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Gamma Scan

Gamma Scan

A gamma camera (γ-camera), also called a scintillation camera or Anger camera, is a device used to image gamma radiation emitting radioisotopes, a technique known as scintigraphy. The applications of scintigraphy include early drug development and nuclear medical imaging to view and analyze images of the human body or the distribution of medically injected, inhaled, or ingested radionuclides emitting gamma rays.

Imaging techniques

Coded aperture mask for gamma camera (for SPECT) Scintigraphy (“scint”) is the use of gamma cameras to capture emitted radiation from internal radioisotopes to create two-dimensional images.

SPECT (single photon emission computed tomography) imaging, as used in nuclear cardiac stress testing, is performed using gamma cameras. Usually one, two or three detectors or heads, are slowly rotated around the patient’s torso.

Multi-headed gamma cameras can also be used for positron emission tomography (PET) scanning, provided that their hardware and software can be configured to detect “coincidences” (near-simultaneous events on 2 different heads). Gamma camera PET is markedly inferior to PET imaging with a purpose-designed PET scanner, as the scintillator crystal has poor sensitivity for the high-energy annihilation photons, and the detector area is significantly smaller. However, given the low cost of a gamma camera and its additional flexibility compared to a dedicated PET scanner, this technique is useful where the expense and resource implications of a PET scanner cannot be justified.

Construction

Diagrammatic cross section of a gamma camera detector.

Details of the cross section of a gamma camera A gamma camera consists of one or more flat crystal planes (or detectors) optically coupled to an array of photomultiplier tubes in an assembly known as a “head”, mounted on a gantry. The gantry is connected to a computer system that both controls the operation of the camera and acquires and stores images. The construction of a gamma camera is sometimes known as a compartmental radiation construction.

The system accumulates events, or counts, of gamma photons that are absorbed by the crystal in the camera. Usually a large flat crystal of sodium iodide with thallium doping in a light-sealed housing is used. The highly efficient capture method of this combination for detecting gamma rays was discovered in 1944 by Sir Samuel Curran whilst he was working on the Manhattan Project at the University of California at Berkeley. Nobel prize-winning physicist Robert Hofstadter also worked on the technique in 1948.

The crystal scintillates in response to incident gamma radiation. When a gamma photon leaves the patient (who has been injected with a radioactive pharmaceutical), it knocks an electron loose from an iodine atom in the crystal, and a faint flash of light is produced when the dislocated electron again finds a minimal energy state. The initial phenomenon of the excited electron is similar to the photoelectric effect and (particularly with gamma rays) the Compton effect. After the flash of light is produced, it is detected. Photomultiplier tubes (PMTs) behind the crystal detect the fluorescent flashes (events) and a computer sums the counts. The computer reconstructs and displays a two dimensional image of the relative spatial count density on a monitor. This reconstructed image reflects the distribution and relative concentration of radioactive tracer elements present in the organs and tissues imaged.

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Gastroentrology

Gastroenterology is the branch of medicine focused on the digestive system and its disorders.

Diseases affecting the gastrointestinal tract, which include the organs from mouth into anus, along the alimentary canal, are the focus of this speciality. Physicians practicing in this field are called gastroenterologists. They have usually completed about eight years of pre-medical and medical education, a year-long internship (if this is not a part of the residency), three years of an internal medicine residency, and two to three years in the gastroenterology fellowship. Gastroenterologists perform a number of diagnostic and therapeutic procedures including colonoscopy, endoscopy, endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound and liver biopsy. Some gastroenterology trainees will complete a “fourth-year” (although this is often their seventh year of graduate medical education) in transplant hepatology, advanced endoscopy, inflammatory bowel disease, motility or other topics.

Hepatology, or hepatobiliary medicine, encompasses the study of the liver, pancreas, and biliary tree, while proctology encompasses the fields of anus and rectum diseases. They are traditionally considered sub-specialties of gastroenterology.