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Nuclear medicine

(Positron Emission Tomography )
nov 2007
Prepared by

■ Muhammad nasr Ahmed mosead

■ Wael bawady mostafa kamal
Nuclear medicine

■ Nuclear medicine is a subspecialty within
the field of radiology. It comprises
diagnostic examinations that result in
images of body anatomy and function. The
images are developed based on the
detection of energy emitted from a
radioactive substance given to the patient,
either intravenously or by mouth.
Nuclear medicine

■Nuclear medicine images can assist the
physician in diagnosing diseases.
■Tumors, infection and other disorders
can be detected by evaluating organ
Nuclear medicine
can be used to:
■ Analyze kidney function
■ Image blood flow and function of the heart
■ Scan lungs for respiratory and blood-flow problems
■ Identify blockage of the gallbladder
■ Evaluate bones for fracture, infection, arthritis or tumor
■ Determine the presence or spread of cancer
■ Identify bleeding into the bowel
■ Locate the presence of infection
■ Measure thyroid function to detect an overactive or underactive
examination preparation

■no special preparation is needed for a
nuclear medicine examination
■if the procedure involves evaluation of
the stomach, you may have to skip a
meal before the test.
■kidneys, you may need to drink plenty of
water before the test.
the equipment

■ you lie down on a scanning table. Consequently,
the only piece of equipment you may notice is the
specialized nuclear imaging camera

■ Itis enclosed in metallic housing designed to
facilitate imaging of specific parts of the body

■A nearby computer console, possibly in another
room, processes the data from the procedure.
How does the procedure work?

■ You are given a small dose of radioactive material,
usually intravenously but sometimes orally
■ a radiopharmaceutical agent or tracer, eventually
collects in the organ and gives off energy as
gamma rays.
■ The gamma camera detects the rays and works
with a computer to produce images and
measurements of organs and tissues
Procedure problems

■ Some minor discomfort during a nuclear medicine
procedure may arise from the intravenous injection
■ With some special studies, a catheter may be placed into
the bladder
■ Lying still on the examining table may be uncomfortable
for some patients

Finally, Most of the radioactivity passes out of your body in
urine or stool. The rest simply disappears through natural
loss of radioactivity over time.

■ Thefunctional information provided is unique and
currently unattainable by using other imaging

■ Nuclearmedicine is much less traumatic than
exploratory surgery, and allergic reaction to the
radiopharmaceutical material is extremely rare.

■ Because the doses of radiopharmaceutical administered
are very small, nuclear medicine procedures result in
exposure to a small dose of radiation . Nuclear medicine
has been used for more than five decades, and there are
no known long-term adverse effects from such low-dose
■ be sure to inform your physician if you are pregnant. In
general, exposure to radiation during pregnancy should
be kept to a minimum.
■ Rarely , Allergic reactions to the radiopharmaceutical can

■ Nuclear medicine procedures are time-consuming.
They involve administration of a
radiopharmaceutical, acquisition of images and
interpretation of the results .
■ It can take hours to days for the
radiopharmaceutical to accumulate in the part of
the body under study
■ Imaging can take up to three hours to perform
What is pet ?
■ The
name "PET" comes from Positron Emission
Tomography . This technique allows us to
measure organ function while the patient is
comfortable, conscious and alert

PET represents a new step forward in evaluating
function of internal organs and in diagnosing
malignant tumors. Unlike X-rays or a CT scan,
which show only structural details within the
body, PET excels at determining organ function.
■ comes from Positron Emission Tomography
■ gives us a picture of the brain at work.

■ We can now study the chemical process
involved in the working of healthy or diseased
human brains in a way previously impossible
PET instruments
The cyclotron
■ Cyclotrons accelerate charged particles
using a high-frequency, alternating voltage
(potential difference). A perpendicular
magnetic field causes the particles to spiral
almost in a circle so that they re-encounter
the accelerating voltage many times.
■ For PET and SPECT we use Cyclone-30
■ When the cyclotron principle is used to accelerated
electrons, it has been historically called a betatron
■ A moving charge in a cyclotron will move in a circular path under
the influence of a constant magnetic field. If the time to complete
one orbit is calculated:

■ it is found that the period is independent of the radius. Therefore if
a square wave is applied at angular frequency qB/m, the charge will
spiral outward, increasing in speed

■ When a square wave of angular frequency

■ is applied between the two sides of the magnetic poles, the charge
will be boosted again at just the right time to accelerate it across
the gap. Thus the constant cyclotron frequency can continue to
accelerate the charge
Cyclotron for PET

■ Itproduces a large quantity of protons (heavy
particles with an electrical positive charge) and
get them moving at an accelerated rate along a
circular orbit, inside a chamber controlled by
powerful alternating electromagnetic fields. Thus,
the particles gain energy and are smashed against
a target at nearly the speed of light. The atoms of
a substance placed in this target are transformed
by this bombardment into radioactive, unstable
isotopes, by means of a nuclear reaction.
radioactive isotopes for PET

Must be
1- capable of emitting positrons when they decay
2- have a short period of unstability, i.e, it wil take a
few minutes for any given atom of this isotope to
emit a positron and become a stable element. The
average measure of this instability is called half-
3- readily incorporated into an useful
radiopharmaceutical, by chemical synthesis
The most frequently used radioisotopes in PET are:

■ Carbon-11, with a half-life of 20 min
■ Nitrogen-13, with a half-life of 10 min
■ Oxygen-15, with a half-life of 2 min
■ Fluorine-18, with a half-life of 110 min
■ Thisis why most of the PET installations in
the world have the cyclotrons just by the
side of the PET machine. It is truly a race
against the clock, once the radioactive
isotope is produced, to synthesize the
radiopharmaceutical and get injected into
the patient, so the PET and the cyclotron
should be a few minutes away from each

■The positron is the antiparticle or the
antimatter counterpart of the electron.
The positron has an electric charge of
+1, a spin of 1/2, and the same mass
as an electron

■When a low-energy positron collides
with a low-energy electron,
annihilation occurs, resulting in the
production of two gamma ray
511 keV
+ -

511 keV
How does PET work?
• Typical Resolution of human full body scans about 10mm
• There exist other applications for PET technology outside human imaging
■The gamma rays leave the patient’s
body and are detected by the PET
scanner. The information is then fed
into a computer to be converted into
a complex picture of the patient’s
working brain.
The gamma camera

■ itis necessary to detect the gamma ray emissions
in order to attain the functional information. The
instrument used in Nuclear Medicine for the
detection of gamma rays is known as the Gamma
camera. The components making up the gamma
camera are the collimator, detector crystal,
photomultiplier tube array, position logic circuits,
and the data analysis computer ( electronics
component )
1. Camera Collimator

■ Thefirst object that an emitted gamma
photon encounters after exiting the body is
the collimator. The collimator is a pattern of
holes through gamma ray absorbing
material, usually lead or tungsten, that
allows the projection of the gamma ray
image onto the detector crystal.
2. Scintillation Detector

■ In order to detect the gamma photon we use
scintillation detectors. A Thallium-activated
Sodium Iodide [NaI(T1)] detector crystal is
generally used in Gamma cameras
■ A gamma ray photon interacts with the detector
by means of the Photoelectric Effect or Compton
Scattering with the iodide ions of the crystal. This
interaction causes the release of electrons which
in turn interact with the crystal lattice to produce
3. Photomultiplier Tubes
■ Therefore, photomultiplier tubes are attached to the back
of the crystal. At the face of a photomultipler tube (PMT)
is a photocathode which, when stimulated by light
photons, ejects electrons

■ The PMT is an instrument that detects and amplifies the
electrons that are produced by the photocathode. For
every 7 to 10 photons incident on the photocathode, only
one electron is generated. This electron from the cathode
is focused on a dynode which absorbs this electron and
re-emits many more electrons (usually 6 to 10)
■ These new electrons are focused on the next
dynode and the process is repeated over and over
in an array of dynodes. At the base of the
photomultiplier tube is an anode which attracts
the final large cluster of electrons and converts
them into an electrical pulse
4. Position Circuitry
■ receive the electrical impulses from the tubes in
the summing matrix circuit (SMC). This allows the
position circuits to determine where each
scintillation event occurred in the detector crystal

5. Data Analysis Computer
■ inorder to deal with the incoming projection data and
to process it into a readable image of the 3D spatial
distribution of activity within the patient
PET scanner

- inner diameter crystals
140 mm
- animal port 120 mm
20x4 PM's in a ring
axial shift for alternative
PM row
axial sensitive length
130 mm
Diagnostic methods
■ New radiopharmaceuticals based on positron
■ Radiopharmaceuticals with high specificity.
■ More advanced application programs which
improve both sensitivity and specificity of the
■ Improved performance of the gamma camera
■ Improved detection of positron emitters
■ More sophisticated methods for
reconstruction and correction of tomographic
■ Advanced electronic reporting systems.

■No! Nuclear medicine is an efficient
■diagnostic and therapeutic tool and
■is justified from a medical point of view.
■Muhammad ziyada

■Ahmed mosead

■Wael bawady

Mostafa kamal