Advancing Nuclear Medicine Through Innovation by National Research Council, Institute of Medicine, Board on

By National Research Council, Institute of Medicine, Board on Health Sciences Policy, Division on Earth and Life Studies, Nuclear and Radiation Studies Board, Committee on State of the Science of Nuclear Medicine

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More importantly, the use of nuclear medicine procedures has improved patient care in many ways. Nuclear imaging allows physicians to cost-effectively obtain medical information that would otherwise be unavailable or would require more invasive procedures, such as surgery or biopsy. For example, FDG-PET imaging has been estimated to save almost $400,000 per 100 patients when compared to surgery to assess for the presence of malignancy in indeterminate lung lesions as seen on CT (NLM 1998). 2 SOURCE: Data from American College of Radiology Research Department.

The increasing use of FDG-PET scanning, which provides approximately the same absorbed dose to patients as cardiac studies, deserves similar considerations as well as raises some additional concerns given the higher energy of annihilation (positron-producing) photons. Shielding and other measures need to be employed in order to protect radiation personnel, families, and bystanders (Madsen et al. 2006) and need to be incorporated into contemporary clinical and preparatory facilities. Radiopharmaceuticals are administered in small mass amounts, generally nanomoles, so as to follow the tracer principle.

The existence of disease subtypes may, in part, explain why similar clinical diagnoses often result in substantially different outcomes in different individuals. Nuclear medicine may contribute to the management of such diseases by providing information about individual responses to therapy. 5, FDG-PET can be used to monitor responses of individual tumors to treatment by demonstrating whether there has been a change in FDG uptake. Such monitoring allows earlier determination of the effectiveness of approved treatments in individual patients and, if necessary, enables the patient to start an alternative treatment sooner.

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