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Nuclear MedicineAnswering your questions

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Nuclear Medicine

Nuclear medicine1

What are the benets o nuclear

medicine?Nuclear Medicine uses sae levels o radiationrom radioactive tracers to provide inormation

about the unction o specic organs. In somecases, radioactivity can also be used to treat certainconditions such as an overactive thyroid.

Nuclear medicine enables doctors to produce aquick and accurate diagnosis or a wide range oconditions and diseases at any age. In turn, this

allows the appropriate treatment to begin as earlyas possible, providing a ar greater chance o beingully eective. In addition, the tests are painless andmost scans expose patients to only a minimumamount o radiation. It is a very accurate way toexamine whether some tissues are unctioningproperly.

Therapy using nuclear medicine is an eective andsae way o controlling and in some cases, eliminatingcertain conditions such as an overactive thyroid,thyroid cancer and certain types o arthritis. Nuclearmedicine is a vital part o modern healthcare as itprovides many people the opportunity to continue

living ull and healthy lives.

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Answering your questions

2Australian Nuclear Science and Technology Organisation

Is nuclear medicine sae?Nuclear medicine is very sae because the radioactivetracers or radiopharmaceuticals commonly used arequickly eliminated rom the body, through its naturalunctions. In addition, the tracers used rapidly losetheir radioactivity. In most cases, the dose o radiationnecessary or a scan is very small. For example, apatient having a lung scan is exposed to the samedose o radiation they would receive rom eight returnair fights between Sydney and London.

When is a nuclear medicine scanneeded?On average, one in two Australians will need anuclear medicine scan during his or her lietime.Scans using radiopharmaceuticals can diagnosenumerous conditions. Scans o the heart, thyroid,

lungs and kidney are common. However, by ar themajority o scans involve the skeleton. These areusually carried out to diagnose inection, tumourspread, and ractures or sports injuries.

Should I prepare or a scan?

Some scans may require special preparation. Aswith other tests, i you are pregnant or i there isany possibility that you may be pregnant or i youare breasteeding, you must tell your physician. It isimportant that you read all the material given to youprior to your appointment.

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Nuclear Medicine

Nuclear medicine3

What can I expect when I have

a scan?When you undergo a scan, a radiopharmaceutical will

be given, either by injection into a vein, by mouth or

through a breathing device. The radiopharmaceutical

will concentrate in the particular part o your body

under investigation.

Sometimes you may have to wait or a ew hours

or even a day or two ater the radiopharmaceutical

has been administered or the scan to be done.

This is because it may take a while or the

radiopharmaceutical to lodge in the

part o your body to be examined.

The radiopharmaceutical

continuously gives o invisible

radiation, known as gamma rays

that are recorded as images.

These images are stored digitally

on computer or reporting by

doctors who will be able to tell ithe part o your body being tested

is unctioning normally.

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Australian Nuclear Science and Technology Organisation 4

Are there dierent types o scans?

Yes, there is gamma camera imaging and positron

emission tomography (PET) imaging.

Gamma imaging operates in two dierent modes,PLANAR imaging and single photon emission

computed tomography (SPECT) imaging.

I your doctor reers you or a nuclear medicine scan,

one or more o the ollowing methods may be used:

PLANAR imaging

PLANAR is the most common o the three

methods. It involves the injection into the body o

a small amount o a chemical substance tagged

with a radioactive tracer. Depending on the

chemical substance used, the radiopharmaceutical

concentrates in the part o the body being

investigated, or example the skeleton, lungs,

heart or liver, and gives o gamma rays. A gamma

camera produces a two-dimensional image o the

radioactivity occurring in that organ.

SPECT imaging

SPECT is also widely used and the process oinjecting a radioactive tracer is the same as the

PLANAR technique. Instead o being stationary, the

gamma camera moves around the body providing a

series o images. This takes about 20-30 minutes.

SPECT and PLANAR imaging are highly convenient

technologies as they use radiopharmaceuticals,

which can be easily distributed, stored and mixed

ready or use at nuclear medicine clinics and

hospitals across Australia.

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Nuclear Medicine

Nuclear medicine5

PET imaging

PET is a very similar technique to SPECT but

uses dierent radiopharmaceuticals. The

radiopharmaceuticals required or PET have very

short hal-lives and are produced by a cyclotron.The most common radiopharmaceutical used is

radioactive sugar. PET studies require you to lie

quietly or up to one hour ater the injection so that

the radiopharmaceutical localises correctly rather than

going to your muscles.

Will I have to stay in hospital?Patients having a diagnostic scan will oten be asked

to stay in the nuclear medicine department or a ew

hours, although in some cases patients are asked to

return or a number o visits or to stay in hospital or

a short period.

I you are undergoing therapy, particularly or an

overactive thyroid gland, you will probably be treated

as an outpatient and will not need to stay in hospital.

I you do need to stay or certain types o therapy,

then you will usually only be in hospital or two or

three days. This is not because o any risk to your

health but because doctors want to ensure that

radioactive materials are dealt with saely when they

are excreted rom your body.

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What does nuclear medicine

treatment involve?

By ar the widest application o nuclear medicine

is or diagnosis. However, there are a number o

occasions when radioactive materials are used to

treat certain conditions, particularly cancer. This is

known as therapy.

Nuclear medicine therapy usually involves taking

radiopharmaceuticals orally (either in capsule or liquid

orm) and the most common conditions treated in

this way are overactive thyroids and thyroid cancer.

Radiopharmaceuticals are also injected into the body,

usually the joints, to treat certain types o arthritis.

Newer treatments involve the intravenous injection

o radiopharmaceuticals or the relie o pain rom

tumours that have spread to bone. In Australia many

patients are treated with radiopharmaceuticals thathave a medical eect on their bodies. For most, one

dose is all that is required.

Are there any side eects?

Side eects are extremely rare or diagnostic scans.

When radiation or radiopharmaceuticals are used intherapy, there are sometimes minor side eects.

These will be explained to you by the nuclear

medicine sta together with measures to reduce or

avoid the symptoms.

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Nuclear Medicine

Nuclear medicine7

Who carries out nuclear medicineprocedures?

I your doctor recommends you have a scan or

nuclear medicine treatment, you will be placed in

the care o a team o specially trained proessionals.

Physicians, technologists, pharmacists and nurses

will ensure that you receive a high level o care andthat your doctor is provided with accurate reports on

your condition.

What happens ater a scan or

therapy?

The specially trained physicians will report on the

scans appearance and send the results to your doctor

to evaluate, together with those o any other tests

you may have had. In the majority o cases, you will

be able to continue your daily activities as usual.

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Where are radiopharmaceuticalsproduced?

Australia is certainly a lucky country in the sense

that it is one o the very ew nations in the world

to produce the radioactive tracers necessary or

diagnostic nuclear medicine. In act, without the

ability to produce radiopharmaceuticals in Australia,we would have to import all o them rom as ar away

as Europe, Canada and South Arica.

Radiopharmaceuticals are manuactured in Sydney

by the Australian Nuclear Science and Technology

Organisation (ANSTO) using its nuclear research

reactor, OPAL.

Cyclotrons can also be used to produce dierent

types o Radiopharmaceuticals however the most

widely used, technetium-99m, can only be produced

using a nuclear research reactor.

The manuacturing process is regulated by strictquality-control requirements as approved by the

Australian Government.

The radiopharmaceuticals are supplied to nuclear

medicine centres across Australia. Every year

thousands o people are diagnosed and treated at

these centres. Without access to this vital technology,many Australians would be acing a reduced quality o

medical care.

Australia also exports radiopharmaceuticals to the

United States and Asia.

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Nuclear Medicine

Nuclear medicine9

Understanding radiation?

Radiation is a type o energy, which exists in our

environment in many orms and comes rom both

natural and man-made sources. Light that allows

us to see and the warmth we get rom the sun or

rom nature are natural orms o radiation. Examples

o man-made radiation include the microwave

radiation that is used or cooking and radio waves or

communication over long distances.

Ionising radiation comes rom both natural and

man-made sources. It comes rom outer space, the

sun, the earth, the air, our ood and drink and rom

the buildings we live in. This is the

natural background radiation to

which everyone is exposed. Each

o us receives a small dose o

naturally occurring radiation

on an annual basis. Nuclear

medicine studies use man-

made ionising radiation, asdo X-ray studies.

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The nucleus o an atom contains two types o

particles neutrons and protons. Non-radioactive

atoms have a stable ratio o neutrons and protons

in the nucleus, while radioactive atoms have an

unstable ratio. Radioactive atoms are made by

adding either extra neutrons or extra protons.

Atoms with extra neutrons in the nucleus are

neutron-rich; they are produced in a nuclear reactor

and these orm one group o isotopes that are used

as radiopharmaceuticals.

Over 80 per cent o the radioisotopes used in medicalprocedures, including the most commonly used

radiopharmaceutical technetium-99, can only be

produced commercially in a nuclear research reactor.

What is a hal-lie?

Nuclear medicines used or diagnosis or treatmentgenerally have short hal-lives. A hal-lie is the time it

takes or the level o radioactivity to drop to hal the

starting level. Nuclear medicines typically have a hal-

lie o several hours or days. This means they rapidly

lose their radioactivity level within the predetermined

hal-lie.

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Produced by ANSTO Health in Cooperation with the Australia andNew Zealand Society o Nuclear Medicine (ANZSNM) and the

Australia and New Zealand Association o Physicians in Nuclear

Medicine (ANZAPNM).

For urther inormation, please contact the nuclear medicine

department at your nearest hospital.

P i d M h 2012

ANSTO Health is a subsidiary o the Australian Nuclear

Science and Technology Organisation (ANSTO) which

is Australias centre o nuclear expertise specialising inthe applications o nuclear science.

ANSTO is based at Lucas Heights in southern Sydney;

it is a publicly owned organisation overseen by the

Federal Government.

Members o the public are welcome to visit ANSTO or

organised tours.

I you wish to nd out more about tours, to understand

how nuclear science improves the lives o Australians,

or to obtain urther inormation, please call ANSTO on

(02) 9717 3111.

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