Nuclear medicine is the medical specialty dedicated to the use of radioelements (radioactive isotopes) for the study, diagnosis and treatment of pathologies affecting organs or tissues.

These radioelements emit different types of radiation, including photons, positrons, negative beta particles or alpha rays. This makes it possible to see and analyze the functioning of various organs.

Thus, the doctor can access functional and metabolic imaging to detect lesions that may be deep, monitor their development, but also precisely guide any surgical procedure to be performed.

Nuclear medicine uses four types of images:

• dynamic images: a series of images captures movement or activity and makes it possible, for example, to observe the blood flow near an organ;
• static or planar images: the images are two-dimensional and appear one at a time;
• whole body images: they are two-dimensional and represent the front or back of the body;
• single-photon emission tomography images: the images are three-dimensional and make it possible to visualize the functioning of the organ studied.

Note that nuclear medicine complements radiology, ultrasound or magnetic resonance imaging. (IRM).

There are many reasons for doing a nuclear medicine imaging test. These include:

• detect a tumor;
• determine the spread of cancer;
• find out if cancer treatment is working;
• diagnose inflammation;
• check how well the heart pumps blood;
• or check the structure or function of tissues or organs, such as the brain, thyroid gland, liver, heart, kidneys or even bones.

The specialist uses medical imaging to diagnose and treat various pathologies. It intervenes before, during and after the examination:

• Before the examination, he questions his patient to find out his history of surgery, his allergies, his sensitivity to drugs, his symptoms. The radiopharmaceutical (radioisotope) is then administered by injection, inhalation or ingestion. It accumulates in the organ or tissue being examined, and then the examination can begin;
• During the examination, the patient lies on a specialized table and stands still. A gamma camera (stationary or not), a probe or even a PET (positron emission tomography) device captures the radioactivity emitted by the product. A computer creates images from it and the doctor analyzes and interprets them;
• After the examination, the doctor makes sure that all is well with his patient, and communicates the results to him.

There is minimal risk associated with radioisotope exposure to consultation with a nuclear medicine specialist. The dose of radioactive material administered depends on the type of procedure performed and the part of the body to be examined. Possible side effects are bleeding, swelling at the injection site, or an allergic reaction to the radiopharmaceutical. But it is extremely rare.

The doctor and / or his team will present these risks to you before the examination so that you can make an informed decision. It should be remembered that the doses of radioisotopes used for imaging examinations are low and do not present a health hazard when these examinations remain occasional. Also note that the possible risks are low compared to the benefits that these exams offer.

Become a specialist in nuclear medicine in France

To become a specialist in nuclear medicine, the student must obtain a diploma of specialized studies (DES) in nuclear medicine:

• he must first follow 6 years at the faculty of medicine, after his baccalaureate;
• at the end of the 6th year, students take the national classifying tests to enter the boarding school. Depending on their classification, they will be able to choose their specialty and their place of practice. The internship in nuclear medicine lasts 4 years and ends with obtaining the DES in nuclear medicine.

Finally, to be able to practice and carry the title of doctor, the student must also defend a research thesis.

Becoming a specialist in nuclear medicine au Quebec

After college studies, the student must:

• follow a doctorate in medicine, lasting 1 or 4 years (with or without a preparatory year for medicine for students admitted with a college or university training deemed insufficient in basic biological sciences);
• then specialize by following a residency in nuclear medicine for 5 years.

Before going to the appointment, it is important to take recent prescriptions with you, but also any imaging exams already carried out (x-rays, scans or MRI).

To find a nuclear medicine specialist:

• in Quebec, you can consult the website of the association of medical specialists in nuclear medicine in Quebec (3);
• in France, via the website of the Ordre des médecins (4).

When the consultation with the pediatrician is prescribed by an attending physician, it is covered by the Health Insurance (France) or the Régie de l’assurance maladie du Québec.