How Nuclear Medicine Is Advancing Diagnosis and Treatment Of Disease
Development and Innovation It has the sound of science fiction. Small amounts of radioactive material inserted into a patient to diagnose and determine the severity, or treat a variety of diseases.
It’s called nuclear medicine and its use is saving lives and improving the quality of life for those struggling with illness. You might also not know that Canada is a leading producer of the radioactive material, called a medical isotope, with about one-third of the world’s supply produced at Ontario’s Chalk River Laboratories.
“... but nuclear medicine is much more precise in telling us where the disease is at.”
“Nuclear medicine has been used for more than 50 years, and it’s a safe procedure with low radioactive exposure,” says Dr. Christopher O’Brien, President of the Ontario Association of Nuclear Medicine. “In fact, it’s less exposure than you’d get from an X-ray or CT scan.”
The medical isotope emits a small amount of energy after being inserted into the body, which is detected by a special camera, and with the assistance of a computer produces images that assess the function of organs and tissues. This non-invasive and painless procedure has revolutionized the way doctors diagnose and treat diseases.
How nuclear medicine is benefiting patient care
“A typical X-ray would show us the anatomy of an organ or other part of the body,” says O’Brien, “but nuclear medicine is much more precise in telling us where the disease is at.” This information is valuable to patients and doctors, so the illness can be properly treated.
Nuclear medicine is commonly used in the diagnosis of bone infections or fractures, cancers, heart disease, blood clots in the lungs, inflammatory bowel disease and Crohn’s, stroke and Alzheimer’s. Increasingly it’s being used for patients with lung disease, providing a better tool to detect and diagnose the disease early to prevent further lung deterioration and to individualize treatment for patients.
According to O’Brien, studies suggest that in 30 percent of cases, nuclear medicine is able to offer more appropriate diagnosis and treatment than what was originally thought.
Dr. Andrew Ross, Division Head, Nuclear Medicine at Halifax’s QEII Hospital and President of the Canadian Association of Nuclear Medicine says nuclear medicine is sort of like the Sherlock Holmes of medicine.
“We can see the subtleties really well,” he says. “A twisted ankle might look normal on an X-ray, but there may be small fractures that get overlooked, or patients with a history of breast or prostate cancer come to us with back pain. With a simple test we can solve the mystery, and determine if it’s structural pain, or if the cancer has spread.”
Ross adds that while less than 10 percent of diagnostic imaging uses nuclear medicine technology, it is indispensable for the difficult cases that a CT scan or X-ray can’t figure out. Additionally, given that it is non-invasive, it is safer than other procedures, because it doesn’t have the same kinds of potential side effects that other procedures have. It’s a better option, for example, than feeding a catheter into someone’s heart when assessing blood supply to the heart.
While nuclear medicine is effective at diagnosing disease, or bone and tissue damage, it can also be used to treat cancer and other medical conditions. If there is cancer in the liver, doctors can shoot tiny amounts of the radioactive material into the liver, shrinking the tumor and destroying the cells.
This technology allows doctors to assess if the treatment is working, and in some cases, it might mean patients wouldn’t require multiple sessions of chemo or hormone therapy. This is better for patients’ quality of life, and reduces the cost to the health system.
“With more accurate diagnosis and treatment we can prevent debilitating treatment or surgery that is not necessary.”
New advances lead to better treatment
There have been significant advances in the use of nuclear medicine. The medical isotopes are much more sophisticated, and the equipment and cameras used are much better. One of the biggest evolutions in recent years is the use of hybrid imaging, which combines the benefit of seeing the anatomy with a CT scan with a nuclear imaging camera. “This is tremendously helpful,” says Ross. “With more accurate diagnosis and treatment we can prevent debilitating treatment or surgery that is not necessary.”
The next breakthrough in nuclear medicine is finding applications for new medical isotopes, and expanding their use. One example, according to Ross is a new medical isotope approved for use in Europe and the U.S. that is more accurately diagnosing Alzheimer’s disease.
“The burden of this particular disease is rising, and it’s difficult to diagnoses,” he says. “This is an especially exciting time for nuclear medicine. New isotopes will lead to new clinical options by identifying the right patient with the right treatment, and absolutely this will improve treatment and save lives.”