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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 with their preps are listed. If instructions are not listed, your physician will inform you about your exam or you may call Murray Hospital's Radiology Department at (270) 762-1921.

Bone Scan Total Body
An IV injection will be given in your arm during your first visit. You may leave after the injection. 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.

Breast Image (Nuclear Medicine)
You will be given an injection in the vein of your arm. The injection will take about 5 minutes. After the injection, you will lie on your stomach on a special table. Images will be taken of your breasts with a nuclear medicine camera. Additional images will be taken of your chest while you are lying on your back with your arms up. The Nuclear Medicine Technologist will place small skin markers on your chest during the imaging. The images will take about 1 hour. It is very important that you lie still, or the images will become blurred.

Cardiac Stress Test
You should not eat or drink anything after midnight before your test. Caffeine should also be avoided for 24 hours prior to the test. During the first part of the test, an IV will be started in your arm. You will receive an injection of Technetium Cardiolite, a radioactive tracer. After a 30-45 minute wait, you will then lie on an imaging table while a large camera takes pictures of your heart in a resting condition. This will take about 15-20 minutes. The stress part of the test is next and will take approximately 1 hour with an exercising time of less than 15 minutes. If you are unable to exercise on a treadmill, the stress can also be done as a pharmacologic stress using either Dobutamine or Adenosine. The exercise technologist will place 10 patches on your chest to monitor your heart's activity. A blood pressure cuff will be put on your arm to monitor your blood pressure. If you are able to walk on the treadmill, you will exercise by walking on a motorized treadmill with a doctor present. You will begin walking at a very slow pace with the speed and incline increasing every 3 minutes. As you are walking, it is important to tell the doctor and technologist how you are feeling. It is normal to get very tired and short of breath while walking. The technologist will encourage you to walk as long as possible. A small amount of Cardiolite will again be injected into the IV when your heart rate is at peak stress or at the appropriate time after injecting Dobutamine or Adenosine if you are being pharmacologically stressed. You will be asked to keep walking for about 1 more minute. You will then be asked to eat or drink, and return to the nuclear medicine department 15-60 minutes later, depending on the type of stress. A second set of images of your heart will be obtained at this time. It is important to lie still as the camera takes another set of images for about 15-20 minutes.

Gallbladder Image
This exam will study your liver and gallbladder functions. You should not eat or drink anything for at least 6 hours prior to your exam. You will be given an injection of a radioactive tracer into the vein of your arm. The examination can take up to 2 hours, and includes the possibility of delayed views. After your gallbladder has filled with the tracer (usually about 1 hour into the test), you will be given a 30 minute IV infusion of CCK, a naturally occurring enzyme in your digestive system, which will empty your gallbladder and give the radiologist an ejection fraction for your gallbladder. During the imaging you will be lying on your back on a table. It is important that you hold still or the images will be blurred.

GI Bleed Image
A GI Bleed is done to determine the site in the abdomen that is actively bleeding. The technologist will draw a small amount of you blood for tracer labeling. After about 20 minutes this blood will be re-injected into you blood stream. You will be imaged for about 1 1/2 hours with the possibility of taking additional images at 3, 6, and 24 hours. You will be lying on your back on a table during the imaging process. It is important that you hold still or the images will be blurred.

Limited Bone Scan
An IV injection will be given in your arm during your first visit. You may leave after the injection. 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. 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.

Lung Image (Nuclear Medicine)
The lung ventilation/perfusion exam will assist the doctor in evaluating any abnormalities in your lungs. The examination will take approximately 1 hour. You will be lying on your back on a table. It is important that you hold still during the exam, or the images will be blurred. The lung scan is a two part procedure. The first part of the exam involves breathing in a radioactive gas through a mask to evaluate the air flow to your lungs. This will take approximately 5 minutes. The second part of the exam involves an injection of a radioactive tracer in the vein of your arm. Following the injection, eight different images of your lungs will be taken to evaluate the blood flow to your lungs.

MUGA (Nuclear Medicine) The MUGA exam will check the function of your heart. You will be given two injections 30 minutes apart in the vein of your arm. The procedure can take up to 1-1 1/2 hours. You will be asked to lie on your back on a table. Some electrodes will be placed on your chest to monitor your heart's rhythm. A large camera will then teak images of your heart so that the radiologist can evaluate the ejection fraction and wall motion of the left ventricle of your heart.

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 45 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.

Thyroid Uptake & Scan
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 Murray Hospital's Radiology Department at (270) 762-1921 or talk to your doctor.

White Blood Cell Image: This exam will detect sites of infection. The first day you arrive, the nuclear medicine technologist will draw your blood for labeling. The blood will be taken to the laboratory and the white blood cells will be tagged with a radioactive tracer in order to detect areas of disease. This process will take 2 to 3 hours and will be followed by a reinjection of your labeled cells into your IV. Depending upon the reason for your exam, you will be imaged at different times ranging from 1 hour post injection to 24 hours later. Each session of imaging may last up to 1 1/2 hours. During the exam you will be lying on your back on a table. It is important to hold still or the images will be blurred.

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 Murray Hospital's Radiology  Department at (270) 762-1921.

Nuclear medicine scans are stored on x-ray film. 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. 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 (270)762-1296. The radiologist's bill is separate from the hospital's. If you have questions regarding your bill from the radiologist, please call (270) 759-1805.

You must be registered in the hospital computer before the exam can be performed. You should first report to registration 30 minutes before your exam is scheduled. If you are pre-registered, you may go directly to the radiology department located on the hospital's first floor.

 
  MCCH

Murray-Calloway County Hospital
803 Poplar Street
Murray, KY  42071
(270) 762-1100

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