When you walk into a hospital, you will know about internal medicine and surgery, and you will also know about laboratory and radiology, but when it comes to nuclear medicine, many people may not have heard of it. In fact, nuclear medicine has a history of more than 100 years.
Nuclear medicine is the science of nuclear technology applied in the field of medicine, and nuclear medicine department (formerly called isotope room, isotope department) is a department that uses modern nuclear technology to diagnose and treat diseases. The mention of nuclear technology may scare people, but in fact, nuclear medicine is the peaceful use of nuclear technology, mainly using a small amount of short half-life nuclides, and the radiation to the human body is very low. Nuclear medicine radiation is very safe for human body.
The most basic technology of nuclear medicine is radionuclide tracer technology, which provides an effective modern technological means for diagnosis and treatment of diseases, allowing in vivo imaging diagnosis, in vitro detection and diagnosis as well as nuclear therapy. Among them, the application of nuclear medicine imaging involves all organs of the whole body, and can be used for the examination of tumor, cardiovascular, neurological, respiratory, digestive, skeletal, endocrine, hematopoietic, genitourinary system and other diseases, diagnosing and evaluating diseases from functional and metabolic levels, which has wide application value in clinical practice.
However, due to the unbalanced development of nuclear medicine in China, nuclear medicine departments are mostly concentrated in large hospitals at provincial and municipal levels, and few small and medium-sized hospitals have nuclear medicine departments. With the popularization of nuclear medicine in the future, I believe you will come into contact with the word “nuclear medicine” more and more often.
Advanced imaging equipment PET/CT for health protection
There are two major imaging technologies in nuclear medicine, namely SPECT and PET imaging instruments.
SPECT: Single Photon Emission Computed Tomography (SPECT) is a conventional imaging instrument for nuclear medicine. Conventional CT focuses on evaluating the nature of diseases from structural changes, while SPECT focuses on evaluating the occurrence and development of diseases and clinical treatment efficacy from functional status, especially in the evaluation of kidney function, early diagnosis and prognosis evaluation of coronary heart disease, diagnosis and neurological function evaluation of brain diseases, and diagnosis and differential diagnosis of systemic skeletal diseases, etc., which have unique advantages and are widely used in clinical practice.
PET: It is a positron emission computed tomography imaging device. PET/CT is a large functional metabolic and molecular imaging diagnostic device combining PET and multi-row spiral CT, which has the examination functions of both PET and CT and provides accurate information on anatomical structure and functional and metabolic changes of lesions (such as malignant tumors) in one examination.
The diagnostic accuracy of PET/CT is significantly better than that of PET alone or multi-row CT, and the combination of PET and CT is truly complementary (1+1>2), which is an epoch-making milestone in the history of medical imaging diagnostic technology. PET/CT is one of the most advanced medical imaging technologies at the cellular-molecular level, and one of the most important high technologies in the international life sciences (brain function, gene and protein function imaging diagnosis) research and its clinical application.
It is one of the most advanced medical imaging diagnostic equipment in the world and one of the main symbols of high-tech medical diagnostic technology in developed countries today.
PET/CT can quantitatively and dynamically detect the changes of metabolic substances or drugs in human body outside the body, which becomes the best means to diagnose and guide the treatment of various malignant tumors, coronary heart diseases and brain diseases, and is mainly focused on three major fields in clinical medicine: malignant tumors, neurological system and cardiovascular system.
1.Application value in neurological diseases: PET/CT can be applied to the localization of epileptic lesions and assessment of surgical efficacy. The localization of epileptic lesions by PET/CT has a coincidence rate of over 90% with the traumatic cranial cortical EEG localization, providing a new non-invasive option for the localization of epileptic lesions; providing an effective means for the early diagnosis and differential diagnosis of various dementias, the extent of the disease and the assessment of the efficacy of the disease treatment; providing an effective means for the diagnosis and assessment of the efficacy of the disease treatment. It provides an effective tool for the early diagnosis and differential diagnosis of dementia, the extent of the disease, and the evaluation of the efficacy of treatment;
It also provides an effective tool for early diagnosis and differential diagnosis of dementia, evaluation of the extent of the disease and the efficacy of treatment. widely used.
2.Application in cardiovascular system: PET/CT technology is the golden indicator to determine whether the myocardium at the site of myocardial infarction is alive or not, and provides the most effective means to evaluate the feasibility of coronary artery bypass grafting and coronary artery endovenous angioplasty and their prognosis.
PET/CT can also provide cardiovascular functional metabolic information such as myocardial perfusion, metabolism and receptor alteration. Combined with CT coronary angiography, plaque nature and other anatomical information, it has important application value for the diagnosis, prognosis judgment and treatment decision of coronary heart disease, as well as for the diagnosis and disease course judgment of vascular inflammation, identification of atherosclerotic plaque nature and diagnosis of vulnerable plaque.
3.Application value in tumor: PET/CT is the “radar” for tumor detection. PET/CT imaging technology can display abnormal metabolic lesions and their anatomical structures in a multi-dimensional manner, which provides the most advanced modern means for early detection of tumors.
Especially for middle-aged and elderly people with high work pressure or tumor-prone people with family history of tumor, regular PET/CT examination can detect the tiny hidden cancer lesions in the body at an early stage and realize early detection, early diagnosis and early treatment of cancer.
PET/CT can perform whole-body imaging on patients. One PET/CT whole-body imaging can provide information on the presence or absence of metastases in various organs of the body, such as brain, lung, lymph nodes, liver, adrenal glands and bones, which is helpful for accurate clinical staging of various tumors, such as lung cancer, breast cancer, colon cancer, ovarian cancer and lymphoma.
PET/CT can identify tumor necrosis, fibrosis and residual or recurrence after chemotherapy, radiotherapy and surgery, and can detect the efficacy of tumor treatment (surgery, radiotherapy and chemotherapy) by observing the changes in the specific metabolism of cancer tissue before and after treatment to identify patients with tumor metastases. Through
PET/CT examination can further search for the primary lesion of tumor, which is helpful to guide or adjust the clinical treatment plan.
PET/CT can help radiation therapists to outline more reasonable biological target areas and help to develop accurate tumor radiotherapy plans.
”Nuclear missile” targeted therapy keeps you away from the disease
Nuclear Medicine Nuclide Therapy is the application of radionuclides with the same physical properties through various specific biological substances carrying radiopharmaceuticals or using the properties of special elements needed by the human body, which can gradually gather with the blood flow to the lesion of a specific target (similar to a missile), and then use the short-range rays emitted to kill the diseased cells to achieve the purpose of treating the disease.
At present, dozens of diseases have been treated by nuclear medicine nuclide, which has the characteristics of simple method, small radiation dose and good efficacy. It has obvious advantages in the treatment of targeted tumors, bone metastases, and hyperthyroidism.
Among them, radioactive 131 iodine treatment for hyperthyroidism (hyperthyroidism) is one of the earliest and most widely used targeted treatment methods in nuclear medicine in treatment. It takes advantage of the thyroid gland’s need for iodine, and after the administration of radioactive 131 iodine, the thyroid follicles are able to take up 131 iodine and use the rays emitted by 131 iodine to destroy part of the thyroid gland, reduce the synthesis of thyroid hormones, and achieve the purpose of controlling hyperthyroidism.
Generally, after taking 131 iodine, the effect can appear in 3 to 4 weeks; then the symptoms will be reduced month by month, the thyroid gland will shrink and the weight will increase; in 3 to 4 months, most patients can reach the normal level of thyroid function. The general efficiency of one treatment is more than 95%, the cure rate is about 79%, and the recurrence rate is only 1% to 4%.
Radioactive 131 iodine therapy is one of the most effective treatments for common hyperthyroidism. It has high cure rate, low recurrence rate, short treatment course, simple method, no obvious side effects, and low treatment cost, and is especially suitable for patients with poor efficacy of anti-hyperthyroid drugs, recurrent relapse, allergy to anti-hyperthyroid drugs, impaired liver function in combination with hyperthyroidism, low white blood cells or platelets, and hyperthyroid heart disease.
For unmarried people, after 131 iodine has cured hyperthyroidism, they can still have children. This is because hyperthyroidism affects several systems and organs in the body, resulting in an imbalance in their functional status, among which the reproductive system is no exception, which can lead to irregular menstruation, reduced or irregular ovulation, or even non-ovulation. As a result, it can lead to infertility in women of childbearing age, or they may not be able to conceive easily or are unsuitable for pregnancy. On the contrary, after six months of 131 iodine treatment, the symptoms of hyperthyroidism are relieved or cured, and the biochemical indicators of thyroid function return to normal and pregnancy is possible and easy to conceive.
Since most of the 131 iodine is taken up by the thyroid gland, the radiation to the reproductive system such as ovaries is very low and decays and excreted quickly, and there is almost no radiation in the body after 3 months of treatment, so radioactive 131 iodine treatment for hyperthyroidism will not affect the reproductive system and it is very safe to get pregnant after 6 months of treatment.