Nuclear Medicine Procedures


Cardiovascular Procedures

Ejection  Fraction/Wall Motion  (MUGA) (back to list)

Clinical Indications Drug intervention studies (chemotherapy), cardiomyopa­thies, CAD, CHF, valvular heart disease.
Patient Preparation NPO 4 hours prior to exam
Time Frame 1 hour
Conflicting Examination or Medications None
   

SPECT Myocardial Perfusion Scan with Chemical Stress (back to list)

Clinical Indications Chest pain, EKG changes, acute/old MI, CAD, pre and post CABG/angioplasty, inadequate level of exercise, COPD and severe peripheral vascular disease, presurgical clearance.
Patient Preparation Restrict xanthine medications (36-48 hours); NPO 4 hours prior to exam, no caffeine 24 hours prior to test.
Time Frame 2 - 4 hours
Conflicting Examination or Medications Allergy to aminophylline, resting hypotension, unstable angina, caffeine or nicotine, xanthine medications.

 SPECT Myocardial Perfusion Scan with Treadmill Stress (back to list)

Clinical Indications Chest pain, EKG changes, rule out acute/old MI, CAD, pre and post CABG/angioplasty.
Patient Preparation Discontinue beta-blockers, calcium antagonists, and nitrates, if possible. NPO 4 hours prior to test. No caffeine 24 hours prior to test.
Time Frame 2 - 4 hours
Conflicting Examination or Medications Beta-blockers, calcium antagonists, nitrates, and caffeine.

Endocrine Procedures

Thyroid (Technetium 99m) Scan (back to list)

Clinical Indications Thyroid nodule, substernal thyroid or mediastinal mass.
Patient Preparation None
Time Frame 1 hour
Conflicting Examination or Medications Synthroid - must be off 3-4 weeks prior to the exam. Iodine containing medications. Contrast agents, 2-3 months.

Thyroid 1-123 Uptake and Scan (back to list)

Clinical Indications Hyperthyroidism (thyrotoxicosis), multinodular goiter, Graves' disease, abnormal thyoid lab work, autonomous thyroid nodule.
Patient Preparation NPO 4 hours prior to dose (first appointment), TSH, T3, T4 should be done within 30 days of test.
Time Frame

2 hours over 2 days with 3 appointments:
DAY 1:
Appointment #1 - 30 minutes, Appointment #2 - 1 hour
DAY 2:
Appointment #3 - 30 minutes

Conflicting Examination or Medications

Thyroid Med Discontinue List:
• Radiographic contrast agents – 6 weeks
• Myelogram – 1 year
• Antithyroid drugs (PTU and Tapazole/methimazole) – 1 week
• Levothyroxine (Synthroid) – 6 weeks
• Triiodothyronine (Cytomel) – 2 weeks  

Thyroid Cancer (back to list)

Clinical Indications Thyroid carcinoma, metastasis.  
Patient Preparation Patient receives I-131 oral dose 48-72 hours prior to scan. Serum pregnancy test (beta HCG) done within 3 days before test for all females in child bearing age (12-55, no exceptions). TSH will be done on all patients within 3 days before the test.  
Time Frame 2-1/2 hours, 48 hours apart:
Appointment #1 - 15 minutes
Appointment #2 - 2 hours, 15 minutes  
Conflicting Examination or Medications Thyroid Med Discontinue List:
• Radiographic contrast agents – 6 weeks
• Myelogram – 1 year
• Antithyroid drugs (PTU and Tapazole/methimazole) – 1 week
• Levothyroxine (Synthroid) – 6 weeks
• Triiodothyronine (Cytomel) – 2 weeks  

Parathyroid (back to list)

Clinical Indications Hypercalcemia, renal stones or failure, history of para­thyroid tumors, bone disease, preoperative evaluation for parathyroidectomy (for hyperparathyroidism), elevated parathyroid hormone level.  
Patient Preparation None
Time Frame 2 - 4 hours  
Conflicting Examination or Medications None