Nuclear Medicine is a medical specialty that uses safe, painless and cost effective techniques both to image the body and treat diseases. It involves the use of minute quantities of radioactive substances combines with pharmaceuticals to study the functioning of various organs and to some extent the structure of the anatomy. It is a procedure to gather medical information, that may be otherwise unavailable with the other existing modalities which may require surgery. This detection process allows to disease to be treated early in its course, leading to highly successful prognosis. In a Nuclear Medicine scan a very small amount of material or radiopharmaceuticals which is commonly called the/radiotracer (not the dye) is injected either through the IV route or orally or by inhalation into the body. They produce gamma ray emission from the target organ, which is subsequently scanned by a special type of camera called SPECT.
The other alternatives of utilizing these radioisotopes are called invitro technique commonly designated as Radioimmuno Assay. As per this method a patients blood /plasma is collected in a vial from which the serum is separated out and tracer antibody tagged with I-125 or cobalt-57 is added to estimate the particular level of hormone, some of the common day to day hormones are T3, T4, TSH, FreeT3, FreeT4, and thyroid antibodies for thyroid function test. Infertility hormones such as FSH, LH, Prolactin, Progesterone, Oestradiol(E2), Oestradiol(E3), Testosterone (Total & Free) tumor markers such as CEA, AFP, PSA, CEA-125, CA-15.3,CA-19.9 etc.
Dynamic Nuclear Medicine Scans
Invivo Nuclear Medicine scans are HMPAO Brain SPECT, static brain scan, thyroidscan. Lung perfuston / ventilation scan, stress MUGA with NG intervention for LVfunctons. Stress Thallium myocardial perfusion scan. Gated SPECT tetrofosmin mvocardial scan, static and dynamic liver scan. whole body bone scan. DTPA renogram to assess kidney function, DMSA cortisol renal scan, Gl bleeding detection scan, Hepathbiliary imaging scan, Ga-67 whole body scan and 1-131 MIBG scan etc., are also performed routinely.
- Whole body scan using 99mTc - MDP radioisotope shows physiological distribution of radiotracer throughout the skeletal system. No localized hot or cold area is seen which is suggestive of Normal Bone Scan.
- Stress Thallium Myocardial perfusion scan at stress as well as rest reveals uniform stress perfusion pattern in all the defined myocardial segment suggestive of uniform & normal blood flow through the coronary arteries without any evidence of Coronary Artery Disease.
- 99mTc tetrofosmin myocardial perfusion reveal dilated left ventricle wit multiple areas of stress perfusion defects involving anteroseptal & inferior segment of myocardium suggestive of absence blood supply through LAD &Right Coronary Artery with evidence of reperfusion with resting reinjection of 99mTc tetrofosmin involving whole of anteroseptal segment with the absence of reperfusion involving inferior segment that suggestive of viable myocardium involving anteroseptal & almost dead myocardium involving inferior segment
- (a-b). 99mTc DTPA dynamic renal scintigraphy reveal normal sized both kidneys with uniform cortical uptake. Good excretion by both kidneys .Individual relative functions are almost normal .No obstructive hold up pattern suggestive of normal status of both kidneys.
- 99mTc radiotracer thyroid scan reveals normal sized both lobs with uniform uptake pattern .Normal visualization of salivary glands activity suggestive of Normal Thyroid Scan.
- 99mTc radioisotopes static thyroid scan shows diffuse enlargement of both lobe of thyroid with increased uptake pattern .(13.6% in right lobe &13.6% in left lobe ). Non visualization of salivary glands activity suggestive Toxic Diffuse Goitre.
- (a) 99mTc Macro Aggregated Albumin radioisotopes lungs perfusion scintigram in various projection reveals multiple areas of perfusion defect involving both lobe of lungs region suggestive of bilateral embolism.
- (b) After administration of thromobolytic therapy the macro Aggregated Albumin radioisotopes lungs perfusion scintigram was repeated in the same patient reveals almost re-establishment of normal blood flow pattern in the form of reperfusion of both the segments of lungs region suggestive of successful Thromobolytic Therapy.
Dr. Rashmi Angadi is a Consultant and In charge of the dept. of Nuclear Medicine and PET-CT at KLES Dr Prabhakar Kore Hospital and MRC, Belagavi, Karnataka. She has gained extensive experience in the speciality of Nuclear Medicine with expertise across wide spectrum of various Nuclear Medicine services including Diagnostic Radionuclide applications in SPECT-CT and PET-CT molecular imaging in Nuclear Oncology, Cardiology, Neurology, Endocrinology, Nephrology etc and PET-CT guided Radiation Therapy Planning and as well in therapeutic radionuclide applications including thyroid disorders, neuroendocrine tumors, bone pain palliation, radioembolisation procedures for hepatocellular cancer and liver metastasis.
Her areas of interest includes Nuclear Cardiology especially FDG PET imaging for myocardial viability, Nuclear Neurology with special attention towards Epilepsy, Nuclear Nephrology, and various other general Nuclear Medicine Procedures.
She completed her Post Graduate Degree in the speciality of Nuclear Medicine, Diplomate of National Board, New Delhi. She underwent her training at Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, a premier multi-speciality hospital accredited for Post Graduate Medical Courses (DNB) under National Board of Examinations.
She qualified the Radiation Safety Officer Examination, conducted by Atomic Energy Regulatory Board (AERB), Bhaba Atomic research Centre (BARC), Mumbai, India.
She received specialised training at AIIMS, New Delhi and PGI Chandigarh towards Radiolabelled Peptide Receptor Therapy for Neuroendocrine cancer, Lu-177 DOTA-NOC therapy, Y90 Synovectomy, Y90 theraspheres therapy and I-131 mIBG therapy etc.
She completed her M.B.B.S from Karnataka Institute of Medical Sciences, Hubballi, achieving five gold medals to her honour. She is trained in various fields of medicine for an overview of diseases and disorders, and hands on insight towards various treatments and management protocols for better vision and understanding in the field of diagnostics and therapeutic Imaging.
She has worked as a tutor in the department of community medicine at Belgaum Institute of Medical Sciences, Belagavi.
Society of Nuclear Medicine India (SNMI)
Association of Nuclear Medicine Physicians of India (ANMPI)
Research and publications:
Submitted a Dissertation titled “Assessment of Myocardial viability: Comparison of Tc-99m Sestamibi Myocardial Perfusion Scintigraphy and cardiac F-18 FDG PET CT”
Scientific Papers presentation at State and National Conferences:
- Paper titled “FDG PET CT in T cell lymphoma” at Annual Conference of Association of Nuclear Medicine Physicians of India, at Delhi.
- Case report titled “FDG PET CT in Neurolymphomatosis” at the Annual Conference of Southern Chapter, Society of Nuclear Medicine, India at Calicut.
Invited Talks / Lectures:
- As a speaker for the session “PET CT in Neurology”
Symposium on Nuclear Oncology and PET CT.
Apollo Hospitals Bangalore
- As a chairperson for the session “PET CT in Urogenital malignancies” CME on Uroradiology.
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Participant in following workshops:
- 17th annual conference of SNM(I)- southern chapter scientific programme at Thirupathi.
- 43rd annual conference of the society of nuclear medicine, India held at Chennai.
- CME on therapeutic applications of nuclear medicine at PGI Chandigarh.
- Poster presenetation on “FDG PET CT in T cell lymphoma” in ANMPI conference held at Delhi.
- Paper presentation on “FDG PET CT in Neurolymphomatosis” in Kozhikode, Kerala 18th annual conference of the southern chapter of SNM(I).
- 3rd hands-on-training in nuclear medicine therapy being conducted at AIIMS, Delhi.
- Physics practical session at Tata Memorial Hospital, Mumbai and Manipal, Karnataka.