Nuclear Medicine Imaging Studies

If there is ANY chance at all that you may be pregnant or you are currently breastfeeding, please inform the Nuclear Medicine Physician before the test commences.

Bone Scans
Why are bone scans needed?

Suspected fracture, arthritis, infection, tumour, Paget's Disease, staging of cancer or looking for the cause of bony pain
The bone scan may looks at the blood supply to your bones, and unlike an X-ray, examines the metabolism of your bones which may indicate disease.

Preparation:

Nil, however you should bring any previous x-rays and bone scans along with you.

About the bone scan:

You will be given an injection into a vein in your arm of a radioactive tracer (^99mTechnetium MDP) which goes to your bones. Some images may be taken straight after the injection, particularly if your doctor is querying an infection, inflammation or fracture.
You will then be given a time to return to the department 2-3 hours later. This wait enables the tracer to be adequately taken up by the bones. You may leave the department in this time and there are no restrictions on what you can do (eg. Eat, drink), however you will be encouraged to drink plenty of fluids and void before the scan.
When you return, images will be taken using a gamma camera and these images plus a written report will be sent to your doctor.
The images take between 30 - 60 minutes and you will be required to lay still on a bed while a camera moves above, below and around you.
You may remain fully clothed throughout the scan and will only need to remove items such as belts, necklaces and metal objects (eg. Keys, coins) from your pockets.

Are there any side effects ?

There are no common side effects to this test. You will not feel dizzy, sleepy or hot and sweaty. Rarely, sensitive people may develop an itchy rash after injection.

What is a Gallium Scan?

Why are Gallium scans needed?

Suspected infection, tumour, Hodgkin's or Non-Hodgkin's Lymphoma.

Preparation:

Nil
If your doctor suspects that you have an infection you may need to have a bone scan first.

About the Gallium Scan:

On the first day you will be given an injection into a vein in your arm of a radioactive tracer (⁶⁷Gallium citrate). This takes a minimum of 24 hours to accuulate in areas of infection and a minimum of 48 hours to accumulate in tumours. You will be given times to return for the images at 24 or 48 hours after the injection.
When you return, images will be taken using a gamma camera and these images plus a written report will be sent to your doctor.
The images take between 30 - 90 minutes and you will be required to lay still on a bed while a camera moves above, below and around you.
You may need to return to the department at 24 hours after the initial scan if the Nuclear Medicine Physician requests this and times will be given to you.
You may remain fully clothed throughout the scan and will only need to remove items such as belts, necklaces and metal objects (eg. Keys, coins) from your pockets.

Are there any side effects ?

There are no known side effects to this test. You will not feel dizzy, sleepy or hot and sweaty.

Cardiac Scans

Cardiac studies in Nuclear Medicine can assess the heart in different ways :

Testing blood flow to the heart - assessing Coronary Artery Disease
Testing heart function - the Gated Blood Pool scan
Testing for damaged tissue after a heart attack

What is Coronary Artery Disease?

The arteries supplying blood to the heart muscle, are collectively known as coronary arteries.
In CORONARY ARTERY DISEASE some of the vessels become narrowed, restricting the blood flow to parts of the heart muscle. If the vessel blocks and heart muscle supplied by it dies, a myocardial infarction results. This is also known as a heart attack or coronary.
A narrowing of a coronary artery may produce chest pain if blood flow is too restricted, known as ANGINA.
The narrowing is due to a build up of fats and other substances in the lining of the vessel, a process called ATHEROSCLEROSIS.
Types of Cardiac scans:

Exercise Thallium Scan
Dipyridamole Thallium Scan
Exercise Tetrofosmin Scan
Dipyridamole Tetrofosmin Scan
Gated Blood Pool Study

Why perform an Exercise/Dipyridamole Thallium/Tetrofosmin Scan ?

Suspected coronary artery disease, suffering chest pain, and assessing the viability of the heart muscle.

Preparation:

No caffeine containing beverages after midnight.
Fast from 7:00 am - before this you may have a light breakfast eg. Lightly buttered toast and orange juice.
Wear suitable clothing and footwear if having an exercise test
Know that the test may take the whole day, however you may have a break of 2-3 hours in the middle of the day.

About the Exercise Thallium/Tetrofosmin Scan:

You will be asked to go straight to the Cardio-vascular Investigation Unit (Level 6, Theatre Block, Royal Adelaide Hospital) in the morning.
You will be connected to a heart monitor (ECG) and a drip line put into a vein in your arm.
You will be asked to walk on a treadmill that will slowly increase in speed.
Your heart rate and blood pressure will be monitored the whole time, however if you experience any shortness of breath or chest pain or similar symptoms, tell the staff immediately.
You need to exercise for as long as possible to improve the effectiveness of the test.
One minute prior to you stopping, the radiotracer (²⁰¹Thallium chloride or ^99mTechnetium Tetrofosmin) will be injected through the drip line.
After the exercising is complete you will be taken to the department of Nuclear Medicine.
The images are taken while you are lying on your back with your hands above your head.
The images take approximately 30 minutes.
You may be asked to return to the department in the afternoon for another set of images that will show your heart when it has been rested. You will be given instructions to tell you what time you need to return and if there are any restrictions on what you can do in that time.
All of these images plus a written report will be sent to your doctor.

About the Dipyridamole Thallium/Tetrofosmin Scan:

Dipyridamole is used if the doctor thinks that you will be unable to exercise adequately on a treadmill.
The medication can affect people with lung disease or asthma, so you should tell the doctor peforming the procedure and bring your medication with you.
You will be asked to go straight to the Cardio-vascular Investigation Unit (Level 6, Theatre Block, Royal Adelaide Hospital) in the morning.
You will be connected to a heart monitor (ECG) and a drip line put into a vein in your arm.
An infusion of Dipyridamole will be given through the drip line to dilate the coronary arteries to test coronary blood flow reserve.
Your heart rate and blood pressure will be monitored the whole time, however if you experience any shortness of breath or chest pain or similar symptoms, tell the staff immediately.
One minute prior to stopping the infusion, the radiotracer (²⁰¹Thallium chloride or ^99mTechnetium Tetrofosmin) will be injected through the drip line.
After the infusion is complete you will be taken to the department of Nuclear Medicine.
The images are taken while you are lying on your back with your hands above your head.
The images take approximately 30 minutes.
You may be asked to return to the department in the afternoon for another set of images that will show your heart when it has been rested. You will be given instructions to tell you what time you need to return and if there are any restrictions on what you can do in that time.
All of these images plus a written report will be sent to your doctor.

What does a Gated Blood Pool Scan show?

Assessing heart function (eg. before & after chemotherapy/or other heart disease), or checking the size and motion of the left ventricle.

Preparation:

Nil

About the Gated Blood Pool Scan:

You will first be given a small injection of a substance called Stannous pyrophosphate. This enables the blood to be labelled with a radioactive tracer.
10-15 minutes after this injection some blood will be taken to which the radioactive tracer will be added.
10-15 minutes later you will be taken into a room and asked to lie on a bed. You will be connected to an ECG machine for the scan and then you will be reinjected with your own blood.
Images will be taken by a gamma camera for approximately 10 minutes each.
You may need 1-3 images depending on the reasons for the test and you may also need to exercise during the images.

Lung Scans

What is a lung scan ?
A lung scan looks at the air and blood flow into your lungs and gives different information from a chest x-ray.

When is a lung scan performed?

Shortness of breath, chest pain, suspected pulmonary embolism (blood clots) or chronic obstructive airways disease.

Preparation:

You will need to bring any chest x-rays that you have had done previously.

About the Lung Scan:

The test is done with you lying on a bed with the gamma camera moving around you or with you sitting up and turning around for each image.
The first part involves breathing in a radioactive gas through a tube to demonstrate the air supply to the lungs. This takes about 5 minutes and a technologist will be with you the whole time and will give you a break if you need one.
Images will then be taken at different angles around your chest.
The second part involves a small injection into a vein in your arm to demonstrate the blood supply to your lungs.
The images will be repeated.
The nuclear medicine physician will then compare the 'ventilation' and 'perfusion' images and the films and a written report will be sent to your doctor.

Are there any side effects ?

There are no common side effects to this test. You will not feel dizzy, sleepy or hot and sweaty if you are very short of breath, the test may be modified to make you more comfortable.

Renal Studies

What does a renal scan test for?
A renal scan is a diagnostic test used to assess the anatomy, function, and blood supply of your kidneys.
Where are my kidneys ?
Your kidneys are located just below the middle of your back and on either side of your spine. The right kidney is just lower than your left kidney. Each of your kidneys are connected to your bladder which is located behind your pubic bone, by a tubular structure called the URETER. The bladder is emptied via another tubular structure called the URETHRA, which leads to the exterior of the body.
What is involved ?
Preparation:

You need to be well hydrated ie. Drink 1-2 litres of water beforehand.

About the Renal scan:

You need to empty your bladder just prior to beginning the scan.
You will be asked to remove all metal objects or belts from around your waist.
You will need to lie on a bed for most of the test.
After you are in the correct position a nuclear medicine physician will give you a small injection into a vein in your arm.
The images are started immediately as you have this injection and you will need to lie very still for approximately 30 minutes.
After the first set of images you will be asked to go to the toilet and empty your bladder before returning for several shorter images.
The nuclear medicine physician will then decide if :

You need an injection of a diuretic (if there appears to be a blockage as the kidneys drain), this requires another 20 minutes of images
You need to have blood samples taken at 1 hour and 3 hours after the injection of the tracer, you will be allowed to leave the department in between these samples and there are no restrictions on what you can do in that time. (this test accurately measures kidney function)
You do not need any further images or blood samples.

After the test you can leave and a copy of the films and a written report will be sent to your doctor

Are there any side effects ?

There are no common side effects to this test. You will not feel dizzy, sleepy or hot and sweaty. The injected material will be completely cleared from your body within 24 hours. By drinking extra fluids and going to the toilet more frequently, will clear the radiopharmaceutical from your body much quicker- so drink up!!!

Gastrointestinal studies

The gastrointestinal tract (GIT) is composed of multiple organs, and is characterised by relatively long transit times through each. Although radiology can assess the structure of some parts of the GIT, its function needs to be assessed over longer periods of time.

Nuclear Medicine allows us to assess GIT function by giving patients a radioactively labelled meal. The movement of this meal can be monitored over time with the gamma camera, and the rate of movement compared to established normal ranges.

What is involved?

The studies presently available are :

Oesophageal transit
This study assesses the transit time from the mouth to the stomach of solid food.
There can be holdups in moving food due to physical or physiological problems, and this study aids in diagnosing these problems.
You are required to sit in front of a gamma camera, and then given a small piece of a radioactively labelled cooked meat patty to chew.
You will be required to swallow this, then have dry swallows every 15 seconds until the food has entered your stomach.
This is repeated 3 times.
The appointment generally takes no more than 30 minutes.
Gastric emptying (often performed with an oesophageal transit first)
This study assesses the movement of solid and liquid food from the stomach to the intestine.
You are required to sit in front of a gamma camera, and given a cooked meat patty to eat, along with a cup of glucose drink.
The study generally takes 2 to 3 hours, with data continously collected for 30 minute periods. You will be allowed a short spell between each period.
Small bowel transit
This test allows us to assess the transit of liquids through the small bowel.
You will be given a radioactively labelled glucose drink and required to lie flat on a bed for 5-6 hours whilst we take pictures.
There are short breaks every hour to allow a stretch.
Colonic transit
This test examines the transit time through your colon (large bowel) of a test meal.
It uses a glucose drink which we can observe over a period of up to one week as it passes through your body.
On day 1, you will be required to attend for 10 minutes to have the radioactive dose, and then a 30 minute scan in the afternoon.
On subsequent days, you are required to attend for 30 minutes on each day.
Each scan requires you to lie flat on a bed.

Patient Preparation

Gastrointestinal tests require you to fast overnight, and may require you to return for further imaging.
Each test has its own preparation :

Oesophogeal and gastric emptying
- All medications related to management of gastro-intestinal symptoms to cease 48 hours prior to test.
  This includes Cisapride(Prepulsid), Maxalon, Donperidone(Motilium)
- No smoking from 9pm on the day before the test
- Fast from midnight on day of study
- Water allowed up to 8am
- Diabetics should bring their insulin with them
- Gastric emptying patients should bring some reading material with them
Colonic transit
- All medications related to colonic transit (mainly laxatives) to cease 3 days prior to test
- No smoking from 9pm on the day before the test
- Fast from midnight on day of study
- Water allowed up to 8 am
Small bowel transit
- No special preparation required

Are there any common side effects ?

There are no known side effects to any of these tests. You will not feel dizzy, sleepy or hot and sweaty. If you have special dietary requirements (eg vegetarian) we would appreciate being informed before you attend, as an appropriate test meal may be prepared for you.

Central Nervous System studies

Shunt function study
This tests if the shunt inserted into the skull to drain excess fluid from the brain is functioning.

Patient Preparation

Nil - but the site around the shunt will have to be shaved before the injection

What is involved ?

A small injection will be given into the shunt chamber and images taken for the next 30 - 60 minutes

Are there any common side effects ?

CSF leak
This test determines if there is leakage of the cerebro-spinal fluid from the brain into the nasal passages.

Patient Preparation

What is involved ?

You will have pledgets (cotton wadding) inserted into your nasal passages by and Ear Nose & Throat specialist.
The Nuclear Medicine physician will inject a small amount of radioactive tracer at the base of your lumbar spine, and images will then be taken of your head every hour for up to 5 hours.
The pledgets will then be removed, but if the procedure is inconclusive, more may need to be inserted again the next day.
The lumbar puncture procedure has some side effects, such as headache, which your doctor will discuss with you.

Ceretec Brain scan
This test examine the function of the brain to determine signs of dementia , poor circulation of blood in the brain, or epilepsy.

Patient Preparation

What is involved ?

You will have a catheter inserted into a vein in your arm to allow us to inject the radiopharmaceutical
You will be rested in a darkened room for approximately 20 minutes
After this time, you will be given a small injection into the catheter in your arm, and then rest for a further 10 minutes
You need to then lie on a bed for a further 30 minutes whilst a camera takes images around your head for about 30 minutes

Are there any common side effects ?

Endocrine studies

Thyroid scan
This test examines the function of the thyroid gland which may be over or under active, or enlarged.

Patient Preparation

If you are taking medications which affect the thyroid, or thyroid hormones, you must discuss this your doctor or the nuclear medicine specialist as some treatments need to be stopped or modified.

What is involved ?

You will have a blood sample taken prior to the test for testing of thyroid hormone.
The Nuclear Medicine physician may examine you for signs of goitre
You will then be given a small injection of a radioactive pharmaceutical into your arm
After 30 minutes images will be taken over your neck

Are there any common side effects ?

Generally nil, although ceasing medication may have some effect.

Parathyroid scan
This test examines the parathyroid glands. You may have an overactive parathyroid gland that affects calcium metabolism in your body. This may require surgery, and to help the surgeon, the status of the parathyroid can be determined.

Patient Preparation

What is involved ?

You will receive an injection of a radioactive pharmaceutical into the arm
Images of the neck and chest region will be taken for up to 45 mins
You will be required to return a few hours later in the day for delayed images

Are there any common side effects ?

Home

Nuclear Medicine

Bone Densitometry

P.E.T.

Urea Breath Tests

Scientists

Nuclear Medicine Imaging Studies

Types of Cardiac scans:

Why perform an Exercise/Dipyridamole Thallium/Tetrofosmin Scan ?