Nuclear medicine physician

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Nuclear medicine physicians, also called

radiopharmaceuticals, for diagnosis and therapy. Nuclear medicine procedures are the major clinical applications of molecular imaging and molecular therapy.[3][4][5] In the United States, nuclear medicine physicians are certified by the American Board of Nuclear Medicine and the American Osteopathic Board of Nuclear Medicine
.

History

In 1896,

humans was performed by Herman Blumgart and Otto Yens.[7]

Some of the earliest applications of radioisotopes were therapy of hematologic malignancies and therapy of both benign and malignant thyroid disease. In the 1950s

Rosalyn Yalow
. Dr. Yalow was co-winner of the 1977 Nobel Prize in Physiology or Medicine (Dr. Berson had already died so was not eligible). Radioimmunoassay was used extensively in clinical medicine but more recently has been largely replaced by non-radioactive methods.

In 1950, human imaging of both

Society of Nuclear Medicine (SNM) was organized in Spokane, Washington (US),[10] and (1958) Hal Anger developed the gamma scintillation camera,[11]
which could image a whole region at the same time.

Initial introduction of radioisotopes into medicine required individuals to acquire of a considerable background information which was foreign to their medical training. Often a particular application drove the introduction of radioisotopes into a health care facility. As other applications developed the physician or group that had developed knowledge of and experience with radioisotopes usually provided the new service. Consequently, the radioisotope service found homes in several established specialties – commonly in radiology due to an interest in imaging, in pathology (clinical pathology) due to an interest in radioimmunoassay, and in endocrinology due to the early application of 131I to thyroid disease.[12]

Nuclear medicine became widespread and there was a need to develop a new specialty. In the United States, the American Board of Nuclear Medicine was formed in 1972.[13] At that time, the specialty include all of the uses of radioisotopes in medicine – radioimmunoassay, diagnostic imaging, and therapy. As use of and experience with radioisotopes became more widespread in medicine, radioimmunoassay generally transferred from nuclear medicine to clinical pathology. Today, nuclear medicine is based on the use of the tracer principle applied to diagnostic imaging and therapy.

Practice

Procedures

Instrumentation

  • Planar imaging
Most radionuclides give off
gamma-rays when they decay. A 2-dimensional image of the radionuclide distribution can be made with a gamma camera, often called an Anger scintillation camera after its inventor, Hal Anger
.
  • SPECT
    )
Multiple planar images taken from different angles around a patient can be reconstructed to form a stack of cross-sectional, tomographic images.
Some isotopes emit positrons (the anti-matter equivalent of an electron) when they decay. The positrons travel a short distance in tissue and then annihilate with an electron giving off two nearly back-to-back gamma rays. Positron emission tomography takes advantage of these back-to-back gamma rays to localize the distribution of the radioisotopes.
  • Combined molecular and anatomic imaging:
    PET/MRI
The advantage of nuclear medicine is that it provides molecular and physiologic information, but it is relatively poor at providing anatomic information and the resolution is relatively poor. In recent years, instruments have been developed which allow both radioisotope and anatomic imaging. Most widespread are PET/CT scanners combining PET and computed tomography. Increasingly common are SPECT/CT scanners. Instruments combining PET with magnetic resonance, PET/MRI, are starting to be used.
  • Non-imaging instrumentation
Non-imaging instruments are used for measuring
radiation safety
.

Training

In the United States, the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association Bureau of Osteopathic Specialists (AOABOS) accredit nuclear medicine residency programs, and the American Board of Nuclear Medicine (ABNM) and the American Osteopathic Board of Nuclear Medicine (AOBNM) certify nuclear medicine physicians. After completing medical school, a post-graduate clinical year is followed by three years of nuclear medicine residency. A common alternate path for physicians who have completed a radiology residency is a one-year residency in nuclear medicine, leading to sub-specialty certification by the American Board of Radiology. A less common path for physicians who have completed another residency is a two-year residency in nuclear medicine.[15]

Other professionals

Nuclear medicine procedures are performed by

Nursing support, especially in the hospital setting, is valuable, but may be shared with other services. Nuclear medicine is a technology embedded specialty depending upon a large number of non-physician professional, including medical physicists, health physicists, radiobiologists, radiochemists, and radiopharmacists
.

Residency trained nuclear medicine physicians have the most extensive training and highest level of certification, including all aspects of diagnosis and radionuclide therapy. However, current U.S. regulations do not prohibit other physicians from interpreting nuclear medicine studies and perform radionuclide therapy.

endocrinologists
treat hyperthyroidism and thyroid cancer with 131I. The mix of physicians rendering nuclear medicine services varies both between different countries and within a single country.

See also

References

  1. ^ PET/CT with contrast
  2. ^ Radiology (ACR), Radiological Society of North America (RSNA) and American College of. "Professions in Nuclear Medicine". Radiologyinfo.org. Retrieved 2023-10-23.
  3. ISBN 978-1-85233-972-2
  4. ^ National Atomic Museum
  5. PMID 10715020
  6. PMID 8829275
  7. PMID 12902429
  8. PMID 8829277
    .
  9. ^ A History of positron imaging
  10. PMID 8829279
  11. PMID 8829278
  12. PMID 8829276
  13. PMID 8829280
    .
  14. ^ PET center of excellence
  15. ^ ABNM brochure Archived 2007-07-01 at the Wayback Machine
  16. ^ nuclear medicine technologists

External links

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