Therapeutic Application in Nuclear Medicine

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Therapeutic Application in Nuclear Medicine

  1. 1. Made by: Sara Allithey, Shatha Al Mushayt 2010 Therapeutic Application in Nuclear Medicine
  2. 2. Outline 1. Introduction to therapeutic nuclear medicine 2. Benefits vs. risks 3. Preparation 4. Applications of NM therapy a. Radioactive iodine I-131 therapy b. Palliative bone pain treatment c. Zevalin d. TheraSphere
  3. 3. Introduction •Radioactive materials are used for therapeutic irradiation of cells and/or organs. •Typically, a small amount of a radiopharmaceutical (Rph) is introduced into the body by injection or ingestion. •The Rph is attracted to particular organs or tissues. •From their locations, the radioisotope releases small amounts of radiation which will act on target cells and/or organs. http://www.poole.nhs.uk/our_services/nuclear_medicine/therapeutic_procedures/what. asp
  4. 4. Benefits • Non-invasive treatment  less traumatic than surgery. • It is a systemic treatmentit targets sites which may not be known to exist by the doctor. • Only 1 injection or oral dose is needed normally. • Patient can normally leave the hospital directly after the procedure. • Rph’s emitted ionizing radiation travels only a short distance, thereby minimizing unwanted side effects and damage to nearby structures. http://www.poole.nhs.uk/our_services/nuclear_medicine/therapeutic_procedures/what.asp
  5. 5. Risks • The total radiation received from radionuclide therapy is generally so low; an insignificant risk of causing cancer in the future. • Effects on the blood forming organs are usually short lasting and should be controlled by the doctor. • Radionuclide therapy is not carried out on pregnant women. • Allergic reactions to the Rph’s can occur(extremely rare). http://www.poole.nhs.uk/our_services/nuclear_medicine/therapeutic_procedures/what.asp
  6. 6. Patient preparation •For some treatments no special preparation is required. •However for all treatment involving the thyroid you must follow special advice regarding medicine and diet. http://www.poole.nhs.uk/our_services/nuclear_medicine/therapeutic_procedures/what.asp
  7. 7. Common Nuclear Medicine therapies include: • 131I-iodine for hyperthyroidism and thyroid cancer or Mets. • Yttrium-90-ibritumomab tiuxetan (Zevalin) for Lymphoma. • Samarium-153 or Strontium-89 for palliative bone pain treatment. • TheraSphere for liver cancer.
  8. 8. Radioactive iodine I-131 therapy 1. To treat hyperthyroidism (overactive thyroid) 2. To treat thyroid cancer or Mets. Capsule of I-131  absorbed into the bloodstream in the GIT concentrate in the thyroid glanddestroying the gland’s cells. http://www.radiologyinfo.org/en/glossary/glossary1.cfm?gid=641 Radioactive iodine -thyroid
  9. 9. Radioiodine ablation • It is radiation therapy in which; • Riodine is administered • To destroy or ablate residual healthy thyroid tissue remaining after thyroidectomy. http://www.thyca.org/ablation.htm
  10. 10. Zevalin • Zevalin is used to treat follicular lymphoma. • It combines a Y-90 radioisotope, with Monoclonal antibody. • It is given when lymphoma failed to be treated with monoclonal AB alone. Mechanism: 1. As Zevalin enters the bloodstream, the AB recognises an antigen(called CD20) and attaches to it. 2. Radiation is released from the yttrium radioisotope, killing the B-cell. http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttype Ibritumomabtiuxetan.aspx-Y90s/Biologicaltherapies/Monoclonalantibodies/
  11. 11. Zevalin cont. • Zevalin attacks both normal & malignant B-cell lymphocytes. • However, the body quickly replaces any normal WBC’s that are damaged. http://www.reuters.com/finance/stocks/companyProfile?symbol=SPPI.OQ http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Biol Ibritumomabtiuxetan.aspx-Y90/Monoclonalantibodies/ogicaltherapies
  12. 12. palliative bone pain treatment 1.metastron • Metastron (strontium-89 chloride) • IV injection used to relieve the bone pain caused by cancer. • It is similar to calcium chemically. • It reaches the areas where bones are absorbing extra calcium & causing pain then it stays there for many weeks steadily providing pain relief. http://www.southend.nhs.uk/NR/rdonlyres/34D3FA0F-7E44-4677-9DA3- E8D7DED59B9A/0/Metastrontreatment.pdf
  13. 13. palliative bone pain treatment 2.Quadramet • Quadramet is a radiopharmaceutical (drug + a Samarium-153 radioisotope). • Used for patients with pain from cancer that has spread to their bones. • Quadramet finds areas of increased bone growth and gives off radiation that reduces pain. http://www.poole.nhs.uk/our_services/nuclear_medicine /therapeutic_procedures/quadramet.asp
  14. 14. TheraSphere • Radiation treatment for liver cancer that cannot be removed by surgery e.g. HCC. • Involves injecting a large number of tiny radioactive glass beads (TheraSpheres) into the liver arteries. • The TheraSpheres travel through the blood vessels until they lodge into the smaller blood vessels of the liver tumor. • The beads stay there and give off radiation that destroys the cancer cells with little injury to the healthy liver. • After 3 days, the beads lose their radioactivity. Image http://www.uwhealth.org/healthfacts/B_EXTRANET_HEALTH_INFORMATION-FlexMember- Show_Public_HFFY_1126651799450.html
  15. 15. Thank You

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