Therapy In Nuclear Medicine

  1. What have we talked about and what should you already know?
    1. Therapy for hyperthyroidism
    2. Therapy for thyroid cancer
  1. Palliation of bone pain from painful bony metastases will be covered next semester
    1. 89Sr
    2. 153Sm
  1. Polycythemia Vera
    1. Is a chronic hematologic disorder in which the patient has a significant increase in erythrocytes, myeloid, megakaryocytic, and fibroblastic cells
    2. Elevated Hct level is not a specific indication for this disease. The over production of red cells can be best determined by an exam know as Red Cell Mass. This procedure will be discussed next semester
    3. Treat with 32P phosphate (Important! this is a clear solution)
      1. This pure beta emitter goes to RBC production sites (bone marrow) and destroys a certain amount of cells, reducing the bodies ability to produce RBCs
      2. A concern - destroying to many production sites
    4. Comments on the procedure
      1. Setup an IV and allow sterile saline to drip into the vein
      2. Make sure that the IV is clearly established in order to prevent subcutaneous infiltration of the dose which will cause a radiation burn
      3. 3-5 mCi of 32P phosphate is injected into the IV tubing (again note that it is a clear liquid)
      4. Patient is re-evaluated in 10-12 weeks
      5. If a second dose is required then no more than 6 mCi is administered during any 6 month interval
  1. Intracavitary therapy
    1. Used to control recurrent effusions in the pleural and peritoneal cavities caused by malignant disease
    2. By introducing a colloid tagged with beta radiation the macrophages engulf the particles and become radiated
    3. Material will also become involved with the lymphatic system
    4. Stage I and II ovarian carcoma may require this type of treatment
    5. 32P chromic phosphate is used for this study ((Important! the color of this solution is brownish-green)
    6. Procedure
      1. Using a sterile field the physician using a 1% lidocaine solution to anesthetize the point of entry
      2. Using a 19 gauge syringe the cavity is penetrated
      3. A three-way stopcock is used
      4. 1-3 mCi of 99mTc-sulfur colloid is injected and images are taken to determine if a pathway to the cavity has been established. In the abdomen, look for the "gutters"
      5. Once the pathway has been established 15 mCi of 32P chromic phosphate is injected

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      Intracavitary Therapy Procedure