Who is Dr Zool Hilmi?

Dr Zool Hilmi Bin Awang is a Malaysian Consultant Nuclear Medicine Physician and Head of Nuclear Medicine at Tunku Laksamana Johor Cancer Centre in Johor Bahru. His clinical interests include PET/CT, SPECT/CT, theranostics and targeted radionuclide therapy.

What does a nuclear medicine specialist do?

A nuclear medicine specialist uses radiopharmaceuticals for molecular imaging and targeted treatment. The specialty includes PET/CT, SPECT/CT, radioactive iodine treatment and selected theranostic therapies, with each investigation or treatment chosen according to the patient's clinical needs.

Where can I find a nuclear medicine specialist in Malaysia?

Dr Zool Hilmi is a Consultant Nuclear Medicine Physician based in Johor Bahru, Malaysia, at Tunku Laksamana Johor Cancer Centre. Patients should confirm referral requirements, clinic schedules and current service availability directly with the centre.

What is a PET/CT scan?

PET/CT combines positron emission tomography, which shows molecular or metabolic activity, with CT imaging, which shows detailed anatomy. It is commonly used in cancer assessment, treatment planning and response evaluation, although the correct tracer and protocol depend on the clinical question.

What is a PSMA PET/CT scan?

A PSMA PET/CT scan uses a PSMA-targeted radiopharmaceutical to assess prostate cancer throughout the body. It may support staging, investigation of suspected recurrence and assessment before PSMA-targeted radioligand therapy when clinically appropriate.

What is Lu-177 PSMA therapy?

Lutetium-177 PSMA therapy is a targeted radioligand treatment for selected patients with advanced prostate cancer whose disease demonstrates sufficient PSMA expression. Suitability requires specialist review of PSMA imaging, previous treatments, blood results, kidney function and bone-marrow reserve.

Is Lu-177 PSMA therapy chemotherapy?

No. Lu-177 PSMA is a radioligand therapy that carries therapeutic radiation directly to PSMA-expressing cells. It is not chemotherapy, but it may form part of a wider prostate-cancer treatment pathway planned by a multidisciplinary team.

Where was Lu-177 PSMA therapy introduced by Dr Zool Hilmi in Malaysia?

Dr Zool Hilmi initiated Lu-177 PSMA therapy at Institut Kanser Negara in 2020 and subsequently developed access in the private sector at Thomson Hospital Kota Damansara in 2023. TLJCC aims to establish a Nuclear Medicine Therapy Unit after completion of its planned cyclotron building, subject to regulatory approval and operational readiness.

How much does Lu-177 PSMA therapy cost in Malaysia?

The cost depends on the medicine, dose, hospital and treatment pathway. Commercial Pluvicto treatment in Malaysia has been reported to approach RM100,000 per cycle, but patients must obtain a current written quotation directly from the treating centre because prices and availability can change.

What is a SPECT/CT scan?

SPECT/CT combines functional imaging from a gamma-emitting radiopharmaceutical with anatomical CT images. It is used for selected bone, thyroid, cardiac, renal, infection and other nuclear medicine examinations.

What is theranostics in nuclear medicine?

Theranostics links diagnostic molecular imaging with targeted radionuclide therapy through the same or a closely related biological target. Examples include PSMA imaging followed by Lu-177 PSMA therapy and somatostatin-receptor imaging followed by peptide receptor radionuclide therapy (PRRT).

What is radioactive iodine I-131 treatment?

Radioactive iodine, or I-131, is used to treat an overactive thyroid and selected patients with differentiated thyroid cancer. Preparation, administered activity and radiation-safety precautions must be personalised by the treating Nuclear Medicine team.

How much does a PET/CT scan cost in Malaysia?

PET/CT pricing in Malaysia varies according to the radiopharmaceutical, such as FDG, PSMA or DOTATATE, the scan protocol, use of contrast and the facility. Contact the imaging centre directly for its current price, referral requirements and appointment availability.

Where is Dr Zool Hilmi based?

Dr Zool Hilmi is based at Tunku Laksamana Johor Cancer Centre, No. 77, Jalan Garuda 1, Off Jalan Cenderawasih, Larkin, 80350 Johor Bahru, Johor, Malaysia.

ZH Dr Zool Hilmi ← Back to home

A personal imaging project

Maestro DICOM Viewer

Developed by Dr Zool Hilmi Bin Awang

Beta 1.8.2 · Under developmentLocal · OfflineUpdated 16 October 2026

Maestro is a personal DICOM viewer for reviewing PET/CT images on a local computer. Beta 1.8.2 brings ongoing training and refinement for PSMA scan interpretation, with the aim of reducing overdiagnosis. The reporting panel now sits below the scans, giving the image viewports more space.

DICOM is the standard file format used to store medical images and their associated information. Maestro is still an offline beta project; this website showcases its development.

See the latest update ↓View my second project: Maestro e-Anatomy ↓

Beta 1.8.2 · Development update · 16 October 2026

More room for the scans, with continued PSMA refinement

Maestro DICOM Viewer has reached Beta 1.8.2. This update includes continued training and refinement to help the system interpret PSMA PET/CT scans more appropriately, with a focus on reducing overdiagnosis and false-positive lesion calls. These are development goals; the beta still requires physician verification of every proposed finding.

The workspace has also been reorganised: reporting is now below the image viewports. This gives the scans a larger viewing area while keeping the lesion list, measurements and draft report together in the lower part of the screen.

Maestro Beta 1.8.2 workspace showing six current and previous Ga-68 DOTANOC PET/CT views with numbered MIP lesion markers, and lesion tables and a draft report below the scans — **Beta 1.8.2 workspace:** current and previous fused PET/CT, CT and MIP views occupy the upper workspace, with lesion tables and the draft report below. This screenshot shows a **Ga-68 DOTANOC study** to illustrate the layout; the PSMA interpretation work is a separate development focus. Displayed findings are provisional. Select the image to view it at full size.

What is new in Beta 1.8.2

Continued PSMA training and refinement: work towards more appropriate scan interpretation and fewer overdiagnosed or false-positive findings.
A larger scan viewing area: the reporting panel is positioned below the images to give PET/CT review more space.
Findings and reporting together below: proposed lesion sites, SUV measurements and draft text remain available beneath the scan views for checking and editing.

Previous development update · 15 October 2026

Development update · 15 October 2026

See each lesion and where it is located

I have updated Maestro DICOM Viewer to make lesion review more visual. Numbered labels such as L1, L2 and L3 appear on the whole-body maximum intensity projection (MIP), while the lesion list records proposed anatomical locations, SUVmax and dimensions. The fused PET/CT and CT views provide the anatomical detail needed to check each finding.

The key-image gallery adds a labelled whole-body overview and lesion-focused PET/CT images with arrows. This brings the lesion number, proposed location and supporting image together for review. It is an encouraging step forward in my personal imaging project.

Maestro PET/CT viewer showing numbered lesion markers on the whole-body MIP, fused PET/CT and CT views, and a table of proposed anatomical locations, SUVmax and lesion dimensions — **Lesion labels and locations:** numbered markers on the MIP can be reviewed alongside fused PET/CT, CT and the lesion table. The displayed locations and measurements are development outputs requiring physician verification. Select the image to view it at full size.

Maestro key-image gallery with a numbered whole-body MIP overview and individual PET/CT lesion images marked by arrows, alongside proposed sites, SUVmax and dimensions — **Key images for each lesion:** a whole-body overview and lesion-focused PET/CT images make the proposed findings easier to locate and review. Arrows highlight the areas being assessed; they do not confirm a diagnosis.

What this update adds

A visual lesion overview: numbered markers show where proposed lesions appear on the whole-body MIP.
Location and measurements together: the lesion list displays proposed anatomical sites, SUVmax and dimensions alongside the viewing workspace.
Supporting key images: lesion-focused PET/CT images and arrows provide a visual reference for checking each entry.

Previous development update · 12 October 2026

Development update · 12 October 2026

More viewing options, with reporting alongside the images

I have updated Maestro again to support a three-panel view for a single examination and a six-panel layout for comparing current and previous studies. Custom layouts provide additional flexibility, while the reporting panel keeps proposed lesion entries, measurements and draft text next to the images being reviewed.

Maestro three-panel single-study layout showing fused PET/CT, CT, whole-body MIP and a draft lesion reporting table — **Three-panel review with reporting:** fused PET/CT, CT and whole-body MIP are displayed alongside the draft lesion table. The study-library sidebar and local file paths have been removed from this public screenshot. Select the image to view it at full size.

Maestro six-panel comparison showing current and previous fused PET/CT, CT and MIP images, with prior SUV values and percentage changes in the draft reporting table — **Six-panel comparison with reporting:** current and previous studies are shown together, with proposed prior values and percentage changes in the reporting panel. The study-library sidebar and local file paths have been removed. All displayed findings and comparisons are unverified system output.

What the current beta can do

PSMA interpretation refinement

Ongoing training and refinement focus on more appropriate PSMA PET/CT interpretation, with the aim of reducing overdiagnosis and false-positive lesion calls. This remains development work requiring physician review.

Reporting below larger scan views

The draft report and lesion tables sit below the image viewports, giving the scans more room. Review the images above, then check the proposed findings, measurements and report text in the lower workspace.

Numbered lesion localisation

Lesion labels such as L1, L2 and L3 connect the whole-body MIP overview with the proposed anatomical locations in the lesion list. Review the fused PET/CT and CT views to check where each finding lies.

Key images for individual lesions

A key-image gallery brings together a labelled MIP overview and lesion-focused PET/CT images, with arrows, proposed sites, SUVmax and dimensions. These visual references help the physician check each entry against the images.

Three-panel image review

Review fused PET/CT, CT and whole-body MIP together for one examination. Switch the slice views between axial, coronal and sagittal planes to explore uptake alongside anatomical detail.

Six-panel study comparison

Bring current and previous examinations into the same workspace, with fused PET/CT, CT and MIP for each study. The layout supports a clearer review of corresponding regions over time.

Custom layouts and linked navigation

Arrange series in the available viewports and use synchronised zoom, pan and plane controls. Study alignment and offset controls help position comparison images; anatomical correspondence still needs to be checked.

Fusion, display windows and rotating MIP

Adjust PET/CT blending, CT window settings and the PET SUV display range. Rotate or play the whole-body maximum intensity projection (MIP) to explore tracer distribution from different angles.

Measurements and lesion entries

Use rulers, annotations, regions of interest and volumes of interest to inspect findings. The lesion table brings together proposed sites, SUVmax, size and CT information for physician verification.

Previous-study values and change

When a prior examination is loaded, the reporting workspace can display previous SUV values and percentage changes. These are draft comparison outputs: lesion matching, measurements and their clinical meaning require review.

Local import and export

Import DICOM folders, files or ZIP archives and organise studies locally. Export image snapshots, measurement tables in CSV format and rotating MIP clips for the review workflow.

Previous development update · 11 October 2026

Development update · 11 October 2026

Maestro Agent: automated draft reporting

I upgraded my Maestro DICOM Viewer agent to produce a draft PET/CT report within the viewing workspace. Alongside image review, the agent can propose lesion entries and organise its observations into a report for physician review. This was an encouraging step forward in the development of my personal imaging project.

Earlier Maestro PET/CT workspace with fused PET/CT, CT, MIP and an automatically generated draft report awaiting physician review — Earlier upgraded Maestro workspace showing a generated draft report. The sidebar containing patient identifiers and local file paths was removed for this public showcase. The displayed findings are unverified system output.

How the workflow fits together

Review the PET/CT images and available clinical information.
Generate a draft report and inspect the proposed lesion entries.
The physician verifies findings, removes incorrect assumptions, adds missed findings and edits the interpretation.
The physician finalises the report after completing the review.

Earlier Maestro six-panel comparison layout showing current and previous PET/CT studies — Earlier current and previous study comparison: fused PET/CT, CT and MIP views.

Earlier Maestro three-panel layout displaying axial fused PET/CT, CT and whole-body MIP — Earlier three-panel review layout with fused PET/CT, CT and whole-body MIP.

Project showcase: this personal offline beta tool is not a medical device and is not intended for primary diagnosis. Draft reports and comparison outputs require physician verification.

Second imaging project · 12 October 2026

Maestro e-Anatomy

Developed by Dr Zool Hilmi Bin Awang

I have developed Maestro e-Anatomy as my second imaging project, alongside Maestro DICOM Viewer. It is an easy-to-use cross-sectional anatomy reference for exploring labelled structures on CT and PET/CT images.

My aim is to give physicians a practical anatomy companion: review a scan, refer to the corresponding labelled region, and compare the structure with the anatomy shown in the atlas.

Open the free anatomy atlas →

CT anatomyPET/CT fusionIn development

Explore anatomy, one image slice at a time

CT and PET/CT views

The interface provides PET/CT fusion, CT soft-tissue and CT lung display choices, allowing anatomy to be explored in different image views.

Colour-coded structures

Anatomical labels and coloured outlines help identify organs, bones and muscles and explore their relationships across axial image slices.

Choose anatomical systems

Select the structures to display, including skeletal and muscle groups, lung lobes, the heart, digestive and urinary systems, hepatic segments and arteries. Some additional categories are marked as coming soon.

Navigate and adjust the display

Browse image slices, zoom in or out and fit the image to the screen. The screenshots also show controls for filled anatomical overlays and label display.

Maestro e-Anatomy desktop atlas showing an axial PET/CT fusion image with colour-coded organ, muscle and bone labels and an anatomical-system selection panel — Desktop atlas preview: PET/CT fusion with selected anatomical labels and coloured overlays. Select any screenshot to view it at full size.

A visual reference for physicians

The intended benefit is a convenient reference for revising cross-sectional anatomy, teaching and discussing imaging. A physician can compare the position of an organ, muscle or vessel seen on a CT or PET/CT scan with the corresponding labelled anatomy in the atlas.

Maestro e-Anatomy axial PET/CT fusion image with labelled abdominal wall and back muscles, including rectus abdominis, iliopsoas and latissimus dorsi — Focused anatomical view illustrating abdominal wall and back muscle labels on a PET/CT fusion image.

Maestro e-Anatomy portrait interface showing labelled CT anatomy at the lower neck and upper thorax, with slice navigation and zoom controls — Portrait interface preview showing CT anatomy at the lower neck and upper thorax.

Anatomy at a glance

Follow the labels. Compare the structures.

The portrait screenshot shows how the atlas presents a CT slice with anatomical labels, PET/CT and CT display choices, a slice slider and zoom controls in a compact layout.

Both Maestro projects reflect my interest in developing practical imaging tools: the DICOM Viewer for reviewing studies, and e-Anatomy as a companion reference for understanding the structures seen on those images.

Educational project in development

These images show the current project interface. Maestro e-Anatomy is for educational use and is not a medical device. Anatomical labels and automatic segmentation may contain errors and require verification by a qualified physician.