ways radiation is used in medicine

diagnosis of disease, therapy, and research

Diagnosis covers a wide range of exams from fairly routine x
rays to complex CT scans and the injections of radioactive
material for nuclear medicine imaging.
Radiation therapy involves delivering a large dose of radiation
to a small area of the body.
Therapy is primarily directed to the killing of tumor cells as
part of the treatment of cancer.
Radiation therapy may also be used in the treatment of other
diseases, such as coronary artery disease, by applying a
large radiation dose to a small area on the inside surface of
the vessel to reduce the probability that the artery will close
(occlude) in the future.
NUCLEAR MEDICINE
discovery of x rays in 1895 was a major turning
point in diagnosing
physicians finally had an easy way to "see" inside
the body without having to operate
Newer x-ray technologies such as CT
(computerized tomography) scans have
revolutionized the diagnosis and treatment of
diseases affecting almost every part of the body.
Other sophisticated techniques have provided
physicians with low-risk ways to diagnose heart
disease . For example, doctors can now pinpoint
cholesterol deposits that are narrowing or blocking
coronary arteries, information essential for
bypassing or unclogging them.
NUCLEAR MEDICINE
Half of all people with cancer are treated with
radiation, and the number of those who have
been cured continues to rise.
There are now tens of thousands of individuals
alive and cured from various cancers as a result
of radiotherapy.
In addition, there are many patients who have
had their disease temporarily halted by
radiotherapy.
Radionuclides are also being used to decrease or
eliminate the pain associated with cancer--such
as that of the prostate or breast--that has spread
to the bone.
Radionuclides
a technological backbone for much of the biomedical
research being done today
used in identifying and learning how genes work.
Much of the research on AIDS is dependent upon the use
of radionuclides.
Scientists can engineer, produce and "arm" monoclonal
antibodies in the laboratory to bind to a specific protein on
a patient's tumor cells--with radionuclides.
When such "armed" antibodies are injected into a patient,
they bind to the tumor cells, which are then killed by the
attached radioactivity, but the nearby normal cells are
spared.
So far, this approach has produced encouraging success
in treating patients with leukemia.
USE OF RADIONUCLIDES
Every major hospital in the United States has a nuclear
medicine department
radionuclides are used to diagnose and treat a wide variety
of diseases more effectively and safely by "seeing" how the
disease process alters the normal function of an organ.
To obtain this information, a patient either swallows, inhales,
or receives an injection of a tiny amount of a radionuclide.
Special cameras reveal where the radioactivity accumulates
briefly in the body, providing an image that shows normal
and malfunctioning tissue.
Radionuclides -are also used in laboratory tests to measure
important substances in the body, such as thyroid hormone.
Radionuclides are used to effectively treat patients with
thyroid diseases, including Graves disease--one of the most
common forms of hyperthyroidism--and thyroid cancer.
PET scanning
another clinical and research tool
positron emission tomography
involves injecting radioactive material into a
person to "see" the metabolic activity and
circulation in a living brain.
PET studies have enabled scientists to pinpoint
the site of brain tumors or the source of epileptic
activity, and to better understand many
neurologic diseases
For example, researchers were able to learn how
dopamine--the chemical messenger
(neurotransmitter) that's involved in Parkinson's
disease--is used by the brain
PET scanning
The test involves injecting a very small dose of a
radioactive chemical, called a radiotracer, into the vein of
your arm.
The tracer travels through the body and is absorbed by
the organs and tissues being studied.
Next, you will be asked to lie down on a flat examination
table that is moved into the center of a PET scannera
doughnut-like shaped machine.
This machine detects and records the energy given off by
the tracer substance and, with the aid of a computer, this
energy is converted into three-dimensional pictures. A
physician can then look at cross-sectional images of the
body organ from any angle in order to detect any
functional problems.
PET scanning
PET scans are most
commonly used to detect
cancer
heart problems (such as
coronary artery disease
and damage to the heart
following a heart attack),
brain disorders (including
brain tumors, memory
disorders, seizures)
other central nervous system
disorders.
DIAGNOSIS AND TREATMENT
The use of ionizing radiation has led to major
improvements in the diagnosis and treatment of patients
with cancer.
These innovations have resulted in increased survival
rates and improved quality of life.
Mammography can detect breast cancer at an early stage
when it may be curable.
Needle biopsies are more safe, accurate, and informative
when guided by x-ray or other imaging techniques.
Radiation is used in monitoring the response of tumors to
treatment and in distinguishing malignant tumors from
benign ones.
Bone and liver scans can detect cancers that have spread.
Treatment Options
Three-Dimensional Radiation Therapy (3D-CRT)
a nonsurgical cancer treatment procedure
shapes the radiation beams so that they conform to the
shape of the tumor
technique allows physicians to accurately treat the
cancerous tumor, as well as areas of potential cancer,
while minimizing the amount of radiation that vital organs
and healthy tissue adjacent to the tumor receive.
Therefore, the target radiation dose can be increased
without exposing healthy parts f the body to increased
levels of toxicity.
used to treat prostate cancer, lung cancer and certain
head and neck cancers.
Treatment Options
Intraoperative Radiation Therapy (IORT)
combines surgery and radiation therapy
allows a large, single dose of radiation to be delivered to
the tumor site while reducing the level of radiation
exposure to normal adjacent tissue
Usually, surgery is performed first; the surgeon removes as
much of the tumor as possible. Then a dose of radiation is
given directly to the remaining cancer as well as nearby
areas where cancer cells may have spread.
The radiation dose is controlled and is allowed to penetrate
only as far as needed to treat the tumor.
In general, nearby normal tissue and organs do not receive
radiation.
Treatment Options
Brachytherapy and Interstitial Implantation
an advanced cancer treatment
radioactive materials known as seeds or
sources are placed directly inside or very near
the tumor, giving a high radiation dose to the
tumor while reducing the radiation exposure to
adjacent healthy tissues
provides both low dose rate (LDR) and high
dose rate (HDR) brachytherapy.
Both procedures deliver appropriate doses of
ionizing radiation to the treatment area.
some specific radioisotopes used to cure various cancers
Iodine-131 is administered orally as a liquid or capsule in the
treatment of thyroid cancer.
Phosphorus-32 is instilled either in an intraperitoneal or
intrapleural space to treat malignant effusions.
Radioactive Sr-89 and Sm-153 are injected intravenously to
relieve pain from bone cancers.
Many radioisotopes are used as sealed sources to treat
cancer such as Cs-137, Ir-192, Sr-90, and I-125.
Cobalt-60 is used in a machine (teletheraphy unit) as a
source of intense gamma radiation for the treatment of a
variety of cancers.


Radiation Therapy
also called radiotherapy
highly targeted, highly
effective way to destroy
cancer cells in the breast that
may stick around after
surgery.
Radiation can reduce the risk
of breast cancer recurrence
by about 70%.
Despite what many people
fear, radiation therapy is
relatively easy to tolerate and
its side effects are limited to
the treated area.
Two different ways to deliver
radiation to the tissues to be
treated:

a machine called a linear accelerator that
delivers radiation from outside the body
pellets, or seeds, of material that give off
radiation beams from inside the body
Tissues to be treated might include the
breast area, lymph nodes, or another part
of the body.
Magnetic resonance imaging
mri
most commonly used in radiology to visualize detailed internal
structure and limited function of the body
provides much greater contrast between the different soft
tissues of the body than computed tomography (CT) does
especially useful in neurological (brain), musculoskeletal,
cardiovascular, and oncological (cancer) imaging
Unlike CT, it uses no ionizing radiation, but uses a powerful
magnetic field to align the nuclear magnetization of (usually)
hydrogen atoms in water in the body.
Radio frequency (RF) fields are used to systematically alter the
alignment of this magnetization, causing the hydrogen nuclei to
produce a rotating magnetic field detectable by the scanner.
This signal can be manipulated by additional magnetic fields to
build up enough information to construct an image of the body.
Saggital views of knee and human head
Mri scanner
Herniated disc
MRI scans can display more
than 250 distinct shades of
grey, each reflecting slight
variations in tissue density or
water content.
It is in those subtle shades
that radiologists unlock the
secrets of the tissues.
For example, abnormal
tissue, such as a brain
tumor, will look different than
the normal tissue
surrounding it.
The technologist and
radiologist have the ability to
alter imaging parameters
(like the timings of the RF
pulse and gradients) to
emphasize areas of injury or
disease or to acquire higher
image resolutions.
X-ray computed tomography
Tomography is imaging by sections or sectioning,
through the use of waves of energy.
In conventional medical X-ray tomography, clinical
staff make a sectional image through a body by
moving an X-ray source and the film in opposite
directions during the exposure.
Consequently, structures in the focal plane appear
sharper, while structures in other planes appear
blurred.
By modifying the direction and extent of the
movement, operators can select different focal planes
which contain the structures of interest.
Ct scans
A computerized axial tomography scan is an x-ray
procedure that combines many x-ray images with
the aid of a computer to generate cross-sectional
views and, if needed, three-dimensional images of
the internal organs and structures of the body.
Computerized axial tomography is more
commonly known by its abbreviated names, CT
scan or CAT scan.
A CT scan is used to define normal and abnormal
structures in the body and/or assist in procedures
by helping to accurately guide the placement of
instruments or treatments.
A large donut-shaped x-ray machine
takes x-ray images at many different
angles around the body.
These images are
processed by a computer
to produce cross-
sectional pictures of the
body.
In each of these pictures
the body is seen as an x-
ray "slice" of the body,
which is recorded on a
film.
This recorded image is
called a tomogram.