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Nuclear medicine

What is Nuclear Medicine?

Nuclear medicine tests involve giving a patient a small amount of a radioactive tracer attached to a pharmaceutical compound, called a radiopharmaceutical. Following this, images are taken using a special scanner called a nuclear medicine gamma camera, which detects the distribution of the radiation being emitted from the body. These images allow assessment of different organs throughout the body depending on the type of radiopharmaceutical used.

The radioactive tracer is specific to the scan being performed and is most commonly injected into the blood stream through a vein, but might be given in different ways, including:

  • swallowed;

  • injected directly into the tissue beneath the skin; or

  • inhaled (breathed in).

Only a small, amount of radiopharmaceutical is given to the patient to keep their radiation dose to a minimum whilst achieving good quality results.

Radioactivity can also be used as a therapy to treat some cancers or conditions. In these cases, the amount of radiopharmaceutical given is greater, and it mostly goes to (targets) the diseased tissue or organ. The type of radiopharmaceutical given emits ionising radiation that has the maximum effect on the part of the body or organ system being treated.

The incidence of allergic reaction to a radiopharmaceutical is very low and most do not stay in your body for long.

What is a bone scan?

A nuclear medicine bone scan can be used to detect bone injury (such as a broken bone), bone disease (such as cancer) or infection in the bones. It can also be used to review response to treatment.

There are two parts to a bone scan.

  1. A small amount of radiopharmaceutical is injected into the blood stream through a vein. Depending on the reason for your visit, ‘early’ images may be taken straight away. These images show the blood flow in the body. Part 1 can take 15 – 30 minutes.

    The radiopharmaceutical attaches to the bone over time, and is imaged using a special scanner (gamma camera).
  2. After 2 – 4 hours, the patient returns to the department for ‘delayed’ images, as the radiopharmaceutical has now made its way to the bone. These images can take 60 minutes.

There is no special preparation for a bone scan. It is recommended that the patient is well hydrated.

Before the start of the test, please inform the staff if you are pregnant or breast feeding, or markedly claustrophobic.

What is a Myocardial Perfusion Scan (MPS)?

Also known as a nuclear medicine cardiac stress test.

This scan investigates the blood supply to the heart muscle and the function of the heart

To prepare for the test, please wear comfortable clothing and shoes that are suitable for light exercise.

Please have only a light meal before the test. It is essential that you have no food or drink containing caffeine for 24 hours prior to the test. This includes tea, coffee, cola and chocolate.

Medications that slow the heart rate (e.g. beta blockers) may need to be ceased for 48 hours prior to the test. This decision will be made after consultation with you and your doctor. Do not cease any medications without medical advice from your doctor and the nuclear medicine specialist. There are two parts of a myocardial perfusion scan.

  1. Stress Component: The stress component of the test is aimed at increasing the blood flow to the heart muscle to show any changes in blood supply more clearly. Increasing the blood flow to your heart muscle can be achieved be exercising on a treadmill, or if you are unable to exercise, a medication can be administered to provide the same outcome as exercise.

    When your heart has reached a target work capacity, a radiopharmaceutical (radioactive tracer) is injected into the blood stream through a vein. You will then be asked to rest in the waiting room for approximately 30 minutes. During this time, you might be given a drink or something to eat. This helps make the images of your heart clearer. You may experience side effects if a pharmaceutical was used to stress your heart. These side effects will be discussed with you by the nuclear medicine team prior to starting and will be treated if necessary.

    After the stress component has been completed, caffeine is now permitted.

    After 30 minutes, the heart is scanned using a gamma camera. Images take approximately 15minutes while the camera rotates around your chest. A CT scan at a low radiation dose, may also be done as part of the study for further detail. After review of the images, you may be given an appointment time to return in the afternoon for Part 2 – the resting scan.
  2. This second part images your heart in its ‘resting’ state. You will be given a second injection of the same radiopharmaceutical. Again, you will be asked to sit in the waiting room for approximately 30 minutes. Your second set of images is then taken, similar to your first scan.

Before the start of the test, please inform the staff if you are pregnant or breast feeding, or markedly claustrophobic.

What is a lung (VQ) Scan?

A ventilation–perfusion (VQ) scan is a nuclear medicine scan that assesses the airflow (ventilation) and blood flow (perfusion) to the lungs.

There are two parts to the scan:

  1. The radioactive tracer is inhaled to show the air flow to the lungs. Images are taken by a gamma camera which rotates around your chest for approximately 10minutes while you lie flat on the scanner bed
  2. After the first set of images, a radiopharmaceutical is injected into a vein in your arm. Similar images are again taken, for the same length of time. This part demonstrates the blood flow to the lungs.

In total the scan takes 30 - 45minutes.

There is no special preparation for a lung scan and you won’t feel any differently.

Before the start of the test, please inform the staff if you are pregnant or breast feeding, or markedly claustrophobic.

What is a Renal Scan?

A renal scan is a study which looks at the function of your kidneys. A small amount of radiopharmaceutical (radioactive tracer) is injected into the blood stream through a vein. Images are taken immediately after the injection using a gamma camera while you lie quietly on the scanner bed. Images show the blood flow to the kidneys, and the production and clearance of urine from the kidneys through the ureters to the bladder. The initial scan takes approximately 30 minutes.

The Nuclear Medicine Specialist may decide to give a medication called Lasix (Furosemide) to encourage the kidneys to produce more urine. The kidneys are then scanned for a further 20 minutes.

Please be well hydrated for the study.

Before the start of the test, please inform the staff if you are pregnant or breast feeding, or markedly claustrophobic.

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