Nuclear Medicine
Nuclear Medicine
Significant milestones relating to clinical research, medical diagnosis, and treatment in recent years have been witnessed primarily due to nuclear medicine. This revolution has weaved in critical aspects of diagnostic imaging using radioactive substances, therapeutic applications, and radiopharmaceutical production to support targeted therapy. Some of the techniques that apply radiotracers for diagnostic purposes within the medical field include Positron Emission Tomography (PET) scans used in oncology to stage cancers, Single Photon Emission Computed Tomography (SPECT) scans, hybrid imaging, and Octreotide scintigraphy. Nuclear medicine therapeutic applications include using radiolabeled monoclonal antibodies, radioactive iodine for treatment, and radiopeptides targeting neuroendocrine tumor cells. Essentially, this paper describes the type of radiation mainly exploited, patient preparation, advantages plus limitations relating to nuclear medicine, expounds on the kinds of diseases diagnosed or treated via nuclear medicine procedures, and evaluates the application of therapeutical techniques and radiopharmaceuticals.
First, gamma rays are the most used in nuclear medical procedures owing to their high-energy photon radiations. Basically, a radioisotope utilized in diagnostics needs gamma rays emission possessing enough energy to enable penetration for them to leave the body (World Nuclear Association, 2023). The high energy of gamma emitters corresponds to a high frequency and a shorter wavelength desirable for in vivo application. The characteristic higher penetration is desirable for targeted therapy and diagnostic visualization. Notably, patient preparation for nuclear medicine procedures is essential to ensure accuracy and patient safety. According to Kasalak et al. (2020), most safety incidents witnessed in nuclear medicine occur with IV drugs, during administration, and with clinical procedures. As such, a comprehensive medication review should be the first preparation. All current medications must be documented to prevent drug interactions. Again, the patient should be adequately hydrated before such procedures to help with the urinary elimination of radiotracers. Likewise, depending on the test, the patient needs advice on fasting and food intake.
Next, this novel medical practice has several advantages. Compared to other imaging modalities, nuclear medicine imaging techniques can identify and assess therapeutical response earlier, allowing for faster diagnosis and optimized treatment planning (Nuclear Medicine RCP Specialty of the Month, n.d.). Such functional physiological imaging captures abnormalities before anatomical changes, hence saving lives. Another advantage is the high sensitivity that enables organ function assessment. Both anatomical evaluation and physiological function assessment are possible with nuclear medicine (Goldenhart & Senthilkumaran, 2021). This benefit accords it great sensitivity to modifications in the structure or function of an organ. Additionally, techniques like PET scans allow whole-body imaging and are non-invasive. Reasonably, the therapeutic application of targeted radionuclides is an immense advantage of nuclear medicine.
Further, the limitations of nuclear medicine include exposure to radiation, specificity issues, and high initial setup costs. Patients receiving radiotherapy are sufficiently exposed to radiation via imaging procedures carried out prior to or during every session of therapy, as well as during simulation and portal evaluation (Mettler et al., 2020). Exposure to ionizing gamma radiation is a potential risk for developing secondary cancers. Despite the high sensitivity, radionuclides lack specificity as they may accumulate in inflammatory cells and infectious tissues, producing false positives. For example, due to absorption in both cancer cells and several normal cells, the radiopharmaceutical 67Ga-citrate’s specificity is overly compromised (Salmanoglu et al., 2018). Lastly, the high cost incurred when setting up PET scans and other nuclear medicine equipment hinders hospital organizations from developing such advancements, thus becoming a significant limitation to improved healthcare.
Nonetheless, PET scans, hybrid imaging, and Octreotide scintigraphy are well-appraised among healthcare givers. PET scans are particularly instrumental in early cancer detection, staging, and monitoring responses to treatment. It estimates tissue cells’ metabolic activity (Johns Hopkins Medicine, 2019). This aspect enables the accurate identification of anomalies within the body. Besides, it can facilitate whole-body imaging, cardiac imaging, and assessment of neurodisorders.
On the other hand, hybrid imaging effectively couples nuclear medicine techniques like PET and SPECT with computed tomography (CT) scans, precipitating an enhanced disease visualization and characterization ability. Similarly, radiolabeled octreotide can locate neuroendocrine tumors precisely. It is the gold standard for identifying neuroendocrine tumors (Eychenne et al., 2020). This evaluation is a result of its high efficacy and safety. Finally, other nuclear therapies using radiopharmaceuticals include using Iodine-131 for treating thyroid disorders, monoclonal antibodies labeled with radionuclides to treat lymphomas, Iodine-131 meta-iodobenzylguanidine (MIBG) therapy to target cancer cells in neuroblastoma, and the use of Strontium-89 and Samarium-153 to treat bone metastases.
In conclusion, the scientific and technical concepts of nuclear medicine have profoundly impacted healthcare by supporting early diagnosis of chronic diseases, enhancing precision treatment, and improving patient outcomes. Nuclear medicine therapies provide focused and efficient means of treating specific diseases while providing distinct molecular and functional imaging advantages. Effectively, patient preparation supports patient safety, assures the accuracy of nuclear medicine procedures, and maintains their usefulness in diagnosing and treating a wide range of medical disorders. Therefore, it is essential to spur intensive research to optimize patient care areas, explore safer radiopharmaceuticals, and broaden the uses of nuclear medicine treatments.
References
Eychenne, R., Bouvry, C., Bourgeois, M., Loyer, P., Benoist, E., & Lepareur, N. (2020). Overview of radiolabeled somatostatin analogs for cancer imaging and therapy. Molecules, 25(17), 4012. https://doi.org/10.3390/molecules25174012
Goldenhart, A.L., & Senthilkumaran, S. (2021). Nuclear medicine test. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK567749/
Johns Hopkins Medicine. (2019). Positron emission tomography (PET). John Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/positron-emission-tomography-pet
Kasalak, Ö., Yakar, D., Dierckx, R.A.J.O., & Kwee, T.C. (2020). Patient safety in nuclear medicine: Identification of key strategic areas for vigilance and improvement. Nuclear Medicine Communications, 41(11), 1111–1116. https://doi.org/10.1097/MNM.0000000000001262
Mettler, F.A., Mahesh, M., Bhargavan Chatfield, M., Chambers, C.E., Elee, G., Frush, D.P., Miller, L., Royal, H.D., Milano, M.T., Spelic, D.C., Ansari, A.J., Bolch, W.E., Guebert, G.M., Sherrier, R.H., Smith, J.M., & Vetter, R.J. (2020). Patient exposure from radiological and nuclear medicine procedures in the United States: Procedure volumes and effective dose for the period 2006–2016. Radiology, 295(2), 418–427. https://doi.org/10.1148/radiol.2020192256
Nuclear Medicine RCP Specialty of the Month. (n.d.). British Nuclear Medicine Society. Retrieved December 24, 2023, from https://www.bnms.org.uk/page/NuclearMedicineRCPSpecialtyoftheMonth
Salmanoglu, E., Kim, S., & Thakur, M.L. (2018). Currently available radiopharmaceuticals for imaging infection and the holy grail. Seminars in Nuclear Medicine, 48(2), 86–99. https://doi.org/10.1053/j.semnuclmed.2017.10.003
World Nuclear Association. (2023). Radioisotopes in medicine. World Nuclear Association. http://world-nuclear.org/information-library/non-power-nuclear-applications/radioisotopes-research/radioisotopes-in-medicine.aspx
