Head of the Department of Nuclear Medicine:
Davlatiarov Dilshod Gayratovich

The Department of Nuclear Medicine of the Center is the only institution in Central Asia licensed to work with an open source of radiation for medicinal purposes.

The Department of Nuclear Medicine complies with the working conditions set by the IAEA international standards of 18.02.98. on nuclear medicine, adopted in the city of Vienna and on the basis of the order of the Ministry of Health of the Republic of Uzbekistan dated 12.11.93. "On the radiological service in the medical field."

Over the past five years, a technical cooperation program has been implemented between the International Atomic Energy Agency (IAEA) and the Ministry of Health of the Republic of Uzbekistan (project No. UZB / 6006 /). Under the project, the IAEA donated the following medical equipment to the Endocrinology Center: a two-head OFEK tomograph Nucline TM SPIRIT DH-V and a stationary radiological laboratory FGH LAF model 40C1E (laboratory system for storing and packaging radiopharmaceuticals with a dosage calibrator).

The use of SPECT technologies made it possible to develop nuclear medicine in Uzbekistan for diagnostics and treatment, both in endocrine service and in other areas of medicine. Modernization of the nuclear medicine department of the RSNPMC Endocrinology of the Ministry of Health of the Republic of Uzbekistan, with the help of the IAEA, has made it possible to raise the diagnosis of various endocrine diseases to the world level.

Based on the Research Institute of Endocrinology from 2002 to 2010. several international training courses on East Asia were conducted under the auspices of the IAEA. Many specialists underwent training at the IAEA in European countries.

Six employees of the Department of Nuclear Medicine completed on-the-job training in nuclear medicine in European countries under the auspices of the IAEA, project #.UZB / 6006 /.

Several international training courses on Eastern Eurasia under the auspices of the IAEA were held at the Center of Endocrinology:

• May 12-18, 2003 - international training course “Application of radioimmunoassays in oncology and endocrinology”.
• 19-23 August 2004 - international training course "Diagnostics and treatment of complications of diabetes mellitus in nuclear medicine".
• April 13-18, 2005 - international training course "Diagnostics and treatment of cancer in nuclear medicine".
• July 6-10, 2009 - international training course "Application of SPECT technologies in oncology and cardiology".

On the basis of the Department of Nuclear Medicine, modern, improved diagnostics and treatment of patients with endocrine pathology are carried out in compliance with international WHO standards.

The department conducts radionuclide examinations of the thyroid and parathyroid glands, dynamic renal examination - renography and static examination of the kidneys, bone scintigraphy, heart SPECT and dynamic liver examination. Over the period from 2010 to 2015, more than 9000 radioisotope studies were carried out.

Postoperative treatment of highly differentiated thyroid cancer (DTC) NaJ131 patients with their regular monitoring (determination of thyroglobulin in serum and scintigraphy with iodine isotopes) is carried out. For five years, 460 patients with thyroid cancer have been successfully treated with iodization, 57 of them are from Central Asian countries. The five-year survival rate was 95%. The goals of radioiodine therapy for thyroid cancer are (Nuclear Medicine in Thyroid Cancer Manegement, IAEA 2009).

• destruction of the remaining after surgery fragments of the gland, as well as foci of tumor tissue if it is impossible to remove it radical;
• detection of differentiated thyroid cancer metastases not detected by other diagnostic methods and their simultaneous treatment;
• destruction of cells synthesizing thyroglobulin, which allows it to be correctly used as a tumor marker during further observation.
• radioiodine therapy is recommended after thyroid ectomy for thyroid cancer in most cases. when: leaving the primary tumor focus outside the thyroid capsule and the presence of regional and / or distant metastases.

Radioiodine therapy with NaJ131 is performed in patients with various etiology of thyrotoxicosis. Over five years, radioiodine therapy was administered to 848 patients with thyrotoxicosis, 121 of them from neighboring countries.

Recently, the department has widely used the third generation drug - Samarium 153Sm oxabifor. The combination of β- and γ-radiation in the spectrum of the drug, a relatively short half-life of 46.3 hours, as well as a low radiation energy of 0.81 MeV made it one of the most demanded RP for the palliative treatment of multiple metastatic skeletal lesions and in chronic diseases of the musculoskeletal system. -motor apparatus (deforming arthrosis).

Also, on the basis of our department, the radiopharmaceutical "Br omezide, 99mTs" has been tested for the study of the hepatobiliary system, which is highly competitive due to a specific protein of blood serum, with endogenous compounds such as bilirubin and low renal clearance.

2000 patients with various endocrine pathologies undergo outpatient examination (scanning, renography, iodine diagnostics, scintigraphy) in the Department of Nuclear Medicine for a year.

Modernization of the X-ray radiological, technical base of the Endocrinology Center will allow for modern, improved diagnosis and treatment of patients with endocrine pathology in compliance with international WHO standards. Currently, due to the low throughput of the SPECT tomograph, physicians in the nuclear medicine department must work in two shifts, thereby increasing the radiation exposure of medical personnel. With SPECT-CT, it will be possible to selectively examine small endocrine glands such as the pituitary gland, pancreas, adrenal glands. Also, this device can work in stand-alone mode as a computer tomograph. If CT is available, the brain will be examined before and after surgery. Images of parenchymal organs will be performed in case of multiple endocrine neoplasia (MEN-1 and MEN2). MEN-1 is Vermeer's syndrome: tumors of the pituitary gland, parathyroid glands and pancreas. MEN-2 - medullary thyroid cancer and pheochromocytoma (adrenal tumor). The obtained data will be entered into the memory of personal computers for further analysis, which will make it possible to simultaneously serve a large flow of patients. At the same time, the throughput will increase to 4000 patients per year, the radiation load on medical personnel will decrease five times, with an improvement in the quality of examinations.

Branch structure.

1. The first block of the department of nuclear medicine - radionuclide diagnostics, where there are rooms equipped with special equipment for diagnosing various diseases using radioisotopes (NaJ-131; Tc-99; Sm-153). With their help, in-line examination of patients is carried out (dynamic and static examination of the kidneys, renography, scanning of the thyroid gland and parathyroid glands), also SPECT examinations of bones, heart, lungs, examination of the whole body after radioiodine therapy in patients with DTC.
2. The second block - radionuclide support, where the control and measuring radiological laboratory with a storage for radioisotopes is located:
   • VLB 202. sanitary check.
   • Radionuclide protection system SOMO 170 (isotope storage, washing, treatment and dosimetry room)
3. The third block - four radioisotope active rooms for patients after radionuclide therapy with NaJ-131 and Sm-153.