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Established in 1977, the Department of Nuclear Medicine at the Jaslok Hospital and Research Centre has been a pioneer in the country for this speciality. Being one of the first departments in nuclear medicine in the private sector, it has several firsts to its credit —Padmabhushan, Dr. R.D. Lele, Founder and Director of the department, introduced nuclear cardiology with multiple-gated acquisition (MUGA) scans for the first time in the country. Our department was the first in the country to get a triple-head gamma camera and the first solid-state dedicated cardiac camera in Asia. Recently, a 5-ring 16-slice PET-CT scanner was added to the list. We introduced brain perfusion imaging in India and recently we also got dopamine transporter (DaT) imaging for Parkinson’s disease for the first time in India.
We also introduced somatostatin receptor PET-CT imaging in the private sector for the diagnosis and management of neuroendocrine tumours. This was followed by introduction of peptide receptor radionuclide therapy (PRRT) for treatment of inoperable somatostatin positive neuroendocrine tumours such as carcinoids, insulinomas, phaeochromocytomas and pancreatic neuroendocrine tumours.
We are among the 6 departments in the country that offer this service. Earlier, patients had to travel to Europe for this therapy that costs 10,000 euros per cycle. For 3 cycles, they had to bear a total cost of over 20 lakh rupees. We offer this therapy to Indian patients for 1.2 lakh rupees per cycle, amounting to 3.6 lakh rupees in total. Over 70 therapies have been given till date. This therapy provides a good control of the disease with a significantly improved quality of life.
We have just acquired the most advanced 5-ring 16-slice PET-CT scanner. Only 13 such machines exist in the world. With this scanner, the time taken for a PET-CT scan is very short and the injected radiotracer is reduced by half, thereby decreasing the degree of radiation exposure to the patient.
The other scanners include one 16-slice SPECT-CT scanner and a dedicated solid-state cardiac camera. We have 3 dedicated therapy rooms for treatment of thyroid cancer and neuroendocrine tumours. We offer every possible nuclear medicine diagnostic scans including myocardial perfusion scan for coronary artery disease, brain scan for Alzheimer’s disease, thyroid scan, salivary scan, lung ventilation and perfusion scan, bone scan, kidney scan, liver and hepatobiliary scan, gastric emptying scan, lymphatic scan, fluorodeoxyglucose (FDG) PET-CT scan for cancer detection, staging and follow up for cardiac viability and neurology applications.
We also provide treatment for hyperthyroidism with radioiodine and sentinel-node detection for breast cancer and treatment of hepatic metastases with selective internal radiation therapy (SIRT). We train 2 candidates per year for the Diplomate of National Board (DNB) degree in nuclear medicine. Over 20 candidates have passed out from our department and currently, they head various Nuclear Medicine Departments across India.
Thus, we are making a significant contribution in the diagnosis and management of cancer patients in India, apart from all other cardiac, neurological and infective diseases.
The following scans are performed routinely in the department:
o Brain perfusion scan (99mTc- ethylene cysteine diethylester (ECD) single-photon emission computed tomography (SPECT)-CT with low energy ultra high resolution (LEUHR) FAN BEAM collimators—the only one in India)
o Dopamine transporter SPECT-CT (TRODAT scan) for Parkinson’s disease (introduced in India for the first time by Jaslok Hospital and was a great achievement for the country)
o Brain PET-CT for dementia, epilepsy, stroke, tumours and depression
o Myocardial perfusion scan ( 99mTc-tetrofosmin) for coronary artery disease (introduced in India, largest experience in the country and the only dedicated solid-state camera in India providing the fastest scan with least radiation. Routine with physical and pharmacological stress)
o Stress FDG scan for ischaemia
o Myocardial viability scan (18 FDG PET-CT)
o MUGA scan for myocardial function
o Whole-body PET-CT ( with oral and IV contrast) for diagnosing and staging cancer and following response to therapy
o Whole-body 68Ga-DOTANOC PET-CT for neuroendocrine cancer (the only facility in Mumbai)
o Whole-body 68Ga-prostate-specific membrane antigen (PSMA) scan for prostate cancer
o Whole-body 18-fluorothymidine positron emission tomography (FLT PET)-CT for cancer versus infection
o Whole-body 131-iodine scan for thyroid cancer
o Thyroid scan for thyrotoxicosis, thyroid nodules
o Parathyroid scan (99mTc-methoxyisobutylisonitrile (MIBI) dual-phase SPECT-CT)
o 131I-metaiodobenzylguanidine (mIBG) and 68Ga-DOTANOC scan for phaeochromocytoma
o Gastric emptying study for gastric motility problems
o Gastro-oesophageal reflux studies
o Gastrointestinal bleeding scan
o Salivary scan
o Meckel’s diverticulum scan
o Liver scan for chronic liver disease
o Hepatobiliary scan for gallbladder function, biliary atresia and biliary leaks
o Diuretic renal scan for obstructive uropathy
o Glomerular filtration rate (GFR) estimation
o Vesico-ureteric reflux (VUR) scan
o Transplant kidney evaluation
o Enalaprilat scan for renal artery stenosis
o Testicular scan
o Lung ventilation and perfusion scan for pulmonary embolism
o Lymphoscintigraphy for lymphatic obstruction
o Sentinel-node scan in breast cancer
The following therapeutic procedures are offered in the department:
o 131-iodine high-dose therapy for thyroid cancer in special isolation ward, Atomic Energy Regulatory Board (AERB) certified
o Peptide receptor radionuclide therapy (PRRT) for neuroendocrine cancer with 177Lu-DOTATATE
o Yttrium-90 TheraSphere for hepatic cancer (primary and metastatic)
o Samarium-153 therapy for painful bone metastases
Awards/Fellowship
* Presented research papers at International conferences in Nuclear Medicine,
* Delivered the S. Seth Endowment Lecture of University of Bombay for year 1994 on “Brain SPECT – a New Frontier”.
* IMA oration on “Nuclear Medicine”, Nagpur 2002
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