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Often referred to more simply in medical circles as nukes or nuke med, nuclear medicine is kind of a shift away from traditional radiology. So most traditional radiology techniques, CAT scan, ultrasound, MRI, uses an expensive machine to produce and recapture some kind of physical energy that takes a snapshot of the body’s internal anatomy. So basically we’re just looking at the anatomy inside your body. In nukes, however, we take a slightly different approach. We form a substance that’s a, say a normal chemical in your body, for example, glucose, the most basic fuel, sugar that your body uses for fuel. We then take that molecule and we make it radioactive. So in the case of glucose, we tag it chemically with a radioactive fluorine atom, and then inject it into the body. We wait for a little bit of time and let that glucose go wherever it wants to go and let your body do whatever it will do with it.
Since that glucose is radioactive, I can then use one of our nuclear medicine cameras, we have two different types, in this case, it would be a PET detector, to detect where all of that radioactive glucose has gone. Now, instead of just looking at the anatomy inside your body, I’m actually looking at the physiology inside your body. When I say that, I mean how your body is actually working, how it’s functioning, how efficiently is it burning that glucose, where is it burning that glucose the most? So nuclear medicine docs, in addition to their specific type of diagnostic exams, also do a limited set of radiation treatments. Because we are trained to prescribe and handle radioactive, biochemicals, sounds scary, this qualifies also us to administer non-external beam radiation treatments. So the external beam radiation, gamma knife, those types of things, are what you traditionally think of when you hear radiation therapy.
Those types of radiation therapy are given by a different type of doctor called the radiation oncologist. The type of unsealed source radiation treatments that nuclear medicine physicians like myself administer would be something like radium 223. We give that to end stage prostate cancer patients who have stopped responding to their medical therapy. These treatments can give much needed relief for extensive and longstanding severe bone pain. And in the case of radium 223, has actually been shown to extend the life expectancy of those patients. This is just one example, but there are a number of treatments like this. Radioactive antibodies that specifically seek out and kill lymphoma cells, radioactive iodine for the selective treatment of cancerous or even just overactive but non-cancerous thyroid tissue, and the future possibilities for nuclear medicine are endless. Nuclear medicine is probably the smallest and least common area in the radiology department that patients go. But it’s an extremely important niche that’s filled by your nuclear medicine physician.
