Nuclear Medicine
What is Nuclear Medicine?
Nuclear medicine is a separate modality within the field of radiology. It uses radioactive tracers to show the function of different organs within the body. These tracers are most often given to the patient by intravenous injection, although some studies require the swallowing of a radioactive capsule. The camera used in nuclear medicine then detects the gamma rays being emitted from the patient, forming an image on the computer screen. For most studies performed in nuclear medicine, the radiation to the patient is comparable to that of a chest x-ray. As with any study in radiology, the patient should tell the technologist if there is a chance of pregnancy or if the patient is breastfeeding.
What does the Nuclear Medicine camera look like?
The nuclear medicine gamma camera at AMI is a large metallic ring comprised of two cameras that sit 180 degrees of each other. The scanner is open on all sides, and the patient table is positioned in between the two scanners. The cameras are able to translate up and down the length of the table, and are also able to rotate around the table.
How should I come prepared for my Nuclear Medicine Scan?
There are many different studies in nuclear medicine requiring many different preparations by the patient. Most often your doctors office will give you specific directions for your test at the time of scheduling. Directions can also be found for some of the more common studies on the back of the order sheet that your doctors office may have given you, and also on this web site. If you have any questions regarding your test and the preparation required, please feel free to give us a call.
You will generally not have to change out of your clothes for a nuclear medicine procedure, but you will be required for some studies to remove any metal object such as loose change, pocket knives, belt buckles, and some jewelry.
How long will my Nuclear Medicine examination take?
Studies in nuclear medicine vary in time, ranging from several minutes to several hours. Some studies involve scanning at different times during a single day, or some studies are carried out over several days.
Who interprets my Nuclear Medicine examination and how do I get the results?
The radiologist on site at AMI will interpret your exam. A radiologist is a physician who specializes in interpreting nuclear medicine procedures and other radiology examinations for the detection of abnormalities of the internal organs and bone structures. A signed report with the radiologist interpretation will then be available to your physician 24 hours after your exam. Your physician's office will inform you on how to obtain the results.
Exams commonly performed in Nuclear Medicine
Bone scan: This is a study that looks for stress fractures, loosening of prosthesis, bone infection, or spread of cancer to the bones. An injection is given into the vein of an arm, and pictures are obtained 3 hours later. The scan takes about 45 minutes to 1 hour. There is no special prep for the test, but the patient is instructed to drink plenty of fluids during the 3 hour break.
Hepatobiliary Scan: This is a gallbladder study, sometimes referred to as a HIDA or PIPIPDA scan. This study looks at the function of the gallbladder and is sometimes performed after an ultrasound report shows normal anatomy. This study involves two different injections given through an IV. The first is the radioactive tracer for imaging and the second is an agent that stimulates the gallbladder to contract. The total scan time varies between 1.5 to 2 hours. Patients should not have anything to eat or drink at least 8 hours prior to the study.
Renal Scan: This is a study that looks at the blood flow and function of both kidneys. An injection is given into the vein of the arm and pictures take approximately 45 minutes to 1 hour. There is no required preparation, although it's best if patients are well hydrated.
Lung Scan: This is a study that looks at both the air flow and blood flow to the lungs, evaluating shortness of breath, the lungs prior to lung reduction surgery or looking for a pulmonary embolism (clot) in the lungs. It involves both inhaling a radioactive tracer and an injection into the vein of an arm. The pictures take approximately 1 hour. There is no special preparation.
Thyroid Uptake and Scan: This is a study that looks at the function of the thyroid. It is used to evaluate patients with abnormal thyroid lab values and/or symptoms of thyroid disorder. A radioactive capsule is given to the patient and the patient returns 4 hours later for a quick check, and then again 24 hours later for 1 hour of imaging. Patients should not have anything to eat at least 4 hours before taking the capsule and for 1 hour after. Patients should be off of any thyroid medications at least 3-4 weeks prior to the study. A serum pregnancy test is required for this test on all females within childbearing age, unless proof of hysterectomy or tubal ligation is present.
Radioiodine Therapy (Ablation) of the Thyroid: This is a therapeutic study involving a dose of radioactive iodine designed to destroy abnormal thyroid tissue. Both your doctor and our radiologist will review your thyroid condition to make the best determination in the amount of therapy required. Patients receiving a higher dose (thyroid cancer patients) will be given specific instructions to follow for 3-4 days after the ablation. They will be consulted by a radiation physicist and our radiologist prior to receiving the capsule. Patients with hyperthyroidism will have a few minor restrictions and will be consulted by our radiologist. Patients should not have anything to eat at least 4 hours before the test and for 1 hour after the test. Patients should be off of any thyroid medication at least 3-4 weeks, and a serum pregnancy test is required for all females within childbearing age unless proof of hysterectomy or tubal ligation is present.
I-131 Whole Body Scan: This is a study done to evaluate the presence of thyroid tissue in patients that have undergone a thyroidectomy due to carcinoma of the thyroid gland. A radioactive capsule (non therapeutic, diagnostic only) is given and the patient returns 2 days later for the scan. The scan takes about 45 minutes to 1 hour. Patients should not have anything to eat 4 hours prior to the capsule and for 1 hour afterward. Confirmation by lab work that TSH is greater than 35 is required, as patients should be off of their thyroid replacement long enough to achieve this. A serum pregnancy test is required for all women within childbearing age unless proof of hysterectomy or tubal ligation is present.
Myocardial Perfusion Imaging (Cardiolite Stress test): Myocardial Perfusion Imaging (cardiolite stress test) is used to assess the blood flow to the heart, in order to determine the amount of coronary artery disease, to diagnose the cause of chest pain and to evaluate the extent of muscle damage after a heart attack. This test includes two phases: rest and stress while monitoring blood pressure and heart rhythm. This test takes approximately 2 to 5 hours and may be completed on 1 day or 2 separate days. The rest phase includes an injection of the imaging tracer and images that take place 30 minutes to 1.5 hour after injection. The resting images take about 30-45 minutes to complete and are acquired while the patient is lying down on their back with their arms raised above their head. The stress phase s usually performed with exercise on the treadmill with an injection of the imaging tracer during exercise and stress images take place 15 minutes to 1.5 hours after exercise. But if a patient is unable to exercise a medication stress may be performed. The patient should wear loose fitting comfortable clothing and tennis shoes suitable for exercise. Depending on the purpose of the test, one or more cardiac medications may need to be stopped for 24-48 hours before the test. Please check with your physician before the test. The patient will be asked to not eat or drink 3 hours prior to the test, avoid caffeine for 24 hours before the test, avoid nicotine 8 hours prior to the test and bring a list of all their medicines or all their medicines with them.