Diagnostic
I. GAMMA CAMERAIMAGING (PLANAR and SPECT-CT)
GE-Infinia Hawkeye is a dual detector system combined with a four-slice CT, for faster acquisition, more versatility leading to increased diagnostic confidence. Provision of data fusion with CT images allows for better anatomical localization of tracer uptake, enabling more specific diagnosis.Tumour Imaging
- Whole Body Radioiodine Scan : For follow up of differentiated thyroid carcinoma
- 99m TcGHA/MIBI : For detection of residual/recurrence of brain parenchymal tumors
- 99m TcSestamibiScintimammography
- 1-131 MIBG Scan
- Sentinel Node Imaging
Cardiovascular Applications
- Stress/Rest Myocardial Perfusion Scan: For detection of myocardial ischemia & assessment of myocardial viability
- Resting MUGA Scan :For serial assessment of LV function in patients undergoing chemotherapy with cardio toxic drugs.
- PET Scan: For viability assessment
- SPECT (Single Photon Emission Computed Tomography) Thallium Scan
- Planar Thallium Scan
- Resting MUGA Scan
Renal And Genito-Urinary Application
- Renal Dtpa (Diethylene Triamine Pentaacetic Acid)Scan
- Renography for function and renal evaluation
- Diuresis renography for obstructive uropathy
- Captopril renogram for evaluation of renovascular hypertension
- Serial GFR quantification for patients undergoing chemotherapy with nephrotoxic drugs
- Renal Dmsa(Dimercapto Succinic Acid)/Gha (Glucoheptonic Acid) Scan
- Drcg (Direct Radionuclide Cystogram) Scan With Or Without Ufmt (Uroflowmetry)
- Captopril Renal Study
- Testicular Scan
- Transplant Evaluation
- Donor evaluation
- Post transplant evaluation
Bone Scan
- For whole body metastatic skeletal survey
- Growth and metabolic disorders like osteomalacia, hyperparathyroidism and Pagets disease.
Three Phase Bone Scan
- For assessment of active infective/inflammatory pathology.
- Vascular pathology like avascular necrosis, sickle cell disease, bone graft viability, reflex sympathetic dystrophy
- Early diagnosis of cases of trauma (fractures/soft tissue injury), sports injuries (shin splints/stress fractures)
Gastrointestinal Applications
- Colonic Transient Study
- Salivary Gland Study
- Gastric Emptying
- Ge-Reflux Study Gastric Emptying
- Oesophagial Motility Disorders
- Gastrointestinal Bleed Study
- Meckel’s Scan
- Liver Spleen Scan
- Hepatobiliary Scan
- For diagnosis of acute and chronic cholecystitis
- Diagnosis and follow up of biliary atresia
- Diagnosis of post operative complications like biliary leak, biliary strictures
- Quantification of gall bladder function
- Liver Transplant Evaluation
- Assessment of graft function and early detection of post transplantcomplications like leak (localization of site), obstruction, rejection.
Ventilation Perfusion Scans
- Diagnosis of pulmonary embolism
- Quantification of pulmonary function pre and post lobectomy/lung transplantation
- Quantification and assessment of ventilation and perfusion and parenchymal lung diseases (COPD, asthma, cystic fibrosis)
- Hepato-pulmonary shunt diagnosis in cirrhosis/ congenital heart diseases and other conditions
- Lung Ventilation Scan
- Lung Perfusion Scan
Brain Spect Study
- 99M TC ECD (EthyICystemnate Dimer) /HMPAO (Hexa Methyl Propyisne Amine O) Scan & Pet Scan
- Assessment of cerebral perfusion in:
- Early detection and differential diagnosis of dementia (Alzheimer’s, Parkinsonism, Picks Disease, Multi-infarct Dementia)
- Localization of epileptogenic focus in refractory epilepsy
- Early detection of cerebral ischemia in acute cerebrovascular disease
- Neuropsychiatric disorders
- Assessment of response to therapy (hyperbaric/drugs/psychotherapy)
- C.S.F Scan
Radionuclide Cysternography
To rule out normal pressure hydrocephalusEndocrine Applications
- Thyroid Scans
- Tc-99m Thyroid Scan
- Radioactive Iodine Uptake and Scan
- I-131 MIBG Scan
- Thyroid Perfusion
- Thyroid Uptake & Scan
- I-131 Whole Body Scan
- Parathyroid Scan
- Adrenal Gland Imaging:I-131 Mibg Scan
Infection Imaging
- WBC Scan
- For localization of occult infection
- For painful joint prostheses (differentiating aseptic loosening/infection)
- For PUO (Sarcoidosis/opportunistic infections like PneumocystitisCarinii in immune-compromised patients and malignancies)
- FDG Pet Scan
Miscillenious Scans
- Lymphoscintigraphy
II. PET SUITE – FIRST OF IT’S KIND IN WORLD
Nation’s first simultaneous PET MRI
- Acquires MR and PET data simultaneously.
- Reduces the radiation burden to the patient ,PET component is the only source of radiation.
- PET MRI is superior to PET CT for brain, breast, head & neck, prostate, colon, uterus hepatobiliary-pancreatic, bone & soft tissue, and childhood cancer.
Ultra HD time of flight PET CT
- 427 slice/second ultra HD PET-CT with time of flight technology.
- The facility is equipped with highly specialized 4D respiratory gating software on the high end PET-CT giving extremely valuable radiotherapy traetment planning data, which can be used by the radiotherapist to deliver highly precise radiation dose, synchornized with patients breathing pattern.
LIST OF TESTS AVAILABLE
F-18 Based Tests- Whole Body FDG PET CT
- Whole Body FDG PET MRI
- Brain – FDG PET MRI
- Brain – FET PET MRI
- Head and Neck FDG PET MRI
- Breast – FDG PET MRI
- Whole Abdomen FDG PET MRI
- Musclo Skeletal FDG PET MRI
- FDG Cancer Staging PET MRI
- FDG Whole Body Cancer Screening PET MRI
- Whole Body DOTA PET CT
- Whole Body PSMA PET CT
- Whole Body DOTA PET MRI
- Whole Body PSMA PET MRI
- Brain – DOTA PET MRI
Theranostics Nuclear Medicine
Theranostics Nuclear Medicine What is theranostics? Theranostics is the term for combination of therapeutics and diagnostics (using one radionuclide to image tumours and a second radionuclide to treat tumours by delivering cancer-killing radiation). Basically, it means targeting a single receptor molecule on cancer cells with two different radionuclides (imaging and therapy). This is to achieve a precise and personalized treatment strategy. The diagnostic phase of theranostics Tumour cells have a shell, called a membrane; there are certain proteins such as the somatostatin receptor (SSTR2) on the tumour cell membrane that can serve as a target for cancer drugs. Ga-68 DOTATOC is a radioactive diagnostic drug that targets SSTR2. Ga68 DOTATOC is injected into a patient’s vein and travels throughout the bloodstream to all organs and tissues of the body. If the patient has a neuroendocrine tumour with SSTR2 on the tumour cell membranes, the Ga-68 DOTATOC will bind to the SSTR2 and the tumour will light up on a PET scan.
The therapeutic phase of theranostics Once neuroendocrine cancer is diagnosed using Ga68- DOTATOC PET scan, the Ga-68 can be replaced with another radionuclide, such as lutetium-177 (Lu- 177) or yttrium-90 (Y-90), that can target and kill tumour cells that have SSTR2 on their membranes.
Therapeutic Y-90-DOTATOC and Lu-177-DOTATATE can both be injected into a patient’s veins and travel to any part of the body that has SSTR2 proteins. These therapeutic drugs bind to the SSTR2 proteins like a key in a lock, allowing the drug to enter the tumour cells and kill it by damaging that cell’s DNA. Healthy cells around the tumour that do not have SSTR2 proteins on their membrane are not affected by the drug. Such strategy allows oncologists to image treatable cancer tissues more completely, select patients for therapeutic applications, see precisely where therapeutic agents will be delivered, and monitor the ability of the therapeutic agent to shrink tumours over time. Theranostics provide oncologists with novel and highly effective tools to create precision treatment strategies and predict benefits of a particular treatment based on the patients unique molecular and genomic profile. THERANOSTICS: "SEEING WHAT WE TREAT TREATING WHAT WE SEE" This is also a called targeted radionuclide therapy as it is aimed at the particular molecular target of the functioning cancer cells. Therefore, a higher dose of radiation can be targeted at the tumour without affecting many normal healthy cells
How theranostics is different from traditional radiotherapy? Radiation therapy can be highly effective in treating cancer or alleviating symptoms in patients with untreatable advancedstage cancers. Approximately half of all cancer patients will receive radiation therapy at some point in their treatment, which uses externally or internally delivered x-rays, protons or other high energy particles to target and destroy cancer cells. While improved technological approaches have reduced healthy tissue deterioration, traditional radiotherapy still causes side effects that can be difficult for some patients to tolerate. In addition, traditional radiotherapy is unable to target more than one site of disease, limiting its utility for patients with metastatic cancer. However, traditional radiotherapy remains one of oncology’s most powerful treatment tools. This novel approach to tumour treatment, targeted radionuclide therapy, is reengineering the use of radiation treatments in precision oncology and delivering a new class of cancer therapies. The goal of targeted radionuclide therapy development is to combine alpha, beta or gamma-particle emitting isotopes or radionuclides with peptides, antibodies, or small molecules, to develop therapies with high specificity for certain types of tumours. Delivered to the patient intravenously, targeted radionuclide therapies are designed to travel directly to the tumour to deliver therapeutic radiation with high precision. This precision is intended to focus delivery of the radiation to the tumour tissue while minimizing radiation exposure to normal tissue. What type of cancer can be treated with theranostics? Theranostics can be effective in treating metastatic, inoperable tumours in the advanced stage of disease including prostate cancers and neuroendocrine tumours of various organs like the stomach, pancreas, small & large intestines and lung. Last but not the least, post-operative ablation of residual thyroid remnant and treatment of metastatic thyroid cancer is also in the gamut of theranostics. The above cancers have sufficient evidence available currently that there is a definite benefit in using radionuclide therapy. However, many other cancers may also have a benefit when they express certain types of target receptors like fibroblast activation protein (FAP) and chemokine receptors (CXCR4), can be targeted with theranostics
Our Molecular and Targeted Radionuclide Theranostics include:
*PRRT for Neuroendocrine Tumours
- Lutetium -177 DOTATATE therapy
- Actinium – 225 DOTATATE therapy
- Yttrium – 90 DOTATATE therapy
*PRLT for Prostate Cancer
- Lutetium -177 PSMA therapy
- Actinium – 225 PSMA therapy
*TARE for Liver Cancer/Liver Mets
- Yttrium- 90 Microspheres therapy
- I-131 Radio-lodine therapy for Thyroid Cancers
- I-131 MIBG therapy for Pheochromocytoma & Neuroblastoma
- Lutetium EDTMP therapy for Bone Metastasis Multi-disciplinary tumour board approach Excellent experience from the past by the Nuclear medicine – Molecular Therapy Physicians team Increased progression free survival Well known reduction in Symptoms Minimum side effects Quick discharge Ray of Hope in advanced Cancers