Nuclear Medicine
Molecular imaging, tracer biology, theranostics, dosimetry and cross-specialty workflows.
Tracer–target relationship
Start with what biological process or molecular target the radiopharmaceutical represents.
- Capture
- Radiopharmaceutical, radionuclide, molecular target/process, administered activity as source data when clinically required, date.
- Why it matters
- Interpretation begins with biology; uptake is not synonymous with malignancy.
Common trap
Do not treat tracer uptake as a generic cancer marker independent of target biology.
18F-FDG family
A glucose-metabolism tracer family used broadly across oncology in validated settings.
- Capture
- Clinical question, preparation/quality context, acquisition, relevant uptake pattern and comparison study.
- Why it matters
- The same uptake pattern can have malignant, inflammatory, infectious or physiologic explanations.
Common trap
SUV alone is not a diagnosis.
PSMA-targeted imaging / therapy pathway
PSMA-targeted agents support target-expression imaging and, in validated settings, radioligand-therapy pathways.
- Capture
- Agent, clinical context, target-positive disease distribution, discordant lesions, prior imaging/therapy.
- Why it matters
- The theranostic concept links demonstrated target expression with appropriately validated treatment pathways.
Common trap
PSMA uptake is not completely specific to prostate cancer and must be interpreted anatomically and clinically.
Somatostatin-receptor pathway
SSTR-targeted imaging characterizes receptor expression and can connect to peptide-receptor radionuclide therapy pathways in appropriate settings.
- Capture
- Agent, receptor-positive disease distribution, relevant discordance, comparison imaging, prior therapy.
- Why it matters
- Target heterogeneity can matter as much as overall positivity.
Common trap
Do not reduce a heterogeneous scan to a single positive/negative field.
Radioiodine pathway
Iodine handling by thyroid tissue underpins diagnostic and therapeutic radioiodine workflows.
- Capture
- Clinical context, iodine preparation/contamination issues, distribution, therapy history, relevant laboratory context.
- Why it matters
- Preparation and competing iodine exposure can materially affect interpretation and therapy.
Common trap
A technically compromised study should not be interpreted as biologically negative.
Hybrid imaging
Combine molecular information with anatomical localisation from CT/MR where available.
- Capture
- Modality, attenuation/anatomical dataset, registration quality, lesion localisation.
- Why it matters
- Molecular uptake becomes clinically useful when accurately localised and compared with structural imaging.
Common trap
Misregistration and physiologic uptake can mimic disease.
Acquisition quality & preparation
Record preparation and technical quality as evidence, not as invisible assumptions.
- Capture
- Preparation, uptake interval when relevant, motion, artefact, injected/extravasated activity issues, scanner/protocol context.
- Why it matters
- Technical limitations can change sensitivity, quantification and confidence.
Common trap
A negative or low-uptake study is not reliable if key quality conditions failed.
Response assessment
Response interpretation must use a named framework and comparable studies when such a framework is applicable.
- Capture
- Baseline/comparator, criteria/framework, lesion changes, new lesions, uncertainty.
- Why it matters
- Visual impression and formal response classification are different outputs.
Common trap
Do not compare quantitative values across incompatible acquisition conditions without qualification.
Theranostic workflow
Separate target demonstration, treatment eligibility, administered therapy, dosimetry and response into traceable steps.
- Capture
- Eligibility source, target-expression evidence, agent, cycle/date, dosimetry when used, toxicity/response follow-up.
- Why it matters
- Theranostics connects diagnostics and therapy but should not collapse them into one opaque decision.
Common trap
Imaging positivity alone does not automatically establish treatment eligibility outside the applicable validated criteria.
Dosimetry
Treat dosimetry as a structured measurement process with model, assumptions, timepoints and uncertainty.
- Capture
- Method/model, timepoints, organs/lesions, absorbed dose estimates, uncertainty, software/version.
- Why it matters
- Dose estimates depend on acquisition and modelling choices and should remain reproducible.
Common trap
A single dose number without method and uncertainty is not fully interpretable.
Radiation protection & practical constraints
Keep radiation-safety requirements and release instructions as a jurisdictional implementation layer.
- Capture
- Applicable regulation/guideline, patient instructions, staff/public considerations, local facility requirements.
- Why it matters
- Safety obligations vary by radionuclide, procedure and jurisdiction.
Common trap
Do not copy one country’s release or radiation-protection rules into another jurisdiction.
Radionuclide-guided surgery
Represent radioguided localisation as a cross-specialty workflow linking tracer administration, intraoperative detection and pathology.
- Capture
- Tracer, timing, target/basin, detector method, specimens retrieved, pathology correlation.
- Why it matters
- This is a natural bridge between Nuclear Medicine, Surgery and Pathology.
Common trap
Detection success is not equivalent to pathological positivity.