Riley Polumbus: Nuclear medicine

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— An elite runner complains of severe foot pain, yet her X-ray was negative. A 55-year-old man experiences chest pain while riding his mountain bike. A cancer patient is about to begin chemotherapy.

What do these individuals have in common? They all are candidates for a nuclear study.

A nuclear medicine study is a form of diagnostic testing or radiology. Most of us are familiar with the common forms of radiology such as an X-ray, MRI or CT scan. Each of these tests studies different types of problems in different parts of the body.

Nuclear studies can help find issues not found by these tests, as well as supply additional information such as how an organ is functioning.

For example, the runner's X-rays did not show any fractures to the small bones of the foot. So her doctor ordered a bone scan performed through a nuclear study to see if she had a stress fracture - a hairline fracture so small it may not be seen by an X-ray.

As for the mountain biker with chest pain, his doctor prescribed a nuclear study to look at how blood is flowing to his heart. Unlike other tests that simply take pictures of an organ, bones or tissues, nuclear studies can take a series of pictures to show movement. Consequently, if there is something blocking or impeding the mountain biker's flow of blood or function of his heart, this study can diagnose it.

Certain cancer patients also will undergo a nuclear study to determine a baseline of their heart's function. After undergoing chemotherapy, the patient will be tested again to see if their heart has been affected and whether the patient can stand another round of chemotherapy. Some cancer patients also may be prescribed a bone scan to determine whether the cancer has spread.

During a study, a Yampa Valley Medical Center nuclear technologist injects the patient with an extremely low-level radioactive chemical. The chemical is absorbed into a body system such as circulatory, respiratory or digestive.

Once absorption is complete, the tech uses a special "gamma camera" to follow the chemical as it moves through the system, showing radiologists how it is functioning.

Yampa Valley Medical Center recently acquired a new gamma camera for its nuclear studies. The camera has dramatically improved the patient experience.

"Previously, patients would need to lie still for a long time in order for us to collect all the necessary information," YVMC lead nuclear technologist Kevin Chapman said. "With the new camera, we're able to complete the exam in half the time."

As the patient lies on the table, the camera, which resembles a giant doughnut, automatically revolves around the person. The camera has two lenses, enabling it to capture images on both sides of the body.

The new equipment has a flat-screen monitor that assists the technologist at the start of the test. The monitor can then be converted to a DVD player, allowing the patient to watch a favorite movie during the procedure.

"Not only does this improve patient comfort, it makes it easier for our nuclear medicine technologists to get the best possible image," YVMC radiologist Dr. Fred Jones said. "These improved images, combined with the latest digital software, enhance the process needed for diagnosis."

Nuclear medicine tests will detect blockage, tumors and other functional disorders. The presence of cell disorders and infections can be found as well.

"Oftentimes, the study enables us to address more than one issue," Jones noted. "As we track the chemical through one area of the body on its way to another, we may make more than one diagnosis."

The new gamma camera became available this spring and is one example of how YVMC is continually investing in the latest equipment to meet the community's needs.

Riley Polumbus is the communications specialist at Yampa Valley Medical Center.

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