation scintigraphy
- Brain SPECT
-Renal scintigraphy (DTPA-MAG-3) dynamic renal scintigraphy, DMSA static renal scintigraphy, captopril renal scintigraphy, ERPF-GFR quantitative measurement)
- Heart and circulatory system scans (T1-201 or Tc-99m MIBI and gated myocardial perfusion scintigraphy, MUGA, radionuclide angiography, lymphoscintigraphy)
-Bone scintigraphy (whole body bone scintigraphy, Bone SPECT, three - phase bone scintigraphy, bone marrow scintigraphy and to use for the diagnosis of osteoporosis, measurement of bone mineral densitometry by DEXA
- Thyroid tests (thyroid scintigraphy by, whole body scan by I-131, thyroid uptake tests (Tc-99m or I-131)
- Gastrointestinal scintigraphy (hepatobiliary system scintigraphy, liver SPECT, detection of gastrointestinal bleeding, salivary gland scintigraphy, determination of gastric emptying, liver – spleen scintigraphy, liver blood pool SPECT, Meckel’s diverticulum research gastro- esophageal reflux scintigraphy)
- Diagnosis and monitoring of tumor (whole body scan by T1-201 or TC-99m MIBI, whole body scan I-131, whole body scan by 131 MIBG, octreotide scintigraphy by In-111, Ga-67 scintigraphy.
- Infection imaging (Ga-67 scintigraphy, Tc-99m HIG scintigraphy,Tc-99m HMPAO leukocyte scintigraphy)
- Other scintigraphic procedures (parathyroid scintigraphy, testicular scintigraphy, etc.)
- Gama probe (identification of sentinel lymph node is done during the operation of cancer patients)
- C-14 urea breath test (helicobacter pylori infection which causes serious diseases from superficial gastritis to gastric lymphoma by placing into the gastrointestinal system the diagnostic of it has been made.)
- PET-CT (It has been serving with its three waiting rooms, one jump-up room)
Treatment Procedures in our department
Hyperthyroid disease has been treated by I-131 radionuclide therapy.
Heart (myocardial perfusion) scintigraphy: Heart muscle is fed through special blood vessels called coronary arteries. If coroner vessels get narrowed or occluded, this case is called coronary artery disease. Your heart can not receive enough oxygen. This situation causes no complaint or heart disease called “ischemic” or may lead to infection. We have been monitoring the heart muscle supplied by these vessels by stress-rest myocardium test;
Stress-rest myocardium test has been applied for two different cases following an effort test (treadmill or drug application) and after resting time by giving radioactive drug intravenously based on the specialty of drug’s retention properties of the heart muscle. The resting work is sometimes on the someday with stress work or sometimes is not.
Myocardium scintigraphy: It is often used for the diagnosis of coronary heart disease.
Investigation of chest pain, determination of its course, balloon angioplasty, before coronary artery bypass grafting practices, and follow-up after it, follow-up medical treatment.
Bone Scintigraphy: There is no need to be hungry for the diagnostic. During bone scintigraphy, vessels of arms or legs are usually injected. Monitorization starts just after the injection and 2-4 hours later.(for the accumulation of the drug in bone) Later monitorization could be made if it is necessary. During this period you need to drink so much water and go to the toilet too often.
Thyroid Scintigraphy: For this scintigraphy it is necessary to monitor after the injection of arm vessel for about 15-20 minutes. It is not necessary to be hungry for it.
DMSA Renal Scintigraphy: You do not need to be hungry for diagnostic. For this scintigraphy, the patient is usually injected by the arm vessel and 3-4 hours later the imaging is recorded by a camera.
DTPA or MAG3 Renal Scintigraphy: You do not need to be hungry for the monitorization but it is important to drink too much water before it. The arm vessel is usually injected for renal scintigraphy and the patient is watched for about half an hour by camera. Please do not move during this procedure.
Gastroesophageal Reflux Scintigraphy: You need to hungry for 2-4 hours before the monitorization. For the babies you need to bring a feeder with some milk or orange juice. The patient drinks milk with drug, lays down under the camera an hour later, then monitorization starts.
Iodine Scan: For this monitorization our medical doctor will talk to you and explain the necessary diet and asks you not to take some drugs in certain periods. You need to be hungry for four hours before the procedure. You will take liquid or tablet-shape, low-dose radioactive iodine. It is important not to drink or eat anything except for water for two hours. It is necessary for the body to increase the absorption of radioactive iodine. The images are going to be recorded a day later of receiving iodine. If your doctor deems it necessary, imaging can also be done later.
Iodine Treatment (I-131 Hyper Thyroid Treatment): For hyperthyroid (thyrocele) patients, radioactive iodine 131 treatments is very common and comes first as a preferred way of the treatment. It carries no risk for the patient revealed by the studies conducted since 1944. For this procedure our nuclear medical doctor will talk to you about the diet and asks you not to take certain drugs periodically. You must be very careful about the drugs forbidden before the treatment. Otherwise, you cannot handle the result you expect. You need to be hungry four hours before monitorization. You will take liquid or tablet-shape low-dose radioactive iodine. It is important not to drink or eat anything except for water for 2-4 hours. It is necessary for your body to increase the absorption of the radioactive iodine. Depending on the dose of I-131 you have taken, it is expected not to reach into the community. Please be careful about that.
PET/CT: By PET/CT the functional and anatomic details of the organs can be seen at the same time. The FDG molecule (a radioactive substance) marked by Flor-18 making position radiation and being a derivative of sugar is injected intravenously. It is expected the radioactive substance spread throughout the body in a certain period (nearly 30-60 minutes). The plam images of (CT and PET images) of the patient taken under the camera can be obtained as three-dimensional in about 15-20 minutes. Therefore, normal or abnormal functions of pathological domains in organs and tissues can be monitored as 3D. This method provides vitally important information about the patients especially for oncological practices. The diagnostic modality has very important application areas such as; the prevalence of the disease, operation, what the most suitable treatment for the patient radiotherapy or chemotherapy is, evaluation of the treatment response, where the radiotherapy should be given. For some of the oncology patients it is impossible to make decision about what the next step is, without this inspection. Apart from the oncology patients it could be possible to monitor whether the heart muscle keeps have normal activity of it or not. Especially for the patients who had heart attack it could change the way of treatment by determining how much the heart muscle has affected. It has been used efficiently for Alzheimer and epilepsy patients.