The Diagnostics

The Nuclear Medicine Department at Gemelli is probably the largest in Italy in terms of the number of services available and the number of staff involved, it offers affiliated and private patients all the diagnostic and therapeutic procedures with radiopharmaceuticals that can be performed today, from the most conventional to the experimental ones. It is in fact equipped with a laboratory for the production of experimental radiopharmaceuticals (TracerGlab) and a laboratory for experimentation on small animals at the hospital of the university (Cenris).

Linked to university

The Department of Nuclear Medicine is a structure of the Polyclinic Gemelli IRCCS Foundation with functions as "headquarters" of the School of Specialization in Nuclear Medicine of the University.

The university and hospital staff are therefore involved in both diagnostic and therapeutic activities in Nuclear Medicine and Teaching at the Degree Courses, the Specialization Schools, the Doctoral, Master and Postgraduate courses of the University, as well as the activities of research in Nuclear Medicine both at the University and at the IRCCS.

Staff

In addition to the Director (Prof. Alessandro Giordano) and the Secretary (Dr. Josephine Seminara), the Department of Nuclear Medicine counts among its staff:

• PET-CT Center (10,000 exams per year),
• 8 Specialists in Nuclear Medicine (2 with university teaching role),
• 2 Specialists in Diagnostic Imaging,
• 5 Health Technicians of Medical Radiology,
• 9 Administrative staff,
• 6 Radiopharmacy staff,
• 2 Conventional Nuclear Medicine and Therapy Service (9,000 services/year),
• 7 Specialists in Nuclear Medicine (2 with university roles),
• 8 Health Technicians of Medical Radiology,
• 4 Administrative staff,
• 1 Radiopharmacist,
• 4 OSS personnel.

In rotation between the two departments

• 14 Postgraduates (average of 3 per year for each of the 4 years of Specialization),
• 8 Nurses,
• 2 Health physicists.

Investigation

Many other diagnostic investigations are carried out with variable trends based on the requests that come from wards/outpatient patients:

• Thyroid scans (about 10/week),
• Lung perfusion scans (about 5/week),
• Kidney scans (about 10/week),
• Salivogram (about 1/week),
• Study of the esophagus-gastric transit (about 5/week),
• Study of intestinal permeability (about 12/week),
• Study of intestinal bleeding (rare),
• Hepato-biliary scintigraphy (rare),
• Adrenal scintigraphy (about 2/week),
• Lymphoscintigraphies (about 5/week).

In addition, 5 beds for radionuclide therapy (protected ordinary hospitalization), managed in collaboration with the Radiotherapy UOC, allow the carrying out of Medical-Nuclear Therapy for:

• Thyroid neoplastic pathology (about 12 per week),
• Benign thyroid disease (about 4 per week),
• Neuroblastomas (rare),
• Hepatic neoplasms, by means of radioembolization technique in an operating room of the Interventional Radiology (about 40 every year).

Excellent equipment and methods

The Nuclear Medicine Complex Operating Unit boasts the presence of numerous high-tech work tools:

• A 19 MeV Cyclotron: 2 radiopharmacies compliant with the recent legislation on the preparation of radiopharmaceuticals, with handling cells in a sterile environment,
• 2 PET-CT Tomographs:
  • Siemens Biograph TF (2013),
  • Siemens Vision (2020),
• 5 cameras:
  • 2 SPECT-TC dual head Siemens Intevo2 (2014),
  • 1 SPECT cardiodedicated CZT DSPECT (2013),
  • 1 GE Infinia Dual Head SPECT-TC (2004),
  • 1 single head GE millennium MG (2008),
• 3 probes for radio-guided surgery.

Radiopharmaceuticals routinely used at the Nuclear Medicine Department

• For scintigraphy:
  • 99mTc-HMPAO,
  • 99mTc- pertechnetate,
  • 99mTc-sestaMIBI,
  • 99mTc-tetrofosmin,
  • 99mTc-albumin nanocolloids,
  • 99mTc-albumin macroaggregates,
  • 99mTc-DTPA,
  • 99mTc-HIDA,
  • 99mTc-D3c-99mTc MDP,
  • 99mTc-Stannous Pyrophosphate,
  • Sodium Iodide Capsules (123I),
  • 131I-Norcolesterol (Norcol),
  • 131I-meta-iodine-benzyl-guanidine,
  • 123I-meta-iodine-benzyl-guanidine,
  • 123I-ioflupane,
  • 67Ga-citrate,
  • 153Sm-EDTA,
  • 201TlCl.
• For PET:
  • 18F-FDG;
  • 68Ga-Regaloc;
  • 68Ga-PSMA;
  • 11C-Methionine,
  • 18F-Methylcholine;
  • 13N-Ammonia;
  • 18F-Vizamyl;
  • 18F-Neuracec;
  • 18F-DOPA.
• For therapy:
  • 131I-NaI;
  • 90Y-microspheres;
  • 223Ra-Dichloride,
  • 177Lu-oxodotreotide,
  • 177Lu-PSMA (experimental).

Research and publications

Areas of research in conventional Nuclear Medicine

• Changes and optimization of the rules of good preparation.
• Semi-quantitative functional imaging of the study of bone metabolism.
• SPET with 123I-FP-CIT in the clinical phenotypes of Parkinson's disease.
• Applications of radio-guided surgery.

Areas of research in the therapeutic field

• Simultaneous use of nuclear medicine diagnostic techniques for the personalized treatment of patients with differentiated thyroid carcinoma.
• Radiation protection in nuclear medicine.
• Dosimetry in nuclear medicine.

PET research areas

• Prognostic role of artificial intelligence applied to FDG-PET / CT.
• Use of different tracers for the application of PET / CT aimed at personalized medicine in various tumor pathologies.
• Clinical applications of radiomics.
• Evaluation of the diagnostic performance of PET / CT with different tracers in the study of different pathologies, cancerous and not.
• Diagnostic and prognostic role of PET / CT in inflammatory diseases.
• Role of PET / CT in neurodegenerative diseases.
• Correlation between quantitative PET parameters with different tracers and immuno-histochemical evaluations in some tumor pathologies.