Nuclear Medicine

Our department delivers comprehensive diagnostic and therapeutic applications of this unique specialty, which employs minute amounts of radioactive material called radiopharmaceuticals to study the function of body systems and organs. Handling and use of radio- pharmaceuticals is governed by stringent international and national regulations and our team of highly-qualified consultants ensure the compliance with the standards set for the safe and appropriate use radiopharmaceuticals in medicine. Our physicians are backed by a team of physicists, radio-chemists, cyclotron engineers and technologists to deliver this technology and labour intensive service.

Facilities & Services

Unlike conventional x-rays and CT where an individual is exposed to radiation from an external source, the radiopharmaceuticals in nuclear medicine are introduced in to the body through an injection, food or aerosols. A patient undergoing a nuclear scan is a source of radiation for a brief period during which images are acquired and judgment is made about the functional status of the organ or system utilising a gamma camera or a PET/CT scanner. The amount of radiopharmaceuticals is carefully calculated and varies according to a patient’s age, size and type of investigation. Portable Molybdenum- Technetium generators are the primary source of radio-active material, which is sourced from internationally licensed vendors. Our department acquires these generators from three different sources to ensure constant availability. PET radiopharmaceuticals have to be produced on site and since 2009, SKMCH&RC houses Pakistan’s first IBA Cyclotron for this purpose.

The Nuclear Medicine Department is also equipped with two dual-head GE gamma cameras and one hybrid imaging Philips PET/CT scanner. The hot labs for preparation of radiopharmaceuticals are equipped with Lemer isolators and Synthera® synthesisers. Images are processed and analysed on dedicated work stations and archived on the Picture Archiving Communications System [PACS], accessible throughout the Hospital, making SKMCH&RC a filmless digital setup.

Our department has an unwavering commitment to education and research. We are affiliated with College of Physicians and Surgeons Pakistan for training in FCPS Nuclear Medicine. Additionally, we also host visiting MSc. in Nuclear Medicine fellows from Pakistan Institute of Engineering and Applied Sciences in Islamabad. Former trainees from our department have been awarded fellowships in UK and USA. Our faculty is also involved in teaching of medical imaging technologists enrolled in the BSc (Hons) in Medical Imaging programme in collaboration with University of Bradford and the medical technologist programme of the University of Health Sciences in Lahore. Our physicists are involved with MSc in Physics students from University of the Punjab with special focus on medical physics. Research work from our department has been presented and published at both the international and national level.

Even after 16 years of persistent progress and investment in technology, equipment and human resource, the Nuclear Medicine Department at SKMCH&RC remains the foremost department for the specialty in Pakistan.

Diagnostic Nuclear Medicine

PET/CT:

  • Oncology (cancer staging and follow-up)
  • Cardiology (hibernating myocardium)
  • Neurology (tumour versus necrosis)
  • Fever of unknown origin

Nuclear Oncology:

  • PET/CT
  • Radioactive iodine (thyroid cancer)
  • Gallium-67 (lymphoma, infection)
  • MIBG [neuroendocrine tumour]
  • Octreotide (somatostatin receptor studies)
  • Sentinel lymph node
  • Scintimammography

Nuclear Cardiology:

  • Myocardial perfusion studies
  • MUGA
  • FDG PET

Genitourinary System:

  • Dynamic renal imaging (DTPA, MAG3)
  • DMSA
  • Captopril studies
  • Nuclear cystography
  • Testicular imaging

Musculoskeletal Imaging:

  • Bone scan
  • Bone Marrow colloid scans

Gastrointestinal Imaging:

  • Gastric emptying
  • GI Bleed
  • Meckel’s Scan
  • Urea breath test

Hepatobiliary Imaging:

  • HIDA
  • Liver-Spleen colloid imaging

Pulmonary Imaging:

  • V/Q scans for PE/function assessment

Endocrine Imaging:

  • Thyroid, parathyroid and adrenal imaging

Infection Imaging:

  • Gallium
  • FDG
  • Bone scan

Neurological Imaging:

  • Brain FDG PET/CT

Bone Densitometry:

  • DEXA scan (expected to be initiated in 2012)

Therapeutic Nuclear Medicine:

  • Radioactive iodine (I131) therapy for benign and malignant thyroid disease
  • Palliative treatment for metastatic bone pain with Sr-89
  • Thyroid cancer clinics/Thyroid multidisciplinary clinics

Training

The department of Nuclear Medicine offers full four years of FCPS II training for resident doctors, post FCPS one year fellowship in Nuclear Oncology/ Nuclear Medicine, training and research facilities to M.Sc. (Nuclear Medicine and Medical Physics) fellows from the Pakistan Institute of Engineering and Applied Sciences (PIEAS University) and to M.Sc. (Physics) students from the University of Punjab (PU), Lahore.  Department also offers 4 or 8 weeks elective rotation for Medical College students. Students from College of Pharmacy PU come to the department for observing and attending lecture on radiopharmaceuticals preparation and handling. Clinical rotation of nursing for Diploma in Oncology/Cancer Nursing is also entertained.

Research

Three research projects of trainees are underway apart from the other miscellaneous research activities. Every year abstracts are sent for poster and oral presentations to renowned nuclear medicine societies and research work is presented internationally.

Published Papers
“Pleomorphic Liposarcoma Metastatic to the Thyroid Gland”
Clin Nucl Med 2002; 27:9-10.

“Differentiated thyroid carcinoma in a juvenile patient”
Clin Nucl Med 2008; 33:319-20.

“Abdominal Tuberculosis Diagnosed on Gallium Scintigraphy in a child with Pyrexia of Unknown Origin” Ann King Edward Med Col 2005; 11: 575-6.

Poster and Oral Presentations
“Managing Juvenile differentiated thyroid carcinoma: Our Experience from 1994-2008”
Accepted at the 56th SNM Annual meeting to be held from 13th to 17th June 2009 in Toronto, Canada.

“Oncological Imaging with Ga-68 PET: The story so far…”
Accepted at the 56th SNM Annual meeting to be held from 13th to 17th June 2009 in Toronto, Canada.

“Recombinant TSH (rhTSH) use in pediatric differentiated thyroid carcinoma (DTC) patients”
37th Annual Scientific meeting of the BNMS to be held in Manchester, April 2009.

“Preoperative cardiac risk stratification with Gated myocardial perfusion scintigraphy (G-MPS) for non-cardiac surgery in cancer patients”
37th Annual Scientific meeting of the BNMS to be held in Manchester, April 2009.

“Clinical utility of I-131 MIBG in patients with neuroblastoma: 8 years experience”
39th Annual Scientific Meeting of ANZSNM to be held in April 2009, Sydney Australia.

“Judicious Use of Recombinant TSH in Management of Differentiated Thyroid Carcinoma in a Developing Country and Charity-based Hospital Setting”
8th INCTR meeting held at Anatalya, Turkey from March 22nd to 24th 2009.

“Sentinel lymph node biopsy in the treatment of early breast cancer: Experience in 300 cases”
J Pak Med Assoc 2008; 58 No: 12S: S25.

“Correlation between serum thyroglobulin levels done prior to baseline I-131 whole body pre-therapy scan and frequency of radioactive iodine therapy in juvenile differentiated thyroid carcinoma”
J Pak Med Assoc 2008; 58 No: 12S: S23

“Low dose Gallium Scintigraphy in the diagnosis of Sarcoidosis”
94th Scientific Assembly and Annual Meeting of RSNA 2008.

“Recombinant TSH in management of differentiated thyroid carcinoma: Five year experience 2003-2008”
9th Asia Oceania Congress of Nuclear Medicine & Biology, at New Delhi, India held from 31st October to 4th November 2008.

“Sentinel lymph node detection in bilateral early breast cancer patients”
9th Asia Oceania Congress of Nuclear Medicine & Biology, at New Delhi, India held from 31st October to 4th November 2008.

Clinical usefulness of low dose Gallium scintigraphy in the diagnosis of Sarcoidosis.
9th Asia Oceania Congress of Nuclear Medicine & Biology, at New Delhi, India held from 31st October to 4th November 2008.

“Correlation between serum Thyroglobulin levels prior to baseline I-131 whole body pre-therapy scan and frequency of radioactive iodine therapy in juvenile differentiated thyroid carcinoma”
Joint International Conference of the CPSP and Bangladesh College of Physicians held at Dhaka, Bangladesh from 21st October to 23rd October 2008.

“Sentinel lymph node detection in early breast carcinoma patients: A single center preliminary experience”
Eur J Nucl Med Mol Imaging 2008; 35 (Suppl 2): S289

“Clinical significance of Somatostatin Receptor Scintigraphy in follow up of Medullary carcinoma thyroid patients with hypercalcitoninaemia”
Eur J Nucl Med Mol Imaging 2008; 35 (Suppl 2): S265

“Clinical usefulness of rhTSH aided Radioactive Iodine (RAI) treatment of patients with differentiated thyroid carcinoma”
Eur J Nucl Med Mol Imaging 2007

“Assessment of pulse rate as initial predictor of final outcome of Radioactive Iodine (RAI) therapy in patients with hyperthyroidism”
Eur J Nucl Med Mol Imaging 2007

“High dose radioactive iodine I-131 therapy for treatment of hyperthyroidism in Pakistani patients: A single center experience”
Proceeding of 9th World Congress of Nuclear Medicine & Biology, Seoul, Korea 2006.

“Differentiated Thyroid Cancer (DTC: A Single Center Experience in Pakistan)”
Eur J Nucl Med Mol Imaging 2004; 31: ppS436.

“Recombinant human thyrotropin for Iodine-131 therapy in management of differentiated thyroid carcinoma: A single center case series from Pakistan”
Eur J Nucl Med Mol Imaging 2005; 32: ppS197.

“Patients with Differentiated Thyroid Carcinoma: A 10-year experience from Pakistan”
Eur J Nucl Med Mol Imaging 2005; 32: ppS222.

“Attenuation of Ionizing Radiation by Water and its Impact on Image”
Pakistan Journal of Science 2003; 55: 4-9.

“Verification of Thyroid Uptake Calculations and Calculation of Radiation Absorbed Dose to the Thyroid Gland from Tc-99m thyroid uptake scans”
Pakistan Journal of Scientific Research 2002; 54: 3-4.

“Impact of Pixel Size on Resolution of Gamma Camera”
Pakistan Journal of Scientific Research 2003; 55: 1-4.

“Correlative Study of Gallium-67 Uptake in Histological Variants of Non Hodgkin’s Lymphoma”
Eur J Nucl Med and Mol Imaging 2007.

Awards, Certifications & Affiliations

The department of Nuclear Medicine is recognized by the College of Physicians and Surgeons of Pakistan for the full four years of FCPS II training. FCPS-II final examination (April 2009) was held at SKMCH & RC. Trainees are encouraged during their due course for research awards and fellowship grants.

INCTR Poster Award, Abstract selected for 3rd Scientific Writing Workshop of INCTR to be held in fall 2009.
CYP-APPNA & YPPRC Award for poster presentations December 2008.
ARCCNM Award for oral and poster presentations The 9th Asia Oceania Congress of Nuclear Medicine & Biology, at New Delhi, India held from 31st October to 4th November 2008.
PET-CT training fellowship with EANM Marie-Curie Training Grant at Clinical PET Center, St. Thomas’ Hospital, London, United Kingdom, 2007.
ARCCNM Award for oral presentation at the 9th World Congress of Nuclear Medicine and Biology, Seoul, Korea 2006.
UICC ICRETT Fellowship Award in Nuclear Oncology at Royal Free Hospital London, United Kingdom for project “Radioimmunotherapy in Non-Hodgkin’s Lymphoma” 2006

Online Donation Box

Donate any amount of your choice or be an official online fundraiser of Shaukat Khanum Memorial Cancer Hospital and Research Centre by following these simple guide lines: Step-1: Sign up http://bit.ly/2kJuvwn Step-2: Create your fundraising page Step-3: Donate and pass it on to your friends If we all do a little, we can do a […]


more details »

Donate Now

Many young innocent lives are being saved at Shaukat Khanum Memorial Cancer Hospital and Research Centre. Last year, your Zakat made it possible to treat almost 75% of our patients for free. This year we need 5.5 billion rupees to help those who cannot afford to pay for their own treatment. While the revenue from […]


more details »

Press Release

Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) celebrated its 22nd birthday in a colorful event organized by Shaukat Khanum Tigers’ Club. Nearly 700 school children from various cities across Pakistan participated in the event. A large gathering showed the enthusiasm of children for their passion to fight against cancer. Children from different schools […]


more details »

Events

Keep yourself updated with our latest events, held throughout the year and all around the world. Your participation in these events directly supports our mission of fighting cancer.   Upcoming Events Previous Events Groundbreaking of Shaukat Khanum Memorial Cancer Hospital and Research Centre, Karachi December 29, 2016 22nd Birthday Celebrations – Annual Card Competition December, […]


more details »


© All Rights Reserved by MIS Department at SKMCH & RC