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Nuclear Medicine

tomography

Nature of the work

Nuclear medicine covers all applications of unsealed radioactive materials in diagnosis, therapy and research. The delivery of nuclear medicine in the UK is currently provided by physicians, radiologists and those dually accredited in radiology and nuclear medicine.

Working in nuclear medicine

Nuclear medicine deals with a range of pathology across all age ranges, but specific clinical practice involves major input in:

  • oncology
  • cardiology
  • nephro-urology
  • orthopaedics
  • rheumatology
  • neuropsychiatry.

Services are hospital based and are either integrated with other radiology facilities or comprise their own independent department. The range of diagnostic investigations has increased over recent years, with continuing radiopharmaceutical development and the wider availability of equipment like tomographic gamma cameras and positron emission tomography (PET) imaging systems.

Advances in drug radio-labelling and delivery systems have led to a parallel expansion in unsealed source therapy, extending the range of conditions that can be treated by this approach. This, together with the expanding role of nuclear cardiology studies in coronary heart disease, the rising importance of PET scans in cancer staging, and the delivery of sentinel node imaging in patients with breast cancer and melanoma, will have a major positive impact upon the importance of the specialty.

Common procedures / interventions

Nuclear physicians carry out enjoyably varied and complex procedures. Diagnostic procedures involve:

  • bone scintigraphy
  • stress and rest myocardial perfusion scintigraphy
  • radio-isotope renal imaging
  • lung scintigraphy
  • measurement of glomerular filtration rate
  • positron emission tomography.

Therapeutic procedures include:

  • radio-iodine treatment of thyrotoxicosis
  • radio-iodine treatment of thyroid cancer
  • palliation of bone metastases.

Associated sub specialties

Nuclear medicine can be combined with other sub specialties such as acute internal medicine and endocrinology. Sub-specialist areas also include:

  • nuclear cardiology
  • oncology
  • metabolic bone disease
  • paediatrics

Most nuclear medicine specialists also undertake radionuclide therapy.

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