Nuclear Medicine Patient Information
Nuclear Medicine is a method of obtaining diagnostic images by giving the patient a small dose of a radioactive isotope (injected material called a tracer). Pictures are then taken with a special camera which is able to detect the location of the tracer in the body and create images which the physician can evaluate.
Nuclear Medicine began approximately 50 years ago and has evolved into a major medical specialty for both the diagnosis and therapy of diseases. In a Nuclear Medicine scan, the radioactive material is introduced into the body by injection, swallowing, or inhalation. Different types of injection material are used to study different parts of the body. The amount of material used is carefully selected to provide the least amount of radiation exposure to the patient, yet ensure an accurate test. A special camera is used to take images of your body.
The radiation dose to the body is comparable to an X-ray exam and there are no side effects with the materials used.
What Happens After The Dose is Given?
Some images are started immediately after the dose is administered; other exams require circulation time to give the dose time to collect in the organ being studied.
A special camera will be used to take pictures (images). The camera may be installed in a hospital or physician's clinic, or it may also be housed in a mobile imaging vehicle. In all instances, the camera works the same way and gives the same results.
The patient may be asked to lie down or sit in front of the camera. The technologist will position the camera close to the area of the body that is to be imaged.
Scans range in time from a few minutes to several hours, depending on the type of exam being done. The camera does not have any effect on the body and the technologist makes the patient as comfortable as possible before starting the exam.
Please allow extra time for additional views or delayed images which may be required. Time requirements for the test, which are communicated by scheduling personnel, are only estimates. Actual time requirements vary.
What Does the Test Show?
Nuclear Medicine studies are different from most X-ray, Ultrasound, or CT examinations because they specialize in showing some aspect of the function of the body system being studied. Very simply, nuclear medicine studies look at how a specific organ is working (e.g. blood supply to the organ). Physicians often order an X-ray and a nuclear study to determine both structure and function.
- The patient's identity must be verified prior to starting the exam.
- All patients are asked to bring their insurance cards and a list of the medications they are currently taking with them to their appointment.
- Patients under the age of 18 will need to be accompanied by a parent or a guardian to give authorization.
- Female patients will need to inform the technologist if they are pregnant or if they are currently breast feeding.
- The patient's weight will be requested.
Combined Nuclear Medicine Patient Guide
A Bone Scan is an exam of the skeleton and may be of a limited area or the whole skeleton and takes approximately 4 to 5 hours (including the circulation time). Depending on the physician's order, images may be taken of a limited area or of the whole skeleton. The patient will be required to lie flat and remain still (a pillow can be placed under the knees for comfort). A radioactive "tracer" will be injected into the patient's vein. Images may also be taken (during the injection) to show initial blood flow to the area of interest. After the injection, the patient will be able to leave for 2 to 3 hours to allow blood circulation to the bones. (The patient will be asked to remain well hydrated during that time.) The technologist will inform the patient as to when to return for their exam. Images will take between 30 to 90 minutes, depending on the physician's orders. (A Bone Scan may also be called a Whole Body Bone Scan, 3 Phase Bone Scan, Limited Area Bone Scan or even a Bone Tomo Scan.)
A Hepatobiliary Scan is an exam of the gallbladder that takes approximately 2 hours. The patient will be required to lie flat (a pillow can be placed under the knees for comfort). A radioactive "tracer" will be injected into the patient's vein through an established site in the vein. The patient will need to lie flat for approximately 2 hours. The gallbladder will be imaged for about 1 hour to watch the "tracer" circulation (to evaluate the gallbladder as it is filling). A second injection will be given to show function (the contraction of the gallbladder, during a 30 min continuous picture). (A Hepatobiliary Scan is also known as a HIDA Scan or Gallbladder Scan.)
A Lung Scan is a two-part exam of the lungs which takes approximately 1 to 1 ½ hours. The patient will be required to have a chest X-ray just before or just after the scan. The patient will be required to lie flat (a pillow can be placed under the knees for comfort). A radioactive "tracer" will be injected into the patient's vein. Images will be taken around the lungs to show the blood flow. The (perfusion) images take about 30 to 45 minutes. The patient will then be asked to inhale an aerosol "tracer" (using a breathing apparatus). Images will be taken around the lungs again but this time to show air flow. The (ventilation) images will take about 15 to 30 minutes. (A Lung Scan is also known as a VQ Scan (Ventilation, Quantitative), VP Scan (Ventilation, Perfusion).)
A Cardiac Scan is an exam of the heart that takes approximately 4 hours. The test consists of two parts – one with the heart at rest and one with the heart stressed (as in exercising). The patient will need to be able to lie flat and remain still, with their left arm or both arms above their head ( a pillow can be placed under the knees for comfort).
Cardiac Scan: The patient will receive two radioactive "tracer" injections through an established site in the vein. These injections will need to circulate for 30 to 60 minutes each prior to each scan. There will also be a delay period usually between the two injections. One injection will be given at a "resting" heart rate state; this dose will circulate through the relaxed heart muscle. The "resting" heart will then be scanned for about 30 minutes. The other injection will be given at a "stressed" state during a treadmill stress test (or a medicated stress test/injection). This dose will circulate through the open vessels of the stressed heart muscle. The post "stressed" heart images will take about 30 minutes. Depending on the physician order, this test may be scheduled as a one-day procedure or a two-day procedure, with either the "resting" or "stress" test portion scheduled first. (A Cardiac Scan is also known as a Myocardial Perfusion Scan; it will sometimes be referred to by the "tracer" names such as a Cardiolite, Myoview, Dual Isotope or as a Thallium Stress Test; or it can also be referred to as a Bruce, Adenosine, Persantine or as a Dobutamine Stress Test (these are names for the treadmill protocol or medication used during the stress test). Can also be a combination of the "tracer" name and stress protocol. (e.g. Adenosine Cardiolite Stress Test) etc.)
A Thyroid Scan is an exam of the thyroid gland that can be performed 2 different ways. The patient will be required to lie flat (a pillow can be placed under the knees for comfort).
- A 99m Technetium Thyroid Scan is performed to show the structure of the gland. A radioactive "tracer" is injected into the patient's vein. The dose will need to circulate to the gland for about 15 to 30 minutes. The images will then take about 15 to 20 minutes.
- An Iodine-123 Thyroid Scan** is performed to show the structure of the gland (size/shape) and the function (how it is working). The patient will be given an oral capsule to swallow. The patient will then be able to leave for 4 to 6 hours to allow the capsule to dissolve and circulate to the gland. The images will take about 45 minutes upon returning. A 24 hour set of images may also be required, which take about 15 minutes.
**IMPORTANT NOTE (For Iodine-123 scan patients): To ensure an accurate thyroid function (update %), it is important for the patient to not have had any thyroid medications for up to 6 weeks, any X-rays/CT scans with Iodinated Contrast for 3 to 6 months, any high potency vitamins for 4 weeks, or any Cough/Cold Syrups, lozenges, bronchodilators or expectorants for 2 weeks prior to their exam. (If unsure, ask the ordering or interpreting physician.)
A Renal Scan is an exam of the kidneys that takes approximately 45 minutes to 1 hour. The patient will be required to like flat (a pillow can be placed under the knees for comfort). A radioactive "tracer" will be injected into the patient's vein. The images will be started during the injection and will continue for 30 to 45 minutes. This will show immediate blood flow and circulation to the kidneys. (A Renal Scan may also be referred as a Renal Function Scan, or as a MAG2 Renal Scan (the radioactive "tracer" name), it may be ordered a/Captopril or Lasix (or with both). If these medications are added to the MAG3 scan, the patient should not take their ACE Inhibitors or diuretic for 48 hours prior to the exam.)
Please ask about the other Nuclear Medicine scans that may be ordered by the physician. They may also require specific patient preparation:
- Brain Scan
- Breast Scintigraphy Scan
- Cystogram (Voiding)
- Esophageal Reflux Scan
- Gastric Emptying Scan
- GI Bleed Scan
- Liver/Spleen Scan
- Meckel's Diverticulum Scan
- Hemangioma Scan
- MUGA Scan
- Parathyroid Scan
Information for Breast Feeding Females
Some of the radioactivity that you will be given for your test or treatment may deposit in breast milk and be transferred to a breast feeding baby or child resulting in unnecessary exposure to radiation. If you are breast feeding, it is our policy to give you instructions and recommendations on interrupting breast feeding. The technologist or staff physician will speak to you about the particular material you will receive and the time we recommend you not breast feed.
Failure to interrupt breast feeding for any radiopharmaceutical listed above may have no consequences for your child; however, it is our practice that unnecessary radiation exposure is avoided whenever practical.
After your Nuclear Medicine scan, your images are sent to a physician who specializes in the review of these images. This physician will prepare a report that is shared with your doctor (the doctor who ordered your Nuclear Medicine exam). Your doctor will consider this information and is responsible for contacting you with the results. He or she can answer any questions you may have about your results at that time.
As part of your Nuclear Medicine scan, you were given an injection of a radioactive material in order to create diagnostic images of your body:
- Drink plenty of water (an extra 64 ounces of water).
- The extra water will cause you to void (urinate) frequently (this is desired).
Your injection required a puncture through your skin. Even though proper steps were taken to prevent infection as a result of this skin puncture, an infection in this area is possible. Please seek medical care if:
- The injection site becomes red, painful to the touch, or hot to the touch.
- A lump that was not present when you finished your scan develops at the injection site, or a small lump that was present becomes larger over time.
Ask Questions or Report Concerns
If you have any questions or concerns related to the imaging procedure that you had done today, please e-mail firstname.lastname@example.org or call 800.437.4628 and ask for the Quality Improvement Department. Unresolved concerns can be reported to The Joint Commission by calling 800.994.6610 or by going through their website, www.jointcommission.org.
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I was very relaxed through the whole procedure. The technologist was very professional at his job.
– Perry, IA
The staff was wonderful to me and took very good care of me.
– Luverne, MN
The technologist was professional and informative.
– McCook, NE
They did a very good job and a thorough examination. I was well pleased with the outcome of everything.
– Wayne, NE
The technologist was very patient and was really good at letting me know what was going to happen next!
– Hazen, ND