Nuclear medicine diagnostic procedures

Scintigraphy is an imaging procedure used in nuclear medicine diagnostics to visualize metabolic activity in tissue or the function of organs. To produce the images (scintigrams), short-lived radioactively labeled substances (radiopharmaceuticals) are introduced into the body and accumulate in the tissue to be examined. A gamma camera is then used to measure and visualize the radiation emitted by the radiopharmaceuticals. The visualized progression between the uptake and excretion of the radioactive substance makes it possible to assess organ function.

Range of applications of scintigraphy

• Bone scintigraphy for the diagnosis of benign and malignant bone diseases
• Thyroid scintigraphy for the assessment of thyroid nodules and thyroid function as a supplement to laboratory tests
• Renal scintigraphy for the diagnosis of renal transport disorders
• Pulmonary scintigraphy to assess pulmonary blood flow (for surgical planning or to rule out pulmonary embolism)

Single photon emission computed tomography (SPECT) is a nuclear medicine imaging method similar to scintigraphy. In combination with computed tomography (CT), the anatomy of the examined organ can be examined in detail in addition to the function - this combination of information on the function (SPECT) and the anatomy and structure (CT) of the examined organ often enables better diagnostics. In addition, the image quality of SPECT can be significantly improved by combining SPECT and CT.

Range of applications of SPECT/CT

• SPECT/CT of the heart to assess the blood flow to the heart muscles. The CT examination can also be used to quantify calcification of the coronary arteries.
• SPECT/CT of the feet, knees and hips for the assessment and precise localization of bone changes

PET/CT combines two imaging examination methods: PET (positron emission tomography) and CT (computed tomography). It provides very precise and informative images of cell functions and structures.

PET provides a three-dimensional image of metabolic processes by showing the distribution of a radioactively labeled substance in the organism. PET scanners simultaneously record emitted gamma rays. The measuring system has a high spatial resolution and is arranged in a ring around the patient.
In PET/CT, a PET scanner is combined with a modern computer tomograph (in one device).

After intravenous administration of a low-radiation substance, its distribution in the body is monitored and examined. Cells with a more active metabolism - such as tumor cells - accumulate the radioactive substance more than healthy cells. As the radiation decays, they release more energy, which is measured precisely and becomes brightly visible in the coloured three-dimensional image. As radiation hits different structures in the body (air, soft tissue, bone), it is attenuated differently. This change is corrected by CT. It also enables precise anatomical classification of the PET findings.

Our department has had this state-of-the-art diagnostic procedure at its disposal since June 2007. PET/CT can significantly optimize treatment planning, and patients may even be spared further examinations and operations. Due to the extremely short half-life of the radiation and the low dosage of the radioactive substance, radiation exposure is very low. There are usually no side effects.

Range of applications of PET/CT

The most commonly used radiolabeled substance for PET/CT is glucose^{(18F-2-fluorodeoxyglucose}= FDG). PET after injection of FDG has established itself as a safe and sensitive method for in-depth clarification of most malignant tumors and other diseases. It is used in the fields of oncology, inflammation diagnostics, cardiology and neurology. The CT scan can be performed with or without contrast medium.

In certain cases, we use more suitable radioactively labeled substances for PET/CT, e.g. ^82Rb, ^68Ga-DOTATOC, ^68Ga-PSMA, ^{68Ga-exendin-4}, ^18F-choline, ^18F-FET, ^18F-DOPA, ^{18F-flutemetamol}, ^{18F-florbetaben}

Localization diagnostics

To diagnose tissue and functional changes, we use drugs that emit weak radioactive radiation for a short time (radiopharmaceuticals). We couple an energy emitter - usually a radioisotope with gamma (γ) or positron (β+) emission - to a suitable carrier and deliver the drug via the bloodstream, the food metabolism or the air we breathe to the body regions or organs that are to be examined.

Cameras for nuclear medicine imaging procedures (PET: Positron Emission Tomography or SPECT: Single Photon Emission Computed Tomography) are then used to examine the local distribution, excretion and accumulation of the radioactive compound. The resulting image shows the distribution and density of the energy emitters and can be used for diagnostic purposes.

Functional diagnostics

For functional diagnostics, short-lived, low-level radioactive drugs are delivered via the bloodstream, the food metabolism or the breath specifically to the region of the body whose metabolic properties are to be examined. The radiation from the drug is converted into a diagnostic image (scintigram) using a gamma camera, which shows the local and temporal distribution of the substance as well as certain metabolic products. Gamma emitters are mainly used, which penetrate the tissue easily but have a very short half-life.

We carry out various functional tests that enable a specific diagnosis of different diseases (e.g. blood volume, gastrointestinal transit, red blood cell life, xylose test).

Offer

• patient-specific portioning of commercial radiopharmaceuticals^{(18F radiopharmaceuticals}, Xofigo), colloidal formulations for radiosynoviorthesis, preparations for SIRT
• radioactive preparation of inactive kit formulations: ^{99mTc radiopharmaceuticals}(over 10 products), ^{111In-Octreoscan}, ^{111In/90Y-Zevalin}
• Production of diagnostic and therapeutic somatostatin analogs: ^{68Ga/177Lu-DOTATOC}
• Laboratory management of clinical studies in nuclear medicine, production of investigational medicinal products, determination of pharmacokinetics