Nuclear Med

[Guest YongQ]

Just something I've been pondering, does anybody have any idea what Nuclear Medicine is, and how it differs from Radiology?

[Guest strider2004]

I believe it has more to do with treatment and some advanced imaging techniques. They do a lot of cancer treatment like mapping the tumour with CT imaging and then blasting it with radiation in the specific region. They might also do prostate tumour seeding but I guess the urologist could do that. This is where radioactive seeds are injected directly into the prostate.

 

PET(positron emission tomography) is often located NEAR the nuc med specialist in the hospital. PET involves injecting a radioactive dye into your body and seeing where it is picked up. Most metabolically active areas(such as tumours) pick up more dye. So it's basicaly like a bone scan but with more advanced imaging.

 

Radiology has many imaging modalities(x-ray, CT, MRI, ultrasound) but nuc med specialists deal more with radioactive decay and a few expensive machines do that. You also need a source for positrons so most PET and SPECT machines are in Vancouver or around Southern Ontario(or Quebec)

 

My undergrad was in biophysics so I know a bit about this stuff. At least I should, though I didn't do too well in the imaging course.

[Guest Ian Wong]

I believe the blasting of tumours is in the domain of the radiation oncologist, as is the new technology (brachytherapy) of implanting radioactive pellets into/near the tumour site to increase the local radiation exposure while minimizing harm to healthy tissue.

 

A diagnostic radiologist interprets all types of films (US, XR, CT, MR and their subtypes), and may do some small procedures like ultrasound-guided biopsies and such. Interventional radiologists go much further, and introduce catheters into large arteries and then thread them to where they need to go. For example, they (and interventional cardiologists) can stick a catheter into the femoral artery (at your groin) and run it into the coronary arteries to do arteriograms or angioplasties to either diagnose arterial occlusions or to dilate a clogged artery respectively.

 

The interventional rads guys will go even further up the body and insert catheters from the femoral artery all the way up into the cerebral circle of Willis (at your brainstem) to obliterate vascular aneurysms before they blow (and give you a stroke).

 

As far as I know, the nuclear medicine guys do stuff like radioactive iodide for diagnosing and treating thyroid nodules/cancer, do radioactive bone scans, and basically play around with radioactive isotopes to generate computer images. But I really don't know for sure. All's I know is that I'm not going to get taught it at UBC, and for this reason I'm unlikely to explore it as a career.

 

Ian

UBC, Med 3

[Guest JenniferLR]

I am the wife of a radiologist, and Ian got the basic duties of diagnostic and interventional radiologists correct, I believe. There is currently a great deal of new research being conducted in neuro interventional radiology (the field that interests my husband) in which tumors are directly fed chemotherapy drugs through the arteries of the brain. Diagnostic radiologists, since they don't have to do procedures, have the option increasingly of doing "teleradiology". They read the films on their home computers and never have to really go into work!

 

According to my husband, there are two paths to nuclear medicine (in the US at least): 1)do a residency in internal medicine and then a fellowship in nm or 2)do a residency in radiology and then a fellowship in nm. Nuclear Medicine physicians work with radioactively labeled molecules injected into different parts/systems of the body in order to take long exposure radioactive "pictures" to determine how different systems/parts of the body are functioning. I probably didn't explain it as well as he could, but that is the gist of it! I hope I helped!