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Nuclear medicine is a complex of methods for diagnosing and treating various pathologies, primarily oncological, using radioactive isotopes (radionuclides). Diagnosis is performed using PET and SPECT scanning, while therapy involves targeted radiation impact on disease sites in the body with minimal damage to healthy tissues. These methods are also used in cardiology (ischemic heart disease diagnosis), neurology (Alzheimer's disease and epilepsy diagnosis), endocrinology (thyroid disease treatment), and orthopedics (inflammation and hidden fracture diagnosis).
These methods differ from radiotherapeutic approaches, which use external directed beams of ionizing radiation (e.g., X-rays or electrons) to destroy tumors and for other clinical purposes.
Radionuclide Diagnostics
When certain cancers are suspected, and also to clarify diagnoses, doctors may prescribe radionuclide diagnostics – a high-precision molecular imaging method focused on detecting tumors, even several millimeters in size, and metastases throughout the body. Studies are conducted using radiopharmaceuticals (RPh) and modern tomographic methods such as scintigraphy (e.g., for bone tumor detection), single-photon emission computed tomography (SPECT/CT), and positron emission tomography with computed tomography (PET/CT).
The general operating principle of these methods is as follows: a radiopharmaceutical is administered to the patient, which selectively accumulates in specific tissues and organs depending on their metabolic activity or specific biochemical processes. For example, tumor cells are characterized by increased glucose consumption, so 18F-FDG, a glucose molecule labeled with fluorine-18 isotope, is often used as the agent. Then a special gamma camera, SPECT, or PET installation captures radionuclide radiation, creating images showing pathology patterns for the physician.
The main difference between radionuclide diagnostics and more common methods (e.g., MRI or CT) is that results provide not just an anatomical picture but a functional map allowing visualization of metabolic processes, blood flow, receptor distribution, and other biological activities in tissues. This allows, in the case of oncological pathology, detection of malignant neoplasms and metastases even before structural changes visible on other imaging methods appear.
Radionuclide Diagnostics Methods Available in Russia
In recent years, thanks to government focus on cancer disease problems as well as private clinic investments, Russia has formed a professional radionuclide diagnostics segment. Although scanner availability and study numbers in Russia are still lower than in the USA, Japan, or Germany, new radionuclide diagnostics centers are opening in the country and modern equipment is being purchased.
For example, the largest specialized PET-Technology network has opened 33 PET/CT centers in 25 regions since 2011, which have conducted 900,000 studies during this period. St. Petersburg company MIBS is also developing its PET/CT scanner network. Advanced nuclear diagnostics centers have been opened by clinics such as EMC, Hadassah Medical Moscow, Russian Railways Medicine, and Medsi Group in Otradnoye. In Khimki, a major specialized hub "Institute of Nuclear Medicine" appeared thanks to Medicine JSC investments. Government clinics and federal medical centers are also being equipped with PET/CT and SPECT scanners – funded by program budgets and other government sources. In Moscow in 2024, a modern radionuclide diagnostics and therapy center opened at the Kommunarka Moscow Multidisciplinary Clinical Center. In one year, over 5,000 patients underwent high-precision radioisotope diagnostics at the medical center.
In Russia as of 2024, according to Rosatom and Ministry of Health data, there were 178 operating SPECT devices and over 100 PET scanners in government and private clinics, whereas in 2015 there were only 54 PET scanners. In 2023, over 285,000 PET/CT studies and 533,000 examinations using SPECT/CT devices and gamma cameras were performed in Russia.