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General
Nuclear Medicine
Frequently Asked Questions - Nuclear Medicine & SPECT
What
is General Nuclear Medicine?
Nuclear
medicine is a subspecialty within radiology. It comprises diagnostic
examinations that result in images of body anatomy and function. The images
are developed based on the detection of energy emitted from a radioactive
substance given to the patient. Radiation to the patient is, generally,
similar to that resulting from standard x-ray examinations.
What are some common uses of the procedure?
Nuclear
medicine images can assist the physician in diagnosing diseases. Tumors,
infection and other disorders can be detected by evaluating organ function.
Specifically, nuclear medicine can be used to:
-
Analyze
kidney function
-
Image blood
flow and function of the heart
-
Scan lungs
for respiratory and blood-flow problems
-
Identify
blockage of the gallbladder (cystic duct)
-
Evaluate
bones for fracture, infection, arthritis or tumor
-
Determine
the presence or spread of cancer
-
Locate the
presence of infection
-
Measure
thyroid uptake to detect hyperthyroidism or hypothyroidism
How should I prepare for the procedure?
Usually, no
special preparation is needed for a nuclear medicine examination. However, if
the procedure involves evaluation of the stomach, you may have to skip the
meal immediately before the test. If the procedure involves evaluation of the
kidneys, you may need to drink plenty of water before the test.
What does the equipment look like?
During most
nuclear medicine examinations, you will lie down on a scanning table.
Consequently, the only piece of equipment you may notice is the specialized
gamma camera used during the procedure. It is enclosed in metallic housing
designed to facilitate imaging of specific parts of the body. It can look like
a large round metallic apparatus suspended from a tall, moveable post or a
sleek, one-piece metal arm that hangs over the examination table. The camera
can also be within a large, doughnut-shaped structure similar in appearance to
a computed tomography (CT) scanner. Often, the camera is beneath the table out
of view.
A nearby
computer console, possibly in another room, processes the data from the
procedure.
How does the procedure work?
You are given
a compound, usually intravenously but sometimes orally, containing a small
amount of a radioactive substance that localizes in specific body organ
systems. This compound, called a radiopharmaceutical or tracer, eventually
collects in the organ and gives off energy as gamma rays. The gamma camera
detects the rays and works with a computer to produce images and measurements
of organs and tissues.
How is the procedure performed?
A
radiopharmaceutical is administered into a vein. Depending on which type of
scan is being performed, the imaging will be done either immediately or a few
hours or even two days after the injection. Imaging time varies, generally
ranging from 20 to 45 minutes.
The
radiopharmaceutical that is used is determined by what part of the body is
under study since some compounds collect in specific organs better than
others. Depending on the type of scan, it may take several seconds to several
days for the substance to travel through the body and accumulate in the organ
under study, thus the wide range in scanning times.
You must
remain as still as possible during imaging. If the gamma camera is moved
slowly along the body, the resulting image is called a planar scan. Sometimes
sequential images are obtained to show how an organ functions over time.
After the
procedure, a physician with specialized training in nuclear medicine checks
the quality of the images to ensure that an optimal diagnostic study has been
performed.
What will I experience during the procedure?
Some
discomfort during a nuclear medicine procedure may arise from the intravenous
injection, usually done with a small needle. With some special studies, a
catheter may be placed into the bladder, which may cause temporary discomfort.
Lying still on the examining table may be unpleasant for some patients.
The
radiopharmaceutical loses its radioactivity generally over 24 hours. It passes
out of the body in the urine or stool.
Who interprets the results and how do I get them?
Most patients
undergo a nuclear medicine examination because a referring physician has
recommended it. A physician who has specialized training in nuclear medicine
will interpret the images and forward a report to the referring physician. It
usually takes one to three days to interpret, report and deliver the results.
What are the benefits vs. risks?
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Nuclear
Medicine procedures will result in exposure to a small dose of radiation.
However, the doses of radiopharmaceutical administered are the smallest
possible. Nuclear medicine has been used for more than three decades, and
there are no known long-term adverse effects from such low-dose studies.
Allergic
reactions to the radiopharmaceutical can occur, but are extremely rare.
What are the limitations of General Nuclear Medicine?
Nuclear
medicine procedures are time-consuming. They involve administration of a
radiopharmaceutical, obtaining images, and interpreting the results. It can
take hours to days for the radiopharmaceutical to accumulate in the part of
the body under study. Imaging can take up to three hours to perform, though
new equipment is available that can substantially shorten the procedure time.
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