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Nuclear Medicine

What is Nuclear Medicine?

Nuclear Medicine is a sub-department of the Main Radiology Department located on the ground floor. The procedures may demonstrate anatomy and/or function of body organs. The images are developed based on the detection of energy emitted from a radioactive substance given to the patient. Radiation to the patient is generally similar to that resulting from standard x-ray examinations.

What are the preps for Nuclear Medicine?

Nuclear Medicine procedures usually require preparation prior to arrival. If the procedure involves evaluation of the abdomen, the patient may have to be NPO prior to appointment. If the procedure involves evaluation of the kidneys the patient may need to drink plenty of water prior to appointment. Patients must bring a list of all medications.

Nuclear Medicine Prep Guide

Procedure	Prep	Estimated Time of Exam
Bone Scan	May continue with meals and medication No barium studies 2-3 days prior to scan Drink 2 glasses of water 2 hours prior to appointment Please send any pertinent x-rays with patient	3-4 hour delay after injection/patient may leave and return for completion of exam
Liver Scan	May continue with meals and medication No barium studies 2-3 days prior to scan	15 minute delay after injection/additional 45 to 60 minutes to complete exam
Liver Spect Scan	May continue with meals and medication No barium studies 2-3 days prior to scan	15 minute delay after injection/additional 45 to 60 minutes to complete exam
Hida Scan	NPO after midnight Diabetic patients should not take insulin or oral diabetic medication prior to appointment. No morphine for 6 hours prior to appointment.	60 to 90 minutes Hida Scan with cck stimulation will take additional 30 minutes
Gastric Emptying Study	NPO after midnight Diabetic patient should not take insulin or oral diabetic medication prior to appointment	Patient will eat oatmeal with radioisotope and is monitored for 60 minutes/2 hours delayed scan if indicated
Gallium Scan	Continue with meals and medication Drink one 16 oz glass of water prior to appointment No barium studies 2-3 days prior to scan A colon prep may be needed prior to the actual scan	If ordered for inflammation/infection or abscess, the patient is injected and scanned at 6 and 24 hours post injection. Patients will be instructed when to return for delayed images. If ordered for Lymphoma’s/Hodgkin’s or non-Hodgkin’s patient must return for additional 48 & 72 hour scans. Patients will be instructed when to return for delayed images.
Parathyroid	NPO for 6 hours prior to appointment	Scan obtained 10 minutes post injection and delays at 2 hours
Thyroid Scans Technetium Scan TC04 I-123 Cont…	NPO 6 hours prior to appointment Patient must not have had an iodinated contrast study for the last 3 months Example: IVP, CT or Angiogram. Patient must be off thyroid medication 3 weeks Example: Thyroid Hormones or PTU Cannot schedule I-123 on Fridays Please schedule prior to 2 PM Monday - Friday	Thyroid or Technetium Scan 20 minute delay after injection/scan takes 20 to 30 minutes I-123—if a patient is dosed with capsule 4 to 6 hour delay/scan takes 45 to 60 minutes If uptake is requested the patient will be instructed to return the next day to finish exam
I-131 Whole Body Scan	NPO 6 hours prior to appointment Off Thyroid medication three weeks Patient must not have had an iodinated contrast study for the last 3 months Example: IVP, CT, or Angiogram	Patient will be given doses and instructed to return the next day for scanning
I-131 Therapy Treatment	NPO 6 hours prior to appointment The ordering physician must have prior consultation with the Radiologist Must have negative pregnancy test prior to appointment. If applicable call results to 377-4070	Nuclear Medicine staff will give patient safety instructions. Patient will follow-up with referring physician
Renal Scan Captopril Scan	May continue with meals Must be off blood pressure medication and diuretics (Lasix) for 48 hours prior to appointment — please check with ordering physician	Patient is injected and a Flow and Delayed scan is obtained. The Flow Study is completed within 45 minutes. Patient will be instructed to return for a 5 hour delayed scan for Captopril scan
Octreo scan	No barium studies 2-3 days prior to scan Referring physician will instruct patient to take bowel prep day prior to appointment	Patient may leave and will return for 4, 24, 48 & possible 72 hour scan.
Lympho-cyntography	May continue with meals and medications	If indicated images up to 4 hours
Lung Scan	May continue with meals and medication Chest X-ray within 24 hours prior to appointment	60 to 90 minutes

How does Nuclear Medicine work?

For General Nuclear Medicine, the patient is given a radioisotope intravenously or orally. The radioisotope localizes in a specific body organ system. The radioisotope or tracer gives off energy as gamma rays. The gamma rays are detected by a camera and images are produced with help from a computer.

How is the exam performed?

A radioisotope is given intravenously or orally. Imaging times will depend on which type of scan is requested. Imaging will be done either immediately or delayed a few hours or it may be necessary to return the next day for a complete exam.

The patient must remain as still as possible during scanning. Patient movement will cause blurring of the images. If indicated, delayed images will demonstrate how an organ functions over time. The radioisotope will lose it radioactivity generally over 24 hours. It passes out of the body in the urine or stool.

Common uses of Nuclear Medicine Studies:

• Analyze kidney function
• Image blood flow and function of organs
• Identify blockage of the gallbladder (cystic duct)
• Evaluate Bones for fracture, infection, arthritis or tumor
• Determine the presence or spread of cancer
• Locate the presence of infection
• Measure thyroid uptake to detect hyperthyroidism or hypothyroidism
  

Radiology Report Turnaround Process

A Radiologist who is a physician experienced in Nuclear Medicine and other Radiology procedures will analyze the images and send a report to the patient’s referring physician. The referring physician will inform the patient of the Nuclear Medicine findings.

We have a departmental goal of 6 hours for Radiology Report Turnaround time. We measure the time from radiology request entry to the time the transcriptionist types the final report. The radiology report is also available via our Digital Dictation System, immediately after Radiologist completes dictation. The DVI system phone number is 377-3745. You must first enter your six (6) digit PIN number, your department number, and the patient’s medical record number to access the report.

What are the Benefits VS Risks?

Benefits-

• The information provided by Nuclear Medicine examinations is unique and is not available by using other imaging methods. For many diseases Nuclear Medicine Studies yield the most useful information needed to make a diagnosis.
• Nuclear Medicine may eliminate exploratory surgery

Risks-

• Exposure to small dose of radiation.
• Other imaging methods should be considered for pregnant patients.
• Allergic reactions to the radioisotope can occur, but are extremely rare.