Nuclear Medicine

Introduction

Nuclear Medicine is a branch of specialized medical field, in which radioactive materials or radiopharmaceuticals are used for diagnostic and therapeutic purposes. For diagnostic purpose, scans performed after injection of radiopharmaceuticals has the ability to assess the function of an organ/tissue. Meanwhile, for therapeutic purpose, radiopharmaceuticals specifically target the diseased organ/tissue, subsequently, able to destroy the targeted organ/tissue.

Vision

Nuclear medicine department shall be a centre of excellence in the provision of comprehensive, safe, up-to-date and compassionate nuclear medicine services to the community.

Mission

To provide quality and professional diagnostic and therapeutic nuclear medicine services through the safe use of radioactive substances.

Objectives

1. To provide services in imaging, non-imaging and treatment using radioactive materials, method and facilities that are appropriate, accurate, safe and of the highest quality in patient care. For this purpose, Nuclear Medicine Department, Hospital Kuala Lumpur will ensure certain parameters are monitored such as;

to complete patient's report/study results within ≤ 5 working days for normal cases and ≤ 2 days for urgent cases
services given in the department are based on the followings:
1. waiting time prior to see doctor's is less than 90 minutes
2. patients with benign thyroid disease will receive radioiodine therapy ≤ 1 month

2. To actively involved in the training of the healthcare personnel which will eventually translate into high standards of patient care.

3. To carry out research and development pertaining to services provided.

Organisation Chart

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Services

Services provided are classified under treatment and investigations :

A. Treatment

1. Radioactive Iodine (Iodine-131) for :
  - Patients with relapse / resistant thyrotoxicosis
  - Thyroid cancer patients
2. Radiosynovectomy using Yttrium-90, Rhenium-186 or Erbium-169 in haemophilia patients with bleeding in the joints (refractory haemarthrosis).
3. Selective Internal Radiation Therapy (SIRT) with Yttrium-90 microspheres for patients w
4. ith liver cancer and liver metastasis.
5. Iodine-131 Metaiodobenzylguanidine (MIBG) therapy for cancers such as paraganglioma, pheochromocytoma and neuroblastoma treatments.
6. Lutetium-177 therapy for prostate cancer
7. Yttrium-90 therapy for cystic craniopharyngioma
8. Follow-up cases

B. Investigations

1. Planar, SPECT and SPECT/CT
  1. Brain scan
    - TRODAT
    - Epilepsy
    - Brain perfusion and others
  2. Musculoskeletal scan
    - HDP
    - MDP
    - Triple phase
  3. Cardiac scan
    - Perfusion
    - Viability
    - MUGA
    - Amyloidosis
  4. Lung scan
    - Ventilation and Perfusion
    - Perfusion
  5. Renal scan
    - DTPA
    - MAG-3
    - DMSA
  6. Measurement of Glomerular Filtration Rate (GFR)
    - DTPA
    - EDTA
  7. Endocrine scan
    - Tiroid
    - Paratiroid
    - MIBG
    - Iodin-131
  8. Gastroenterology and hepatobiliary scan
    - Gastric emptying study
    - Oesophageal motility
    - Meckel’s diverticulum
    - Red blood cell tagging for intestinal bleed
    - SeHCAT for bile malabsorption
    - HIDA
    - Liver scan
  9. Lymphatic scan
    - Sentinel lymph node mapping for breast cancer and melanoma
    - Lymphoscintigraphy
  10. Others:
    - Pleural/peritoneal leak study
    - Liver-lung shunt study
    - Dacrayoscintigraphy for lacrimal gland
    - Salivary gland scintiography
2. PET/CT Imaging
  1. Oncology
  2. Infection and inflammation
  3. Brain
  4. Cardiology
  5. Paediatric

Service Schedule

DAY	7.30 am - 1.00 pm	2.00 pm - 5.30 pm
MONDAY	Nuclear Medicine Clinic Admission of thyroid cancer patients to the Radioiodine Ward for radioiodine (Iodine-131) therapy Follow-up for thyroid cancer patients Treatment and follow-up for thyrotoxicosis patients Counselling for myocardial perfusion scan Consultation for thyroid cancer patients after patients have undergone whole body scan Scan Unit Nuclear Medicine consultation and imaging Stress study for myocardial perfusion imaging Whole body scan of thyroid cancer patients admitted from the previous Thursday	Nuclear Medicine imaging Counselling for myocardial perfusion scan Scan reports preparation Grand ward rounds Patient discharge from Radioiodine Ward
TUESDAY	Nuclear Medicine Clinic Follow-up for thyroid cancer patients Treatment and follow-up for thyrotoxicosis patients Counselling for myocardial perfusion scan Scan Unit Nuclear Medicine consultation and imaging Stress study for myocardial perfusion imaging	Nuclear Medicine imaging Counselling for myocardial perfusion scan Scan reports preparation
WEDNESDAY	Nuclear Medicine Clinic Counselling for myocardial perfusion scan Registration and consultation for PET/CT patients PET/CT imaging in IJN Scan Unit Nuclear Medicine consultation and imaging Stress study for myocardial perfusion imaging	Nuclear Medicine imaging Counselling for myocardial perfusion scan Scan reports preparation PET/CT imaging in IJN
THUSRDAY	Nuclear Medicine Clinic Admission of thyroid cancer patients to the Radioiodine Ward for radioiodine (Iodine-131) therapy Follow-up for thyroid cancer patients Treatment and follow-up for thyrotoxicosis patients Counselling for myocardial perfusion scan Registration and consultation for PET/CT patients PET/CT imaging in IJN Scan Unit Nuclear Medicine consultation and imaging Stress study for myocardial perfusion imaging	Nuclear Medicine imaging Counselling for myocardial perfusion scan Scan reports preparation PET/CT imaging in IJN Grand ward rounds
FRIDAY	7.30 am - 12.15 pm	2.45 pm - 5.00 pm
FRIDAY	Nuclear Medicine Clinic Registration and consultation for PET/CT patients PET/CT imaging in IJN Consultation for thyroid cancer patients after patients have undergone whole body scan Scan Unit Nuclear Medicine consultation and imaging Whole body scan of thyroid cancer patients admitted on Monday	Nuclear Medicine imaging Counselling for myocardial perfusion scan Scan reports preparation PET/CT imaging in IJN Whole body scan for thyroid cancer patients Patient discharge from Radioiodine Ward

Client Charter

We in Nuclear Medicine Department will ensure:

Every patient is given quality, patient oriented and timely service with emphasis on customer satisfaction. Priority is focused on customers who need immediate service. Services given in the department are based on the followings:
1. Waiting time prior to seeing the doctor is less than 90 minutes.
2. Patients with benign thyroid disease will receive radioiodine therapy ≤ 1 month.
The dignity and confidentiality of patient information is maintained.
Patient is provided with professional, honest and sincere service by a team of skilled, committed and compassionate personnel.
Patient will be given clear explanation of agreed procedures and treatments including the risk and options available.
To complete patient’s report/study results within 7 working days for normal cases and 2 days for urgent cases.