Nuclear Medicine Table of Contents:

Transcription

1 Nuclear Medicine Table of Contents: Bone Scan 3 Phase Bone Scan Whole Body Cardiolite Cardiac Stress Test Gastric Emptying Gastrointestinal Bleed Scan Gated Cardiac Study Hepatobiliary Scan I-131 Therapy for hyperthyroidism Liver and Spleen Scan Lung Ventilation and Perfusion Scan Meckel s Imaging Melanoma Study Parathyroid Imaging Renogram Sentinel Node Tagged White Blood Cell Scan Thyroid Scan Thyroid Uptake and Scan

2 Bone Scan 3 Phase: Length of Test: 60 minutes first appointment 60 minutes second appointment (3 hours later) Prep: Patient should be well hydrated. Can be done same day as CT (if requested). Bone scan before CT if possible. Description: The test looks at bone metabolism and can detect stress fractures, bone mets, osteomyelitis and bony infarcts. The patient is injected with a radiotracer and initial imaging will be taken. The patient returns 3 hours later for delayed imaging. Contraindications/Conflicts: No GI barium 48 hours prior to test Nuc Med Bone Scan Patient may leave between appointment times.

3 Bone Scan Whole Body: Length of Test: 30 minutes first appointment 60 minutes second appointment time (3 hours later) Prep: Patient should be well hydrated. Can be done same day as CT (if requested). Bone scan prior to CT if possible. Description: The test looks at bone metabolism and can detected stress fractures, bone mets, osteomyelitis, and bony infarcts. The patient is injected with a radiotracer and then returns 3 hours later for imaging. Contraindications/Conflicts: No GI barium 48 hours prior to test Nuc Med Bone Scan Patient may leave between appointment times.

4 Cardiolite Stress Test: Other Names: Regadenoson (Lexiscan), Treadmill, Dobutamine Length of Test: approximately 3.5 hours total time (sometimes a 2 day test) 60 minute Rest 90 minute Stress 1 hour between tests. Prep: Nothing to eat or drink 4 hours prior to test. No caffeine or nicotine 12 hours prior to test. May need to hold medications. (Contact Nuclear Medicine department/nurse for guidelines). Description: The test includes a rest and a stress phase (sometimes done on separate days). An IV will be started and a tracer will be injected. Images of the heart will be made 30 minutes after the injection. The stress test will be done and then another set of images will be taken. The two set of images will be compared. Contraindications/Conflicts: Patient over 450 pounds. Extreme hypertension. Patients over 275 should be scheduled for a two day procedure. Please review with Nuclear Technologist. Nuc Med Stress Test

5 Gastric Emptying Study: Length of Test: 4 hours Prep: Nothing to eat or drink after midnight. Description: Patient will be asked to eat a meal of scrambled eggs and toast. An image will be taken every 15 minutes of the stomach until it has emptied. Nuc Med Gastric Emptying

6 GASTROINTESTINAL BLEED SCAN: Other Names: GI Bleed Scan, Tagged Red Blood Cell Scan Length of Test: 2 hours Prep: NPO Description: The patient is injected with a radiotracer and images of the abdomen are taken for one to two hours. Contraindication: No Barium 48 hours prior Schedule: Can be done as an add on Nuc Med GI Bleed Scan

7 Gated Cardiac Study: Other Name: MUGA scan, Radionuclide Ventriculogram Length of Test: 2 hours Prep: None Description: An IV will be started and an injection will be given. After about 20 minutes, the patient will lay flat while images are taken in three projections around the heart. The scan looks at cardiac wall motion and pumping efficiency. Contraindications/Conflicts: Cannot be done same day as bone scan. Nuc Med Gated Cardiac/MUGA Scan

8 Hepatobiliary Scan: Other Names: HIDA scan Length of Test: 2 hour test, may take 3 hours in rare circumstances. Prep: Nothing to eat or drink 8 hours before appointment. No morphine derivatives at least 4-5 hours prior to exam. May take toradol with no restrictions. No fentanyl for one hour prior. Description: The test looks at the function and anatomy of the biliary system. An IV will be started and a radiotracer given. Images will be taken for hours. When the gallbladder fills with tracer, another medicine will be given to cause the gallbladder to contract. Contraindication/Conflicts: No morphine derivatives at least 4-6 hours prior to exam. No fentanyl for one hour prior. May be done as inpatient or ER Nuc Med Hepatobiliary Scan

9 I-131 Therapy for Hyperthyroidism: Please consult with Nuclear Medicine Staff when scheduling this procedure. Other Names: Thyroid ablation Length of Test 1 Hour Prep: Nothing to eat or drink after midnight. Bring photo ID, and bring someone with patient to listen also to Radiologist counseling. Ordering physician must send signed order and recent labs (TSH, T4, T3). Negative serum pregnancy test day of therapy (females under 50). No previous x-ray or CT dye for 4-6 weeks prior. Description: Patient will be given a radioactive capsule by mouth. It will ablate the thyroid gland and reduced its output. The patient will be counseled by a nuclear medicine radiologist about restrictions and precautions. Contraindications/Conflicts: Pregnant or breastfeeding. Thyroid medications ( and some other meds-check with staff). Patient cannot be around small children or pregnant women for 2-7 days. Patient shouldn t use mass transportation for 2-5 days. Severe allergy to Iodine. Nuclear Medicine staff will consult with Nuclear Radiologist. Nuc Med Thyroid Therapy

10 Liver and Spleen Scan: Length of Test: Can take up to 2 hours. Prep: None Description: Patient is injected with a radiotracer and images will be taken over the liver and spleen area. The scan looks at function and anatomy of the liver and spleen. Contraindications/Conflicts: No barium 48 hours prior Nuc Med Liver/Spleen Scan

11 Lung Ventilation and Perfusion Scan: Other Names: VQ Scan Length of Test: approx. 2 hours Prep: None Description: There will be inhalation and injection of radiotracers to help diagnosis the presence of PE (pulmonary embolus). The patient will lie on the imaging table while breathing through a mask. Then there is a small injection of a tracer followed by more imaging. Contraindications/Conflicts: Extremely severe COPD. Patient must be able to follow directions for ventilation scan. Schedule: Usually IP or ER may schedule Nuc Med Lung Scan

12 Meckel s Imaging: Length of Test: 1.5 hours Prep: Nothing to eat or drink after midnight. Description: The patient will be injected with a radiotracer and images of the abdominal area will be taken to look for the presence of a Meckel s diverticulum. Contraindications/Conflicts: No barium 48 hours prior Nuc Med Meckel s scan

13 Melanoma Scan: Length of Test: 2 hours Prep: Usually test is pre-op. NPO, Ambulatory Surgery will call patient with instructions. Description: The patient will be given injection around melanoma site by surgeon ordering the test. Images will be taken for 2 hours. Nuc Med Melanoma Scan

14 Parathyroid Imaging: Length of Test: 3 hours total. Patient may leave for one hour in between imaging. 60 minute Imaging 60 minute Break 60 minute Delayed Imaging Prep: None Description: Patient will be given an IV injection of a radiotracer and images will be taken over the neck area and then again one hour later. Scan shows enlargement and location of the parathyroid glands. Nuc Med Parathyroid Scan

15 Renogram: Other Names: Renal Scan Length of Test: 90 Minutes Prep: Patient should be well-hydrated Description: Patient will be given an IV injection of a radiotracer while images are taken of the kidneys. The scan checks the function of the kidneys. Nuc Ned Renogram

16 Sentinel Node Other Names: Lymph and Lymphatic Imaging Mammo Needle localization may be scheduled to follow Nuclear Medicine procedure. Length of Test: 2 hours Prep: NPO, Ambulatory Surgery will call patient with instructions. Description: The patient will be given a sub Q injection in the affected breast of a radiotracer by the surgeon. Immediate and delayed images will be taken. The scan will show the location of the sentinel lymph node(s). The patient is often taken to x-ray and then surgery immediately afterwards. Nuc Med Sentinel Node (OR will Schedule to coordinate time of exam with surgery time)

17 Tagged White Blood Cell Scan: Other Names: WBC scan for infection or osteomyelitis. A three phase bone scan will be done also if not done previously. Length of Test: 2 day test (3 visits) 60 minutes for initial visit 60 minutes for return visit 3 hours later 120 minutes next day, 24 hours after 2 nd visit Prep: None Description: An IV will be started and blood will be drawn from the patient. The patient will come back several hours later so their tagged white blood cells can be re-injected. They will come back 24 hours later for the imaging. The scan looks for infection in the bone. Nuc Med White Blood Cell Scan Must start test first thing in the morning. (7:30 or 8:00). A driver will take patients blood to Cardinal Health Pharmacy, in Des Moines, to be labeled and returned.

18 Thyroid Scan: Length of Test: 30 minutes first appointment to take a pill. 60 minutes second appointment 6 hours later for the scan. Prep: Nothing to eat or drink for 8 hours. No thyroid medications (off Synthroid 4-6 weeks, off PTU 1 week). No x-ray procedures which require IV contrast in the last 6 weeks. Description: The test looks at the shape and size of the thyroid. The patient will come and take a pill in the morning, and return 6 hours later for imaging (images will take 30 to 45 minutes). Contraindications/Conflicts: No thyroid medications (off Synthroid 4-6 weeks, off PTU 1 week). No x-ray procedures which require IV contrast in the last 6 weeks. Severe allergy to Iodine. Nuclear Medicine will consult with Nuclear Radiologist. Nuc Med Thyroid Scan

19 Thyroid Uptake and Scan: Other Names: Length of Test: 2 day procedure (3 visits) 30 minutes for pill. 60 minutes 6 hours later. 30 minutes 24 hours after first appointment. Prep: Nothing to eat or drink 8 hours before appointment. No thyroid medications (off Synthroid 4-6 weeks, off PTU 1 week). No x-ray procedures which required IV contrast in the last 6 weeks. Description: The test looks at the function and size of the thyroid. The patient will be given a small capsule of radioiodine for the uptake and scan (in the morning appt). Images taken at 6 hour appointment (takes about 60 minutes). Return 24 hours later for 30 minutes (uptake only). Contraindications/Conflicts: No thyroid medications (off Synthroid 4-6 weeks, off PTU 1 week). No x-ray procedures which required IV contrast in the last 6 weeks. Severe allergy reaction to Iodine. Nuclear Medicine staff will consult with the Nuclear Radiologist. Nuc Med Thyroid Uptake and Scan

20 Nuclear Medicine Procedures Order After Hours: Call the Diagnostic Imaging Department and talk to the tech on duty when the test is order. They will order the appropriate doses necessary for the test. If test is cancelled, notify Diagnostic Imaging Department ASAP to cancel doses. Check the book for preparations needed.