Nuclear medicine studies combine radiology technology with the use of radioisotopes to help diagnose, manage and treat disease. Nuclear medicine uses tiny amounts of radioactive materials that are attracted to specific organs, bones or tissues, causing them to emit low doses of radiation. These rays are captured on specialized gamma SPECT (Single Photon Emission Computerized Tomography) or PET (Positron Emission Tomography) cameras that work with computers to produce images for radiologists to interpret. Nuclear imaging is particularly helpful in visualizing bone tumors and tracing blood flow to various parts of the body, diagnosing functional problems in organs, such as the thyroid and lungs.

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A bone scan is often ordered when a patient has bone pain. The exam can diagnose any subtle or hidden fractures that are often not seen in a routine x-ray.  If a patient has chronic foot pain, a bone scan will show if there is a stress fracture. The study is also used if bone cancer, bone infection, arthritis or other bone pain is present in a patient. A bone scan is also helpful in detecting bone abnormalities from Paget’s Disease, osteomalacia, fibrous dysplasia or avascular necrosis. It is also used to see if cancer has metastasized to the bone.

A gall bladder scan is done to evaluate how the gallbladder functions.  It is ordered when a patient complains of upper right quadrant abdominal pain or is jaundiced. Patients typically undergo an ultrasound initially to see if there are structural problems within the gallbladder. If the test is normal, a functional, hepatobiliary scan can provide a more in-depth study. The exam can determine if there is a blockage in the bile ducts that connect the liver to the gallbladder and small intestines. The test shows, through use of a gamma camera, how the radioactive agent moves through the liver, bile ducts, gallbladder and small intestines.

Thyroid Imaging
Thyroid imaging determines if a patient’s thyroid is working properly, diagnoses hyperthyroidism, reveals lumps or inflammation, shows if cancer treatment is working and if cancer has spread. The test is called a radioactive iodine uptake test (RAIU).  It evaluates the structure and the function of the thyroid, a gland that controls the body’s metabolism. An iodine agent, which collects in the thyroid, is injected into a vein or swallowed by the patient. The SPECT camera records the gamma rays or energy released from the iodine, measuring how much is absorbed into the gland. This helps determine the size, shape and location of the thyroid as well as the function of the gland. Whole-body thyroid scans are performed on patients who have been diagnosed with thyroid cancer.

Thyroid Therapy
Iodine therapy - radioiodine I-131- is used to treat hyperthyroidism, also called an overactive thyroid. The thyroid gland produces hormones that regulate the body’s metabolism.  When the gland becomes overactive, it releases too much of the hormones, increasing metabolism. Often patients who present with weight loss, an enlarged thyroid, fast heart rate, high blood pressure and intolerance for heat, are tested for hyperthyroidism.   

The iodine is swallowed by the patient, causing it to collect in the thyroid gland, where it begins to destroy the additional thyroid cells. In some cases, the treatment slows the thyroid to the proper levels, but in others it can lead to an under active thyroid, which needs additional medical treatment. Graves Disease, multinodular goiters, thyroid cancer and other conditions are also treated with radioiodine I-131.

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