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Nuclear Medicine


Nuclear medicine provides information about the anatomy of the body and the functions of specific organs. When you undergo a nuclear medicine scan, an isotope, or an organ specific drug that contains a small amount of radioactive substance is either injected or swallowed. Different isotopes are used for different imaging needs, depending on how they concentrate in the body. After administration of the isotope, most patients are asked to wait a specific period of time prior to scanning. The waiting time varies, depending on how long it takes various organs to process the compound. If you are pregnant or nursing you should tell your physician and the technologist that is working with you.

Bone, liver, lung, heart and thyroid scans
There are several kinds of nuclear medicine scans, including bone, liver, lung, cardiac and thyroid scans. Most of our examinations require that you have an injection into a vein, most commonly in your arm, some examinations involve more than one injection.

Bone Scans
During a bone scan you will be injected with an isotope, asked to wait for three hours, and then scanned for 30 to 40 minutes. During the scan you will be positioned under a camera which will take pictures on film of your body. You may breathe normally during the exam. You are not exposed to further radiation during the scan itself: the camera is only picking up the radiation from the compound. This exam has no particular preparation although you are encouraged to drink at least 32 ounces during your wait. The scan looks for fracture, arthritis and metastatic disease.

Gastric Emptying
This exam requires that you take no food for at least six hours prior to the scan. The time for the exam is about 2 1/2 hours, during which time you will be asked to eat a radioactive egg. The scan records the rate at which food empties from your stomach.

Hepatobiliary or HIDA Scan
The HIDA scan requires that you fast for six hours prior, and that you plan on spending 1 1/2 to 2 hours here for the exam. This scan evaluates the liver, bile ducts and gallbladder. You must be off any narcotics for at least six hours prior to the exam.

H-Pylori
This examination looks for presence of the H-pylori Bacteria in the stomach. The patient is given a small amount of radioactive matter in a pill, taken with water. After 10 minutes the patient is asked to blow up a balloon, which is shipped out of state to another lab for processing. Please consult the technologist for a list of things you should avoid prior to the exam, some for as many as 30 days. The results on this test can take anywhere from 2 to 4 weeks.

Lung
Lung scans take about 20 - 30 minutes and are performed as a ventilation and perfusion study. With the ventilation scan a patient breathes in an odorless, tasteless radioactive gas to monitor the amount of air taken into the lungs. The Perfusion portion involves an injection of radioactive particles which become trapped in the lungs and highlights the pulmonary capillary network. This test usually looks for blood clots, or pulmonary embolism.

Lymphoscintigraphy
Lymphoscintigraphy is performed prior to sentinel node biopsy. This exam looks for the first lymph node adjacent to a site of either breast or skin cancer. Radioactive material is injected in approximately four sites around the place where the cancer was found. The injections for this procedure are done in the tissue, not in the vein. These exams are usually performed three hours prior to surgical removal of the cancer.

MUGA (Multi-gated Acquisition)
The MUGA is a heart exam performed on many patients undergoing chemotherapy. The MUGA looks at blood pumped by the heart to measure cardiac output. This exam is done prior to the start of some chemotherapy and after treatment, to check that the drugs are not damaging the heart muscle. The test requires no preparation, and takes about 45 minutes to one hour.

Thallium or a Nuclear Stress Test
A Thallium or Nuclear Stress Test is a cardiac exam that takes approximately 2 to 2 1/2 hours to complete. This exam evaluates blood flow to the heart, at rest and during exercise. Stress tests are used to evaluate the heart prior to and after heart catheterization surgeries, the exam shows if there has been a heart attack or increased risk of a heart attack.

Thyroid Uptake and Scan
These exams check for conditions such as Graves Disease and Thyroiditis. The isotope (I123) is administered by mouth in capsule form. A probe is utilized that measures the amount of radioactive material that is accumulated by the thyroid to see how active or inactive the thyroid gland is. After taking the capsule, the patient must wait for four hours and return for a 45 minute scan.

Thyroid Whole Body, Thyroid Therapy, Ablations
These exams are used to check for thyroid cancer and hyperthyroid conditions. A capsule form of the isotope (I131) is used, and is different than the thyroid isotope used in the Uptake exam. There are special precautions to be used with this isotope. Patients taking thyroid replacement hormone may have to stop their medication for several weeks prior to an exam. Please contact the technologist or radiologist directly by calling (775) 770-3393 to find out if your medication needs to be stopped prior to the exam. If you are of childbearing age, you must have a pregnancy test no more than three days prior to the exam.

Kidney Renogram
There are three types of renograms, one of which looks strictly at the function of your kidneys. A Lasix Renogram looks for obstruction or blockage of urine flow from the kidneys, while a Vasotec or Captopril Renogram looks at renal artery blood flow in patients with high blood pressure. You will need to be well hydrated for all three exams, and you may have to discontinue taking any medication. Please talk to the technologist to find out if your medications need to be stopped prior to the exam by calling us at (775) 770-3393.

Prostascint
For prostate cancer patients, this exam is ordered when PSA levels are rising but the bone scan is negative for disease. This exam involves an injection on one day, a four-day bowel preparation and scanning, additional injections and blood work on day five. The exam is extensive and involves much patient preparation, but the results can tell if prostate cancer has returned, or was not revealed in other tests.

Preparing for your exam
When it is time for your exam you will be positioned next to the camera taking pictures of your body . You will not be exposed to any further radiation during the exam itself. The camera is able to capture images of the radioactive isotope you have taken. If you are claustrophobic, please ask a technologist to assist in making you comfortable. You should breathe normally for all of the exams, and are requested to wear warm, comfortable clothing without metal fasteners or zippers. Most exams involve the same amount of radiation as a chest x-ray. Many of the scans have strict preparations regarding patient diet, or other requirements, so please talk to the technologist or radiologist prior to your exam, by calling (775) 770-3393. All of these exams are virtually painless, but can be long. In most cases, the report of your test results will be sent to your physician within 1-24 hours of your exam.

Most isotopes used for nuclear medicine are quickly eliminated from the body naturally, usually within hours and completely within 24 hours. Strict safety standards are adhered to by Saint Mary's professionals, including technologists, physicists, pharmacists and radiologists. Adverse reactions to nuclear medicine are very rare. If you have any concerns about the safety of these procedures, please talk to your doctor, or a Saint Mary's technologist, at (775) 770-3933.
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