Nuclear Radiology

What kinds of nuclear radiology diagnostic studies are available?

There are several nuclear radiology studies available for diagnostic purposes, including: • bone scan • radionuclide ventriculogram (MUGA) • gallium scan • gastric emptying • gastrointestinal bleed • hemangioma scan • hepatobiliary scan (HIDA) • I-123 whole body scan • I-123 thyroid scan • I-123 MIBG scan • brain SPECT • liver/spleen scan • lymphoscintigraphy • Meckel’s scan • OctreoScan • parathyroid scan • renal scan • white blood cell scan • positron emission tomography (PET/CT) • ProstaScint scan • single-photon emission computed tomography / computed tomography (SPECT/CT)

What kinds of nuclear radiology treatments are available?

• Radioiodine for hyperthyroidism • Radioiodine for thyroid cancer • Bexxar and Zevalin for lymphoma

Is nuclear radiology safe?

Yes. The radiation dose is similar to that of other x-ray examinations and the benefits of the scan will outweigh the very small risk associated with any x-ray examination. The radiologist and technologist are trained in radiation safety procedures. All radiopharmaceuticals are manufactured under strict government standards and are administered in the smallest possible doses needed to achieve quality image results. The radioactivity is quickly eliminated from your body usually within 24 hours after the test is completed. There is no reaction or side effect to any of these Nuclear Radiology tests.

Preparation for your diagnostic study

You should receive instructions on when to arrive the day of your scan. This is typically 15-30 minutes before your exam begins. While there is no general set of instructions for all nuclear radiology examinations, you may be told not to eat, drink, or take certain medications prior to your exam. Your physician or the technologist will give you specific instructions on how to prepare. It is important to follow these instructions to ensure the most accurate diagnostic results. Many times you will be able to wear your own clothing for the test, so we suggest you dress comfortably. Occasionally, however, you will be taken to a dressing room and asked to change into a hospital gown.

Things you should let the technologist know

If you are you pregnant or breastfeeding • If you have had a nuclear radiology scan before • If you have had a recent barium study or an x-ray using contrast • If you have any fractures or artificial joints • If you have any allergies

During the diagnostic study

Before the test begins you will be given an injection or pill that contains a small amount of radiopharmaceutical. You should experience little or no discomfort involved in the test. Nuclear radiology procedures are safe, effective and painless. How the test is performed depends on the type of scan your physician has ordered. In many cases there will be a delay between the time of the injection and the actual scan, allowing the radiopharmaceutical to flow through your body. For certain studies additional imaging will occur over several days. In most studies you will lie comfortably on a table. A large camera is positioned over your body or is moved or rotated around you depending on the test. The camera senses the radiopharmaceutical and displays this information digitally.

Sedation and pain management

Certain nuclear radiology studies can last 30 minutes or longer. Some individuals may find it difficult to remain still for that period of time due to chronic pain. Other individuals may have difficulty remaining under the camera due to claustrophobia. Austin Radiological Association can help these individuals complete their study by providing sedation and pain management. We have qualified nurses and paramedics on staff to accommodate patients with these issues. When scheduling your appointment, please notify our staff if you feel you may need sedation or pain management. We will then make arrangements in advance for a nurse or paramedic to assist you.

Canceling your appointment

Cancellations sometimes are unavoidable; however, we ask that you notify us at least one day in advance whenever possible. The radiopharmaceutical is ordered specifically for you – advance notice of cancellation can help avoid this charge. This courtesy also assists the staff in daily scheduling of other patients who may be waiting for an appointment.

After the exam

Before leaving you may have to wait briefly while the images are reviewed. You should be able to resume normal activity as soon as the test is complete. To hasten the process of radiopharmaceutical elimination you should drink extra water and urinate often for 24 hours after your exam. The radiologist — a physician who specializes in interpreting these tests — will examine your scan and he will report the results to your physician. Your physician will then report the results to you.

How will this affect me?

You will not feel anything from the isotope. The only caveat would be for Cholecystokinin (CCK) which can cause nausea and cramping.

What is CCK?

CCK is used with most HIDA scans – it is a medication we inject that causes the gallbladder to contract – we can then measure how well it is working. This medication can cause nausea and cramping which typically last about 5 minutes.

Will it make my urine change color?

No.

Will this make me sleepy?

No, it will not make you sleepy.

Can I eat or drink after the injection?

It depends on the scan, but you should be able to eat most things. We say NPO for at least an hour after I-123 and I-131 pills. For bone imaging, we encourage the patient to drink extra water to flush the isotope from the soft tissues of the body.

How long will the isotope be in me?

It depends on the isotope. For most scans with technetium, half the isotope is gone by natural decay every 6 hours plus your body eliminates it primarily through your urine. It takes approximately 4.8 hours for half to be eliminated. Drink water and void often to speed up the process.