Nuclear medicine includes nuclear physical procedures and radioactive substances whose use in medicine is in diagnostics. This also includes the open radionuclides. Radiation protection in connection with medical, biological and physical principles represents another chapter of nuclear medicine.
What is nuclear medicine?
Nuclear medicine includes nuclear physical procedures and radioactive substances whose use in medicine is in diagnostics. Likewise, radiation protection is another field of nuclear medicine. It is an extensive medical specialty that is divided into several sub-areas. Radioactive substances are used in this field. These include radioisotopes, biological substances, radiopharmaceuticals and other substances. In addition, there is the functional and localization technology in this area. Furthermore, open radionuclides fall within the scope of nuclear medicine and are used in therapy, such as radioiodine therapy. The field is completed by radiation protection, which is defined by medical, biological and physical principles. Within this area, the application of further knowledge such as pathogenesis, symptomatology of diseases and etiology takes place. Furthermore, within nuclear medicine, diagnostic treatment planning is performed in conjunction with dose calculation and radiation protection.
Function, effect, and goals
Nuclear medicine treatment is performed by a radiation therapist. When therapy begins, the therapist applies radiopharmaceuticals to the organ or area of the body to be treated. Beta rays are emitted from the applied radiopharmaceuticals, although this form of radiation is not as harmful as gamma rays. Sometimes surfaces are painted, which must not come into contact with water during the time of treatment. One of the best-known treatments is radioiodine therapy, which is used in cases of hyperthyroidism or thyroid cancer. By means of a capsule containing the radioactively labeled iodide isotope iodine-131, treatment of the disease is carried out by the oral route. Due to the accumulation in the thyroid gland, malignant tissue can be released there as a result of radioactive radiation. In order to clarify the exact treatment, thyroid scintigraphy may be used beforehand. Another field of application is the treatment of inflammatory processes, such as rheumatism in the knee or shoulder joints. In this case, a doctor injects the radioactive isotope Yttrium-90 into the joints. Nuclear medicine is also used as a therapy for neuroendocrine tumors, also known as carcinoids. Physicians rely on the effect of the substances lutetium-177 or yttrium-90. Furthermore, non-Hodgkin’s lymphoma (NHL) is the focus of treatment with nuclear medicine. In this case, radioimmunotherapy is used. The basis of this treatment, in which Y-ibritumomab tiuxetan is used, is antibody therapy. Other areas of application also include myocardial scintigraphy, which is used to determine the presence of myocardial infarction scars or the blood supply to the heart muscle. This examination is usually performed in the form of a combined stress and redistribution scintigraphy. Predominantly, the bicycle ergometer is used to generate the load. Furthermore, nuclear medicine is used for bone scintigraphy. Here, the complete bone structure of people is examined for bone tumors as well as for carcinoma metastases. This procedure can also be used to find out whether inflammation is present in the joints or in the bones. It is also clarified whether complaints arise due to bone injuries or loosening of joint prostheses.
Risks, side effects and dangers
As a rule, hardly any side effects occur during the application of these procedures. This applies to examination as well as therapeutic procedures in the context of nuclear medicine. If side effects do occur, they may be local irritations. However, the occurrence of water retention or inflammation is also possible. However, side effects cannot be completely ruled out in cancer treatments. Ultimately, this depends on the dose of radiation and the severity of the cancer.Provided that only weakly radiating substances are used to treat the disease, the burden on the body will be low. The most important factor in this case is the half-life, which to a large extent is very short. Only a few hours after treatment, a large part of the radioactivity may already have decomposed, which is promoted by drinking a lot. A risk is also to be seen in the psychological factors that can arise due to the restricted daily schedule. Other side effects that can occur during treatment are fatigue, headaches and loss of appetite. In addition, the diagnosis of cancer is difficult to cope with. However, these are side effects that subside with the end of treatment. The severity of the symptoms also depends on the size of the tumor or the treatment area. However, late effects can occur, which include fatigue. It can happen that the resilience remains limited after the end of radiation. In this case, the development of so-called fatigue is likely to have occurred. This is a so-called exhaustion syndrome, which cannot be compared with normal fatigue. With targeted training, the body can be restored to greater efficiency. Today, it cannot be ruled out that among the patients to be treated are those with a defibrillator or a pacemaker. In this case, the treating physicians must help decide which form of treatment is possible for their patients. The individual situation of the patient must be taken into account in such treatment.
