This service is involved in diagnostic imaging and laboratory studies and the administration of radioisotope therapy to patients.
Support is provided to all nuclear medicine departments and radiation protection services are provided to radioisotope departments in Lothian and Fife. The service houses the only Dual Energy X-ray Absorptiometers (DEXA) in NHS Lothian and the only Whole Body Counter in the area.
Bone Densitometry
The NHS Lothian Osteoporosis Service is based in Medical Physics. There are two Dual Energy X-ray Absorptiometry (DEXA) scanners performing clinical and research studies on 6,000 patients per year. Bone mineral density of the spine, hip, forearm and total body are measured for the diagnosis of osteoporosis and monitoring of treatment. In addition the bone density and clinical information are used to calculate fracture risk and provide treatment advice. Secondary care patients are referred from many hospitals, mainly from endocrine, rheumatology, respiratory, gastroenterology and gynaecology clinics. A Fracture Liaison Service and a GP Direct Access DEXA service are also provided and these patients have a nurse consultation immediately after their scan, with referral to a specialist bone clinic or falls service as appropriate.
Body Composition
Lean tissue, fat and bone are measured by DEXA and these measurements can be used in the assessment and monitoring of patients with HIV, cardiac failure, anorexia and cancer.
Glomerular Filtration Rate (GFR)
GFR is measured from the blood clearance of radiopharmaceuticals which are filtered by the kidneys. Blood samples are taken up to 3 hours following the intravenous administration of the radiopharmaceutical. GFR is used to assess renal function in potential live kidney donors and to monitor nephro-toxicity in patients being treated by chemotherapy.
Whole Body Counter
The Whole Body Counter is used to monitor for radioisotope contamination. It consists of very sensitive radiation detectors shielded by 10 tonnes of lead and low background steel, with the detected gamma rays processed by a nucleonics system and multi-channel analyser.
Therapy Administrations
Iodine-131 is administered to in-patients and out-patients for the treatment of hyperthyroidism and thyroid cancer.
Nuclear Medicine
Quality assurance measurements are made on gamma cameras, radionuclide calibrators and other equipment. Advice is provided on the purchase of new equipment and the introduction of new and modified procedures.
Radiation Protection
Radiation protection services are provided to 14 radioisotope departments in 5 hospitals in Lothian and Fife. This includes advice on regulations, calibration of equipment, radiation surveys, investigation of incidents and provision of radiation policies and procedures. Regulatory aspects include acting as Radiation Protection Adviser [RPA] for the Ionising Radiation Regulations [IRR], Medical Physics Expert [MPE] for the Ionising Radiations (Medical Exposure) Regulations [IRMER] and Qualified Person for the Radioactive Substances Act [RSA].
Emergency Planning
Advice is provided on procedures involving major radiation incidents. Staff attend Off Site Centres to advise on public health issues and are also responsible for setting up radiation monitoring units and providing support to A&E.
PET/CT
Two clinical scientists are based in the Clinical Research Imaging Centre, with responsibility for scientific support of the PET/CT scanner and associated equipment. They are responsible for acceptance testing and quality assurance of the scanner, development of protocols and quantitative analysis of PET scans. They are involved in the introduction of new techniques such as respiratory gating and the use of PET for treatment planning and support clinical research studies including the evaluation of novel PET compounds. These posts are part of the service level agreement between LUHD and UoE.
