| Procedures |
| Dual head variable angle e cam gamma camera with well-equipped hot lab. |
| Full fledged treadmill room. |
| Hand held battery operated gamma probe. |
Well equipped modern isolation wards for radioiodine treated. |
| Thyroid cancer patients |
| Procedures |
| Therapeutic Nuclear Medicine |
| 131 I Low Dose Therapy for Thyrotoxicosis – Radioiodine is a medically useful radioisotope, which is used as a permanent form of treatment for Graves Disease, Toxic Multinodular Goiter and autonomous toxic thyroid nodule. This Radioiodine is administerd orally to the patient and is an outpatient procedure. Please contact for details. |
| 131 I High Dose Therapy for Ca Thyroid : Patients with postoperative residual thyroid/functioning thyroid metastases need I-131 ablation therapy for which modern isolation wards have been inaugurated in November 2006. To administer radioiodine in treatment dosages it is mandatory to have this radioiodine ward facility with separate radio pharmacy lab and isolation rooms for patients. AIMS is the first hospital under private sector to have this facility in the state of Kerala. |
| Painful Bone Metastases - For patients with terminally ill cancers with bone metastases, nuclear medicine at AIMS offers pain alleviation with radio-isotopes like Strontium (Sr 89), Phosphorus (P32) and Samarium (Sm 153). The aim of this treatment is to improve the quality of life. Patients eligible for this therapy are those who do not respond to the usual analgesic medications. Usually 70 - 90% of patients respond to this procedure. The mean duration of benefit is 4 - 9 months. Retreatment with same radioisotopes is safe, feasible, and still efficacious. |
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| Miscellaneous |
Lymphoscintigraphy :
This scan is conducted to evaluate Primary and secondary causes of lymphoedema.This is a safe, easy procedure by which the lymphatic flow in bilateral limbs can be assessed. |
Dacryoscintigraphy :
Very minute quantities of Tc Pertechnetate are instilled into the outer canthus of the eyes and the flow of tracer is noted.This is done in patients with watering of the eyes (Epiphora) where an obstruction to tear flow is suspected. This is a very simple, noninvasive method of assessing lacrimal duct patency. |
Indium Octreotide Imaging :
Indium Octreotide (Octreoscan) scans are available at our centre. It is usually done in patients with suspected neuroendocrine tumours like Carcinoid tumours, Medullary thyroid Ca and in Infiltrative orbitopathy due to Graves’ disease etc. This is a new radiopharmaceutical with high sensitivity for various neuroendocrine tumors and their metastases. |
DIAGNOSTIC & INTRAOPERATIVE GAMMA PROBING :
AIMS has a sophisticated new, hand held, cordless, miniature gamma camera instrument called a Gamma Probe. Very few nuclear medicine centres in India are equipped with this instrument, ours is manufactured in Germany. The Gamma Probe is particularly useful during cancer surgeries by onco surgeons and Head and Neck surgeons, and endocrine surgeons for breast, head and neck, thyroid, vulval, cervical and penile cancers, melanoma and also in parathyroid adenomas.
The advantages of using this instrument during these surgeries are:
- accurate localisation of lymph nodes prior to & during the surgery
- confirmation of complete removal of Parathyroid adenoma.
- minimising skin incisions
- intra-operative time
- reducing blood loss
- minimising in-hospital stay
- increasing patient compliance and comfort.
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| Basic Principle of the Technique |
| Just prior to surgery, lympho scintigraphy imaging is performed where minute amounts of radioactive colloids are injected to the patient and the lymphatic drainage pattern is studied using a Gamma Camera. Subsequently the first draining lymph node is identified called the sentinel lymph node, which will most likely be the first to be affected by metastasis. A negative sentinel node makes it highly unlikely that other nodes are involved in that region. |
Lymph node being localized using Gamma Probe during surgery |
| During surgery using the Gamma Probe, this sentinel node is identified, excised and sent for biopsy (frozen section). The test confirms either the presence or absence of cancer in the sample and is performed before completion of the surgery enabling the surgeon to decide whether to do more extensive, mutilating lymph node removal. This represents a significant advantage as a minimally invasive procedure, considering that after surgery, about 70% of patients are found to be free from metastatic disease. The success rate of radioguidance in localizing the sentinel lymph nodes in cancer surgery is about 94 - 97%. |
Radioactivity in the excised lymph node being confirmed after surgery
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For localizing parathyroid tumours, the principle for gamma probe surgeries is different. A Technetium Sestamibi scan is conducted to confirm the presence of the tumour, looking for ectopic parathyroid adenomas. Pre-operatively the skin overlying this neck tumour is marked so that surgeon incises just above the tumour site, minimizing the size of incisions. Successful complete excision of tumour is ensured once again with a gamma probe .It also screens the entire neck for presence of other unidentified tumours by way of imaging.
This Gamma probe radio guided surgeries are extensively used in US and European hospitals with proven efficacy. The Department of Nuclear Medicine offers this new, exclusive and immensely beneficial facility to our patients in association with onco surgeons, head and neck surgeons and endocrine surgeons at AIMS. |
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