ENNuclear medicine in Germany uses radioactive substances to examine and treat patients. People meet it when a doctor says «scintigraphy» or «PET» and, puzzlingly, sends them to a department with radiation warning signs instead of another MRI. Unlike ordinary X-ray imaging, it shows how an organ works, not its shape. It records a signal from a substance injected into the blood, not radiation shone through tissue.
Below are the scans and treatments it covers, a day in the department, the dose, and how a patient from abroad books a scan; other methods are on diagnostics in Germany. It does not replace a consultation: the treating doctor decides whether a scan is needed, and which.
How it works: a tracer that lights up from inside
A radiopharmaceutical, injected into a vein or sometimes swallowed or inhaled, is a molecule the body treats as its own and sends where it is busy: bone, thyroid, tumour cells. Its tracer emits radiation, mapped by a camera outside the body. So the method sees metabolism, not structure, sometimes spotting changes before CT does.
There are two kinds of machine. A gamma camera performs scintigraphy as flat images or three-dimensional SPECT. A PET scanner detects different radiation and gives a finer picture; it is almost always combined with CT or MRI in one machine to lay the functional map over the anatomy. Hence referrals say «PET-CT«, not «PET».
Which scans belong here
They cover the thyroid, cancer and other organs. The most common, thyroid scintigraphy with technetium, separates «hot» from «cold» nodules, those working harder or less than surrounding tissue, and this shapes decisions on surgery or radioiodine. It adds to ultrasound and blood tests, not replacing them; see thyroid examination in Germany.
In cancer, PET-CT with FDG, a labelled glucose, seeks metastases and checks whether treatment works; PSMA PET in prostate cancer targets a surface protein of tumour cells; somatostatin-analogue imaging serves neuroendocrine tumours; bone scintigraphy checks suspected bone metastases. Each answers a specific question from the treating doctor rather than «checking the whole body».
Lesser-known uses: lung perfusion scintigraphy for suspected pulmonary embolism, heart muscle studies, DAT scans for unclear tremor and parkinsonism, kidney function studies in children, and the search for a hidden infection. The German Cancer Research Center’s Krebsinformationsdienst reviews radionuclide imaging and therapy in cancer (in German).
Treatment with radioactive substances
Treatment uses the same idea: swap the tracer for one emitting more strongly over a shorter distance, and the same carrier delivers the dose into the cells that take it up, while surrounding tissue gets less. Hence «theranostics»: a scan first shows whether the tumour takes the substance up; only then is therapy considered.
Radioiodine therapy removes overactive tissue in hyperthyroidism, or tissue left after thyroid cancer surgery. Lutetium-177 PSMA therapy is for advanced prostate cancer; in the EU, for metastases growing despite hormone therapy and chemotherapy. Labelled somatostatin analogues treat growing digestive neuroendocrine tumours that cannot be removed or have spread. Radiosynovectomy treats persistent joint inflammation by injection into the joint. For tumours, a tumour board decides, not nuclear medicine alone.
For patients from abroad, the practical side matters most. In Germany, radioiodine and lutetium therapy are given only in licensed units with shielded rooms, where the patient stays several days with restricted visits; some belongings may stay behind. This is radiation protection law, not a house rule: discharge comes only once relatives’ expected exposure is within the legal limit. Plan the trip with spare days.
Dose, preparation and safety
A diagnostic scan’s exposure is roughly of the order of a CT’s; the substance decays and leaves the body naturally within hours or days, so patients drink plenty and empty the bladder often. Pregnancy is discussed with the doctor before booking; breastfeeding is paused, depending on the substance, for a period the department sets. Children’s doses go by weight.
Ignoring the preparation means rescheduling. FDG PET needs fasting and no strenuous exercise the day before; in diabetes, insulin timing is agreed in advance. Before thyroid scintigraphy, some medicines and iodine contrast must be avoided for weeks, or the image may be unreadable. So the department first asks for your medication list and last contrast CT date; without them, booking is pointless.
Where this is done in Germany
Nuclear medicine in Germany works in hospitals, as a clinic of its own or part of a radiology centre; some scans are also done in outpatient practices. A department needs a radiopharmaceutical laboratory, a licence and specialist doctors. So scans are booked at a named centre, not «in a city», and the referring doctor matters.
Examples of partner departments, not a ranking: the clinic for nuclear medicine at the Charité in Berlin, headed by Professor Winfried Brenner; the clinic for nuclear medicine at Klinikum Stuttgart under Professor Christoph Rischpler; and the centre for radiology and nuclear medicine at Klinikum Dritter Orden in Munich, led by Professor Hermann Helmberger.
Frequently asked questions
Can I have a scan without a medical reason?
No. Under German radiation protection law, a radioactive substance may be given only once a doctor qualified in radiation protection judges that the benefit outweighs the risk. So a scan «just in case» is impossible: it needs a medical question, reports, images and the nuclear medicine doctor’s confirmation.
How does nuclear medicine differ from radiotherapy?
The difference is where the radiation comes from: radiotherapy usually aims a beam at the tumour from outside, while in nuclear medicine a substance given into the body gathers in the cells that take it up. They are separate specialties, and radiotherapy only treats, whereas nuclear medicine both examines and treats.
Can I resume normal life right after the scan?
Usually yes: after a diagnostic scan you can work and drive unless told otherwise. After some scans, such as PET, you will be asked for a while not to hold small children or stay close to pregnant or breastfeeding women; the department says how long. Drink extra that day.
How AlenMed organises the scan
After first contact, a medical interpreter translates the reports and CT or MRI discs, the records go to a nuclear medicine department, and a doctor says whether a scan is needed, which one and when. Medical visa paperwork is prepared alongside.
AlenMed works with 86 partner hospitals in 38 cities and 345 doctors; its office is in Munich. A coordinator books the appointment, explains the preparation, interprets at the consultation and makes sure the images and report reach the doctor at home.
This material is for information only, not an offer; treatment is decided by a doctor at a face-to-face examination.