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Nuclear Medicine

Nuclear Medicine a branch of medical imaging dealing with the use of radioactive materials in the diagnosis and treatment of various diseases and conditions.   Small amounts of radioisotopes are often injected into the body, where emitted gamma rays are detected by the camera.  Nuclear Medicine procedures are safe, effective and prove the information that cannot be obtained using other imaging modalities.

Exam Descriptions

There are several types of common studies associated with Nuclear Medicine, including:

Myocardial Perfusion Study with Lexiscan
This is a non-invasive exam (known as a Nuclear Stress Test) that evaluates overall blood flow to the cardiac muscle at both rest and stress conditions.   A stress test is also performed using a chemical drug called Lexiscan that simulates exercise.   Both the images and stress test helps to determine if any coronary artery disease is present.

Renogram with Lasix
This exam is used to evaluate the patient’s overall kidney function, check urinary tract flow and rule out hydronephrosis, or assess ureteral blockages from kidney stones.  A diuretic called Lasix may also be administered to help evaluate kidney function.

Thyroid Uptake and Scan
This exam is used to evaluate the size and overall function of the thyroid gland. The patient ingests a small pill containing a small amount of radioactive iodine and then returns six hours later for uptake measurement and scanning.  This exam is commonly used to diagnose thyroid gland disorders, such as hyperthyroidism.

Whole Body Bone Scan
This exam is used to evaluate various conditions of bone metabolism, including metastatic bone disease, inflammatory disease, fractures, or bone infections.  Images are performed to evaluate the entire skeleton, with additional images of the area of interest.

HIDA Scan with CCK
This exam is used to determine gallbladder function and evaluate for acute or chronic cholecystitis.  A drug called CCK may also be administered to stimulate gallbladder contraction and determine the gallbladder ejection fraction.

Lung Scan
This exam is performed to evaluate for a pulmonary embolism by imaging ventilation and perfusion to the lungs.  Other less common indications include pre-operative lung function and transplant evaluation.

Gastric Emptying Tougas Protocol
This exam is performed to evaluate the overall gastric function.   A small standardized meal is ingested, and then images are acquired over a period of time which measures gastric emptying.

Datscan Brain Imaging
This exam is performed to visualize dopamine transporters within the brain and evaluate adult patients with suspected Parkinson’s Syndrome vs Essential Tremors.  Patients receive their radioisotope injection in the morning and then return in the afternoon for brain imaging.

Parathyroid Scan
This exam is used to evaluate for a hyperactive parathyroid gland and aid in the detection of any parathyroid adenomas.

Other less common NM exams include:

  • MUGA Scan
  • Indium White Blood Cell Study
  • Octreotide Scan
  • Thyroid Ablation Therapy

Preparation and what to expect during the procedure:

Reno Diagnostic Centers (RDC) follows strict safety standards when performing this procedure. You may expect the following during this procedure:

  1. You are given a radioactive isotope (a compound called a radiopharmaceutical). Depending on the body part to be examined, the isotope is injected, swallowed or inhaled.
  2. The isotope travels through your body giving off energy in the form of gamma rays, which shows the location of the isotope in your body.
  3. The gamma cameras are tools used to take pictures and to measure the organ functioning. A computer then processes the information to produce images of your body.
  4. These images are then studied and interpreted by a board-certified radiologist and a report is sent to your physician.
  5. The results acquired in a nuclear medicine study is combined with the results of general x-rays or other tests that you have received, in order to obtain a comprehensive analysis of your condition.

Myocardial Perfusion Study with Lexiscan

  • Nothing by mouth (for example, food, liquids, etc) 4 hours prior to the exam.
  • No caffeine 24 hours prior such as coffee (including decaf), tea, chocolate, sodas, etc. This also includes over the counter medications containing caffeine (such as Anacin and Excedrin).
  • No Viagra for 24 hours prior.
  • Must bring any inhalers (such as albuterol, etc) used at home.
  • A patient must bring something to eat, such as a snack and a drink for this exam. The patient will eat the snack after the stress test, as this helps to obtain high-quality images.
  • Please advise patients to wear loose-fitting, comfortable clothes, like they are going to the gym. A t-shirt and sweatpants are ideal. If a woman owns a sports bra, advise her to wear one.
  • The patient should wear sneakers; sandals and boots are not appropriate.

Renogram with Lasix
The patient should be well hydrated (with at least 32 oz of water) before arriving for their appointment.

If the patient is taking diuretics, they should stop for 24 hours before the exam.

Thyroid Uptake and Scan

  • Nothing by mouth (for example, food, liquids, etc) NPO 3 hours prior to appointment.
  • Avoid foods known to contain iodine (seafood, sushi, kelp, seaweed, iodized salt) on the day of the exam.
  • Verify patient understands the thyroid medication guidelines and how long they need to be off their medications.
  • Verify the patient has not had any iodine contrast in the last 4 weeks.

Whole Body Bone Scan
There is no preparation for a bone scan prior to the injection. Patients will be required to drink up to 32 oz of water after the injection to ensure high-quality images.

HIDA Scan with CCK
Nothing by mouth (for example, food, liquids, etc) NPO after midnight. If scheduled for an afternoon appointment, the patient must be NPO at least 8 hours.

Lung Scan
There is no preparation for this exam; however, if the patient is known to be a difficult IV stick, they should be well hydrated before arriving for their appointment.

Gastric Emptying Tougas Protocol

  • Nothing by mouth (for example, food, liquids, etc) NPO after midnight. If scheduled for an afternoon appointment, the patient must be NPO at least 8 hours.
  • Is the patient taking any stomach or pain medications, then document in scheduler’s notes and email the Nurse. Patients should withhold all opiates or prokinetic agents which affect gastrointestinal motility for 48 hrs. These include metoclopramide (Reglan), domperidone (Motilium) and erythromycin (Ery-Tab)

Datscan Brain Imaging

  • Nothing by mouth (food, liquids, etc.) after midnight.
  • No caffeine for 24 hours prior to the exam.
  • General Guideline: No mood-altering/cognitive medications or patches (ex. Parkinson’s or Dopamine Antagonistic class of medications (Sinemet, Levodopa, Requip) for 48 hours prior to the exam, No mood-altering medications or patches (anxiety medications, antidepressants, sleeping medications, tranquilizers, etc) 24 hours prior to the exam, if possible. Please refer to the DATscan Medication List Guideline link in the scheduling manual for a more detailed list of medications. Document these medications in the scheduling notes at the time of scheduling, then refer to the technologist or the nurse for guidance. The nurse can go over medications with the patient.
  • The patient should wear comfortable clothing for the exam.
  • No earrings or metal clips in hair.

Parathyroid Scan

  • There is no preparation for a parathyroid scan prior to the injection. Patients will be required to drink up to 32 oz of water after the injection to ensure high-quality images.
  • If the patient is known to be a hard stick, then they should hydrate well before coming in for their parathyroid scan.