Nuclear Medicine Exams

PREPARATION: 
No preparation is necessary prior to the examination. Following injection, the patient will return to the nursing unit or may leave the campus for 2 1/2 - 3 hours. The technologist will inform the patient of a return time, and is encouraged to increase fluid uptake with frequent urination if possible before returning for the imaging portion of the test.

The fluid intake following injection helps with movement and absorption of the material throughout the body and into the bones. Frequent urination helps reduces radiation exposure.

EXAM DESCRIPTION: 
The patient is injected through an IV with a radioactive isotope. Following injection the patient is returned to the nursing unit or allowed to go home if an outpatient and no other tests are scheduled. The patient will return for scanning in 2-3 hours. A scan is taken of the patient's entire skeleton. The patient will lie on their back and the images will be taken from their head to their toes or the area of interest.

LENGH OF TIME INVOLVED: 
The scanning takes approximately 45 minutes - 1 hour.

PREPARATION: 
No preparation is necessary. 

EXAM DESCRIPTION: 
A radioactive isotope is injected through an IV. The patient is placed on their back with their head underneath the camera to obtain the images. 

LENGTH OF TIME INVOLVED: 
The exam takes approximately 15 minutes.

PREPARATION: 
Avoid caffeine, alcohol or drugs known to affect cerebral blood flow (CBF).

EXAM DESCRIPTION: 
A radioactive isotope is injected through an IV. An image of the brain is taken for 45 minutes; the cameras will rotate around the head during this time. Delayed images of the brain are taken approximately 3 hours later. Patients having Diamox Study may have a two-day study.

LENGTH OF TIME INVOLVED: 
Initial preparation and images take about 1 1/2 - 2 hours. The delayed images take about 45 minutes.

PREPARATION: 
No preparation is necessary. Special Procedure Nurse reviews patient's chart/history.

EXAM DESCRIPTION: 
A small amount of radioactive material is injected into the lumbar spine region via a spinal tap. A Radiologist performs the spinal tap in the Radiology Department. Images are then taken a few hours later of the patient’s head while they lie on their back and have their head slide underneath the camera.  

LENGTH OF TIME INVOLVED: 
The scans are performed over a 4-day period at timed intervals of 6, 24, 48 and 72 hours. The delayed scans can be performed on an outpatient basis should the patient be discharged. At each time the patient comes back, the images only take about 5-10 minutes.

PREPARATION:  
Gallium studies should be performed 3 weeks after the last course of chemotherapy or prior to the induction chemotherapy. Bowel preparation with oral laxatives and/or enemas before imaging will usually decrease the amount of activity within the bowel and reduce radiation dose.  Routine use of a bowel preparation is recommended unless the patient is too ill or unable to eat solid food. Retained barium or other contrast material in the Gastrointestinal (GI) Tract may interfere with the scan depending on area of interest. Chemotherapy may decrease Gallium uptake. Bowel preparation is optimal. Oral laxatives before imaging may decrease activity in bowel. 

EXAM DESCRIPTION: 
A small amount of radioactive material is injected through an IV. Images of the patient are taken while the patient is lying on their back on the imaging table.

LENGTH OF TIME INVOLVED: 
Scanning time is approximately 30-45 minutes. Over a 4-day period, the patient will return at 2, 6, 24, 48 and 72 hour delays from injection time for non-tumor imaging. Tumor imaging return 5 and 7 days post injection.

PREPARATION: 
Patient should have nothing by mouth (NPO) and refrain from smoking for at least 8 hours.  Any drugs affecting gastrointestinal motility should be withdrawn for at least 3 half-lives of the drug. Any questions on medications please consult with your physician as well as you may call the Nuclear Medicine Department directly. Certain medications require being off longer than other medications so call several days in advance having of this study done.

EXAM DESCRIPTION: 
The patient will be given a radioactive meal that consists of eggs, toast, and water; it should be completed as quickly as possible, optimally within 5-10 minutes. Images are obtained immediately and every 15 minutes for a period of two hours. During this time the patient is asked to lie on their back on the imaging table.

LENGTH OF TIME INVOLVED:  
This procedure takes approximately 2-2.5 hours.

PREPARATION: 
Patients must have an IV for the injection of the radioactive material.

EXAM DESCRIPTION: 
The technologist will withdraw 3 mL of blood and tag it to a radioactive material that they will inject back into the patient’s IV to begin the images. The images are a continuous picture for the hour duration and the patient will lie on their back during the imaging process with their abdomen underneath the camera.

LENGTH OF TIME INVOLVED: 
This procedure takes approximately 1 - 1.5 hours.

PREPARATION: 
The patient must having nothing by mouth (NPO) 4-6 hours prior to the examination but must have eaten within the last 24 hours. No narcotic drugs for 4 hours prior to exam.  Food in the Gastrointestinal (GI) Tract may delay visualization of the gallbladder. 

EXAM DESCRIPTION: 
An injection of a radioactive material is given through an IV. The abdomen is scanned at 5-minute intervals for approximately 30-90 minutes. Following the initial imaging of the abdomen, if the gallbladder has shown then the technologists may move on to the next step and give a medication called Kinevac, which simulates a fatty meal, to watch the gallbladder contract. This last part takes 30 minutes.

LENGTH OF TIME INVOLVED: 
Approximately 1 hour and 30 minutes, however, in some cases delayed scans may be needed at 2-4 and 24-hour intervals.

PREPARATION: 
The patient must be off of thyroid replacement for several weeks prior to the exam. Patients who have been taking T-3 should be off for two weeks and patients who have been taking T-4, for 4 weeks. A serum TSH should be available at the time of the patient's initial appointment.

To maximize uptake in metastases, the body is usually iodine-starved and TSH levels must be at least 30 u.I.U./L or more prior to the scan. Patient must be on low-iodine diet for 2-4 weeks prior to scan. The patient must not have received any iodine-containing medications or procedures for 1-4 weeks. Thyroid hormones should be reviewed.

Procedure:

1. Explain the procedure to the patient.
2. Notify radiologist of I-131 whole body scan.
3. Record information on written directive record of Nal-131 administration.  Have radiologist fill out dose, procedure desired and sign form.
4. Order proper dosage.
5. Upon patient arrival, verify the patient's identity by more than one method (Name, Birth Date, Social Security Number).
6. Make sure a signed and dated written request from ordering physician is present.
7. Make sure I-131 thyroid therapy questionnaire (pink sheet) is filled out.

 
EXAM DESCRIPTION: 
Patients who have had their thyroid removed for carcinoma undergo evaluation for possible metastatic spread of disease by ingesting a dose of radioactive iodine. Imaging is performed 24 hours if I123 or 2 days if I-131 later to access for any abnormal activity. Patient's undergoing this exam should have had all thyroid tissue removed or have had prior treatment with iodine 131 to destroy the thyroid.

LENGTH OF TIME INVOLVED: 
Initial examination is performed in conjunction with the radiologist who will explain the test to the patient and decide on the dose to be administered. At the time of the second appointment, the patient will receive a capsule of radioactive iodine. Two days after receiving the radioactive iodine, the patient will undergo imaging. Imaging will take approximately 1 hour.

PREPARATION: 
The procedure needs to be coordinated with the Radiologist. The Radiologist may want to inject under the guidance of Ultrasound.

EXAM DESCRIPTION: 
This procedure is to evaluate the patency of Laveen/Denver Shunt in patients with cirrhosis and intractable ascites.

LENGTH OF TIME INVOLVED: 
A sequential of 2-minute images for 10 minutes. If the shunt is not demonstrated, delayed images up to 5 hours may be necessary.

PREPARATION: 
No solid food between injection and scanning if possible.

EXAM DESCRIPTION: 
The patient is injected through an IV with a small amount of radioactive isotope that localizes in the liver and spleen. 5 to 6 images are taken of the liver and spleen. This study can be used for determining the size and shape of the liver and spleen as well as for detecting functional abnormalities of the reticuloendothelial cells of these organs.

LENGTH OF TIME INVOLVED: 
Scanning time takes approximately 20 - 30 minutes.

PREPARATION: 
Patients are to have nothing by mouth (NPO) 4 hours prior to the study. Infants should miss one feeding prior to the study.

EXAM DESCRIPTION: 
The patient is injected through an IV with a radioactive material. The upper and lower abdomen is scanned for a period of 60 minutes. 

LENGTH OF TIME INVOLVED: 
Scanning time is approximately 60 minutes.

PREPARATION: 
No preparation is necessary. The patient should have a mammography procedure prior to breast scintigraphy. Patients should wear a hospital gown that can be opened from the front.

EXAM DESCRIPTION: 
The radioactive material will be injected through an IV in the opposite arm of the breast being examined at the very least, if possible, however, the injection should be in a foot vein. After 5 minutes the patient will lie face down on the imaging table that has an opening for the breast. This examination is to be performed by a female technologist. Images are then taken of each breast.

LENGTH OF TIME INVOLVED: 
The procedure should take 45 - 60 minutes.

PREPARATION: 
No preparation is necessary. Scan is recommended within 24 to 72 hours after onset of symptoms.

EXAM DESCRIPTION: 
The patient is given an injection through an IV with a radioactive material. The patient returns 2 hours later for three scans of the heart. 

LENGTH OF TIME INVOLVED: 
The scan takes approximately 20-30 minutes. There is a two-hour delay between injection and scan time.

PREPARATION: 
No patient preparation necessary.

EXAM DESCRIPTION:  
An injection through an IV of a radioactive material is done. The patient must wait 15-20 minutes for the material to circulate and then images are taken of the parathyroid. The patient is then allowed to leave for 2 hours and must return to have another set of images taken. At this time the camera will rotate fully around the patient’s neck to obtain a continuous image.

LENGTH OF TIME INVOLVED:
Initial visit consists of 20 minutes with a return visit after 2 hours for another 60 minutes.

PREPARATION: 
No preparation is required.

EXAM DESCRIPTION: 
A nurse inserts a catheter into the patient prior to the procedure. A radioactive material added to saline is then going to fill the bladder. Scans are taken with the bladder filled and then as the patient empties out their bladder. The patient must lie on their back while the images are being taken.

LENGTH OF TIME INVOLVED: 
1-2 hours.

PREPARATION:
In order to obtain accurate results from the scan, the patient must be well-hydrated 30 minutes and preferably 60 minutes before the study. Otherwise, no preparation is necessary.

EXAM DESCRIPTION: 
The patient will be asked to change into a pair of depends and hospital pants and an IV will be started. Depends and hospital pants are in case the patient needed to urinate during the procedure, we would not want their own clothing to be ruined. The patient will lie on their back with their kidneys and bladder underneath the camera. A radioisotope is injected through an IV. The kidneys and urinary bladder are imaged over an hour to watch them fill and empty. After 20 minutes of imaging a nurse will give a medication called Lasix, which will help empty out the kidneys resulting in a very full bladder. The patient will not be able to get off the imaging table until the hour of imaging is completed.

LENGTH OF TIME INVOLVED: 
The entire procedure can be performed in approximately 1 hour.

PREPARATION: 
No patient preparation is required. Not necessary to withhold any medications.

EXAM DESCRIPTION: 
An IV will be started where 3 mL of the patient's blood will be withdrawn and mixed into a kit with a radioactive material. The mixing of the kit takes about 20 minutes. The patient's blood will then be injected back into the patient prior to the images. The patient will lie on their back along with EKG wires attached to monitor heart rate during the image. The patient will be slid under the camera to obtain an image of the heart at an angle.

LENGTH OF TIME INVOLVED: 
The examination takes approximately 30-45 minutes.

PREPARATION: 
Patient is to have nothing by mouth (NPO) 4 hours, preferably 12 hours prior to examination. Eating will increase the bowel uptake and decrease the quality of the images. Caffeine must also be stopped at least 4 hours prior to the study.

EXAM DESCRIPTION: 
The patient will receive an injection through an IV of a radiopharmaceutical. Several images or scans of the heart are taken 30-60 minutes following the injection. The patient must lie on their back with their arms up above their head during the images. These images take about 15 minutes.

LENGTH OF TIME INVOLVED: 
The examination takes 30 minutes and is generally followed by a Myocardial Stress Study that will take an additional 60 minutes. If stress is to be done, patient should be off caffeine for 12 hours prior.

PREPARATION: 
The patient must have nothing by mouth (NPO) 4 hours, preferably 12 hours prior to the examination until the exam is completed. Their physician directs medications. No caffeine or caffeine containing food for 12 hours if Pharmaceutical Stress Test. Eating will increase bowel uptake and decrease the quality of the images.

EXAM DESCRIPTION: 
The same IV is used from the beginning of the Resting Myocardial study. During the stress test the patient will either walk on a treadmill or have a medication given through the IV to accelerate their heart rate. Once the patient’s heart rate reaches a certain number, determined by the nurse and doctor, then another small amount of a radiopharmaceutical is injected through the IV.  Several images or scans of the heart are taken 15-30 minutes following the injection. The patient must lie on their back with their arms up above their head during the images. These images take about 15 minutes.

LENGTH OF TIME INVOLVED: 
The examination takes approximately 1 1/2 - 3 hours.

PREPARATION: 
This procedure is either the morning of or the afternoon before the patient's surgery. There is no preparation for this study, but follow any prep you may be on for surgery.  

EXAM DESCRIPTION: 
The patient will be asked to put on a gown and undress from the top up. The patient will lie down on a bed where the Radiologist will give a few small injections of a radioactive material directly into the breast. Following the injections, a quick image will be taken as you lie on your back on the imaging table. This is done prior to surgery so your surgeon can determine if nodes are involved with the breast cancer and they will be removed at the same time of surgery.

LENGTH OF TIME INVOLVED:
1 hour.

PREPARATION:
Patient should have nothing by mouth (NPO) for 2 hours prior to the test. The patient will absorb the capsule better on an empty stomach. You may be asked to not have anything to eat or drink for an hour or so after taking the capsule as well. A consult with a radiologist needs to be done prior to the therapy for patient education and to order the dose.  The patient should have had a thyroid uptake and scan within 3 months. Current thyroid blood work needs to be available and a thyroid ultrasound may be needed. Patient must not be pregnant or breastfeeding.

EXAM DESCRIPTION:
The radiologist will explain the therapy to the patient. A capsule is taken by the patient that will partially or fully destroy the patient's thyroid gland over 2-3 months. There are no images done.  Patient follow up will be with the ordering physician.

LENGTH OF TIME INVOLVED:
This procedure usually takes less than 20 minutes.

PREPARATION: 
The patient cannot have had any x-rays involving the use of Iodineibased contrast materials within 6 weeks, such as a CT with contrast. Prior to the study, patients cannot be on any thyroid medications. Please consult your physician or the Nuclear Medicine Department with any questions.

EXAM DESCRIPTION: 
The patient will first come in and swallow a radioiodine capsule. The capsule is given to the patient in the morning and patient will be given a specific time to return approximately 3-4 hours later. Images and uptake are obtained later the same day, which takes about 1 hour. The patient is required to return the following day for a 24-hour uptake that will take approximately 10 minutes. These return times will be determined with you and the technologist who is giving you the capsule.

LENGTH OF TIME INVOLVED: 
Scanning time is approximately 45 minutes. The uptake, 24 hours after administering the dose, takes approximately 10 minutes.

PREPARATION: 
A chest radiograph should be obtained within 24 hours prior to lung scintigraphy for pulmonary embolism. The patient will have to receive an IV prior to the study.

EXAM DESCRIPTION: 
The patient is instructed to breathe a small amount of radioactive gas for the ventilation portion of the exam for about 5 minutes, followed by several images that take about 20 minutes. The patient will lay flat on their back and their chest will be underneath the camera as it moves around them to obtain the images. Following the ventilation portion is the perfusion portion. During this time an injection of radioactive material is given through the IV. After the injection, the same images are taken around the patient as they lie on their back.

LENGTH OF TIME INVOLVED: 
The examination takes approximately 1 hour depending on patient cooperation.

PREPARATION: 
None. Patient needs to have an IV for access of withdraw and re-injecting material.

EXAM DESCRIPTION:  
Once an IV is started then blood is drawn from the patient and is sent to an outside pharmacy for tagging to a radioactive material. The patient is free to leave until their blood is returned (the staff can call the patient to come back). When the patient returns they will get their White Blood Cells (WBCs) reinjected through their IV. At this time the patient is free to leave and will return early the next morning for the actual imaging of the area of interest. This test is done over a 2-day period.

LENGTH OF TIME INVOLVED: 
This exam takes about 1 hour for the images.