NUCLEAR MEDICINE

Nuclear radiation is used for

Diagnostic
Therapeutic
Diagnostic

Nuclear imaging
PET
SPECT

Therapeutic

Radiation therapy
What is Nuclear Imaging?
Nuclear imaging

Radioactive material is administered into the
patient

Photons emitted in the patients are detected
by a detector

Distribution of the radioactivity in the patient
body is reconstructed from projections
What is the need for Nuclear
Imaging ?


What is the need for Nuclear
Imaging ?

It gives.
Anatomical

Functional

Brain perfusion, function
Myocardial perfusion
Tumor detection (metastases)

Radio Isotopes
What are isotopes?
The elements having same atomic number but different atomic weights or
mass numbers

Types of isotopes
Stable isotopes --- not radioactive
Radio isotopes --- radioactive( radioactive decay or radioactive transformation)




Nucleus
of atom:
protons/
neutrons
EM
Energy
()
Sub atomic Particles
( o or | )
Electron shells
Nuclear stability
Neutron rich
unstable
element
Proton rich
unstable element
Definitions
Activity: The rate of radioactive decay per unit of time of radioactive
sample is named the activity of the sample.

Nuclear activity is measured in curie:
1 [Ci] = 3.7 10
10
decays/sec
(disintegrations/sec)

SI unit it is Becquerel [Bq]
1 [Bq]= 1 decay/second
(disintegrations/sec)

Activity
0
( )
t
N t N e

=
1/ 2
0.693
T

=
( )
( )
( ) ( )
0
t
dN t
A t N t A t A e
dt

= = =
Radioactive decay is described by

N (t) = N(0) e
-t
N(t) - number of radionuclide at
time.
N(0)- number of radionuclide at
t = 0
- decay constant [0.693/t]





Mean life period : It is the period of time
that it would take for all the atoms of
radionuclide to decay
Mean Life = 1/
Half Life period : It is the period of time
that it would take for one half of the atoms
of sample to decay

Half Life period should be short so as to
reduce radiation dose given to the
patient.
Radio activity
There are two types of radioactivity

1. Natural Radioactivity
Most naturally occurring radioactive isotopes are not
clinically useful (long T1/2).
2. Artificial Radioactivity
Artificial radioactive isotopes produced by bombarding
stable isotopes with high-energy photons or charged
particles
Nuclear reactors (n), charged particle accelerators
(Linacs, Cyclotrons)

( )
( )
( ) ( )
0
t
dN t
A t N t A t A e
dt

= = = ( )
( )
( ) ( )
0
t
dN t
A t N t A t A e
dt

= = =
( )
( )
( ) ( )
0
t
dN t
A t N t A t A e
dt

= = =
1/ 2
2.5d 99 99 T m
Mo Tc e v
=
+ +
1/ 2
2.5d 99 99 T m
Mo Tc e v
=
+ +
1/ 2
2.5d 99 99 T m
Mo Tc e v
=
+ +
1/ 2
2.5d 99 99 T m
Mo Tc e v
=
+ +
1/ 2
2.5d 99 99 T m
Mo Tc e v
=
+ +
1/ 2
2.5d 99 99 T m
Mo Tc e v
=
+ +
1/ 2
2.5d 99 99 T m
Mo Tc e v
=
+ +
Alpha Particles (o)

Large Particle = 2p + 2n (like Helium atom)
positively charged
Low speed
Less energy,
Non-penetrating
Range: short (mm in air and few microns in tissue)
not used for Nuclear Imaging
will ionize the matter through which it is passing
proposed of radiation therapy

Beta Particles ()

Small particle
Negatively charged e
-
(
-
)
Positively charged e
+
(
+
) - Positron

High speed
Can penetrate top skin layer
Range: Large (cm- m in air)
Tissue: few mm
Used for radiation therapy
Biological Hazards:
external and internal
Radio nuclides :
32
p- Liver,

Gamma radiation ()
High frequency Electromagnetic radiation
Photons/x-rays
Energy : 50Kev to 3Mev
Penetrating radiation
Range: Large (several meters in air and few cm in tissue)
Shielding: Lead, other metals
Biological Hazards:
external and internal
Used for both imaging and therapy
Fixed energy
For imaging 60 to 511Kev
Radionuclide :
51
Cr (Red blood cells),
131
Ba (intestinal),
131
I (Thyroid),
99m
Tc (Brain,Cardiac)

Positron emission (|
+
)
(annihilation process)
Positron emitters:


11 C , T1/2 = 20 min
many organic compounds (binding to nerve receptors, metabolic activity)

13 N , T1/2 = 10 min
NH3 (blood flow, regional myocardial perf.)

15 O , T1/2 = 2.1 min
CO2 (cerebral blood flow), O2 (myoc. O2 consumption), H2O (myoc. O2
consumption & blood perfusion)

18 F , T1/2 = 110 min
2-deoxy-2-[18F]-fluoroglucose (FDG, neurology, cardiology, oncology,
metabolic activity)
Selection of isotopes:

1)choose an isotope so that the resultant radiopharmaceutical is in the correct
chemical form which will allow it to be absorbed by the particular organ to be imaged.

2) the energy of radiation must be suitable to the detectors to be used. Optimum energy
range for gamma cameras is 100-300 keV. Efficiency drops beyond this range

3) T1/2 must not be too short, otherwise it will decay before the radiopharmaceutical can
be delivered. It must not be too long, otherwise the patient will be unnecessarily
exposed to ionization.

T1/2 (ideal) is a few hours.
Exception: Se is used for pancreas scanning. T1/2 is 120 days


4) radiation dose delivered to patient must be as low as possible

5) radiopharmaceutical must be available, it should be cheap.

The radionuclide that fulfills most of the above criteria is Technetium _ 99m (99m Tc),
which is used in more than 90% of all nuclear medicine studies.



Properties of
99m
Tc:

T
1/2
= 6 h
radiates 140 keV gamma ray
the short half time and absence of Beta emission allows low
radiation dose to patient.
The 140 keV gamma radiation allows for 50% penetration of
tissue at a thickness of 4.6 cm.

Applications:

99m
Tc-Sestamibi (myocardial perfusion, cancer)

99m
Tc-labeled hexamethyl-propyleneamine (brain perfusion)

Other gamma emitters:


123
I,
111
In,
67
Ga,
201
Tl,
81
Kr
m


Radiation Detectors
Gas Detectors
Scintillation Detectors
Semiconductor detectors
Depends upon the voltage applied, this gas
detectors gives different function
Ionization chambers(100v/cm)
Proportional Counter(100v/cm-1000v/cm)
GM Counter (above 1000v/cm)
Nuclear medicine scintillation
detector system.
Detector
Types of collimators
Field of view (FOV)
The area of the patients body that can be
imaged by a single view is named as Field of
View.
Common design is circular and hexagonal

Diverging
Converging
Parallel
Pin hole
Detector
Scintillation crystal




Light photons
High absorption efficiency
High conversion efficiency
High capturing efficiency

Crystals- NaI (TI), bismuth germanate, calcium fluoride

Detector
Positioning circuit
Nuclear medicine scintillation
detector system.
Need for pulse height Analyzer
NaI
Pulse Height Analyzer
Light flash producing different responses in the detecting
photomultipliers

This information is given to Positioning circuit (Capacitive
network or a resistive coupled network)

Gamma camera