Institute of Nuclear Medicine
The Institute of Nuclear Medicine is part of the Division of Medicine

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For Patients

Cardiology

We provide a range of heart scans:

Fused cardiac PET/CT



Myocardial Perfusion Scintigraphy allows doctors to see how well blood is reaching the heart muscle through the coronary arteries.

Myocardial perfusion scintigraphy involves injecting a small amount of a radioactive substance (known as a tracer) into a blood vessel though a small tube.

A special camera, known as a gamma camera, is moved around the person for 10 to 20 minutes.

The gamma camera picks up the radioactive trace and produces pictures that the doctor can use to see how well blood is reaching the heart.

This is done both when the patient is resting and when their heart is beating faster.

The doctor gives them a medicine that makes their heart behave as though they had been exercising.

Myocardial Perfusion PET uses a different tracer and a different camera, called a PET scanner, to produce the pictures of the heart.

Myocardial Viability PET imaging is a type of test that measures the way the heart uses glucose—a type of sugar that all cells in the body use for energy. Cells that have been damaged or killed by heart disease or a heart attack will use little or no glucose. Healthy cells and cells that are recovering from injury will use more glucose. PET viability imaging is used:

• To confirm heart damage suggested by other tests
• To measure how much heart tissue has been damaged by a heart attack or heart disease
• To tell whether a patient may need angiography, cardiac bypass surgery, a heart transplant or other procedures

CT calcium scoring
is a type of X-ray that detects calcium in the coronary artery walls. Fat and calcium build up in the artery walls when a person has coronary heart disease and cause narrowing or blockages.

CT coronary angiography
uses a type of X-ray called computed tomography (CT) scanning and dye injected into the person’s veins to show whether the coronary arteries are narrowed or blocked.

MUGA heart scan looks at how well your heart is beating (the ejection fraction). It is the most accurate and reproducible means of measuring the heart’s ejection fraction.

Oncology

FDG

The Institute of Nuclear Medicine provides a comprehensive imaging service for diagnosis and therapy using radionuclide substances.

These involve small amounts of radioactive 'tracers' to image and stage disease for patients having treatment either clinically or as part of a clinical trial. 

Examples of tracers include agents to image bone as in 'radionuclide bone scan', monitor cardiac function as in ‘muga scan’ and small amounts of radionuclide glucose as in 'FDG PET scan'.

Our nuclear medicine specialists are among leading members in their fields and are dedicated to our patient-centric philosophy.

Our physicians use an interdisciplinary approach for diagnosis and treatment, working with other Cancer specialists at UCLH, the Experimental Cancer Centre and Clinical Research Facility at UCLH.

We are fortunate in being able to use the most advanced imaging facilities available in the UK, including a PET-MRI scanner, two PET-CT scanners, a SPECT-CT camera, and another SPECT-CT camera wholly dedicated to Clinical Trial studies.

We accept referrals and working closely with clinical partners in nearby NHS trusts and also over a wider geographical area.

Neurology

Brain FDG PET

The Institute of Nuclear Medicine is housed in the modern, new, University College Hospital, sited on Euston Road in London.

The department has been on this site since 2006, and is now the largest single site Nuclear Medicine department in the UK.

The Institute has cutting-edge technology ideally suited to Neurological imaging.

Equipment within the department such as SPECT/CT, PET/CT and PET/MRI are able to produce images that combine information on brain function and brain structure in one visit, reducing the need for multiple scan appointments.

These images are particularly helpful for a whole host of brain conditions including:

  • Diagnosis of Movement Disorders such as Parkinson’s Disease
  • Age related disorders such as Alzheimer’s disease and Fronto-Temporal Dementia
  • Brain Cancers, both for diagnosis and to assess disease progression
  • Epilepsy, to help determine the area where epileptic fits start.

In addition to state of the art equipment, the Institute of Nuclear Medicine also has substantial experience in interpreting brain imaging data.

Professor Peter Ell has been involved both with this type of imaging since its inception both clinically and for research.

Dr John Dickson has been involved in brain imaging both clinically and for research since he completed his Ph.D. in Neuroimaging, and has been involved in many UK and international research collaborations since.

Treatment

Radionuclide therapy is an established practice within University College London Hospital.

Currently we receive referrals both nationally and internationally for the treatment of a range of conditions including neuroendocrine tumours (NETs), thyroid carcinoma, meningioma and pituitary tumours.

We also provide conventional radioiodine therapy on an out-patient basis for the treatment of thyrotoxicosis.

We are one of only two centres in the UK to offer paediactric radionuclide therapy.

Within UCLH, we have 10 dedicated rooms for Radionuclide therapy.

These are state-of-the-art, en-suite and lead-lined with a separate room situated adjacent that is designated for comforters and carers.

State-of-the-art diagnostic imaging assessment

We offer state-of-the-art diagnostic imaging assessment to monitor eligibility for radionuclide therapy, incorporating 123I-mIBG (Metaiodobenzylguanidine) scintigraphy, 18F-FDG and 68Ga-DOTATATE PETCT.

Additionally, assessments can be performed on the PET/MR machine located in the UCLH cancer centre.
This is the first machine of its kind in the UK.

Referrals for therapy are discussed in multi-disciplinary meetings comprising a range of medical, scientific and technical staff, where case histories are reviewed together with imaging studies.

A recent addition to the service is the use of 177Lu-DOTATATE therapy to treat patients with Neuroblastomas. 68Ga-DOTATATE PET/CT is used to scan children with neuroblastoma and identify those suitable for radionuclide therapy with 177Lu-DOTATATE.

We have shown, for what is to our knowledge the first time, that treatment with 177Lu-DOTATATE is safe and feasible in children with relapsed or primary refractory high-risk neuroblastomas.

SPECT

The Institute of Nuclear Medicine houses a number of gamma cameras capable of SPECT imaging.

Following an injection of a radioactive tracer, a SPECT scan produces three-dimensional images of body function.

A SPECT scan is commonly performed in combination with a CT scan, with the CT component providing anatomical information.

Functional and anatomical information of the body can in this way be obtained in one single appointment.

The fused data provides better visualisation of the images and enables the clinicians to accurately define the exact location and extent of the disease.

SPECT

The Institute of Nuclear Medicine has extensive experience in a number of SPECT and SPECT/CT imaging procedures, both for routine and research purposes. Some of the indications where SPECT CT has found to be of great benefit are as follows:

  • Bone imaging – The musculoskeletal system is imaged to investigate bone disease and pain
  • Oncology imaging – Tumour sites are localised for both diagnostic and post-therapeutic purposes 
  • Cardiac imaging – Functional images of the heart are acquired, normally in conjunction with ECG monitoring of the cardiac cycle
  • Neuroimaging – Images are acquired for a number of brain conditions, including movement disorders, dementia and epilepsy 
  • Endocrine imaging – Parathyroid adenomas are localised, commonly for surgical workup 
  • Sentinel node mapping  – The lymphatic drainage from tumour sites is imaged

PETMR

The Institute of Nuclear Medicine at UCH was the first department in the UK to set up a clinical PET/CT service to great success, currently imaging approximately 100 patients per week, has now taken on the exciting challenge of being the first to set up a clinical PET/MR. The latest development in hybrid imaging from Siemens in Germany started operation; on the 2 April this year. It has been established as an important part of the brand new UCH Macmillan Cancer Centre to provide its patients with an holistic experience where all essential facilities are under one rather spectacular roof. 

brain PET/MRI
Brain PET/MR

But the scanner is not only used for imaging patients with cancer but is also used to investigate heart and brain function. MRI image of the brain with a radioactive sugar scan showing the fully functioning parts of the brain overlaid. We are looking sideways on at a slice right through the middle of the brain.

This scanner combines positron emission tomography (PET) with magnetic resonance imaging (MRI).  This is quite an engineering marvel as the electronics used by a traditional PET camera don’t work inside a high magnetic field associated with MRI scanners. Instead Siemens redesigned the PET technology so that it could.  

PET/MR cross-section of scanner
PET/MRI


Basically this scanner looks like an MRI from the outside but the difference is that it also has a ring of PET detectors under the cover in the middle of the magnet.  If your doctor requests this exam for you your experience will in fact be very similar to that of having an MRI scan but you will also have an injection of a very small amount of radioactive sugar before hand. The exam will take anywhere between 30 mins and half an hour but you can bring your own music or podcasts to listen to.

In order that the radioactive sugar goes to the right place you will not be able to eat anything for about 6hrs before you arrive and in order to avoid taking anything metal into the MRI scanning room you will be asked to change into a hospital gown or pyjamas.

Once the exam has finished you will be able to eat and go about your normal business although it is advised to keep your distance from small children and crowds for the rest of the day.

If you have any other queries, please contact Dr Anna Barnes anna.barnes[at]uclh.nhs.uk