Nuclear Medicine

Introduction to the Nuclear Medicine Department, Shinan Campus

1. Department overview

The hospital’s Nuclear Medicine Department was established in 1960 and was one of the earliest institutions in China to establish a nuclear medicine department. In 1961, it began clinical radionuclide diagnosis, treatment, and research, and in 1964 it began undertaking nuclear medicine teaching for Qingdao Medical College. After the Nuclear Medicine Building was completed in 1980, the department expanded from the original Isotope Room into a Nuclear Medicine Department, with its specialties divided into three major areas: functional examinations, organ imaging, and radionuclide therapy. In 1994, the nuclear medicine specialty was approved as a master’s degree training site for Imaging Medicine and Nuclear Medicine. In 2006, it was also approved as a master’s degree training site for the second-level discipline of Radiation Medicine. To date, it has trained more than 40 master’s students, while also undertaking continuing education and training for nuclear medicine physicians, technologists, and nursing professionals in Shandong Province. It has trained and supplied a large number of nuclear medicine professionals and has played a significant role in the development of nuclear medicine in Shandong Province.

2. Professional workforce

At present, the Nuclear Medicine Department has 11 physicians, including 4 with associate-senior or higher professional titles, 1 hospital lifetime medical expert, and 7 with doctoral or master’s degrees. It also has 1 nurse-in-charge and 2 technologists. The department currently has a rational staffing structure. Its academic leader has outstanding professional expertise and extensive experience in both radionuclide diagnosis and treatment. The hospital’s lifetime expert and re-employed experts provide instruction by personal example, while the young physicians are enterprising and actively improve their medical skills. In recent years, several professionals in imaging, nuclear medicine, and clinical specialties have joined the department, providing a reserve of talent for its long-term development.

3. Specialty features

• Examination items

Whole-body bone imaging

Pulmonary ventilation/perfusion imaging

Bilateral lower-extremity venous imaging

Dynamic renal imaging

Static renal imaging

Iodine-131 whole-body imaging

Static thyroid imaging

Dynamic thyroid imaging

Parathyroid imaging

Salivary gland imaging

Bone marrow imaging

Dynamic hepatobiliary imaging

Hepatic portal-system imaging

Myocardial perfusion imaging

Cardiac blood-pool dynamic imaging

Lymphatic imaging

Sentinel lymph-node imaging

Iodine-131-MIBG imaging

Whole-body OCT-positive imaging

Cerebral blood-flow perfusion imaging

Multiphasic cerebrospinal-fluid imaging

Ectopic gastric-mucosa imaging

Gastrointestinal-bleeding imaging

SPECT/CT fusion imaging

Bone mineral-density measurement

Carbon-14 breath test

Iodine-uptake test

• Treatment items

Iodine-131 treatment for hyperthyroidism

Postoperative iodine-131 thyroid remnant ablation and lesion ablation for thyroid cancer

Strontium-89 treatment for bone metastases from malignant tumors

Beta-radiation patch treatment for hemangiomas and other skin diseases

Iodine-131-MIBG treatment for pheochromocytoma

Phosphorus-32 treatment for hematologic diseases, joint effusions, and malignant pleural effusion

4. Medical technology

The Nuclear Medicine Department currently has two large, advanced imported ECT systems: one SIEMENS T16 SPECT/CT and one GE Millennium VG Hawkeye SPECT/CT. It also has one dual-energy X-ray bone densitometer (DPX) and one technetium gas generator manufactured in Australia. The quality of examinations has been further improved.

At present, the Nuclear Medicine Department handles more than 10,000 outpatient visits annually. Each year, it performs imaging examinations for various diseases of organs including the bones, lungs, kidneys, thyroid, liver, and heart in more than 12,000 cases; iodine-131 treatment for hyperthyroidism in more than 300 cases; iodine-131 treatment for thyroid cancer in nearly 600 cases; and beta-radiation patch treatment for hemangiomas in more than 500 cases. Since 1962, iodine-131 treatment for hyperthyroidism has been provided to more than 10,000 cases, and postoperative iodine-131 thyroid remnant and lesion ablation for thyroid cancer to more than 6,000 cases. Phosphorus-32 treatment has been provided for approximately 300 cases of various hematologic diseases. Since 1993, 153Sm-EDTMP and strontium-89 treatment for bone metastases has been provided to nearly 4,000 cases. The department has also carried out iodine-131-MIBG treatment for metastatic lesions of medullary thyroid carcinoma. In 2000, it also began radionuclide treatment projects such as intraoperative and ultrasound- or CT-guided interstitial implantation of iodine-125 seeds for malignant tumors.

5. Research and teaching

The Nuclear Medicine Department of the Shinan Campus and the PET/CT Center of the Laoshan Campus jointly undertake most of the standardized residency training in nuclear medicine in Qingdao, as well as nuclear medicine teaching for all specialties of the Medical College of Qingdao University. The department is currently a master’s degree training site for Imaging Medicine and Nuclear Medicine and a master’s degree training site for the second-level discipline of Radiation Medicine. To date, it has trained more than 40 master’s students, who have cumulatively published more than 100 master’s theses and 4 teaching papers. Over the past 3 years, the department has emphasized research and clinical directions characterized by radionuclide diagnosis of tumors and radionuclide treatment of various diseases. It currently undertakes 3 provincial- or municipal-level research projects, has received 2 provincial- or municipal-level scientific research awards, has published more than 100 academic papers in provincial-level or higher journals, and has served as associate editor or contributing editor for more than 10 nationally compiled undergraduate textbooks for medical and pharmaceutical colleges and medical monographs.

6. Patient guide

(1) Department location: Shinan Campus: first floor of the Isotope Building

(2) Consultation telephone: Shinan Campus: 82911534

7. Examination precautions

(1) Please undergo the examination punctually at the scheduled appointment time. ECT examinations take time and sometimes require multiphasic imaging. Please understand and cooperate. If a large number of patients makes it impossible to perform the examination on time, please wait patiently.

(2) After the imaging agent is injected, please wait at the designated location and do not walk around freely, so as not to affect others.

(3) Before entering the examination room, please remove your mobile phone, jewelry, keys, and other metal objects so that they do not affect the examination results.

(4) ECT examinations are prohibited during pregnancy and breastfeeding.

(5) Bone imaging: Fasting is not required. After injection of the imaging agent, drink plenty of water and urinate frequently. Prevent urine from contaminating clothing or skin when urinating. The examination is performed 2–3 hours after injection. Empty your bladder before the examination; failure to empty it may affect the results. Patients with severe bone pain should prepare analgesics.

(6) Myocardial imaging: Stop taking beta-blockers and vasodilators one day before the examination. Fast for more than 4 hours. After injection of the imaging agent, eat 2 fried eggs and 1–2 bags of fresh milk (please bring them yourself). The examination is performed 1–2 hours after injection.

(7) Renal imaging: Fasting is not required. Drink 300–500 ml of water half an hour before the examination.

(8) Hepatobiliary imaging: Fast for 4–6 hours. Pediatric patients must be accompanied by a family member. If the child cannot cooperate with the examination, please prepare sedative medication in advance.

(9) Static thyroid imaging: The examination is performed on an empty stomach. Long-term use of thyroid hormones or iodine preparations, or previous use of iodinated X-ray contrast agents, may affect thyroid uptake of iodine-131 and thus affect the examination result.

(10) Pulmonary ventilation/perfusion imaging: The patient must be accompanied by a family member or attending physician. Critically ill patients must be accompanied by the attending physician and must bring an oxygen bag.

(11) Lymphatic imaging: No special preparation is required.

(12) Ectopic gastric-mucosa imaging: Fast for more than 4 hours. Stop potassium perchlorate, chloral hydrate, atropine, barium preparations, and other such substances before the examination. Pediatric patients must be accompanied by a family member. If the child cannot cooperate with the examination, please prepare sedative medication in advance.

(13) Gastrointestinal-bleeding imaging: Stop taking hemostatic medications before the examination.

(14) Salivary-gland imaging: Do not use atropine, potassium perchlorate, or similar medications before the examination.

(15) Iodine-131 whole-body imaging: Bathe and change clothes before the examination.

(16) Iodine-131-MIBG whole-body imaging: Cleanse the bowel, bathe, and change clothes before the examination.

(17) Carbon-14 breath test: Stop antibiotics and bismuth preparations for at least 30 days; stop aluminum sulfate and proton-pump inhibitors for at least 2 weeks; fast for at least 4 hours.

(18) Iodine-uptake test: Stop eating iodine-rich foods, such as kelp, nori, and other seafood, for 2–4 weeks; stop iodine-containing medicines, such as compound iodine solution and iodinated contrast agents, for 2–8 weeks; stop medicines that affect thyroid function, such as thyroid hormone tablets and antithyroid drugs, for 2–4 weeks.

(19) For questions about other ECT examinations that are unclear, consult the appointment desk or the physician on duty.

(20) Reporting time: Normally no more than 24 hours; reports are delayed when the examination falls on a weekend. In special circumstances, the physician on duty will provide notification.

Introduction to the PET/CT Center of the Nuclear Medicine Department

1. Department overview

The PET/CT Center was established on April 9, 2010, and PET/CT imaging formally began clinical application in November 2010. Over the past 6 years, our hospital’s positron radionuclide imaging specialty has grown from nothing to an established and strong service, making a major contribution to the development of the Nuclear Medicine Department and clinical oncology-related specialties, with good social benefits.

The PET/CT scanner is a multimodality imaging system combining positron emission tomography (PET) and X-ray computed tomography (CT). It is one of the world’s highest-end medical imaging devices and the most advanced molecular imaging technology currently available. More than 15,000 examinations have been completed, and over 85% of those examined have been clinical oncology patients. The number of examinations exceeded 3,000 in 2015 and approached 4,000 in 2016. By 2015, the overall diagnostic accuracy was 92.15%, reaching the diagnostic level of developed countries in Europe and the United States.

By adopting a patient-centered management philosophy, the center established a workflow of consultation–appointment–medical interview–examination–report–interpretation–follow-up. Through communication with patients, family members, and clinical physicians, it rationally manages expectations and scientifically follows indications, achieving the performance goal of one strong result and two satisfactions: good equipment operation, patient and family satisfaction, and clinical physician satisfaction.

2. Professional workforce

The center currently has 11 staff members, covering four areas: diagnosis, nursing, technology, including image acquisition and high-energy physics, and chemical synthesis. There are 6 diagnostic physicians, 2 imaging-agent production and synthesis personnel, 1 technologist, and 2 nurses. Among the 6 diagnostic physicians, 1 has a senior professional title, 4 have intermediate professional titles, and 1 is a resident physician. There are 3 doctoral students and 4 staff members with master’s degrees.

The center has a strong team of professionals in positron radionuclide imaging. It has 1 master’s supervisor in each of the two specialties of Radiation Medicine and Imaging Medicine and Nuclear Medicine at the Medical Faculty of Qingdao University, and 1 member of the PET and Molecular Imaging Group of the Nuclear Medicine Branch of the Chinese Medical Association. The young physicians are highly qualified: 1 has overseas further-study experience, 2 hold doctorates from renowned domestic universities, and 5 can undertake foreign-language teaching for international students. All young physicians have outstanding diagnostic abilities in tumor metabolic imaging.

3. Specialty features

Molecular imaging technology is one of the three major technologies of precision medicine, and PET/CT imaging is one of the typical representative technologies integrating anatomical imaging and molecular imaging. The Discovery VCT PET/CT from GE in the United States, introduced by the PET/CT Center, was the first such system in the Qingdao area and remains the only high-end hybrid scanner there equipped with a 64-row, 128-slice VCT and PET with high system sensitivity of 8.5 kcps/kBq. Compared with similar equipment, its advantages are as follows: ① It significantly reduces the radiation dose received by patients. Compared with other models, the amount of positron-emitting pharmaceuticals is reduced by 50% and the CT radiation dose by more than 40%. ② It provides high image quality. A new variable-slice-thickness scanning technology, VUE Point HD reconstruction technology, and GE’s unique Motion Free motion-artifact elimination technology ensure image quality, thereby achieving precise localization and accurate diagnosis. PET/CT imaging has unique advantages in tumor diagnosis, preoperative staging, efficacy evaluation and monitoring, and tumor screening in high-risk populations.

4. Medical technology

PET/CT can provide early diagnosis of tumors and other diseases. Before tumors produce anatomical or morphological changes in their early stages, PET/CT can detect small lesions that are difficult for other imaging methods to find.

A single PET/CT examination can rapidly obtain whole-body images. It can clearly show the sites and distribution of lesions throughout the body, allowing accurate tumor staging and making missed diagnoses less likely.

PET/CT can achieve the four determinations of medical imaging diagnosis: localization, characterization, quantification, and staging. That is, it detects lesions and clarifies their locations; differentiates benign from malignant lesions; performs quantitative analysis; and accurately determines the stage of disease progression.

PET/CT examinations offer good cost-effectiveness. Although the cost of a single PET/CT examination is relatively high, as long as indications are strictly controlled, the final result compared with the benefit obtained can save most patients approximately 20%–30% of their expenses.

PET/CT examination is safe and noninvasive, including for health checkups of high-risk populations. When conditions permit, PET/CT health checkups may be used for adults over 40, people under high work pressure, long-term smokers, people with a family history of tumors, and people with a history of exposure to carcinogens.

PET/CT brain functional imaging can be used for the localization and diagnosis of refractory epilepsy foci and other purposes.

5. Research and teaching

The center undertakes theoretical teaching and practical training in Nuclear Medicine for five-year and seven-year clinical medicine programs, the Medical Imaging Department, international students, and graduate students of the Medical Faculty of Qingdao University, with 26 teaching hours of theory each year. The PET/CT Center is a master’s degree-granting site in Imaging Medicine and Nuclear Medicine and Radiation Medicine. It has 1 master’s supervisor and has trained 16 full-time graduate students. It has successfully held the national continuing medical education course PET/CT Clinical Applications and New Diagnostic Thinking twice and the provincial continuing medical education course four times.

The center has obtained 1 National Natural Science Foundation project and completed 1 municipal-level research project. It has published 3 SCI research articles, with a highest impact factor of 5.731, 3 SCI case reports, 5 Chinese Medical Association-level papers, and 10 papers in core journals. It served as associate editor of the planning textbook Nuclear Medicine for higher medical colleges and editor-in-chief of Cranial MRI Diagnosis and Differential Diagnosis, 2nd edition. The academic leader also holds national-, provincial-, and municipal-level professional degree positions and serves as an editorial board member of the Chinese Journal of Cancer Prevention and Treatment.

6. Patient guide

(1) Department location

PET/CT Center, second floor of the outpatient department, Laoshan Campus, 59 Haier Road, Laoshan District

(2) Consultation telephone

0532-82913399 (telephone appointments), 82913321