THE RADIOISOTOPE DEPARTMENT

Introduction:

The Radioisotope Department provides an integrated service combining all aspects of unsealed radionuclide use in the area of oncology. Activity includes radionuclide imaging (bone scans, dynamic heart imaging), non-imaging physiological measurements (glomerular filtration rate) and targeted radionuclide therapy including treatment planning (e.g. the use of 131I-metaiodobenzylguanidine, 131I-sodium iodide, 89Strontium etc). Staffing is by medical technical officers (MTOs) and radiographers managed by Radiology, scientific and secretarial support being provided by the Institute of Medical Physics and Engineering.

Areas of activity:

Bone scintigraphy for the early detection and staging of bone metastases continues to be the most numerous radionuclide study performed for oncology support. The department has been proactive in meeting the requirements of the clinicians and we are currently performing an increasing number of gated dynamic heart studies as we monitor cardiac toxicity of chemotherapy agents. We currently perform over 350 GFRs annually in order to monitor the renal function of patients as they undergo chemotherapy. Targeted therapy, a term used to describe the use of therapeutic radiopharmaceuticals from 131I sodium iodide to radiolabelled monoclonal antibodies, is set to become an increasingly important tool due to the rapid development of new tumour seeking pharmaceuticals and a wider range of available radionuclides. 131I sodium iodide is used for both the treatment of thyrotoxicosis and thyroid carcinoma. The radiopharmaceutical metaiodobenzylguanidine (mIBG) continues to establish itself for use in paediatric care and has recently been used more frequently in adults for the treatment of paraganglioma and carcinoid. Successful delivery of targeted radionuclide therapy is dependent upon accurate treatment planning and post therapy assessment, and much of the work of the department is in this specialised area. The use of therapeutic radiopharmaceuticals also requires significant scientific and technical support in areas such as quality assurance and radiation safety (ISO9001), therapeutic radionuclide stock control, dispensing and measurement, the provision of radiation protection advice to staff, patients and relatives, decontamination and radioactive waste management. All of these services are provided by the Radioisotope Department.

Areas of research:

We are currently involved in two research studies. In one we are measuring the uptake of 99Tcm labelled sestasmibi in breast tumours to see if this can be used to help plan the best form of treatment for patients with breast cancer. In the second study we are taking part in a National trial to monitor the effectiveness of the radionuclide 89Strontium for the control of pain in patients whose tumours have spread to bone.

Comments to Ian Driver