Nuclear medicine is a medical specialty that involves the application of radioactive substances to help in the diagnosis or treatment of disease. It records radiation that emits from the body instead of using an external source that generates it, such as an x-ray machine, to help doctors determine what is happening with a person’s health. The emphasis is not on creating images of the anatomy, but the function of what is happening for some reason.
When undergoing a treatment process that involves nuclear medicine, a patient takes radiopharmaceuticals internally, either orally or intravenously. Then an external detector will form images from the radiation emitted from the medication taken. It forms a diagnostic product that is similar to an x-ray, but it gives a complete picture of what is happening to specific parts of the body.
The ability of nuclear metabolism to image disease processes from metabolism is unsurpassed with our current technology. It is not a unique process, so there are some techniques, like an fMRI, that can show metabolism and blood flow. When we evaluate the process and cons of nuclear medicine, we must balance the potential dangers of radioactive substances with the ability to detect health problems early so that an effective treatment plan can be developed for a patient.
List of the Advantages of Nuclear Medicine
1. Nuclear medicine provides functional and anatomic information.
Nuclear medicine tests provide information about the functionality of the body and patient anatomy that are unique to other procedures available to doctors today. It offers the most useful diagnostic information to determine the course of treatment for the individual. The detail levels of these scans are so profound that they can help medical providers to determine if a tumor is benign or malignant. It can determine if surgery is necessary, or if there are other treatment options available. This technology can even help to determine if a disease is present in the body before it starts to cause symptoms.
2. It is a useful tool for determining the status of cancer.
Not only does nuclear medicine provide information about whether a tumor is malignant or benign, but it can also let doctors know if a cancer has metastasized or returned after remission. The advanced imaging procedures that are possible with this technology make it possible to identify where the cancer cells are so that another treatment option becomes possible. This advantage eliminates the need for painful exploratory surgeries that didn’t always provide surgeons with the detailed feedback necessary to perform a diagnosis.
It can also analyze the function of your spleen and kidneys, scan lungs to determine if there are blood-flow or respiratory problems, and identify blockages that occur in the gallbladder. Patients that might have bleeding in their bowels can have this condition diagnosed with this equipment as well.
3. This technology can provide answers for unclear or abnormal lab results.
Nuclear medicine gives doctors another option to consider for patients who receive unclear or abnormal lab results regarding their bone health. A three-phase scan, used in conjunction with -rays and computed tomography or MRIs, can evaluate the source of bone pain for a patient. It has the ability to detect cancer in the bones if it is present. Older patients use this advantage because it can help to find shrouded fractures that can occur because of osteoporosis.
There are several common procedures that use radioisotopes under regulation, including gamma knife, portable imaging devices for podiatrists and dentists, bone mineral analysis, and brachytherapy. Nuclear medicine does not include x-rays or MRIs, even though the procedures are often grouped together. Mammograms are not part of this pros and cons debate either.
4. Nuclear medicine has the ability to help the heart.
There are times when a patient will receive a routine stress test only to find that the results are less than telling. A cardiologist will then order a nuclear-based test if you experience symptoms like chest pain or shortness of breath without an obvious cause. This testing method is extremely effective at diagnosing coronary artery disease, which develops over time as plaque and cholesterol build-up to block the supply of blood, nutrients, and oxygen to the heart. It can cause some side effects that are unpleasant, but the results are often worth the discomfort that the tests can create.
5. The amount of radiation distributed to patients in this procedure is minimal.
When you receive a nuclear medicine procedure, then the amount of radiation exposure you receive is about the same as what a routine x-ray would cause. It is a level that, for most people, is nothing to be concerned about in any way. There can be adverse issues for people who are elderly and children who receive frequent procedures, but it will not impact most patients in a negative way at all.
Before any type of procedure is used involving nuclear medicine, it must be justifiable to ensure that the benefits to the patient outweigh whatever risks may be present. That’s because too much exposure to radiation can damage tissues or organs.
6. The accuracy of the imaging leads to a more accurate diagnosis.
Nuclear medicine makes it easier to manage a complex diagnosis for a patient who may be suffering from several diseases or conditions simultaneously. It can also help surgeons perform complicated procedures with greater accuracy, including the option for remote or robotic surgery. This advantage makes it safer to conduct medicine because there is less need to be invasive with the diagnostic process. Every examination can occur using proven techniques that can highlight a person’s good health or a specific issue that requires= treatment.
7. Nuclear medicine provides a painless way to gather information.
Nuclear imaging is painless, safe, and often cost-effective. That’s why it is a popular choice when doctors need to gather information that may be unavailable or too risky to obtain when using other diagnostic tests. The extreme sensitivity it has to abnormalities in the structure or function of an organ makes it a useful way to collect data too. Since it offers the advantage of early detection, the clarity that doctors receive with this option can allow for a better prognosis in some circumstances.
The number of conditions that it can detect diagnostically included thyroid problems, blood imbalances, and various types of bone pain.
8. There are therapeutic benefits to consider.
Nuclear medicine offers doctors another option when developing a treatment plan because it can produce some therapeutic results. One of the most common reasons why this choice is selected for a patient is because they suffer from exceptional levels of bony pain that standard medications cannot keep under control. It is also useful in the treatment of thyroid cancer and issues with hyperthyroidism. Some blood disorders can stabilize when this option is available for use as well.
9. Most of the radioactivity will pass through the body.
The radiation dosages involved with nuclear medicine are carefully measured and handled so that everyone stays safe. Once you take the radiopharmaceuticals or tracers, then the particles that give off the gamma rays will eventually pass out of the body in the urine or your stool. Anything that remains afterward will typically disappear over time because of the natural loss of radioactivity.
List of the Disadvantages of Nuclear Medicine
1. It may offer adverse impacts on women who are pregnant or breastfeeding.
Many patients wonder if nuclear medicine is dangerous to their health. Although there is an exposure to radiation with the procedures in this category and there are dangers to consider with that element, the tracers use such a small amount that the potential benefits to the individual almost always outweigh the potential risks that someone encounters. The one exception here is for women who are pregnant or breastfeeding so that a doctor can determine if a specific test is safe for the baby.
2. There is a threat of severe allergic reactions with nuclear medicine.
Most of the side effects that people experience when using tracers or undergoing a treatment involve dizziness, abnormal heart rhythms, headaches, and a temporary dip in their blood pressure numbers. There are times when a rare allergic reaction may occur as well, happening as often as 1 in every 40,000 incidents. If you have a history of allergic reactions to medications or have experienced anaphylaxis shock in the past, then you will want to speak with your doctor about whether one of these procedures is useful for your health.
3. The cost of nuclear medicine is unmanageable without insurance or subsidies.
Most people cannot afford the cost of nuclear medicine unless they have health insurance that covers the procedure or subsidies from the government that reduces their obligation. An x-ray tends to be the most affordable option, but it is not unusual for it to cost more than $100 per image. If you require a CT scan, then the charges from the facility will often be more than $4,000. Additional procedures, such as an MRI, fit into this cost category as well even though they fall outside of the realm of nuclear medicine. If you have a high-deductible plan without an HSA, then you could experience this disadvantage as well.
The reason why nuclear medicine is so expensive is the assembly, operations, and maintenance of the equipment. Medical institutions can spend millions of dollars to bring in the equipment to use in the first place. They need to recover that expense in some way.
4. Nuclear medicine does not provide a 100% accuracy rate.
Medical procedures and diagnoses are more accurate thanks to nuclear medicine, but it is also not a perfect system. There can still be failures that occur because of the principle of individual variability. Each person has different biological processes that can impact how the imaging equipment detects the radioactive elements in the body. This disadvantage can be significant enough that it causes a misdiagnosis at times. If you have a severe disease or chronic health issues that this technology may not answer to your satisfaction, then you may want to consider obtaining a second opinion.
Even when the results are clear and accurate, it can take some time to interpret the information in the images thoroughly. Specialists might be called in to look at the data to determine if there are issues that require evaluation. Some diagnoses can happen quickly, but it could be several weeks before a complete answer becomes available.
5. There are specific preparations you must follow to be ready for a procedure.
If your doctor wants to use nuclear medicine to scan for inflammation, bone-related pain, lymphatic system issues, renal concerns, pulmonary health, or brain conditions, then there are no special preparations required for the procedure under most circumstances. If your condition falls outside of that window, then you may need to follow some specific instructions to ensure that the result of the imaging is reflective of your current health status. Here are the standard preparation orders that patients may need to follow.
Thyroid scans can require the stoppage of specific medications prior to the scan, which means a delay of 2-4 weeks may be necessary for some situations.
Cardiac exams require at least 4 hours of fasting before the procedure. If you are receiving a Persantine or stress test, then you cannot consume caffeine for at least 24 hours beforehand.
Any scans that involve the gastrointestinal system will require at least 4 hours of fasting, and there are some tests that may require pre-medication as part of the orders.
6. You must stay for the entire appointment.
Nuclear medicine is not a treatment option that you can suspend because you have a family or work emergency developing. You must stay for the entire appointment for the results to be useful, which means it could be a long-time commitment in some situations. Once you take the compound, it must collect in the organs to give off gamma rays. The imaging is often done the same day, but it could be a few hours to several days later for some patients. Then the amount of time varies to obtain the images needed to produce results, but it usually fits in a window between 20-45 minutes.
New technologies in the field of nuclear medicine have helped to substantially shorten the amount of time that is necessary for procedures, but this disadvantage has not gone away entirely as of yet.
7. You must remain still for nuclear medicine to be effective.
Computers will read the gamma rays that the nuclear medicine gives off through the tracers or radiopharmaceuticals to create an accurate image for a doctor to review. Patients must stay still while the equipment does its work, or the results may end up blurred. It can be challenging for some individuals to maintain complete stillness during this time, especially if they have a co-existing condition like attention-deficit hyperactivity disorder. The range in scanning times can be short, especially for a CAT scan, but you can take breaks for movement between procedures sometimes. Trying to stay still for 45 minutes might be impossible for others – making this a disadvantage that could become problematic.
8. Some patients may require a catheter in the bladder.
There are some special studies that nuclear medicine can complete that may require a catheter to be placed in the bladder. This process can often cause temporary discomfort that may last for some time after the tubing is removed. When you combine this disadvantage with the fact that a patient might need to lie still on an exam table for a lengthy time, it could be enough of an issue that a doctor may need to look for an alternative to ensure the information they obtain from the process is accurate.
Nuclear medicine gives doctors and patients more information to help them understand what may be happening with a disease. This impact of this technology is so positive that it can detect problems in some people before they even start to experience symptoms. Although it doesn’t provide many solutions to treat the problem, the imaging options that are available make it faster to reach a diagnosis compared to convention methods.
This process makes it possible to detect cancer, find Parkinson’s disease, and a variety of other conditions quickly and accurately.
The advantages and disadvantages of nuclear medicine show that one must go to a reputable physician to receive reliable results with this technology. Talk with your local radiologist or ask for a referral from your general practitioner to determine if your health could benefit from the various tests that are available today.
Natalie Regoli is a seasoned writer, who is also our editor-in-chief. If you have any questions about the content of this blog post, then please send our editor-in-chief a message here.