Cardiac Applications:

	Coronary Artery Disease
	Measure Effectiveness of Bypass Surgery
	Measure Effectiveness of Therapy for Heart
	Failure
	Detect Heart Transplant Rejection
	Select Patients for Bypass or Angioplasty
	Identify Surgical Patients at High Risk for
	Heart Attacks
	Identify Right Heart Failure
	Measure Chemotherapy Cardiac Toxicity
	Evaluate Valvular Heart Disease
	Identify Shunts and Quantify Them
	Diagnose and Localize Acute Heart Attacks
	Before Enzyme Changes

Neurologic Applications:

	Stroke
	Alzheimer's Disease
	Demonstrate Changes in AIDS Dementia
	Evaluate Patients for Carotid Surgery
	Localize Seizure Foci
	Evaluate Post Concussion Syndrome
	Diagnose Multi-Infarct Dementia

Oncologic Applications:

	Tumor Localization
	Tumor Staging
	Identify Metastatic Sites
	Judge Response to Therapy
	Relieve Bone Pain Caused by Cancer

Orthopedic Applications:

	Identify Occult Bone Trauma (Sports Injuries)
	Diagnose Osteomyelitis
	Evaluate Arthritic Changes and Extent
	Localize Sites for Tumor Biopsy
	Measure Extent of Certain Tumors
	Identify Bone Infarcts in Sickle Cell Disease

Renal Applications:

	Detect Urinary Tract Obstruction
	Diagnose Renovascular Hypertension
	Measure Differential Renal Function
	Detect Renal Transplant Rejection
	Detect Pyelonephritis
	Detect Renal Scars

Pulmonary Applications:

	Diagnose Pulmonary Emboli
	Detect Pulmonary Complications of AIDS
	Quantify Lung Ventilation and Perfusion
	Detect Lung Transplant Rejection
	Detect Inhalation Injury in Burn Patients

Other Applications:

	Diagnose and Treat Hyperthyroidism
	(Graves' Disease)
	Detect Acute Cholecystitis
	Chronic Biliary Tract Disfunction
	Detect Acute Gastrointestinal Bleeding
	Detect Testicular Torsion
	Detect Occult Infections

Therapeutic Procedures

	Treatment of over-active thyroid
	Treatment of thyroid cancer
	Palliative treatment of bone pain caused by metastatic cancers
	Treatment of liver cancers
	Chronic inflammatory rheumatism
	Treatment of Non-Hodgkins lymphoma, Pheochromocytomas, etc.

Therapeutic Applications

In therapeutic nuclear medicine (radionuclide therapy), unique characteristics of radioactive materials (radioisotopes) are used for therapeutic irradiation of cells and/or organs. Typically, a small amount of a radiopharmaceutical* is introduced into the body by injection or ingestion. The radiopharmaceutical is attracted to particular organs or tissues. From their locations within the body, the radioisotope releases small amounts of energy (radiation) which will act on cells (target cells) and/or organs (target organs). This irradiation can be for the purpose of a curative treatment (for instance thyroid cancer), palliative treatment (for instance for bone pain) or to reduce an organ's function (for instance an over-active thyroid). Radiopharmaceuticals are molecules or chemicals that are attached to a small amount of radioactive isotope that once administered to the patient are able to specifically localize within organs and/or organ systems in health and disease. Radionuclide therapy is used by your doctor as part of your overall treatment. Some common types of radionuclide therapy are:
	Treatment of over-active thyroid
	Treatment of thyroid cancer
	Palliative treatment of bone pain caused by metastatic cancers
	Chronic inflammatory rheumatism
	Treatment of Non-Hodgkins lymphoma, pheochromocytomas, etc.
Benefits versus Risks
Benefits
	Radionuclide therapy is a non-invasive treatment and therefore less traumatic than surgery.
	It is a systemic treatment, which means that it targets sites which may not be known to exist by your doctor.
	The treatment normally consists of only one injection or oral dose. And you can normally leave the hospital directly after the procedure.
Risks
	The total radiation received from radionuclide therapy is generally so low that there is an insignificant risk that it will cause cancer in the future. Some less common procedures, for instance treatment of blood disorders are associated with some risks. How big the risk is and whether it is associated with the radionuclide therapy is still under debate by experts.
	Effects on the blood forming organs are usually short lasting and should be controlled by your doctor.
	Radionuclide therapy is not carried out on pregnant women.
	Allergic reactions to the radiopharmaceutical can occur, but are extremely rare.

Nuclear medicine is absolutely safe, like any medicine they are prepared with great care.
	Small amount of radiopharmaceuticals are introduced into the body
	Designed to enter specific place of disease in the body
	Gamma rays detected using a special camera
	Gamma camera allows physician to see inside body
	Images help in detecting patient's disease
During the imaging procedure, the patient is asked to lie down on a bed facing the gamma camera placed a few inches over the patient's body. Pictures are taken over the next few minutes and used for diagnosis. The risk of a reaction is 2-3 incidents per 100,000 injections of x-ray contrast media. Although exposure to the radioactivity in very large doses can be harmful, the radioactivity in radiopharmaceuticals is carefully selected by the nuclear medicine physician to be safe. Generally after the nuclear procedure, patients are advised to drink lot of fluids and urinate as frequently as they can as it helps to flush the remaining radioactivity out of the body.
Preparation for Nuclear Medicine Evaluation Prior to any kind of Nuclear medicine evaluation a written order is required. The procedure varies for each scan; patients are advised to follow specific instructions carefully. General advice on food, and specific instructions for Cardiac stress, Biliary, Renal, Gastric emptying and PET are given below:

Cardiac stress test (exam time: 5-6 hours)

Biliary Scan (exam time: two to six hours. Small babies may require delayed images to be taken after 24 hours)

Renal Scan (exam time: 45 min initially Delayed images may be
taken at intervals up to 6 or 24 hours)

Renal Scan with Captopril (exam time: 1-1.5 hours)

Gastric Emptying (exam time: 1-3 hours)

Positron Emission Tomography (PET) (exam time: three hours)

Food advice: