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Nuclear
Medicine
Department

 

Common Scans
Cardiac Stress Tests
PET - Positron Emission Tomography
Frequently
Asked
Questions

The Nuclear Medicine Department, located on the 3rd floor, is open from 6:30 am to 4 pm Monday through Friday and is staffed by board certified nuclear medicine technologists and board certified nuclear medicine and nuclear cardiology physicians. 

What is Nuclear Medicine?

Nuclear Medicine performs diagnostic imaging to look at the function of organs and detect diseases in the body.  A radioactive material is injected into the arm or given by mouth so that imaging may be performed.  The material will not make you sick and gives off about the same amount of radiation as having a CT scan.  A wide variety of organs may be examined such as the thyroid, heart, gallbladder, liver, bones, and stomach, to name a few.

Common Scans

Bone Scans
There are six types of bone scans that may detect sport injuries, metastasis, unexplained pain, osteoporosis, neoplasms, fractures, tumors, etc.  There are no eating restrictions with a bone scan.  Before and after the injection, drinking plenty of fluids will help improve the quality of your exam.  The patient will be injected in the arm and then scanned two hours later.  During the two-hour wait there are no restrictions and the patient may leave the hospital. The scan will take anywhere from 40 to 75 minutes.
 

Cardiac Wall Motion (Also known as a MUGA scan)- This test will evaluate how well the left ventricle wall moves and the heart pumps the blood.  There are no food restrictions prior to this scan.  The patient will receive an injection in the arm, wait 30 minutes, and receive a second injection.  These will allow us to see the heart.  The patient will then lie quietly while three different views of the heart are taken.  The test will take approximately 75 minutes.

Lung Scan - Most lung scans are to detect blood clots in the lung.  There are no food restrictions prior to this test.  The patient will be asked to breathe a radioactive material through a tube for five minutes, and then six ventilation images will be taken of your lungs.  The patient will then receive a radioactive injection, which also goes to the lungs, and the same six pictures will be taken again. These images are compared to determine if any blood clots are present.

 Liver Scan  - This scan is to detect problems in the liver such as  cysts, cirrhosis and tumors. There are no eating restrictions prior to the test.  A radioactive injection will be given in the arm.  After allowing the injection to circulate for 15 minutes, the patient will lie on the scan table while various views of the liver and spleen are taken.  The scan takes approximately 30 to 45 minutes.

Hida Scan - This test is to detect problems in the gallbladder or biliary system.  The patient may not eat or have narcotic pain medication for four hours prior to the test.  An injection of radioactive material will be given in the arm and scanning begins immediately.  The scan may take anywhere from 40 minutes to four hours.  After the gallbladder is visualized, an infusion of a medication that caused the gallbladder to contract will be given for some patients.  This medication will give additional information about the function of the gallbladder.

Cardiac Stress Tests

Dual Isotope Stress Test - Also known as Thallium or Cardiolite Stress Test.

This test is to determine if there are blockages in the patient’s coronary arteries. The patient must not eat for four hours prior to the test.  The patient should be off Beta-Blocker medications but only on the instructions from the ordering physician. An IV will be inserted into the patient’s arm, and an injection of a radioactive material will be given. After waiting 15 minutes to circulate, the patient’s resting scan will be taken.  The patient then goes to EKG Department for the actual treadmill portion of the test.  One minute before ending the treadmill test, the patient will receive a 2nd injection.  The patient will then return to Nuclear Medicine for the stress scan.  The entire procedure will take 3 to 3 1/2 hours.

Adenosine Stress Test

This test is to determine if there are any blockages in the coronary arteries.  The patient may not eat four hours prior to the test.  The patient is to be off medications such as Theophylline, Persantine, and Adenosine for 48 hours prior to the test.  The patient is to have no caffeine for 24 hours prior to the test.  An IV will be placed in the patient’s arm and an injection of a radioactive material will be given.  After circulating 15 minutes the patients resting scan will be taken.  The patient will then proceed to the EKG department to have the Adenosine stress portion of the test while the doctor monitors the heart.  While the Adenosine is being infused, another radioactive injection will be given.  The patient then returns to the Nuclear Medicine Department for the stress scan. The entire test will take approximately three hours.

PET - Positron Emission Tomography

What is PET?

PET (Positron Emission Tomography) is an imaging technique used to detect body functions on the cellular level.  This may help detect cancers and determine appropriate management and care of treatment plans.

PET Technology

The Washington Hospital has been a leader in PET imaging since the technology gained widespread acceptance in the late 1990’s.  Initially, The Washington Hospital invested in coincidence imaging.  This technology was upgraded in 2002 to a dedicated PET scanner – providing Washington County residents with technology that was considered to be the standard of care for its time.  As PET technology evolved, the Washington Hospital partnered with UPMC to upgrade its equipment.  In 2007, The Washington Hospital upgraded its PET scanner to a combined PET and CT unit – the GE Discovery Lightspeed 16.  This partnership with UPMC - combined with the expertise of the Board certified Nuclear Medicine physicians interpreting PET/CT allows the residents of Washington County to receive the highest quality of care, close to home. 

PET/CT (Positron Emission Tomography combined with Computed Tomography) provides a powerful weapon in the fight against cancer.  This high tech device is capable of communicating with the radiation therapy planning equipment, enabling the most accurate information to aid in the diagnosis, monitoring and treatment of oncologic disease.  PET/CT can detect cancer cells as small as one centimeter that may not be clearly identified with conventional technology such as computed tomography (CT) scanning alone or magnetic resonance imaging (MRI). Physicians are using PET/CT to diagnosis and plan treatment of cancers, such as lymphoma, colorectal, melanoma, breast, lung  and other cancers.  The Washington Hospital has also joined a national PET registry.  This allows some patients to receive coverage for scans that may not be approved by their insurance carriers.

PET/CT is performed at the hospital in the Nuclear Medicine Department.  The medical and technical staff of the hospital have 9 years of experience performing PET examinations.   The physicians interpreting PET and Nuclear medicine scans at the hospital are board certified in Nuclear Medicine with combined experience of over 20 years. 

 “The GE Discovery Lightspeed 16 provides a technologically advanced tool for use in diagnostic imaging,” said William Castro, M.D., medical director Nuclear Medicine at The Washington Hospital.  “PET/CT imaging complements imaging studies we are currently performing and offers a broad range of applications for new studies including the detection of Alzheimer’s disease and some cardiac disease also. The Discovery LightSpeed 16 will be extremely important in the evaluation of cancer patients and will allow physicians to enhance patient care and improve the management of their patients with cancer,” he said.

According to Dr. Castro, PET/CT  technology is based on cancer tumors’ taste for glucose (or sugar). Patients are required to fast for 12 hours prior to the exam and are then injected with a small amount of a radioactive substance that contains glucose. During the PET scan, the cancer cells absorb more of the glucose than normal cells and they show up as “hot” spots on the image of the portion of the body being scanned. “The important difference is that, with conventional imaging technology, we see only the outline of a tumor. With PET, we can actually see a physiological process,” explained Dr. Castro.  Combining the PET image with a CT scan performed at the same time adds a level of precision that provides patients with the highest level of care and improves the accuracy of diagnosis. PET can also help physicians “stage” a tumor or determine its progression, and know whether treatment of the tumor is effective.

How does PET work?

A small amount of radioactive material which is tagged to a glucose compound is injected into the patient.  This injection will be picked up by the heart, brain and cancerous tumors.  The patient is then scanned from the head to thighs.  The computer reconstructs the  information acquired to form images of the body showing abnormal areas of radioactivity which may represent cancerous tumors.

 When is PET used?

Pet is approved to evaluate the following diseases but not limited to these as additional cancers are approved.

Lung Cancer
Brain Tumor
Ovarian Cancer
Lymphomas
Colorectal Cancer
Pancreatic Cancer
Melanoma
Head & Neck Cancer
Breast Cancer



How Do I Prepare For My Scan?

 

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Plan on being at the hospital for 2 to 2 1/2 hours.

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Do not eat anything after midnight.

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If you have medicines to take you may do so with a small amount of water.

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Register in the Admitting Office on the main floor 15-30 minutes prior to your appointment.

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Upon arrival in Nuclear Medicine you will have an IV plug inserted in your arm and your blood sugar level will be measured.

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You will be injected with a radioactive material and then asked to relax in the PET waiting room for one hour.

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You will then be asked to lie quietly on the scan table as your pictures are acquired. The scan will take approximately 45 minutes.