Nuclear Medicine Helps Doctors Diagnose Tumors, Diseases

from The Children's Hospital (TCH) News, December 2004

By Kimberly Freeman

Getting children to sit still is hard enough for many parents, but imagine trying to get them to sit still for more than an hour while a camera produces images of various parts of their bodies.

For Becky Florea, nuclear medicine technology supervisor at The Children’s Hospital, getting kids to sit still is a daily challenge. But on any given day, she can talk a child into sitting perfectly still instead of having to sedate him or her.

“I work on building trust with the kids and help them understand that the camera isn’t intimidating,” said Florea, the only nuclear medicine tech at Children’s.

Nuclear medicine, a component of radiology, uses radioactive isotopes to image the body to help doctors diagnose and treat diseases. A child needing a procedure such as a bone scan or a HIDA scan for gallbladder function will get an intravenous injection of a minute trace of radioactive material that attaches to a certain type of molecule. Most of the time, the radioactive isotopes do not stay in the patient’s body longer than a day. Florea then would get a scan with a gamma camera, which does not emit radiation.

Through nuclear medicine, doctors are able diagnose and treat fractures, tumors and organ malfunctions, as well as locate the focal point in the brain where seizures occur.

Nuclear imaging often is a last resort for many doctors, Florea said. Before most patients are sent to nuclear imaging, they already have had X-rays or MRIs done. Florea said most of her procedures are bone and kidney scans.

“I am able to tell doctors how well kids’ organs are working,” she said.

Each day, Florea performs five to six procedures of 45 minutes to two hours. The day before procedures, she calls a nuclear medicine company to order all the doses of radioactive material for each patient. Every dose is specifically designed to go the area needing to be imaged, so it is important she has the correct doses for each patient.

After the patient is placed on the imaging table, the camera moves back and forth only a few inches from his or her body, producing images that are then sent to a computer screen.

Florea can see on the screen if a child’s organ is working by looking for excretions in a series of images. Because the radioactive substances congregate in areas of high metabolic activity, Florea also can locate tumors by looking for bright spots on the computer screen.

The Nuclear Medicine department uses the area’s only ADAC Dual Head Vertex Camera, which provides 3-D computer-reconstructed images of multiple views of the organ being imaged.

In addition to imaging patients, Florea also builds a rapport with families and children. Florea is frequently the first person many families see after finding out their child has cancer.

Instead of simply performing her procedures without much parent contact, Florea helps parents better understand what is happening to their child.

“I tell them they need to go and purchase a notepad right away and start jotting things down to ask their doctors,” Florea said. “Parents shouldn’t be afraid to ask questions.”

Besides building rapport with parents, Florea works on building rapport with children. She sees many of the same patients numerous times, so it is important for her to build trust with them, she said.

“I like the interaction with the kids and with their parents,” she said. “I get to gab with the parents and really get to know them.”

Florea’s bulletin board is proof of her success in building that rapport. Family portraits, thank-you cards and artwork are pinned one on top of another as constant reminders of her previous work.

“Kids are fun,” Florea said. “I’m more child-like, like them.”

Because Florea is the only nuclear medicine tech, she is on call 24 hours a day. If a child needs to be imaged as soon as possible, Florea must be ready to perform the procedure.

“This is a one-person show,” said Florea. “I don’t get any weekends off.”

Florea also considers herself a networker. When not in the dark imaging room, she can be found chatting with doctors, volunteers or visitors. She helps with Children’s 101 and high-school career tours.

“I really enjoy meeting new people,” she said. “Working at Children’s really has enabled me to network with so many people. I not only see these people at work but outside as well.”