1、个人简介个人简介 姓名：谢永双姓名：谢永双 副教授，中共党员副教授，中共党员 19981998年广西医科大学本科毕业年广西医科大学本科毕业 20042004年硕士研究生毕业年硕士研究生毕业 个人简介个人简介 广西医科大学核医学教研室教师广西医科大学核医学教研室教师 一附院核医学科副主任医师一附院核医学科副主任医师 主要负责五年制班、本硕班、主要负责五年制班、本硕班、全英班的核医学教学全英班的核医学教学 Introduction Nuclear medicine department of GXMU Yongshuang Xie Nuclear Medicine Definition Conte
2、nt Main characteristic History review and present situationDefinitionIt is a discipline that exploits the properties radioactive forms of various elements in the diagnosis and treatment of disease and medical research.Main ContentsExperimental Nuclear MedicineClinical Nuclear Medicine Radionuclide t
3、racing technique Radionuclide dynamic analysis In vitro radioassay Activation analysis Radioautography Experimental Nuclear Medicine核医学的内容核医学的内容实验核医学实验核医学其任务是研究医学领域的疑难问题，发展、创立新的诊疗技术和方法，推动临床核医学的发展。实验核医学相当于外科学的解剖和生理学，为正确应用核技术提供理论基础。diagnostic nuclear medicine therapeutic nuclear medicine Clinical Nucl
4、ear MedicineNuclear MedicineExperimental nuclear medicineClinical nuclear medicineTracing techniqueDynamic analysisIn vitro radioassayRadioautographyActivation analysisDiagnosisTherapyIn vivoIn vitroImagingFunctionExternal irradiationinternal irradiationRadioimmunoassayImmunoradiometric assayNuclear
5、 Medicine In imaging the radiopharmaceuticals are detected by special types of cameras that work with computers to provide very precise pictures about the area of the body being imaged.Nuclear MedicineNuclear Medicine In treatment,the radiopharmaceuticals go directly to the organ being treated.Main
6、characteristic of nuclear medicine structure and function imaging identify abnormalities very earlier than other diagnostic test Being safe,painless,and cost-effective Character Both structure and function.CharacterCharacter 促进促进 医学的发展医学的发展 核医学的发展核医学的发展 促进促进 如：免疫学的发展导致放射免疫分析技如：免疫学的发展导致放射免疫分析技 术诞生，促进
7、放射免疫显像、放射术诞生，促进放射免疫显像、放射 免疫技术的发展。免疫技术的发展。计算机发展促进核医学影像技术的发展计算机发展促进核医学影像技术的发展绪论绪论核医学与医学的发展核医学与医学的发展History review and present situationNuclear MedicineNuclear Medicine 核医学是一门年轻的学科，从1896年发现放射现象至今也只有114年的历史，而从核医学的起源到现在仅几十年，真正形成核医学学科的历史则更短。1896 1896 BecquerelBecquerel 发现放射现象发现放射现象 物理学奖物理学奖1903 1903 Marie
8、.CurieMarie.Curie 发现镭等元素发现镭等元素 物理学奖物理学奖1911 1911 Marie.CurieMarie.Curie 化学奖化学奖1908 1908 Rutherford Rutherford 发现铀能发射发现铀能发射和和粒子，化学奖粒子，化学奖1921 1921 Frederick Soddy 放射性物质和天然同位素研究，化学奖，放射性物质和天然同位素研究，化学奖，“同位素同位素”一词也是他一词也是他19131913年与苏格兰物理学家年与苏格兰物理学家Margaret ToddMargaret Todd在一次午餐谈话中提出在一次午餐谈话中提出.1921 1921 A
9、lbert Einstein Albert Einstein 发现光电效应的定律获物理奖发现光电效应的定律获物理奖1922 1922 Aston Aston 发现大量同位素及其质谱获化学奖发现大量同位素及其质谱获化学奖1923 1923 Millikan Millikan 在元素的光电效应电荷研究方面获物理学奖在元素的光电效应电荷研究方面获物理学奖1927 1927 Compton Compton 发现了以他本人名字命名的发现了以他本人名字命名的“ComptonCompton效应效应”获物获物理学奖理学奖1935 1935 JoliotJoliot和他的妻子和他的妻子IrIrnene Joli
10、ot-Curie Joliot-Curie人工方合成新的放射性人工方合成新的放射性元素获化学奖元素获化学奖核医学与诺贝尔奖1935 Chadwick 发现了中子获物理学奖发现了中子获物理学奖 1936 Anderson 发现了正电子获物理学奖发现了正电子获物理学奖1938 Fermi 用中子辐照和慢中子核反应生产出新的放射性核素获物理学奖用中子辐照和慢中子核反应生产出新的放射性核素获物理学奖1930 Ernest Orlando Lawrence 生产出回旋加速器生产出回旋加速器1939年获得物理学奖年获得物理学奖1923 Hevesy 首先用同位素进行生命科学示踪研究，提出了首先用同位素进行
11、生命科学示踪研究，提出了“示踪技术示踪技术”的的 概念，概念，1943年获诺贝尔化学奖。年获诺贝尔化学奖。1944 Hahn 在原子核裂变研究方面获化学奖在原子核裂变研究方面获化学奖1960 Libby 发明了放射性发明了放射性14C测龄技术获化学奖测龄技术获化学奖1959 Berson和和Yalow 建立了放射免疫分析法建立了放射免疫分析法1977年年Yalow获诺贝尔医学奖获诺贝尔医学奖1984 Jerne等等 在免疫系统的控制以及单克隆抗体的研究中获医学奖在免疫系统的控制以及单克隆抗体的研究中获医学奖核医学与诺贝尔奖 Becquerel 1896年法国物理学家 Becquerel发现了铀
12、的放射性，第一次认识到放射现象。他在研究铀盐时，发现铀能使附近黑纸包裹的感光胶片感光，由此断定铀能不断地发射某种看不见的，穿透力强的射线。1903年与Curie夫人共获Nobel物理学奖。History look backMarie S.Curie 18981898年在巴黎的波兰化学家年在巴黎的波兰化学家Curie Curie(1867-1934)(1867-1934)与他的与他的丈夫丈夫 Pierre Pierre共同发现了镭共同发现了镭（即（即8888号元素），他们从号元素），他们从3030吨沥青铀矿中提取了吨沥青铀矿中提取了2mg2mg镭。镭。此后，又发现了此后，又发现了PuPu和和Th
13、Th天然天然放射性元素。放射性元素。19031903年年CurieCurie与与 Bequerel Bequerel共共获获NobelNobel物理学奖，物理学奖，19111911年年又获得又获得NobelNobel化学奖。化学奖。History look backDanlos(1844-1912)19011901年法国医师年法国医师DanlosDanlos将放射性镭将放射性镭与结核的皮肤病变接触，试图治疗皮肤与结核的皮肤病变接触，试图治疗皮肤病，可以说是第一次医学应用。病，可以说是第一次医学应用。History look backThe father of clinical nuclear
14、medicine 1926年美国Boston内科医师 Blumgart首先应用放射性氡研究循环时间，第一次应用了示踪技术（将氡从一侧手臂静脉注射后，在暗室中通过云母窗观察其在另一手臂出现的时间，以了解动-静脉血管床之间的循环时间），后来他又进行了多领域的生理、病理和药理学研究。被誉为”临床核医学之父”。History look backThe father of experimental nuclear medicine 美国化学家Hevesy，最早将同位素示踪技术用于植物的研究、人体全身含水量等生理学研究，并发明了中子活化分析技术。于1943年获得了Nobel奖金。并被称为The fathe
15、r of experimental nuclear medicine。History look backErnest Lawrence 1930年美国加州大学校园里，物理学家Ernest Lawrence生产出一个回旋加速器，并生产出多种同位素。1936年，他的兄弟，内科医师John Lawrence 首先用P-32治疗白血病。1939年获物理奖。History look backModern cyclotronIrene Curie&Frederic Joliot1934年，法国放射化学家Curie 和她的丈夫 Joliot用a粒子照射Al 产生放射性30P,第一次用人工核反应方法生产出放射
16、性核素。同年Fermi 等人用中子源轰击靶核生产出多种核素。David Kuhl 1952年美国Pennsylvania大学一年级医学生David Kuhl设计了扫描机光点打印法。1959年他又用双探头的扫描机进行断层扫描，并进一步研制和完善断层显像仪器，使得SPECT和PET成为核医学显像的主要方法。1996年获得了“Cassen award”，被称为The father of emission tomography。可以认为，没有他的远见，核医学有可能不会发展成为具有特色的专业。History look backThe father of emission tomographyAnger
17、andcamera 1957年Anger研制出第一台照相机，称之为 Anger照相机，1963年在日内瓦原子能和平会议上展出。它克服了逐点扫描打印的不足，使核医学显像走向现代化阶段。History reviewBerson&Yalow 1960年美国的Berson和Yalow 将核技术与免疫学技术相结合建立了放射免疫分析法，并首先用于测定血浆胰岛素浓度，由于该法对医学的巨大贡献，1977年Yalow获得了Nobel Prize。History reviewRadioimmunoassayv显像仪器的发展：显像仪器的发展：直线扫描机直线扫描机 照相机照相机 SPECT 符合线路符合线路SPECT
18、 PET CT/PET与与 CT/SPECT。核医学的现状与进展核医学的现状与进展v分子核医学的形成：分子核医学的形成：应用核医学示踪技术从分子水平认识应用核医学示踪技术从分子水平认识 疾病，为临床诊断、治疗疾病的研究提疾病，为临床诊断、治疗疾病的研究提 供分子水平信息甚至分子水平的治疗手段。供分子水平信息甚至分子水平的治疗手段。使医学影像技术走向使医学影像技术走向“分子影像分子影像”时代。时代。核医学的现状与进展核医学的现状与进展Molecular nuclear medicine 受体密度与功能受体密度与功能基因的异常表达基因的异常表达生化代谢变化生化代谢变化细胞信息传导细胞信息传导临床诊
19、断临床治疗疾病研究提供分子水平信息分子水平治疗手段分子影像学的形成分子核医学的形成v治疗核医学的形成与发展治疗核医学的形成与发展 1901年年 镭镭 结核性皮肤病灶结核性皮肤病灶 1903年年 镭镭 近距离肿瘤治疗近距离肿瘤治疗 1905年年 镭镭 突眼性甲状腺肿突眼性甲状腺肿 1939年年 32P 白血病白血病 1942年年 131I 甲状腺功能亢进症甲状腺功能亢进症 核医学的现状与进展核医学的现状与进展v治疗核医学的形成与发展治疗核医学的形成与发展 核素治疗与化疗、放疗的本质区别：核素治疗与化疗、放疗的本质区别：利用核射线治疗疾病利用核射线治疗疾病治疗药物对病变组织具有选择性治疗药物对病变
20、组织具有选择性治疗作用持久治疗作用持久方法安全、简便方法安全、简便 核医学的现状与进展核医学的现状与进展v治疗核医学的形成与发展治疗核医学的形成与发展 发展方向：发展方向：放射性核素的研究放射性核素的研究 携带放射性核素的载体研究携带放射性核素的载体研究 具有前景的研究领域：具有前景的研究领域：放射免疫靶向治疗放射免疫靶向治疗 受体介导的靶向治疗受体介导的靶向治疗 放射性核素基因治疗放射性核素基因治疗 放射性核素微粒肿瘤组织间定向植入治疗放射性核素微粒肿瘤组织间定向植入治疗 核医学的现状与进展核医学的现状与进展K L MAtomneutrons(中子)Protons（质子）nucleon+el
21、ectrons -Configuration of AtomAtomNucleusProtonQuark10-8 cm 10-12 cm 10-13 cm 82.Velocity of particle is 20 thousand km/s in vacuum.It can be blocked off by a paper,since the flight of particle is short.Ionization is more than particle Beta decayBeta decay Emit particles and capture orbital electron
22、s.To be a companion to increase or decrease of atomic number,but the mass number of the new nuclei is the same.Including,and electron capture.Velocity of particle is 200 thousand km/s in vacuum.Penetrability is more than alpha particle.-decay Emit particles Neutron rich nuclei Neutron proton The mas
23、s number of new nuclei is the same as the parent nuclei,atomic number increase 1n p+QMeVSP71.132163215 decay Emission of particle Neutron poor nuclei A proton to neutron transformation Artificial radionuclidep n+e+189F188O+0.66MeVElectron capture,EC An orbital electron is captured to form a neutron.
24、Neutron poor nuclei A proton to neutron P+e-nCharacteristic X-rayAuger electronMneFe55255526Gamma decay and internal conversion Gamma decay may be a part of another decay process,such as ,EC or -Metastable to stable state transition and emission of electromagnetic(transition)New nuclei mass and prot
25、on is the same,but energy changed Internal conversion and Internal conversion electronInternal conversionelectronray)140(994369943669942keVTcTcMohmhGamma decay and internal conversion When the nucleus moves from a higher to a lower energy,either a gamma ray is produced or the deexcitation energy is
26、used to eject an orbiting electron.This latter process is called internal conversion.This orbiting electron is called internal conversion electron(IE).Characteristic of ray Gamma ray is photon No electric charge Penetrability is more than charged particle Low ionization abilityComparison of three de
27、cayalpha decaybeta decaygamma decayMass changedyesnonoProton changedyesyesnoEnergy changedyesyesyes The number of atoms(N)of a given original population(No)which will remain after a given time interval(t)can be calculated by the equation:N=No e-t The law of nuclear decay The law of nuclear decay Dec
28、ay formula：N=Noe-t Decay constant：Decay constant equals to fraction of nuclei decaying per unit time.Characteristic：every radionuclide has different.Commonness：This is the basic exponential equation for radioactive decay.Radioactivity is the number of atoms decaying per unit time.If desired,the equa
29、tion also can be written in terms of radioactivity(A).A=A o e t A0The law of nuclear decay Half lifePhysical half life，(T1/2)the time it takes for one half of the original number of atoms to decay.The longest T1/2 10101010a.a.The shortest The shortest T1/2 1010-10-10s.s.2/1693.0TT1/2=0.693/When half
30、 of the radiopharmaceutical within the body remains,this time is called the biological half time.Biological half life Effective half life：The combination of the physical half life and the biological half life is called the effective half life.Thus T Teffeff will be less than either the biological or
31、 the physical half life.bbTTTTTe2/12/1Effective half life：例：例：I-131I-131在甲状腺的在甲状腺的TeTe计算，计算，I-131I-131物理物理T1/2T1/2为为8.18.1天，设天，设TbTb为天；为天；Te=(8.1x7)/(8.1+7)=3.75天。天。Radioactivity Radioactivity is the number of atoms decaying per unit time.One becquerel(Bq)equals one disintegration per second.a curie
32、(Ci)is 3.7 x 1010 Bq Other unit：KBq、MBq、GBq，Ci、mCi、Ci。Interaction of ray and matter Interaction of charged particle and matter Ionization and excitation Ionization：、matterelectronse-leave orbitfree electron；Charged particlee-Ion pairsSecondary ionization33.85eVmatter Excitation：andmatterorbit e-and
33、got energylow levelhigh levelexcitation state deexcitation Characteristic X-ray and Auger electron Charged particleparticle(deexcitation)Scattering scattering is a class of phenomena by which particles are deflected by collisions with other particles.particleparticleBremsstrahlungBremsstrahlung An e
34、lectron traversing a material may come close enough to the nucleus of an atom that it is sharply deflected in its path due to its attraction to the protons.This acceleration of the electron may produce what is termed a bremsstrahlung photon.particleparticleX-rayAnnihilation radiation The positron is
35、 emitted with a certain amount of kinetic energy that it loses as it moves through its environment.When it comes to rest,it annihilates with a nearby electron to produce two 511 keV annihilating photons moving in opposite directions.This process is called annihilation radiation.Interaction of photon
36、 and matterphotoelectric effect In photoelectric absorption,a photon interacts with the atom,losing all its energy in the process.An inner shell electron(usually a K shell electron)is ejected from the atom.The process is called photoelectric effect.X rayAuger electronphotoelectronKLElectron vacancy
37、filledMe-Incident photonPhotoelectric effectCompton effect Energy range：Several to 0.5MeV Part energy give orbital electrons Residual energy give scattered photonIncidence Compton e-scatteringElastic collisionKLMElectron pair production Photon energy greater than 1.02MeV passes near the high electri
38、c field of the nucleusincidence511keV511keV+e-free electrone-e+Nuclear Medicine Instrumentation What is Nuclear Medicine Instrumentation?How does it work?1.conceptionNuclear medicine instrumentation is essential for nuclear medicine clinical practice and research.imaging instrumentation non-imaging
39、instrumentationIntroductionBasic principle interaction of ray and matter Charged particle:ionization,excitation photon:photoelectric effect electron pair compton effect Basic configuration Radiation detector-crystal scintillation detector the energy of the gamma photon to the pulses of electrical cu
40、rrent transformation.Electronics part different device for different need.Schematic diagram of scintillation detector configuration Scintillation detector Electronic circuitry Recording device Scaler Count rate meter Imaging equipment Scintillation counter cameracamera、ECTECTMainly type of detectorT
41、here are many kinds of detector.Scintillation detector are the most important in tracer imaging.Scintillation detector A radiation detector of the type utilized in nuclear medicine basically acts as a transducer which transforms incoming radiation(gamma photons)into visible light(light photons).This
42、 is the property which made these radiation detectors known as scintillation detector.Scintillation detector NaI(Tl)crystal Photomultiplier(PMT)Pre-amplitierImaging instrument Camera SPECT PET Coincidence circuit SPECT Gamma Scintillation CameraThe main instrument for nuclear medicine imaging is the
43、 large field of gamma camera,First developed in 1956 by Hal Anger.this device has become the main imaging tool of nuclear medicine.Gamma Scintillation CameraIt is consists of:a lead collimator;a scintillation crystal;an array of photomultiplier tubes on the crystal;a positioning logic network;a puls
44、e height analyzer;and an image recording and display device,which is typically a computer system.Gamma Scintillation CameraTomography device ECT：Emission computed tomography SPECT:single photon ECT (one-head,two-head)PET:positron emission tomography SPECT SPECT is performed with a rotating Anger cam
45、era mounted on a special gantry that allows 360-degree rotation around the patient.One-head SPECTMost modern imaging devices have the ability to demonstrate internal structures or functinal information as a sectional sliceTwo-head SPECT GE two-head SPECTtomographyWhole body imaging Siemens tri-head
46、SPECTSPECT imaging Coincidence circuit SPECT SPECT systems used without collimators in a coincidence mode is coincidence circuit SPECT which can be used to detect the two 511-keV annihilation photons.Comparison of ECT and CT,MRI ECT imaging is function and structure imaging,but structure imaging isn
47、t clear like CT,MRI imaging.CT,MRI imaging is structure imaging.ECT imaging shows a cross section of a body with a distributed radiopharmaceutical emitting-ray.CT imaging shows a cross section of a body with a external source emitting X-ray.PET One of the most exciting tomographic techniques is posi
48、tron emission tomography scanning.Positron emitting radionuclides are used with this technique.Siemens PETPETPETPET tracers Decays by emitting a positron A short life Chemically combined with a metabolically active molecule A waiting period11C,13N,15O,18FPET IsotopesNuclide T1/2ProductionCarbon-1120
49、.4 min 10B(d,n)11C Nitrogen-13 9.96 min 12C(d,n)13NOxygen-152.05 min 14N(d,n)15O16O(p,pn)15O12C(a,n)15OFluorine-18110 min 18O(p,n)18FCopper-6412.7 hrs64Ni(p,n)64CuPETImage fusion techniqueTo correlate the relativly coarse PET images to high-resolution anatomic images acquired by MR imageing or CT is
50、 called image fusion.Image fusion techniqueImage fusion techniqueImage fusion techniqueCT-PETPET Brain Metabolism ImagingCT-PET fusion放射治疗计划前后随访放射治疗计划前后随访PET-MRI Imaging FusionNonimaging instrument Uptake Probe Well Counter Dose Calibrator Survey MeterThyroid uptake system Well Counter/Uptake Probe
