Nuclear Medicine Imaging

Nuclear medicine imaging uses small amounts of radioactive material, a special camera and a computer to create images of the inside of your body.

What is Nuclear Medicine Imaging?

Nuclear medicine imaging uses small amounts of radioactive materials (called radiopharmaceuticals or radiotracers) that are either injected into or ingested by the patient. A special camera (called a gamma camera) uses the gamma rays emitted from these materials to create images of the inside of your body.  Nuclear medicine exams also provide metabolic cellular activity as well. Together, both the images and the functional activity measured can help diagnose many types of cancers and many other disorders relating to the heart, gastrointestinal, endocrine or neurological systems.  Often Nuclear Medicine exams can detect disease in its earliest stages, which can result in better treatment options.

Is my exam safe?

Generally yes, the clinical benefits of medical imaging typically outweigh the potential risks of radiation exposure, but please talk with your doctor if you have any concerns.

What if I am pregnant?

Under most circumstances a Nuclear medicine exam including PET/CT exam should NOT be performed on pregnant women due to the risk of radiation exposure to the baby. Your doctor may consult with the radiologist to determine if another study would be more appropriate for you.

How should I prepare for a nuclear test?

Nuclear Medicine Exams

Assess fractures, tumors, arthritis and infection (osteomyelitis). A small dose of a radioactive pharmaceutical will be injected into a vein in your arm before being positioned under the Gamma camera. This drug will not cause you to feel any differently. Imaging will occur 3 hours after your injection. In some instances you will be imaged immediately after the injection then asked to leave and return 3 hours later for an additional set of images.
Evaluates several renal functions; renal artery stenosis or obstruction, renal artery vascular flow, renal hypertension. It may also be used to detect acute tubular necrosis and to evaluate a kidney transplant. A small dose of a radioactive pharmaceutical will be injected into a vein in your arm before being positioned under the Gamma camera. This drug will not cause you to feel any differently. Imaging takes approximately 45 minutes. For some indications you be injected with a diuretic (Lasix) in order to assess renal clearance.
Diagnoses and or assess Parkinson’s disease. A small dose of a radioactive pharmaceutical will be injected into a vein in your arm, then you will be asked to rest for one hour before being scanned for 30 minutes. This drug will not cause you to feel any differently.
Evaluates stomach function. After eating a meal that has been tagged with a trace of a radioactive material, you will then be placed under a Gamma camera where pictures will be taken over a 2-4 hour time period.
Demonstrate gallbladder function or asses for suspected leak. A small dose of a radioactive pharmaceutical will be injected into a vein in your arm before being positioned under the Gamma camera. This drug will not cause you to feel any differently. Imaging will take about 90 minutes. After about an hour of imaging you will be injected with a hormone called CCK this causes the gallbladder to contract and more pictures will be taken.
Detects parathyroid adenomas, as well as glands not seen on ultrasound. A small dose of a radioactive pharmaceutical will be injected into a vein in your arm. This drug will not cause you to feel any differently. After 10-15 minutes you will be positioned under the Gamma camera for about 15 minutes. You will then be allowed to leave for about two hours. Upon your return, 30 more minutes of imaging will be performed.
Evaluates hyperthyroidism, thyroiditis, and thyroid nodules. You will be administered a radioactive iodine pill to swallow and asked to leave and return 6 hours later. Upon returning you will be positioned under the Gamma camera for approximately 45 minutes.
Lymphoscintigraphy is used to find lymph nodes that are involved in melanoma or breast malignancies. Typically this exam is performed pre surgically. A subdermal injection of a radioactive material will be given at the tumor site. Imaging after the injection under a Gamma camera is at the discretion of your surgeon.
Evaluates the anatomy of the liver and spleen. May distinguish a benign versus malignant lesion. A small dose of a radioactive pharmaceutical will be injected into a vein in your arm. This drug will not cause you to feel any differently. You will then lay under the Gamma camera for approximately 20 minutes.

A multiple gated acquisition scan (MUGA) is a noninvasive way to measure the function of your heart while it’s moving. The scan provides a good look at the ventricles of your heart and monitors the ejection fraction of the left ventricle. It can also be helpful in following the strength of cardiac function, cardiomyopathy, and post-infarct or post-chemotherapy treatment.

After an IV is placed in your arm, a small amount of your blood is withdrawn and then tagged with a trace of a radioactive material. After this tagging procedure (about 30 minutes) your blood s reinjected. Three ECG leads will be placed on your chest for cardiac monitoring then you will lay under the Gamma camera for about 45 minutes.

Evaluates cerebral vascular accidents (CVA), neuropsychiatric disorders and cognitive function decline. A small dose of a radioactive pharmaceutical will be injected into a vein in your arm. This drug will not cause you to feel any differently. You will then lay under the Gamma camera for approximately 45 minutes.

What to Expect

Lymphoscintigraphy (99mTc Sulfur Colloid)

Lymphoscintigraphy allows the radiologist to see the workings of your lymphatic system and it can help in diagnosing lymphedema, a condition in which lymphatic fluid accumulates in your soft tissues and can lead to inflammation and obstruction. For this scan, radioactive Tc Sulfur Colloid is injected into the web space between your fingers or toes and images are acquired 20 minutes and two hours after the injection.

RBC liver/hemangioma study (99mTc-labeled RBC’s)

This scan is helpful in determining whether or not a mass found in the liver is a hemangioma (benign growth) or not. Images of the liver are obtained using red blood cells labeled with a radiotracer. Labeling the blood takes 20-30 minutes, the initial imaging takes 30 minutes, and after a 45-minute break, the SPECT images of the liver are taken. There’s no patient preparation for this scan.

HIDA Hepatobiliary scan (99mTc Choletec)

Hepatobiliary scans demonstrate gallbladder function. You’re injected with 99m Tc Choletec. Once on the table, constant images are taken over the course of one hour. Additional images may be needed after the first set of images is taken, and can take up to four hours.

You must not eat anything six hours before your scheduled appointment or take pain medication on the day of the study — opiate medications such as morphine, Demerol, and codeine may result in a false positive.

Parathyroid scan (99mTc-Cardiolite)

Parathyroid scans are helpful in detecting parathyroid adenoma, as well as glands not seen via ultrasound. Upon arrival, an IV is started and you’re injected with 99mTc Cardiolite. After about 10-15 minutes, images are taken for about 30 minutes. Two hours after initial images are taken, the same images are repeated as well as a SPECT scan of the neck (approximately one hour). There is no preparation for this scan.

Thyroid uptake scan (I-123 NaI Sodium Iodide Capsule)

Thyroid scans are helpful in evaluating hyperthyroidism, thyroiditis, and thyroid nodules. The thyroid uptake scan requires three visits to the Medical Imaging Center of Southern California. On the first visit, you swallow a small radioactive iodine capsule. Six hours later, you return to have images taken of your thyroid and measurements of the radioiodine uptake are completed. On the second day, you return for another measurement of the radioiodine uptake.

In preparation for this scan, iodine-containing drugs must not be taken for two weeks prior to the scheduled appointment. This includes radiographic contrast and thyroid hormone replacements. For five days prior, no shellfish or iodine-rich foods should be eaten. Additionally, you should not eat or drink for four hours prior to coming in on the first day.

Bone scan (Tc MDP)

Bone scans can be helpful in identifying fractures, tumors, arthritis, and infection (osteomyelitis). For this scan, you’re injected with a small amount of radioactive tracer (Tc MDP) intravenously. This tracer travels throughout your body to your skeletal system and is distributed into your bones.

After the injection, you may leave the facility for a 2-3 hour break so that the tracer can be absorbed. During this time, you’re asked to drink plenty of water and empty your bladder.

Upon return, images are taken either of the entire body or a specific area, depending on what the referring doctor is requesting. There’s no preparation for this scan but it may be helpful to drink plenty of water prior to your scheduled appointment.

MUGA scan (Tc-labeled RBC’s)

The multiple gated acquisition scan (MUGA) is a noninvasive way to measure the function of your heart while it’s moving. The scan provides a good look at the ventricles of your heart and monitors the ejection fraction of the left ventricle. It can also be helpful in following the strength of cardiac function, cardiomyopathy, post-infarct or post-chemotherapy treatment. There’s no preparation for this scan.

Patient prep Nuclear Medicine Exams

There is no prep. Since the imaging room can be cold, please wear warm, comfortable clothes.

Drink 16 – 32 ounces of water prior to the scan. You may empty your bladder as necessary. No caloric intake 4 hours prior to the scan (water only).

Discontinue all ACE inhibitors for 48 hours prior to your exam (Ace Inhibitor Examples: Benazepril (Letensin), Captopril (Capoten), Enalapril/Enalaprilat (Vasotec), Lisinopril (Zestril and Prinvil), Perindopril (Aceon), Quinapril (Accupril), Ramipril (Altace))

Since the imaging room can be cold, please wear warm, comfortable clothes.

No food or drink 4 hours prior to scan. Do not use skin lotion on the day of test (we will need to apply ECG leads to your chest). If you have a lot of chest hair, please call our facility to speak with the Technologist about shaving your chest prior to arriving for the ECG leads application.
Hydrate well the day before and up to your exam time.  Since the imaging room can be cold, please wear warm, comfortable clothes. Discontinue the following medications for the length of time indicated:
  • Buspirone – 15 hours
  • Citalopram – 24 hours
  • Escitalopram – 24 hours
  • Paroxetine – 24 hours
  • Sertraline – 36 hours
  • Bupropion – 48 hours
  • Selegilene – 48 hours
  • Benzatropine – 3 days
  • Amoxapine – 4 days

No food or drink a minimum of 8 hours prior to a Gastric Emptying Scan. Tell your doctor if you are diabetic, as special arrangements may be required. Discontinue Reglan for 24 hours prior to your exam. Sedatives and narcotics should be discontinued 12 hours prior to your exam.

Since the imaging room can be cold, please wear warm, comfortable clothes.

No food or drink 4 hours prior to scan. No pain medication should be taken 4 hours prior to scan. Since the imaging room can be cold, please wear warm, comfortable clothes.
There is no prep for this exam. Since the imaging room can be cold, please wear warm, comfortable clothes.

No food or drink 4 hours prior to scan. Discontinue the following medications for the length of time indicated:

  • One Week – Methimazole (Tapazole), Carbimazole, Multivitamins
  • Two Weeks – Triiodothronine (Cytomel), Prolthiouracil (PTU)
  • Three Weeks – Lougol’s Solution, Potassium Iodide Solution (SSKI), Topical Iodine (surgical skin prep)
  • Four Weeks – Synthroid (Levothyroxine), Thyroxine, Elctroxin, Levoxine, Iodinated Contrast Agents
  • Three Months – Amiodarone

 

Since the imaging room can be cold, please wear warm, comfortable clothes.

The Surgeons office will provide your prep instructions.
There is no prep for this exam. Since the imaging room can be cold, please wear warm, comfortable clothes.
No caffeine, alcohol, or nicotine for a minimum of 24 hours before your exam.

Do you have any questions?

We understand that people looking for various exams may have a lot of questions, please do not hesitate to contact us so that we can walk with you during this trying time.