SERVICES OVERVIEW

by | Sep 4, 2023

NUCLEAR MEDICINE

PROCEDURES

 

THERAGNOSTICS

TARGETED TUMOUR THERAPY

ADVANCED PROSTATE CANCER

NEUROENDOCRINE CANCER

THYROID CANCER

OTHER

 

THYROID CANCER THERAPY

AND IMAGING

Radioiodine has 3 main indications in the postoperative management of patients with thyroid cancer:

Ablation of residual thyroid tissue with 131-I,

Imaging for possible recurrent disease with 123-I or 131-I,

And treatment of residual or recurrent thyroid cancer with 131-I.

Chylothroax

 

TUMOUR DIAGNOSTIC IMAGING

Tc PSMA/ SESTAMIBI/ OCTREOTIDE/ MIBG

 

Tumour of Primary Unknown

Disease burden (Extend of tumour) with whole body imaging

Residual tumour activity post therapy

Recurrent tumour activity in the midst of post-surgical/ therapeutic changes

Determine sites of biopsy (most metabolic active site)

 

Benign

Sarcoidiosis

Idiopathic lung disease

Other

 

PARATHYRIOD AND INTRAOPERATIVE PROBE GUIDANCE

Localization of parathyroid adenomas

Localization of ectopic parathyroid adenomas

 

SENTINAL NODE LOCALIZATION AND MAPPING  AND INTRAOPERATIVE PROBE GUIDANCE

Breast cancer

Malignant melonomas

Penile Cancer

Cancer of the Cervix

Cancer of the prostate 

 

RENAL SCINTIGRAPHY

Tc 99m MAG3 / Tc 99m DTPA/ GFR

Differential Renal function (contribution of each kidney to global renal function)

Evaluation of obstructive nephropathy and obstructive uropathy associated with hydronephrosis or renal stones, malignancy etc

Evaluation of renal transplantation

Investigation of unknown origin of lumbar pain

Investigation of acute or chronic renal failure

Renal trauma

 

Tc 99m DMSA RENOGRAM

Assessment of parenchymal involvement in acute pyelonephritis

Assessment of renal infarction and scarring post infective or post vasculitis

Assessment of differential renal function and contribution of single kidney function toward global renal function.

Detection of congenital abnormalities: abnormal duplex kidneys, small kidneys, dysplastic kidneys, horseshoe kidney and pelvic kidney.

Distinguish pseudotumors/ benign space occupying lesions (e.g. prominent column of bertini) from tumours

 

CAPTOPRIL RENOGRAM

Determination of the presence of renovascular disorders as a cause of hypertension

Malignant hypertension

Hypertension difficult to control or resistant to medical therapy

Hypertension occurring at extremes of age

Deterioration of renal function during therapy with ACE inhibitors

Deteriorating renal function of no obvious cause

 

RADIONUCLIDE CYSTOGRAM

Direct/indirect

Assess active reflux of urine

 

LIVER AND SPLEEN

HEPATOBILIARY SCINTIGRAM (HIDA SCAN)

Suspected acalculous cholecystitis

Suspected chronic biliary tract disorders

Atresia of the biliary tree (Neonatal jaundice)

Enterogastric reflux

 

LIVER

Hepatic Hemangioma/s

Cirrhosis

SPLEEN

Assessment for splenunculus or residual splenic tissue post splenectomy

 

 

CEREBRAL PERFUSION IMAGING

Evaluation of patients with suspected dementia

Pre-surgical localization of epileptic foci

Determine brain death

 

RADIONUCLIDE CISTERNOGRAPHY

Investigating suspected communicating hydrocephalus (normal pressure hydrocephalus)

Detect the site and severity of a CSF fistula or leakage

To assess the patency of a shunt or pathway in surgical treatment of hydrocephalus

 

DACROSCINTIGRAPHY

Determine functional obstruction of lacrimal ducts

Causes include obstruction of the lacrimal excretion system, xerophthalmia, foreign bodies, and drug induced tear overproduction.

 

SALIVARY GLAND SCINTIGARPHY

Sensitive and valid method for evaluation of the function of the salivary glands.

Relatively safe, well tolerated and easy to perform, and enables an assessment of the function of all major salivary glands.

 

INFECTION/ INFAMMATION

Fever of unknown origin (FUO) for localization of the primary site of infection

Assessment of region/s for residual ongoing or occult infection

Assessment of severity and extent of infection

Assessment of response to therapy

 

SCINTIMAMOGRAPHY

Identifying multicentric, multifocal or bilateral breast cancer in patients with a diagnosis of breast cancer

Breast lump in patient with:

Dense breast

Previous breast biopsy

Previous lumpectomy

Previous radiotherapy in breasts

 

CARDIOVASCULAR SCINTIGRAPHY

MYOCARDIAL IMAGING

Diagnosis of coronary artery disease:

Presence, location (coronary territory) and severity

Assessment of the impact of coronary stenosis on regional perfusion

Distinguish viable hibernating myocardium from scar

Risk assessment and stratification

Post myocardial infarction

Pre-operative for major surgery in patients who may be at risk for coronary events

Monitor treatment effect

Monitor after coronary revascularization

Medical therapy for congestive heart failure or angina

Lifestyle modification

 

EQUILIBRIUM RADIONUCLIDE ANGIOCARDIOGRAPHY (ERNA / MUGA)

Determine global and regional measures of ventricular function (primarily LV function)

These measures of ventricular function may include evaluations of ventricular wall motion, ejection fraction (EF), and other parameters of systolic and diastolic function.

 

 

GASTROINTESINAL SYSTEM

GIT bleed

Meckels Diverticulum

Gastro-Oesophageal transit and reflux in children (Milk scan)

Gastric emptying and transit

Small and large bowel transit

 

TESTICULAR SCINTIGRAPHY

Useful to differentiate the cause of a swollen or painful testicle – distinguish acute testicular torsion from inflammation

<24 hours acute torsion

>24hours late/missed torsion

Epididymitis

 

LYMPHOSCINTIGRAPHY

Lymphoedema of the limbs

Lymphatic leakage

Lymphagiectasia

Chylous ascites

BONE SCNITIGRAPHY

Bone pain

Arthritis (serongetive/ seropositive)

Acute and chronic infections of the bone

Non-infective inflammation of the bone

Reflex sympathetic dystrophy syndrome (complex regional pain syndrome, CRPS)

Avascular necrosis or Perthe’s disease

Traumatic and Sports injuries of bone

Metabolic disease of bone

Benign and primary malignant bone tumours

Metastatic bone tumours

 

THYROID SCINTIGRAPHY

Determine the size of the thyroid gland

Differentiate forms of thyrotoxicosis (thyroiditis, factitious hyperthyroidism, Grave’s disease , toxic multinodular goitre and toxic adenoma)

Calculate specific doses for treatment of hyperthyroidism

Localization and characterization of thyroid nodules

Determine the function of thyroid nodules

Determine functional status of the thyroid gland

Evaluate presence of ectopic thyroid tissues, thyroglossal and substernal masses

 

V/Q SCAN (LUNG SCINTIGRAPHY)

ADULT:

Acute or Chronic  pulmonary embolism

Evaluation of lung function pre-operatively

Evaluation of alveolar capillary permeability after smoke inhalation injury

Evaluation of lung transplantation

Evaluation of patients with bronchitis or obstructive forms of chronic pulmonary disease

Venoscintigraphy to determine DVT

 

PAEDIATRIC:

Primary abnormalities of the lung and pulmonary vessels

Infective and post-infective lung damage

Evaluation of regional lung function with bronchiectasis

Evaluation of postoperative regional lung function

Cystic fibrosis

Foreign body inhalation

Detection and measurement of right-to-left shunts

Evaluation of aerosol deposition before administration of nebulised drugs