Nuclear Medicine

The Complex Operative Unit (C.O.U.) of Nuclear Medicine and the PET-CT Center operates under the Department of Diagnostic, Therapeutic Services, and Transfusion Medicine. The PET-CT Center (S.O.U.), located within the "Giovanni Paolo II" outpatient facility, is equipped with a state-of-the-art GE Discovery IQ PET-CT scanner. This cutting-edge PET/CT system features a 5-ring configuration, offering exceptional sensitivity, the highest available among current systems. This advanced technology significantly reduces the administered dose and shortens acquisition times from 24 minutes to just 8–10 minutes. For younger patients, it enables a 50% reduction in the radiopharmaceutical dose, thereby minimizing radiation exposure. The system is also equipped with advanced functionalities, including: An integrated radiotherapy alignment system, designed in collaboration with radiotherapy physicians and physicists, to develop precise and accurate radiotherapy treatment plans; A cardiac synchronization module; A system to synchronize imaging acquisition with respiratory motion, A new contrast medium injector to perform PET scans co-registered with contrast-enhanced CT examinations.

Additionally, the center features a server and four advanced processing and reporting workstations, complementing the two pre-existing workstations. This infrastructure ensures expedited processing, allowing reports to be delivered approximately one hour after the examination. Our center, the first in Puglia to be equipped with a fixed PET scanner, currently performs over 5,000 PET scans annually (2022 data). The primary applications focus on staging and post-treatment restaging for a wide range of oncological and hematological conditions. PET-CT is also playing an increasingly important role in the management of inflammatory and infectious diseases. At our center, it is possible to perform combined PET-CT with diagnostic CT, including contrast medium administration, in a single session. This approach reduces waiting times and minimizes radiation exposure, while improving diagnostic sensitivity, specificity, and accuracy. These examinations are conducted in collaboration with hospital radiologists, who provide the contrast-enhanced CT report alongside the PET report. To optimize scheduling for examinations, prior treatments and surgical procedures are carefully considered. Typically, reports for PET-CT and PET-CT with contrast medium are delivered on the same day as the examination.

At our center, the following procedures are performed:

·       PET scans with diagnostic CT, including contrast medium administration, conducted in collaboration with the Radiology Unit.

·       Standard PET/CT scans for the most common oncological conditions.

·       PET scans with fluorocholine for staging prostate carcinomas.

·       PET scans with 18F-flutemetamol for the assessment of Alzheimer’s disease or other neurodegenerative conditions.

·       Advanced brain metabolism quantification programs for studying cerebral activity.

The PET Center has recently been authorized to use a Gallium-68 generator, a radioisotope essential for labeling DOTATOC, which is employed in PET scans for neuroendocrine tumors.

At the S.O.U. of Traditional Nuclear Medicine, the following scintigraphic examinations are available:

·       Bone scintigraphy (total body and segmental)

·       Thyroid scintigraphy (with technetium, iodine-131, or iodine-123)

·       Parathyroid scintigraphy

·       Pulmonary scintigraphy

·       Myocardial scintigraphy (stress and resting)

·       Scintigraphy with radiolabeled autologous leukocytes

·       Bone marrow scintigraphy

·       Renal scintigraphy (MAG-3, DMSA)

·       Brain perfusion scintigraphy (ECD)

·       Brain scintigraphy with DaTSCAN

·       Esophageal transit scintigraphy

·       Gastric emptying scintigraphy

·       Lymphoscintigraphy

·       Sentinel lymph node mapping

·       Scintigraphy with MIBG

·       Platelet kinetics studies

·       Red blood cell kinetics studies

·       Erythrocyte volume determination

The Complex Operative Unit (C.O.U.) of Nuclear Medicine is also equipped with a Metabolic Radiotherapy Department, comprising eight protected beds for treating hyperthyroidism, thyroid malignancies, and Selective Internal Radiation Therapy (SIRT). SIRT involves radioembolization with Yttrium-90-labeled microspheres for the treatment of primary or metastatic liver lesions. In January 2023, the center received authorization to use Lutetium-177 for radiometabolic therapy of neuroendocrine tumors with Lutathera.

Annual Activity Metrics: Over 5,000 PET/CT scans performed annually; Approximately 6,000 Nuclear Medicine diagnostic procedures; 200 hospitalizations for metabolic radiotherapy.