Nuclear medicine is an imaging modality that is unique, because it provides doctors with information about both structure and functional assessment of most organs. It is a way to gather medical information that would otherwise be unavailable, require surgery, or necessitate more expensive diagnostic tests. Nuclear medicine imaging procedures often identify abnormalities very early in the progress of a disease long before many medical problems are apparent with other diagnostic tests. 

Nuclear medicine procedures are performed by the injection or ingestion of a small amount of a radioactive tracer.  The tracer is accompanied by a pharmaceutical that is organ specific, together it is a radiopharmaceutical. There are no side effects and no medication contraindications with the radiopharmaceutical administration.  Once the radiopharmaceutical has been administered you will be laid on a table and made comfortable,a gamma camera will be placed over the area of interest and images will be obtained at certain intervals.  

The radiation exposure is minimal and will not cause any short or long term biological effects.  Nuclear medicine procedures are deemed safe and are a great diagnostic tool.

Nuclear medicine offers procedures that are essential in many medical specialties, from pediatrics to cardiology to psychiatry. New and innovative nuclear medicine treatments that target and pinpoint molecular levels within the body are revolutionizing our understanding of and approach to a range of diseases and conditions.
Once your exam is complete, one of our highly skilled radiologists will read the images, and a report will be generated and sent to the ordering physician.  The ordering physician will get the report in 24-48 hrs.  If you have any questions, concerns, or complaints please do not hesitate to contact us.

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Exam explanations

Bone scans
Bone imaging is used to evaluate functional display of skeletal activity.  This is done to detect metastatic skeletal lesions, stress fractures, occult fractures of the hip and pelvis, avascular necrosis, osteomyelitis, and Padgett’s disease.  Bone imaging usually will identify pathology earlier and more frequently than with conventional x-ray.

Whole Body bone Scan
Patient prep: None
Exam time:  15 min for injection then returning 3-4 hrs later for a 30-45 min scan.
Explanation: The patient is injected, with a small amount of radioactive material which has no side affects.  The patient needs to be instructed to drink 32 oz. of fluids between injection and scan.  The camera will scan the patient head to toe, including specific areas as needed.


Limited Bone scan
Patient prep: None
Exam time:  15 min for injection then returning 3-4 hrs later for a 30-45 min scan
Explanation: The patient is injected, with a small amount of radioactive material which has no side affects.  The patient needs to be instructed to drink 32 oz. of fluids between injection and scan.  The exam will encompass one area of interest.
Note:  The doctor must specify what areas to be imaged; also if more than one area of interest is needed then it has to be ordered under Whole Body bone Scan.


Bone SPECT scan 
Patient prep: None
Exam time:  15 min for injection then returning 3-4 hrs later for a 1 hr scan
Explanation: The patient is injected with a small amount of radioactive material then placed under the camera for a series of images of the skeleton at the area of interest.


Bone Marrow Study
This scan demonstrates the distribution of functioning bone marrow with the skeleton.
Patient prep: None
Exam time: 1hr
Explanation:  The patient is injected with a small amount of radioactive material then placed under the camera for a series of images of the skeleton.


Cardiac perfusion imaging
Cardiac or myocardial perfusion imaging is an invaluable aid for the diagnosis and management of coronary artery disease.  Functional imaging directly reflects the delivery of blood to myocardial tissue and provides physiologic information to compare with coronary artery angiography.  Patients are imaged at rest, then again after peak exercise.  This functional analysis will allow for distinction between myocardial ischemia and defects indicating scarring.
Patient prep: NPO after midnight, No caffeine, take only necessary medications based on doctor’s instruction
Exam time:  1-4 hrs
Explanation:  The patient will be injected with a small amount of radioactive material.  (Must have working IV if house patient). 30-45 min later 15 min scan of the heart will be performed.  Once this is complete, the patient will be taken to special medicine for the stress test.  Once the stress test is completed the patient will return to nuclear medicine to have another 15 min scan of the heart.
Note:  There are two ways of stressing the patient, treadmill or Pharmaceutical (Persantine or Dobutamine).  The ordering doctor must specify which depending on the patient’s condition. 


Gastric Emptying 
This exam demonstrates the movement of an ingested bolus of solid or liquid from the stomach into the small intestine.
Patient prep: NPO after midnight. Should be scheduled in AM, early as possible
Exam time: 90 min
Explanation:   The patient will have to eat one scrambled egg that has been injected with a small amount of radioactive material and one piece of toast with 8oz. of water.  If the patient is allergic to eggs we can use oatmeal.  This needs to be eaten as quickly as possible.  Once the meal has been eaten then, the patient will be scanned over the abdomen area. 


GI Bleeding scan 
Radionuclide imaging of patients with acute gastrointestinal bleeding is a highly sensitive, noninvasive way to accurately demonstrate a bleeding site within the GI tract.
Patient prep: None
Exam time: 1 hr
Explanation: 3mls of blood is drawn and tagged with a small amount of radioactive material, which takes 30 min to tag.  This tagged blood is then reinjected and the patient is then scanned at the abdominal area.  


Hepatobiliary imaging (HIDA scan)
Radionuclide imaging of the gallbladder is done on patients suspected of having acute cholecystitis or chronic cholecystitis.  It gives a functional analysis of the gallbladder.
Patient prep: NPO 4-6hrs prior to test
Exam time: 2 hrs
Explanation: The patient will be injected with a small amount of a radioactive material and images are taken for 1 hr watching the Gallbladder fill. Once it is filled a slow infusion of CCK over 30 minutes will take place and images will be taken of the gallbladder contracting.


Liver/Spleen Scan
The exam demonstrates the distribution of the intravascular mononuclear phagocyte system. This aids in the assessment of chronic liver disease, the size and configuration of the liver and spleen. And, the diagnosis of focal nodular hyperplasia and detection of accessory splenic tissue.
Patient prep: None
Exam time: 45 min
Explanation:  The patient is injected with a small amount of radioactive material then placed under the camera for a series of images of the liver and spleen.


Liver SPECT (Hemangioma study)
The Hemangioma study depicts the amount of perfusion and vascular space with hepatic lesions. 
Patient prep: None
Exam time: 1.5hrs with delayed imaging at 3hrs after injection
Explanation:  3mls of blood is drawn and tagged with a small amount of radioactive material, which takes 30 min to tag.  This tagged blood is then reinjected and the patient is then scanned at the abdominal area.  


Lung Ventilation/Perfusion scan (VQ Scan)
Lung perfusion imaging in conjunction with ventilation imaging of the lungs is a noninvasive method of evaluating pulmonary arterial blood flow, specifically pulmonary embolism.  
Patient prep: None
Exam time: 1 hr
Explanation:  The patient will be asked to breathe a radioactive aerosol for 5 min.  Images are then obtained in different projections.  The patient is then injected with a small amount of radioactive material, and the same images are then repeated. 
Note:  This exam is generally ordered only when the patient is allergic to x-ray contrast, creatinine levels are to high or no LG bore IV access.  


Lymphoscintigraphy
This exam demonstrates the flow of lymph from the site of injection in the interstitial space through the draining lymphatic’s and into the sentinel lymph nodes. This is routinely done on patients with breast cancer or melanoma before they go to surgery.
Patient prep: None
Exam time: 1-4 hrs
Explanation:  A radiologist will do 4 injections at the site of the breast cancer or melanoma.  Once that is completed then a series of images are taken around the site to localize lymph nodes.


Meckel’s Scan
This scan depicts the uptake of pertechnetate within the abdomen.  Pertechnetate is secreted by the mucosa of the stomach as well as by any ectopic gastric mucosa.  
Patient prep: 300mg oral Tagament for 150mg of oral Zantac 1hr prior to exam
Exam time: 1 hour
Explanation:  The patient is injected with a small amount of radioactive material then placed under the camera for images of the abdomen.


Muga
This exam evaluates left ventricular wall motion and ejection fraction at rest.  
Patient prep: None
Exam time: 1 hour
Explanation:  3mls of blood is drawn and tagged with a small amount of radioactive material, which takes 30 min to tag.  This tagged blood is then reinjected and the patient is then scanned with their arms above their head for 20min. 


Octreoscan
This scan images neoplasms that arise from the embryologic neural crest and expresses a high density of Somatostatin receptors on their cell membranes.  These tumors are often referred to as Neuroendocrine tumors. 
Patient prep: Stop Octreotide therapy 2 days prior to study and be well hydrated
Exam time: 1 hr at 4hrs and 24hrs after injection 
Explanation:  The patient is injected with a small amount of a radioactive tracer then placed under the camera for a series of images of the affected area..


Parathyroid scan or (sestamibi scan)
This scan depicts hypertrophied parathyroid tissue, to detect parathyroid adenomas.
Patient prep: None
Exam time: 5min then again at 4hrs later for another 5min
Explanation:  The patient is injected with a small amount of radioactive material then placed under the camera for an image of the neck area.


Renal scan with Lasix
Radionuclide imaging studies of the kidney provides sensitive indications of relative renal blood flow, glomerular filtration, tubular function and urinary excretion.  
Patient prep: Void bladder before test
Exam time: 1hr
Explanation: The patient will be injected with a small amount of radioactive material.  The patient is then imaged for 20 min then given Lasix IV and images continue for 20 more min.  


Thyroid Uptake/scan (6hr or 24 hr)
Radioiodine imaging of the thyroid serves multiple purposes.  The uptake portion of the exams provides a method of detecting thyroid dysfunction such as hyperthyroidism or hypothyroidism.  This calculation is helpful in correlation with laboratory blood tests.  The imaging portion is to determine relative function of nodules compared with that of the rest of the gland.  This helps to distinguish benign from malignant nodules.
Patient prep: None
Exam time: 1 hr
Explanation: The patient is given 2 pills to take as early in the morning as possible.  They will return 6 or 24 hrs later for the scan.  A series of images are then taken in different projections.


I-131 Thyroid Therapy for Hyperthyroidism
This procedure uses 1-131 orally to reduce thyroid gland function to the point where the patient is unlikely to become hyperthyroid again.  This is used for the treatment of Graves disease. 
Patient prep: The patient must discontinue iodide containing preparations, thyroid hormones, and other medications that could affect the ability of the thyroid tissue to accumulate iodide.
Exam time: None, Therapy only
Explanation:  The patient will come into the facility and be counseled by a radiologist and then they will be given 2 pills to take with discharge instructions to follow. Then they are instructed to follow up with their doctor.  
Note:  Ordering physician must specify dosage


Tumor imaging (Gallium scan)
This scan offers detection and localization of chronic infection and fever of unknown origin, and detection and localization of tumors.
Patient prep: None
Exam time: 1hr at different timed intervals after injection.
Explanation:  The patient is injected with a small amount of radioactive material then placed under the camera for a series of images of the whole body or affected area.
Note: Ordering physician must specify area to be imaged


VCUG or Cystogram
This scan is used to diagnose vesicoureteral reflux. 
Patient prep: Void Bladder
Exam time: 1 hour
Explanation:  The patient will have a Foley catheter inserted by a nurse.  The Foley catheter will be connected to a bag of saline that is tagged with a small amount of radioactive material.  Once the catheter is in place, the patient will be placed against the image detector and the technologist will fill the patient’s bladder.  Once the bladder is full, the catheter will be removed and the patient will be instructed to void while images continue.  Once the bladder is empty the exam is complete.


White Blood Cell Scan
This exam demonstrates the distribution of labeled white blood cells within the body at various times after IV injection.  When labeled with Tc99m Ceretec, the study can be completed in several hours and is optimal for imaging inflammatory bowel disease, detection of abscesses and infection in soft tissues, particularly in patients with no localized findings.  When labeled with In-111, the study can be extended over two days and is preferred for the diagnosis of vertebral body osteomyelitis.  In-111 can also be used when Ceretec is unavailable.  
Patient prep: None
Exam time: 1 hour at different timed intervals after injection
Explanation:  60ml of blood are initially drawn from the patient then the blood is given to our nuclear pharmacy.  They will take out the red blood cells and leave the white blood cells then, tag the cells with Tc99m Ceretec or In-111 and then send it back to us which takes about 3 hours.  Then we will inject the patient with the tagged white blood cells.  Then 2 hours after that, we will start imaging at certain intervals. Imaging can take up to 48 hrs after injection depending on the patients clinical.  
Note:  The ordering physician must specify the area to be imaged and the radiopharmaceutical to be used depending on the patient’s indications.