Nuclear medicine combines chemistry, physics, mathematics, computer technology, and medicine in using radioactivity to diagnose and treat disease. Though there are many diagnostic techniques currently available, nuclear medicine uniquely provides information about both the structure and function of virtually every major organ system within the body. It is this ability to characterize and quantify physiologic function which separates nuclear medicine from other imaging modalities, such as x-ray. Nuclear medicine procedures are safe, they involve little or no patient discomfort and do not require the use of anesthesia.
Nuclear medicine is the medical discipline that uses radioactive materials to diagnose and treat disease. Scintigraphy, the use of radionuclides to produce images of the body's organs, differs from radiography (x-ray techniques) in that it studies the physiologic and metabolic processes of the body. In isotopic imaging, the source of radiation is a very small amount of radioactive material that is introduced into the patient by injection, inhalation, or ingestion. Combining a radioactive atom with a compound results in a radiopharmaceutical that will target a specific organ to provide anatomic and physiologic information.
During radioactive decay, the isotopes emit radiation, commonly gamma rays, which are detected by an externally placed instrument, a gamma camera or PET (positron emission tomography) scanner. The gamma rays produce scintillations within the detector that are transformed into images. Interpretation of the images by a nuclear medicine physician assists the clinician in a patient's diagnosis and treatment. Nuclear medicine procedures are non-invasive, safe, and effective. The amount of radiation received by the patient is very small and often less than a comparable x-ray procedure.
Nuclear medicine also incorporates in-vitro procedures using competitive binding and radioimmunoassay techniques for measurement of peptide hormones, drugs and other biological substances. Therapeutic uses of radioisotopes include treatment of hyperthyroidism, thyroid cancer, certain blood dycrasias and solid tumors and painful bone metastases.
The residency program in nuclear medicine trains qualified physicians to serve as consultants in the diagnostic and therapeutic use of radioactive pharmaceuticals. The total period of training after medical school graduation is at least four years. Residents are required to have one or more years of preparatory training and three or more years of nuclear medicine residency training in ACGME accredited programs. One year of preparatory training in any ACGME approved specialty training program usually precedes the training in nuclear medicine.
Diagnostic imaging consultation and the management of nuclear medicine facilities are emphasized during the three-year program but training also includes research experience, therapy with unsealed sources, radio-immunoassay techniques and tomographic imaging with single photon emission computed tomography (SPECT) or positron emission radioisotopes.
A minimum of eighteen months of clinical nuclear medicine is required. Training in allied health sciences such as medical nuclear physics, radiopharmaceutical chemistry, radiation biology, instrumentation and computer sciences is also included.
For those who have completed clinical training in other areas, click here to see the curernt American Board of Nuclear Medicine (ABNM) requirements for nuclear medicine certification.
Technologist training programs prepare students to be highly specialized healthcare professionals who work closely with nuclear medicine physicians, pharmacists, and physicists. Technologists are trained to prepare and administer radioactive chemical compounds, known as radiopharmaceuticals, perform patient imaging procedures using sophisticated radiation-detecting instrumentation, be proficient in computer processing and image enhancement, analyze biologic specimens in the laboratory, provide images, data analysis, and patient information to the physician for diagnostic interpretation.