Nuclear medicine is a medical specialty that uses small amounts of radioactive substances to diagnose and treat diseases. These radioactive substances, known as radiopharmaceuticals, are detected by specialized imaging equipment that utilizes the radiation emitted. Common nuclear medicine procedures include PET scans, SPECT scans, and bone scans which provide functional information about organs and tissues. Radiopharmaceuticals are administered to patients and their distribution throughout the body is tracked using gamma cameras or PET scanners. Nuclear medicine plays an important role in diagnosing and monitoring many diseases.

1. PRESENTED BY:
DR. MEGHA BAHAL
MDS 3RD YEAR
GUIDED BY:
DR.SANJAY NB
DR.SHWETA HEGDE
DR.SALONA KALRA

2.  Nuclear Medicine.................
 History of Nuclear Medicine………………
 Nuclear Physics…………….
 Radioactivity…………….
 Radiopharmaceuticals ……………
 Radionuclides ………………
 Gammacamera………………
 PET scan ………..
 SPECTscan…...........
 Nuclear MedicineStudies…………..
 Nuclear MedicineTeam……………
 Safety in NuclearMedicine…………

4.  Branch of medicine that uses radioactivesubstances in
diagnosis and therapy.
 These substancesconsist of pharmaceuticals labelled
with radioisotopes “radiopharmaceuticals”
 In diagnosis, radioactive substances are administered
to patient and the radiation emitted is measured and
location recorded.

5.  In therapy, radioisotopes are administered to
treat disease .
 Nuclear medicine techniques use a carrier
molecule, selected to target the organ/tissue of
interest, tagged with radioisotopes which is
emitting gamma ray

6. speciality that focuses on the use of
radioactive materials called
Radiopharmaceuticals, for diagnosis,
Therapy and medical research

7. Also known as nuclide
imaging
•Introduce radioactive
substance into body
•Allow for distribution and
uptake/metabolism of
compound ⇒Functional
Imaging!
•Detect regional variations of
radioactivity as indication of
presence or absence of specific
physiologic function
•Detection by “gamma
camera”or detector array
•(Image reconstruction)

9. The routes of administration forradioactive
substances include :
 Intravenous injection: the radioactive substancesis
Injected into avein.
 Subcutaneous injection: radioactive substancesis
injected under theskin.
 Inhalation: some radioactive substancesand
radioisotopes are inhaled by thepatient.
 Ingestion: radioactive substances can beingested.

10.  The radioactive materials administered topatients
are known asradiopharmaceuticals.
These consist of :
 Chemical molecule which determines thebehavior
of the radiopharmaceutical in the body.
 The radiation emitted by the radionuclide may be
detected from outside the body by a radionuclide
imaging device (a gamma camera) or may be
detected in a sample of a body fluid (e.g. plasma or
urine)

11. X RAYS 1895
WILLIAM ROENTGEN, noticed some glowing
Barium Platinocyanide across the room
From his experiment, this led to the discovery of X-RAYS.
HENRI BECQUERAL 1896
Discovered that a mysterious x rays were produced from the
uranium

12. •Radioactive tracer is introduced into the body by
injection, swallowing or inhalation.
•Different tracers are used to study different organs.

14. A Few months after ROENTGEN discovered xrays, BEQUEREL
started discovery of naturally occuring radioactive substances.
ATOMIC AGE
The atomic theory was proposed by an early Greek thinker,
Democritus 460 BC-370 BC.

15. JOHN LAWRENCE, is the FATHER OF NUCLEAR MEDICINE.
ATOMIC WEIGHTS 1808
John Dalton , stated that each atom of any element is similar to
every other atom in that element including weight.
PERIODIC TABLE 1871
Dmitry Mendeleev revealed the basic importance of atomic
Weights and of nuclear structure.
He depicted the properties of matter.
CATHODE RAYS 1887
William Crookes pioneered the work on CATHODE RAYS.

16. X RAYS 1895
WILLIAM ROENTGEN, noticed some glowing
Barium Platinocyanide across the room
From his experiment, this led to the discovery of X-RAYS.
HENRI BECQUERAL 1896
Discovered that a mysterious x rays were produced from the
uranium

17. RADIUM 1902
Madame Curie and her husband PIERRE discovered the
Radioactive elements – polonium and radium
Curie = basic unit of radioactivity
I radium = 2.22 x 108 disintegration per minute
NUCLEAR MODEL 1909
Sir Ernest Rutherford constructed the first nuclear model.
SIR NEIL BOHRS QUANTUM PHYSICS
he modified the Rutherford model and showed how atoms
emitted energy.

18.  ARE SELECTED THAT LOCALIZE IN SPECIFIC
ORGANS OR TISSUES
 Ex: GLUCOSE
 THE AMOUNT OF RADIOACTIVE TRACER
MATERIAL IS SELECTED CAREFULLY TO
PROVIDE THE LOWEST AMOUNT OF
RADIATION EXPOSURE

21. The atomic nucleus consists of
positively charged protons and neutral
neutrons.

30. Stable nuclides: –# neutrons ~= # protons (A ~= 2Z) when Z
is small –# neutrons > # protons when Z is large
•Unstable nuclides (radionuclides, radioactive atoms) –
Likely to undergo radioactive decay, which gives off energy
and results in a more stable nucleus

32. Nuclei can contain the same number of protons
but a different number of neutrons

33. Isobars: atoms with the same A but different Z –Different
elements –Eg. Carbon-11 and boron-11
Isotones: atoms with the same number of neutrons but
different A
Isomers: atoms with the same Z and A but with different
energy levels (produced after gamma decay)

34.  At certain ratios, atoms may be unstable, a process
known as spontaneous decay can occur as the atom
attempts to regain stability.
 Any nuclide with an atomic number greater
than 83 is radioactive

37. Binding energy per nucleon

38. Other particles are subatomic particles
1. BOSONS
• Photons
• Gluons
• Gravitons
1. LEPTONS
• Electrons
• Tau
• Muons
• Corresponding neutrinos
1. QUARKS
• Up strange
• Down top
• Charm bottom

40. •During beta decay, energy is released.
•However, it is found that most beta particles do not have
enough kinetic energy to account for all of the energy
released.
•The additional energy is carried away by a neutrino.
•The “flavor” is conserved as the neutrino is the anti-
electron neutrino

41.  ENERGY IS RELEASED IN VARIOUS
WAYS DURING THIS DECAY, OR
RETURN TO GROUND STATE
 RADIONUCLIDES DECAY BY THE
EMISSION OF ALPHA, BETA, AND
GAMMA RADIATION

43. r  
1.21015
mA1 3
mass
number

44. As nuclei get larger,
more neutrons are
required for stability.
The neutrons act like
glue without adding
more repulsive force.

45. Binding energy  Mass deficitc2
 mc2

48. Alpha decay: the nucleus emits a Helium-4 particle (alpha
particle) –Alpha decay occurs most often in massive nuclei
that have too large a proton to neutron ratio. Alpha radiation
reduces the ratio of protons to neutrons in the parent
nucleus, bringing it to a more stable configuration.
–mostly occurring for parent with Z > 82

49. Small amount of radioactive
material is present
Ionizes the air between the
plates of a capacitor
Allows air to conduct
electricity
Presence of Smoke Particles
changes the conductivity

50. Beta decay occurs when, in a nucleus with too many
protons or too many neutrons, one of the protons or
neutrons is transformed into the other.
•Mass number A does not change after decay, proton
number Z increases or decreases.
•Beta minus decay (or simply Beta decay): A neutron
changes into a proton, an electron (beta particle) and a
antineutrino

51. Also known as Beta Plus decay –A proton changes to a
neutron, a positron (positive electron), and a neutrino
–Mass number A does not change, proton number Z
reduces

52. The positron later annihilate a free electron, generate
two gamma photons in opposite directions
–The two photons each have energy 511 KeV, which is the
energy equivalent to the rest mass of an electron or
positron
–These gamma rays are used for medical imaging
(Positron Emission Tomography), detected using a
coincidence detection circuit

54. Gamma knife

55. Most of the time, many
radioactive reactions occurs
in a long series.
The sequential decay of
one nucleus afteranother
is called a radioactive
decay series

56. A nucleus (which is unstable) changes from a higher
energy state to a lower energy state through the
emission of electromagnetic radiation (photons) (called
gamma rays).
The daughter and parent atoms are isomers. –The
gamma photon is used in Single photon emission
computed tomography (SPECT)
Gamma rays have the same property as X-rays, but are
generated different:
–X-ray through energetic electron interactions
–Gamma-ray through isometric transition in nucleus

58.  DESCRIBES THE TIME IT TAKES FOR A
PARTICULAR RADIONUCLIDE TO DECAY TO ONE
HALF OF ITS ORIGINAL ACTIVITY
 HALF-LIVES OF MOST RADIONUCLIDES USED
IN NUCLEAR MEDICINE RANGE FROM
SEVERAL HOURS TO SEVERAL DAYS

59.  EXHIBITS NEARLY IDEAL
CHARACTERISTICISC FOR USE IN
NM
 SHORT PHYSICAL HALF-LIFE OF
6.04 HOURS
 PRODUCES LOW ENERGY,
GAMMA PHOTONS
99MTc

61. The half-life of a
radioactive decay is
the time in which ½
of the radioactive
nuclei disintegrate.

62. Most of the time, many radioactive reactions occurs
in a long series.
The sequential decay of one nucleus afteranother
is called a radioactive decay series

64.  NATURALLY OCCURRING RADIONUCLIDES HAVE
VERY LONG HALF-LIVES AND DELIVER HIGH
ABSORBED DOSE TO THE PATIENTS
 NM RADIONUCLIDES ARE MAN MADE

65.  Emit only gammaradiation.
 Emit gamma ray with the right energy
(120kev – 300kev ) toallowdetection bya
gammacamera.
 Have a shorthalf-life.
 Be cheap.
 Be readilyavailable.

66. Radionuclide Half-life Target
Technetium(99mTc) 6 hours
Salivary gland,thyroid,
bone, blood, liver,
lung, heart
Iodine(131I) 8 days Thyroid
Gallium(67Ga) 78 hours
Tumors and
inflammation

67.  Gammacamera is an electronicdevice used
in medical diagnosis for imaging the
distribution of radioactive compounds in
the tissues. (After the patient byinjection).
 In general: It is a device used for imaging in
nuclear medicine for imaging the gamma
rays emanating from the radioactive
compounds in thebody.

69. The parts that make up the gamma camera:
(1)collimator
In short, is likea filter, filter .. torrent knows rays so that it
passes only rays thatarealmost parallel with some
As shown in thispicture:
But if the use of the device without Collimator will be filming
thedesired part from all sides by the next scan on everyside, and
thereforewill not produceaclearoraccurate picture.

70. (2)Photomultiplier Tube: the machine reveals abigger
electrons produced by thecathode.
In the PhotomultiplierTube base there Anode, which in turn
attracts such a large group of electrons and converted to an
electrical pulse.

74.  Positron emission tomography, or PET, is a medical imaging
technologythatenables physicians toview how organ systems
of the body are functioning at a cellular level. PET is
unsurpassed asadefinitivediagnostictool because itcan help
the physician detectdisease (such as cancerand Alzheimer's),
determine appropriate treatment for that disease, and
efficiently track the body's responses to the treatment.
 It was developed in the mid 1970s and it was the first scanning
method togive functional informationabout the brain.

75.  Patients with conditions affecting thebrain.
 Heart.
 Certain types of Cancer.
 Alzheimer’s disease.
 Some neurological disorders.

76.  A single-photon emission computerized
tomography (SPECT) scan lets your doctor
analyze the function of some of your
internal organs. A SPECT scan is a type of
nuclear imaging test, which means it usesa
radioactive substance and a special camera
to create 3-Dpictures.

77.  Heart Imaging.
 Brain Imaging.
 TumorDetection.
 Bone Scan.

78. PET SPECT
Emits positrons Emits gammaradiation
Higher resolution Lower resolution
Costlier scanner Less capital intensivescanner
Limited half-life of
radiopharmaceuticals
Longer lived radioisotopes

80.  NEUROLOGIC:
 Diagnosestroke.
 Diagnose Alzheimer's
- demonstrate
changes.
 Disease inAIDS
dementia.
 ONCOLOGIC:
 Tumor localization -
tumorstaging.
 Identification of bone
pain due metastatic
cancer.

81.  RENAL:
 diagnoserenovascular.
 obstruction,
hypertension.
 detect renal
transplant.
 Rejection - renal
fonction.
 CARDIAC:
 select patients forartery
bypass orangioplasty.
 localize toxicity dueto
acute myocardial.
 chemotherapy
infarction.
 identify cardiacshunts.

82.  PULMONARY:
 Diagnose & quantify
pulmonary function.
 Emboli perfusion.
 Detectpulmonary.
 Complicationsof
AIDS.
 ORTHOPEDIC:
 Identify bonetrauma.
 Diagnose
osteomyelitis.
 Evaluatearthritic
changes .

83. Other commonapplications:
Diagnose and treat thyroidcancer.
Hyperthyroidism or metastatic
spread.
Detect acute GI &cholecystitis
bleeding.
Detect testicular torsion&
infections.

85. :Nuclear medicine radiologists:
also called nuclear radiologists, are physicians who
use radioactive materials, to diagnose and treat
disease.
:Nuclear Pharmacist:
once known as radiopharmacists , specialize in
preparing, dispensing and distributing
radiopharmaceuticals or radioactive drugs.

86. :Nuclear Medicine Physicist:
Nuclear medicine physicists work with nuclear
imaging instrumentation and radiation dosimetry.
:Nuclear Medicine Technologist:
A nuclear medicine technologist works closely with the
nuclear medicine radiologist. The technologist may
prepare and administer radiopharmaceuticals, perform
imaging procedures, enhance images utilizing a
computer and analyze biologic specimens.

88. Minimize the time youwill
minimize thedose.
Per- plan the
experiment/procedure to minimize
exposure time.

89.  Doubling thedistance from the source can reduce
your exposure intensity by25%.
 Use forceps, tongs, and trays to increaseyour
distance from the radiationsource.
 Move the item being worked on away fromthe
radiation area if possible.
 Know the radiation intensity where you perform
most of your work, and move to lower dose areas
during workdelays.

90.  Position shielding between yourself and thesource
of radiation at all permissible times. Take
advantage of permanent shielding (i.e. equipment
or existingstructures).
 Select appropriate shielding material duringthe
planning stages of theexperiment/procedure.
 Plexiglas, plywood and lead are effective in
shielding radiation exposure. Use theproper
shielding for the type of radioactivematerial
present.