University College Hospital. Having a PET/CT radiotherapy planning scan. Radiotherapy Department Patient information series

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1 University College Hospital Having a PET/CT radiotherapy planning scan Radiotherapy Department Patient information series 22

2 2 If you need a large print, audio or translated copy of the document, please contact us on: (Direct line) ext 73711/bleep ext 73711/bleep 1458 We will try our best to meet your needs.

3 3 Contents Introduction 5 Your PET/CT appointment 5 What is PET? 5 How does PET work? 6 Why is it called a PET/CT scan? 6 Preparing for your PET/CT scan 6 On the day of your PET/CT scan 7 What are the risks of having a PET/CT scan? 8 What are the benefits of having a PET/CT scan? 8 What alternatives to PET/CT are available? 8 What should I do after my scan? 8 Other important information 9 Contact details 10 Where can I get more infomation? 10 Space for notes and questions 11

4 4

5 5 Introduction This booklet has been written for patients who are about to have a PET/CT (Positron Emission Tomography and Computerised Tomography) radiotherapy planning scan. By getting precise details about your cancer, we can target your treatment more effectively. We understand that some patients are anxious about having a PET/CT scan. Let us know if you have any questions or concerns. Your PET/CT appointment Having a PET/CT scan in the radiotherapy treatment position may be your first appointment as part of your radiotherapy treatment planning. The PET/CT scanner is located in the Nuclear Medicine department which is on the fifth floor of University College London Hospital. The Nuclear Medicine department will send you a letter with all the details of your scan, what time to come and how to find them. Some patients may require an extra appointment in the radiotherapy department a day or so before their PET/CT planning scan. If so, you will receive a separate appointment letter from the radiotherapy department. If you do not need to visit the radiotherapy department before your PET/CT planning scan, you will receive a letter from the radiotherapy department with any additional planning appointments required and your provisional radiotherapy treatment start date. What is PET? PET stands for Positron Emission Tomography. Patients are injected with a special radioactive tracer drug. This tracer drug emits a particular kind of signal which can be detected by a PET scanner. These signals are then transformed in to a picture. This picture is called a functional image. The image can then be studied by the radiotherapy team.

6 6 How does PET work? The cells in our body need energy, in the form of sugar (glucose), to function normally. Cancer cells require more energy, and therefore more sugar, than healthy cells. The radioactive tracer (most commonly 18 F-FDG) is a form of radioactive sugar. When the radioactive tracer drug is injected into the body, it is taken up by the cancer cells. This produces stronger signals in these areas. When the signals from the body are converted into a picture, the areas with stronger signals appear brighter than the surrounding healthy cells. Why is it called a PET/CT scan? The PET/CT scanner also takes a CT image. The scanner takes images of your body, using X-rays, and processes them using a computer. The system uses several X rays, taken at different angles, to produce detailed images of the inside of your body. By combining the functional PET image and the CT image we will have more highly detailed images of your disease and internal organs. We will use these images to plan your radiotherapy treatment. Preparing for your PET/CT scan You should have nothing to eat for six hours before your appointment time. Please check your appointment letter from the Nuclear Medicine department. If you do eat it may be necessary to cancel your scan on your arrival. You should drink plenty of plain water. Please do not drink anything else. Take all your prescribed medications on the day of your scan as usual, unless otherwise instructed on your appointment letter. If you have any questions about this, please contact the Nuclear Medicine department on the number: Please avoid any strenuous exercise for twenty four hours prior to your PET/CT scan appointment. For example, running, cycling or gym exercise.

7 7 If you are diabetic, you must contact the nuclear medicine department two days before your scan on: On the day of your PET/CT scan A PET/CT scanner is not a long tube like some MRI scanners, so most people do not feel claustrophobic (trapped) during their scan. If you are very anxious however, we may be able to give you a sedative. If you think you might need a sedative, please contact us before your scan. The whole procedure (explanation, preparation and scanning time) can take up to four hours. You may like to bring some food and drink for after the scan. Please do not bring any children or relatives with you unless they are assisting you to have the scan. You will be asked to change into a hospital gown. You will be given an injection of the radioactive tracer drug. The injection will be into a vein in your arm or hand by a small plastic tube called a cannula. You will then be asked to lie down and rest for one hour. After one hour, you will be taken into the scanning room. We will ask you to lie down on a motorised bed inside the scanner (which looks a bit like a giant doughnut). You will be positioned lying on the bed in the radiotherapy treatment position. The radiographers will draw some pen marks on your skin, stick some small stickers to your skin and then leave the room to take the scan. The bed will move automatically. We will ask you to lie very still during the scan. The scan will last about 30 minutes. Once the scan is complete, the radiographers will come into the scanning room. They may need to do some small permanent dots on your skin. This will all be discussed with you fully before you have the injection. You will then be able to go home and eat normally.

8 8 What are the risks of having a PET/CT scan? During a PET/CT scan, you are exposed to radioactivity from the tracer drug and X-rays from the CT scan. The level of radiation you receive is very carefully controlled and is unlikely to cause you any problems. The risk of complications (such as damage to body cells) increases the more times you have a PET/CT scan. Despite these slight risks, your doctor believes the benefits of having accurate treatment planning provided by PET/CT scans greatly outweighs the risks of the scan. Radiation can harm unborn children, so you must let us know if there is any chance that you may be pregnant. What are the benefits of having a PET/CT scan? Having a PET/CT scan combines two types of imaging in one scan. Your doctor will get highly detailed information about the location of your disease, which will improve the accuracy of your radiotherapy treatment. What alternatives to PET/CT are available? If you choose not to proceed with a PET/CT scan, it will be more difficult for us to plan your treatment effectively. PET/CT allows us to visualise your internal organs better. However, we will still be able to plan your radiotherapy treatment using a conventional CT scan. If you would like to discuss possible alternatives, please speak to your doctor or radiographer. What should I do after my scan? After your scan, you are free to go home. You can eat normally, but continue to drink plenty of fluids for the rest of the day.

9 9 Other important information If you require hospital transport for your PET/CT scan, please telephone the transport department patient assessment team on as soon as you receive your appointment. If you require hospital transport for your radiotherapy appointments, please contact the radiotherapy booking clerk on There are some extremely sensitive radiation detectors in place at some train stations, airports and seaports around the world. These monitors can detect extremely small amounts of radiation and it is possible that, until the radioactivity from your PET/CT scan has completely left your body, you may trigger on of these detectors. In the unlikely event that this happens, there is no need to be concerned. Custom officials are experienced in understanding what the detector has picked up, and may ask you a few simple questions and conduct a non-intrusive examination with a hand-held detector. They may like to see your PET/ CT appointment letter. If you are planning to travel in the near future it is recommended that you carry your PET/CT appointment letter with you. Please ask a member of staff how long your body is likely to retain traces of radioactivity, and therefore whether carrying the appointment letter is necessary.

10 10 Contact details Radiotherapy Planning Department Address: The Radiotherapy Department University College London Hospital 235 Euston Road London, NW1 2BU Direct telephone: Institute of Nuclear Medicine Address: 5 th Floor Tower University College London Hospital 235 Euston Road London, NW1 2BU Telephone: Where can I get more infomation? Royal College of Radiologists Website:

11 Space for notes and questions 11

12 First published: March 2009 Last review date: June 2013 Next review date: June 2015 Leaflet code: UCLH/S&C/CD/RT/PET-CT/2 University College London Hospitals NHS Foundation Trust Created by Medical Illustration RNTNEH Unique Code: 28894

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