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Understanding Nuclear Medicine



What is Nuclear Medicine?

Nuclear medicine involves the use of radioactive materials or isotopes to obtain specific diagnostic information. These isotopes transmit a pattern of X-rays representing the organ size, shape and function. The rays are detected by a special camera that, when coupled with a computer, produces an image on a screen. The isotope is administered intravenously (like a blood test), orally or by inhalation.

Nuclear medicine is also used for treatment of certain conditions such as overactive thyroid glands.

Preparing for the Exam

Each nuclear medicine exam has required preparations. The most frequently performed exams are listed, along with their preps. If instructions are not listed, your physician will inform you about your exam or you may call Baptist Health Lexington's nuclear department at (859) 260-6158.

Bone Scan Total Body
An IV injection will be given in your arm during your first visit. You may leave after the injection (if another test is not scheduled between the injection and scan time). The scan will be performed three or four hours later. The exam takes 45 to 60 minutes and is most frequently performed while you are lying on your back.

Limited Bone Scan
An IV injection will be given in your arm during your first visit. You may leave after the injection (if another test is not scheduled between the injection and scan time). Four hours later, images will be performed of the area in which the doctor is interested (when arms or legs are scanned, both sides are imaged for comparison). The injection takes five to 15 minutes, and the scan time is 30 to 45 minutes.

Three Phase Bone Scan Images of the area of interest are obtained during an IV injection in the arm during your first visit. You may leave after the injection and images. Four hours later, images will be performed of the areas of interest (when arms or legs are scanned, both sides are imaged for comparison). The first visit takes 15 to 30 minutes. The second visit takes 30 to 45 minutes.

Hepatobiliary (Gallbladder)
You should not eat anything after midnight the day before the scan. No morphine medication may be taken four-six hours before the scan. An IV injection will be administered. Images will start five minutes after the injection and continue until the organs of interest are seen. At times, morphine may be injected to improve the study. The exam is not painful, but it is advised you have a driver with you in case morphine is needed. The exam time varies from 45 minutes to several hours.
Hepatobiliary with CCK: A routine hepatobiliary scan is performed, followed by an IV injection of CCK (Sincalide), which causes the gallbladder to contract. Allow 30-45 additional minutes for the exam time.

Renal
You will lie on your back on the scan table and will be given an IV injection in your arm. Images will be started immediately. The exam takes 30 to 60 minutes. If your doctor orders the exam with Capoten, you will be given the Capoten by the radiology nurse 60 minutes before the exam is started. Your blood pressure will be monitored by the nurse. The doctor will inform you about your medications if they need to be discontinued before the exam. You should not eat or drink three hours before the Capoten exam. IV lasix is generally given two minutes into the study, depending on the creatinine values (blood work may be requested).

Thyroid Uptake & Scan
Do not eat or drink four hours before your first visit. On your first visit, a history will be taken by the technologist, and you will be given the isotope orally in capsule form. You may leave the hospital after the dose. Four hours later, images of the thyroid gland will be performed. The next day (24 hours after the capsules were given), you will return for an uptake, a reading of how active your thyroid gland is. The first visit takes 15 to 20 minutes. The second visit takes 45 to 60 minutes. The third visit takes five to 15 minutes. Certain thyroid medications or previous contrast injections will affect the exam. If you are on thyroid medication, please call Baptist Health Lexington's nuclear department at (859) 260-6158 or talk to your doctor.

During the Exam

The individual who will be performing your exam is known as a nuclear medicine technologist. The technologist will obtain a medical history from you and may require some identification. The isotope will then be administered appropriately for the type of exam you are having.

As discussed previously, some exams require a waiting time between dose administration and the scan. You will be told about this when your doctor's office schedules you for the exam.

When it is time for the scan, the technologist will position you on a scanning table and take the appropriate images for your study. Most of the time you will lie on your back and the camera will rotate around you for various images. At times you may need to make some position changes. You will be asked to lie still.

Each image takes from three minutes to one hour. The length of time for the entire procedure varies significantly. Your doctor's office will advise you of the amount of time needed for your particular exam or you may call Baptist Health Lexington's nuclear department at (859) 260-6158.

Nuclear medicine scans are stored in a radiology computer system. A radiologist (a physician specializing in X-ray and nuclear medicine) will interpret the study, and a written report will be sent to your personal physician who ordered the exam.

Important Information

Inform the technologist if you may be pregnant or if you are breastfeeding. If there is a possibility of pregnancy, a pregnancy test will be ordered before the exam.

If you have questions about your bill, please call our business office at (859) 260-6644. The radiologist's bill is separate from the hospital's. If you have questions regarding your bill from the radiologist, please call 1-877-459-2290.

You must be registered in the hospital computer before the exam can be performed. Our registration staff may call you in advance to preregister you. If not, you should first report to registration 30 minutes before your exam is scheduled. If you are preregistered, you may go directly to the radiology department located on the hospital's first floor.