Nuclear Medicine

With the technological advances followed in imaging and treatment of diseases, diseases and physiological events can now be viewed at the molecular level and individualized, targeted treatments are planned.

Nuclear Medicine examinations are easy examinations that do not cause trouble for the patient. Generally called scintigraphy examinations. These examinations provide detailed information about the structure and functions of the organs and are used in disease diagnosis, treatment guidance and patient follow-up.

According to the organ to be examined in scintigraphic examinations, compounds containing different radioactive materials are administered via a small dose of vascular access or, in some studies, orally. In scintigraphic examinations, the radiation dose received by the patient is not different from radiological examinations (such as chest radiography, Computed Tomography) and even lower. Examinations can be performed in children even in the newborn period. Examination is not performed in pregnant women except in rare cases. Imaging is usually done after a certain waiting period.

The waiting time varies between 15 minutes and 2 hours depending on the nature of the test. Imaging is done in a special system known as a gamma camera. This imaging system does not generate radiation, it records the gamma rays from the radioactive material previously given to the patient. The resulting functional images are evaluated by a physician specialized in Nuclear Medicine.

Radiation is readily available in nature, around us and in our home, and is also used in the field of health for diagnosis and treatment. Radiation will be used for your health in minimum doses in the examinations made in the nuclear medicine department.

Nuclear Medicine Department; Different imaging drugs (Radiopharmaceutical) and cameras with different characteristics (PET / CT, Gamma cameras, SPECT / CT…) are used to show the working status, anatomy, physiology and pathology of organs such as heart, kidney, lung, thyroid, liver and brain.

In many different diseases such as cancer, infection, vascular occlusion, metabolic disorders, kidney diseases, brain diseases, changes due to old age … Nuclear medicine examinations can collect information about the presence of the disease and its level, if present, and attempts are made to treat the disease in some diseases such as thyroid diseases.

Many diseases give symptoms at the molecular level before they give an anatomical image. In this way, early diagnosis of diseases and an increase in the success rate of treatment are provided.

Imaging Methods and Treatment Applications

The respiratory system

  • Lung Perfusion and Ventilation Perfusion Scintigraphy (Tc99m MAA)
  • Post-Operative FEV1 Account (Tc99m MAA)

Central Nervous System

  • Brain PET examination (18F-FDG)
  • Brain Perfusion examination (Tc99m HMPAO)
  • Investigation of Ventricular Shunt Opening (Tc99m DTPA)
  • Cisternography (Tc99m DTPA)

Cardiovascular System

  • Myocardial Perfusion Scintigraphy (Thallium201 or Tc99m MIBI imaging)
  • Myocardial PET (Myocardial viability examination with 18F-FDG)
  • Myocardial Sympathetic Innervation Scintigraphy (I123 or I131 MIBG)
  • Radionuclide Ventriculography (MUGA)

Skeletal System

  • Three Phase Bone Scintigraphy
  • Whole Body Bone Scintigraphy
  • Bone PET / BT (F18-NAF)
  • Arthroscintigraphy

Endocrine System

  • Thyroid scintigraphy
  • Thyroid scintigraphy
  • Dacryos cintigraphy

Gastrointestinal System

  • Determination of Gastrointestinal Bleeding Site (Tc99m RBC)
  • Gastroesophageal Reflux Scintigraphy
  • Meckel Diverticulum Scintigraphy
  • Gastric Emptying Time
  • Esophagus Transit Time
  • Salivary Gland Scintigraphy

Genitourinary System

  • Dynamic Kidney Scintigraphy (with DTPA or MAG3)
  • Static Kidney Scintigraphy (DMSA)
  • Dynamic Kidney Scintigraphy with ACE inhibitor (with DTPA or MAG3)
  • Testicular Scintigraphy
  • Vesicoureteral Reflux Scintigraphy (Direct and indirect)

Imaging for Infection

  • Marked Leukocyte Scintigraphy
  • Bone Marrow Scintigraphy with Nano colloid
  • Imaging Infection with the 18F-FDG

Nuclear Hematology

  • Spleen imaging (with denatured erythrocytes)
  • Hemangioma Imaging
  • Lymphoscintigraphy

Nuclear Oncology Treatments

  • Iodine 131 Treatment (low dose and high dose therapy)
  • Neuroendocrine tumor treatment with Lutetium-177 DOTATATE
  • Prostate cancer treatment with lutetium-177 PSMA
  • Prostate cancer treatment with Radium 223 (Xofigo)
  • Radionuclide Therapy, Samarium-153
  • Radionuclide Therapy, Strontium-89
  • Radionuclide Therapy, Rhenium-186
  • Y90 Microsphere Therapy
  • Radio synovectomy

Nuclear Oncology

  • 18F-FDG PET / CT (Positron Emission Tomography)
  • 18F-NAF PET / BT
  • Ga-68 DOTATATE PET / BT
  • Ga-68 PSMA PET / BT
  • Intraoperative gamma probe (Tc99m colloid, I131 and 18F-FDG compatible)
  • Iodine 131 Screening
  • Breast scintigraphy
  • Sentinel Lymph Node Examination (anatomical mapping with SPECT / CT in breast cancer and malignant melanoma)
  • Penta DMSA (V-DMSA) (In medullary thyroid cancers)
  • Display I123 or I131 MIBG
  • PET / CT Imaging (with 18F-FDG or 18F-NAF)
  • Oncological Purpose PET / CT imaging (18F-FDG)
  • Ga-68 DOTATATE PET / BT
  • Ga-68 PSMA PET / BT
  • PET imaging for Heart Viability (18F-FDG)
  • PET imaging in Imaging Brain Diseases (18F-FDG)
  • Bone PET / CT imaging (18F-NAF)

Dacryoscintigraphy

PET / CT combines the information obtained by PET (Positron Emission Tomography) and CT (Computed Tomography) in a single device. In this way, anatomical imaging and functional imaging can be evaluated at the same time.

This advanced technology, which is used in diagnosis, staging and evaluation of treatment response, especially in patients with cancer or cancer suspicion, also provides vital information in non-cancerous diseases such as brain diseases (such as demas and epilepsy) and cardiac tissue viability.

Cancer cells are our own cells that grow uncontrollably. They need energy to grow, multiply and spread. They provide these needs in the body with simple sugar molecules. By replacing one atom of the sugar molecule with radioactive F18, the substance FDG (Fluoro-Deoxy-Glucose) is obtained. This substance is given to the patient in trace amounts. It is expected that the drug is dispersed in the body for about 1 hour. Shooting takes about 20 minutes. In patients who cannot be taken awake due to illness, age or personal condition, shooting is performed in the company of anesthesiologists.

In the Nuclear Medicine department, bone PET / CT scans are also applied with the F18 labeled NAF molecule. NAF molecule is a method that shows the spread of cancers in bone much more sensitive than bone scintigraphy. It is kept in bone structure in proportion to

bone blood supply and remodeling. Imaging times are similar to PET / CT examination with FDG.

The half-life of the radioactive F18 atom used in PET / CT examinations performed with FDG and NAF is 110 minutes, and the patient continues his/her normal life after extraction.

Thanks to TOF (Time of flight) technology, the trace amount of FDG given intravenously for shooting has decreased significantly compared to the old devices.

The drug used does not change any body function and can be used safely in all age groups, including kidney diseases.

With this imaging, cancer cells are investigated in your whole body and answers to the questions of the location of the disease, its prevalence, whether it has spread to other organs, and its character (benign or malignant?), Relapse of the disease, and whether the treatment is working is found. In addition, it directs the treatment by showing the location of the real tumor tissue in patients to be treated with radiation.

Cross-sectional and 3D images obtained are evaluated and reported by Nuclear Medicine physicians who are experts in their fields.

In patients who will receive radiation therapy (Radiotherapy), PET / CT images can be used by Radiotherapy Specialists to make patient-specific treatment planning.

Heart Scintigraphy

Basically, it is an imaging method that helps to understand whether the person has coronary artery disease (CAD) by evaluating the amount of blood reaching the heart muscle.

A radioactive drug containing a low amount of radiation for the film; At the end of the stress test (exercise or pharmacological), it will be injected intravenously. The radioactive drug reaches the coronary arteries through the blood stream and from there to the heart muscle. Then, with the help of a special camera, images showing how the radioactive material is distributed in your heart are obtained. Images are edited and evaluated with the help of a computer. The amount of radioactive drug increases or decreases in direct proportion to the amount of blood flowing to the heart muscle. Thus, information about the stenosis or occlusion in the coronary arteries is obtained by imaging the heart muscle supplied by the coronary arteries.