Most people have never heard of nuclear medicine, but it’s a fascinating medical field that blends physics, chemistry, and biology. Joanna Lewis speaks with Sarah Cade, head of medical physics and bioengineering nuclear medicine at the Royal United Hospitals Bath NHS Foundation Trust to learn more about the field and the hospital’s campaign to raise funds for a new PET-CT scanner. Image: Sarah Cole, head of medical physics and bioengineering nuclear medicine at the Royal United Hospitals Bath NHS Foundation Trust; Credit: Paul Gillis Photography
Despite its profound impact on modern healthcare, nuclear medicine is a speciality that many people outside the medical world have never heard of. Using tiny amounts of radioactive materials, nuclear medicine is used to help visualise, diagnose, and treat disease, from cancer to lung conditions, infections, and neurological conditions like epilepsy and dementia.
Unlike traditional imaging, which primarily shows anatomy, nuclear medicine focuses on function, capturing processes such as metabolism, blood flow, receptor activity, and cellular behaviour.
“So, it’s quite different to things like CT and MRI,” explains Sarah. “CT and MRIs tend to give you structural information. If you break your arm, for example, you have an X-ray, and you can see where the break is. In nuclear medicine, we’re not looking for these kinds of structural changes. What we are doing is injecting a radioactive material into our patients, and that radioactive material is joined to a particular chemical or drug used in the part of the body we’re trying to look at.
“For example, if we want to look at any part of the body that uses sugar, we will inject radioactive sugar. The sugar will emit radiation, so we can then put patients into our scanner a while after the injection. And any areas that have taken up that radioactive sugar will effectively glow brighter on our images, so we can see areas that are more active, that are using more sugar.”
A new scanner
The scanner is a central tool to nuclear medicine, and The Royal United Hospitals Bath is now campaigning to raise £4m for a new PET-CT scanner and extension.
The current PET-CT scanner is nearing 10 years old and is therefore near end of life. While Sarah notes that it will continue to operate for the next few years, when these high-tech machines near end of life they become less reliable.
“We want to be able to keep up with the latest advancements,” Sarah notes. “The new scanner will allow us to scan our patients faster and get better quality images and potentially use a smaller amount of radioactivity.”
Being able to use a smaller amount of radioactivity is one of the key drivers as, Sarah notes, the radiation, while small, is potentially dangerous.
“There are always risks with every treatment. A big part of my job as a physicist is making sure we are using the radiation as safely as we can and really optimising what we’re doing so we are minimising the risks while still getting high-quality images. And obviously, the new scanner is kind of pivotal to that because we will be able to use slightly less radioactive material.”
Another key benefit of a new PET-CT scanner is the ability to scan patients quicker, helping with the hospital’s waiting lists and growing demand for the service. Currently, the RUH scans around 1,900 patients a year, with the demand for the service growing by around 10% each year. With the new scanner, Sarah says the team will be able to go from scanning around eight or nine patients a day to around 15 or 16 patients a day.
A lead-lined extension
But with that growth comes other needs, including more admin staff to manage bookings, radiologists to interpret the scans, and, most notably, a new extension, which Sarah describes as a complex and highly expensive project due to the ionizing radiation.
The expense of the new extension is two-fold. Firstly, the walls will need to be made of lead, as the extension will be for patients who are waiting to be scanned and have been injected with a radioactive material, meaning they are radioactive, and, therefore, must wait in a lead-shielded room to protect staff.
“At the moment, we have three uptake rooms,” Sarah explains. “We have one patient waiting in each room for an hour, and then we scan each of them for around 20 minutes. The extension will add a further two uptake rooms, so we can treat more patients with the new scanner.”
Secondly, the extension will need to be hand-dug to protect the existing scanners. “The detectors are basically crystals, so if there’s too much vibration, they shatter,” Sarah says.
The existing scanner was the first PET-CT scanner at the RUH, marking a significant milestone in the hospital’s history. The new scanner will help the team meet rising demand, improve patient experience, and ensure the hospital can continue delivering cutting-edge diagnostic care for years to come. For a field that often goes unnoticed by the public, the impact of nuclear medicine, and a new PET-CT scanner, is anything but invisible.
To learn more about the campaign, visit ruhx.org.uk/pet-ct