1. Overview of Nuclear Technologies in Healthcare
Dr Harsh Mahajan, MD
Founder & Chief Radiologist, Mahajan Imaging
Chairman, Department of Nuclear Medicine & PET-CT, Sir Ganga Ram Hospital
Consultant, International Atomic Energy Agency, Vienna

2. NUCLEAR MEDICINE
Nuclear medicine is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear medicine, in a sense, is "radiology done inside out" or "endoradiology" because it records radiation emitting from within the body rather than radiation that is generated by external sources like X-rays.

3. Applications of Nuclear Medicine
Diagnostic
Nuclear Imaging
Imaging
In-Vitro Diagnostics - RIA
Therapeutic
Radiopharmaceuticals
Tumours
Thyroid
Synovectomy

4. RADIOTHERAPEUTICS/ RADIOTHERANOSTICS
Iodine Therapy
I-131 therapy for thyroid
Newer pharmaceuticals
Yi-90 resins (Sir Spheres)
Yi-90 glass microspheres (Theraspheres)
Prostate Cancer – Radium-223, Lutetium-177-anti-PSMA
Somatostatin Receptor Analogues for NETs

5. Nuclear Imaging enables us to see body “function”
Gamma Camera
Most common radiotracer is Tc-99
Gold standard for kidney structure and function
Gold standard for heart, brain and thyroid function
Other applications include in bone metastasis, PUO etc.

6. PET scanning has revolutionised diagnosis and staging of cancer
Positron Emmission Tomography (PET)
Involves injection of radiotracers, most commonly – f-18
Gold standard for cancer staging and response to treatment
Excellent for brain and heart functional disorders
Increasing use in PUO, TB etc.

7. Hybrid Imaging

8. FDG PET and PET-CT: Impact in Oncology
Impact on Management:
FDG PET: ~30% patients (range 10%-60%)
PET/CT: incremental impact on patient management: 10-20% patients, including
Planning radiation therapy
Guiding biopsies
Supplement to JNM;2001:42: May 2001, Guest editor: Sajiv S. Gambhir
Supplement to JNM;2004;45: January 2004, Guest editor: Johannes Czernin

9. Critical needs of the hour
Manpower Issues
Training
Need more nuclear medicine courses – both for physicians and paramedics
Need “bridge” courses for nuclear medicine physicians and radiologists given the acute shortage of both in India
Standardization
Need strong and practical standardized staffing guidelines for the nuclear medicine field to grow further

10. Critical needs of the hour
Availability and production of radio-isotopes
Production of more radiotracers in India: currently imported at very high prices and hence unaffordable for most of the population
Ease of obtaining licenses for producing and transporting radiotracers
Reduced duty and taxes on radiotracers, till we can make our own

11. Critical needs of the hour
Education about Radiation Safety
For Radiation Workers
Important to be aware of principles related to radiation exposure to patients (ALARA), patients relatives and themselves
For Patients
Need to be educated about risk-benefit of each investigation / treatment procedure and be informed accordingly – the benefit of getting proper treatment / diagnosis generally outweighs the radiation risk

12. Thank You