Acıbadem Healthcare Group’s Nuclear Medicine Department deals with the use of radioactive materials in small quantities for the diagnosis and treatment of diseases and monitors the distribution of these materials in the body.
While radiology uses imaging to study anatomic details, nuclear medicine uses imaging to study organ functions to diagnose diseases.
Acıbadem Healthcare Group’s Nuclear Medicine Department can image infections, inflammations, cardiovascular system disorders, the skeletal system, thyroid, parathyroid, genitourinary system, pulmonary system, central nervous system, tumors, and intraoperative sentinel node biopsy procedures.
The Nuclear Medicine Department can also scan leukocyte-labeled whole-body scintigraphy.
PET is made with special camera, computer and nuclear medicine. Nuclear medicine uses “radiotracers” that contain a small amount of radioactive material during imaging examinations. They accumulate in tumors or areas of inflammation. Depending on the nature of the given radiotracers, they bind to target proteins in the body. This allows your doctor to detect the disease before it is seen on other imaging tests.
Although the tracer is mostly injected intravenously, it can be swallowed or inhaled, depending on the disease state to be examined. It accumulates in the studied area. A special camera detects gamma-ray emissions from the radio tracer. Camera and computer produce pictures and provide molecular information.
Thanks to the advanced technology used, PET can detect changes at the cellular level and detect the early onset of the disease before other imaging tests.
PET CT scans take detailed 3-D images of organs and structures in the body. The images clearly show the entire part of the body examined, intact and abnormal areas, and highlight how well the organs or tissues in the imaged area are functioning.
PET is often combined with CT scans to further refine the scans. This results in a PET CT scan.
A PET CT scan not only shows what the structures inside the body look like, but also shows how well certain parts of your body are working.
PET CT scan helps identify various conditions such as cancer, heart disease, brain disorders. The doctor uses this information to diagnose the disease, monitor its course or treat it.
PET CT scan is mostly used in diagnosis of cancer disease. In PET CT scan, cancer cells appear as brighter spots than normal cells, because their metabolic rate is higher than normal cells. PET CT scan may be useful in detecting cancer. Also, PET CT scan is used to determine whether the cancer has spread (metastasized) in the body and how well it responds to treatment. It helps to evaluate how well the specialist’s recommended treatment plan is working and, if necessary, to give an idea of how to intervene in treatment. Also PET CT Scan can determine if the cancer has returned after cancer treatment has ended, also it can be used to assess prognosis.
PET CT scan sometimes help plan operations such as coronary artery bypass grafting or brain surgery for epilepsy.
PET CT scan can evaluate tissue metabolism and viability. They can also be used to detect certain conditions that affect the normal functioning of the brain, such as dementia.
Computed tomography (CT) scans use X-rays. PET scans use a radioactive tracer to show how an organ is functioning at the cellular level. It is known that diseases usually start at the cellular level. Thus, a possible disease is detected at the earliest possible level. CT scans and MRIs cannot image at the cellular level.
CT shows detailed pictures of organs and tissues in your body, while PET CT scan finds abnormal activity in organs and tissues more precisely than other imaging tests. It can detect these abnormal activities earlier than other imaging methods. A PET scan and CT scan at the same time (PET CT) combination test produces 3D images that allow for a more accurate diagnosis. Because of this advantage, it uses PET CT scan to provide more information about the condition of the tissue or organ when the possibility of cancer arises.
Thanks to PET-CT scan, cancerous tissue is detected and an idea about its stage is obtained. In addition, during the diagnosis and treatment process, the doctor finds the right place for the biopsy, to follow up whether the treatment methods work throughout the process, It helps to control whether there is residual cancer tissue after treatment or to follow up the cancer development status, whether it is necessary for radiotherapy.
PET-CT scans are an outpatient procedure, meaning the patient can return home after the test is done. When scheduling a PET-CT scan, you will be told what to do. In order for the best scan results, the given instructions should be followed.
Arriving on time is important because the radiotracer used for scanning only works well for a short time. If it’s too late, the scan may need to be canceled.
Usually nothing should be eaten 6 hours before the scan, but the patient may drink water.
Any prescription, over-the-counter (OTC) or complementary drugs used should be reported to the doctor. It should be asked whether it is necessary to use drugs that are used continuously on the day of the test. In addition, chronic diseases such as diabetes need to be reported. In particular, diabetes can alter test results and the radioactive tracer can affect blood sugar. Nursing mothers or if they are likely to be pregnant should be reported. It is recommended not to breastfeed for 24 hours after the test, as it is considered to be risky for the baby.
Information should be given about any possible drug or food allergies, including allergic reactions to iodine.
Heavy exercises such as running, jogging and weightlifting should not be done 24 hours before the appointment.
For claustrophobia, the doctor should be consulted.
Loose, comfortable clothing without metal zippers or buttons should be worn. Any clothing and jewelry that may contain metal, such as belts, earrings, shirts with snaps or zippers, bras, and eyeglasses, affects scanning. It may be recommended to wear a hospital gown during the scan. For medical devices such as pacemakers and artificial hips, the doctor should be informed.
Since PET CT Scan, which enables us to obtain information at the cellular level, can detect cancer cells that have a higher metabolic rate than normal cells, they are mostly preferred for cancer screening.
PET scans are useful in detecting cancer, revealing whether the cancer has spread, checking whether a cancer treatment is working, giving an idea of which method the doctor should use during the treatment process, and finding cancer recurrence.
PET CT Scan images should be interpreted with care. In PET CT scans, sometimes non-cancerous images can be mistaken for cancer or cancerous foci can be missed. Accurate results can be obtained with an experienced team and a careful specialist.
Tumors that can be detected by PET-CT scanning are brain, breast, cervical, colorectal, esophageal, head and neck, lung, lymphatic system, pancreas, prostate, skin, and thyroid tumors.
Gallium 68 (Ga-68) is a nuclear medicine agent used for imaging prostate cancer and endocrine tumors (Gallium-PET) in the Nuclear Medicine Department. A 20-minute PET-CT scan is run after a Gallium-68 isotope has been intravenously administered to the patient and a 60-minute uptake phase has elapsed.
Ga-68 PSMA PET-CT is more successful than PSA, ultrasound, computed tomography, and MRI at staging and investigating relapses and metastases in patients with prostate carcinoma. Ga-68 Dotatate PET-CT is more efficient than classical imaging methods in patients with increased somatostatin receptor expression such as neuroendocrine tumors, meningiomas, pheochromocytoma, etc.
Gallium 68 PET CT offers high potential benefit in patients with moderate and high risk according to pathologic scoring and staging.
Relapses and metastases identified through Ga-68 PET-CT can be successfully treated with Lu-177 (lutetium), another radionuclide. This therapy may prolong survival and increase quality of life.
Lutetium 177 therapy is a treatment method developed for patients with neuroendocrine tumors and prostate cancer refractory to hormone therapy.
Lu-177 therapy targets only the cancerous zone. The literature indicates that Lu-77 peptide therapy contributes to longer survival, improved quality of life, alleviation of symptoms and biochemical marker improvement in patients with somatostatin receptor-positive neuroendocrine tumors. Lu-177 PSMA therapy offers an efficient response even in patients with metastatic castration-resistant prostate cancer after a majority of other treatment options have been used. This well-tolerated therapy has a manageable toxicity profile.
Since Lu-177 penetrates less than 2mm into the tissue, it is less nephrotoxic. This allows reduced bone marrow radiation exposure in patients with diffuse bone metastasis.
It has been demonstrated that Lu-177 PSMA therapy alleviates pain in the majority of patients with late-stage prostate cancer who complain of pain due to metastases.
PSA readings used to follow up on prostate cancer show a decline after treatment. Many studies show that it prolongs survival and increases quality of life for patients with advanced stage prostate cancer.
Lutetium therapy is administered in four to six cycles at two-to-four-month intervals. Interpatient variations affect the total number of cycles and inter-cycle intervals.
The iodine unit uses radioactive iodine therapy to manage thyroid cancer in Acıbadem Healthcare Group’s Nuclear Medicine Department.
The unit has two lead-coated patient rooms for the safety of patients and staff. The rooms are monitored by a nurse with a camera throughout the treatment session. Patients can call nurses and seek information whenever they want. Nurses visit the patient rooms at certain intervals for necessary checks. Other than the primary doctor and nurse, nobody is allowed in the patient rooms.