Nuclear Medicine

What is a Nuclear Medicine Exam?
Nuclear Medicine provides safe and useful methods of obtaining functional  information about various organs of the body. It involves the introduction (usually by IV injection) of a radioactive tracer into the patient. The location of the tracer can be detected using a gamma camera. The gamma camera does not emit any radiation, but rather detects the radiation coming from the patient.               

Nuclear Medicine Exams:

• Gastrointestinal Bleeding Scan: A diagnostic study used to identify an actively bleeding site within the gastrointestinal tract.
  • Patient Preparation: No special preparation is required prior to arrival. Upon arrival, the patient will have a few cc’s of blood removed, have it tagged with a radioactive tracer, and then have it injected into them. Approximate examination time varies between 2-3 hours.
• Lymphoscintigraphy: A procedure for breast cancer involving a periarealar injection of a radiopharmaceutical. The injection is absorbed by the lymphatics and can migrate to lymph nodes. The sentinel lymph node is the first node in lymph node bed to receive lymphatic drainage from the injection. Drainage to more than one lymph node group may occur and, therefore, more than one sentinel node may be identified. These sentinel nodes can be imaged and this will aid the surgeon in his search for these nodes. The patient is taken to an operating room and the nodes are removed for pathology results.
  • Patient Preparation: None is required. Upon arrival the patient is interviewed and an isotope injected, which will take approximately 15 minutes. If the injection is performed in the Nuclear Medicine Department, the imaging is done immediately.
• I-131 Whole Body Imaging: A diagnostic study for the detection of thyroid metastasis and residual functioning thyroid tissue. Iodine-131 is administered orally and imaged 1-3 days later. The I-131 will tend to concentrate in thyroid metastasis and residual thyroid tissue.
  • Patient Preparation: The objective of this test is to maximize the uptake of the administered I-131. Patients should be off thyroid hormones for at least one week prior to the examination. Patients should not have intravenous or intrathecal iodinated contrast material (IVP, CT contrast, Myelogram, Angiogram) for 30 days. A low iodine diet is followed for 7-14 days before the I-131 capsule is administered.
  • Examination Time: Patient interview and capsule administration will take about 15 minutes. The imaging will usually be performed two days following the capsule administration. Imaging takes about 1.5 hours. Imaging post I-131 ablation should be done 7-10 days post dosing.
• Hepatobilliary Imaging: A diagnostic study that evaluates hepatocellular function and the patency of the biliary system. The radioactive tracer is injected intravenously and imaged as it is processed by the liver and biliary system. Normally, we visualize the liver, the biliary ductal system, gall bladder and the small bowel. 
  • Patient Preparation: Patients should be fasting 2-4 hours prior to the examination. Pain medication should be discontinued prior to the examination. We will confirm that you are not allergic to morphine sulfate drugs, in case the Radiologist requests the use of morphine. We will also need any history regarding gall bladder surgeries. 
  • Examination Time:  Varies between 1-4 hours patient to patient, with breaks after the first hour into the exam.
• Lung Scan: A diagnostic study to evaluate the air flow and the blood flow within the lungs. The exam is done in two parts. The ventilation is done first followed by the perfusion study. It is the combined result that leads to the final diagnosis.
  • Patient Preparation: A chest x-ray should be taken within 24 hours prior to the lung scan. The isotope may be administered with the patient either upright or supine for the ventilation scan. The isotope for the perfusion scan should be administered with the patient supine. 
  • Examination Time: It will take approximately 30 minutes for the ventilation scan and 30 minutes for the perfusion scan.
• Gated Cardiac Blood Pool Imaging: Also known as Gated Equilibrium Radionuclide Ventriculography (RVG or Multigated Acquisition- MUGA) and is a method of imaging tagged red blood cells (RBC’s) as they move through the cardiac chambers. 
  • Patient Preparation: No special preparation is needed prior to the examination. Upon arrival the patient will have a few cc’s of blood removed, have it tagged with a radioactive tracer, and then reinjected back into them. 
  • Examination Time: Tagging of RBC’s is approximately 30-45 minutes, along with additional patient set up and imaging that takes approximately 30- 45 minutes. 
• Gallium Imaging: A diagnostic study that is used to localize inflammation and certain types of tumors. The radioactive tracer is injected intravenously and imaged periodically over a period of days. The gallium will tend to localize in the sites of inflammatory process and certain types of tumors.
  • Patient Preparation: Gallium imaging can evaluate various parts of the body. The preparation is tailored to the individual need rather than given uniformly to everyone. No preparation is needed prior to the examination. 
    • On day 1 the patient will be injected.
    • There are no side effects or restrictions on the patient.
    • If  the abdomen is included as an area of interest, a bowel prep my be helpful.
  • Examination Time: Patient interview and injection of gallium will take about 15 minutes. Imaging is performed on one of the following 3 days.  The acuity of the patient’s illness, the type of diagnosis, and other factors will affect when the imaging will be performed.  Infection is imaged at 6 and 24 hours, tumors imaged at 72 hours. It is common to receive additional sets of images the day after the initial set is completed. This is particularly true if the abdomen is included in the areas of  interest. Each imaging session will take approximately 45- 60 minutes. 
• Gastric Emptying Study: A diagnostic procedure performed to evaluate gastric motor function. The radioactive tracer is incorporated into a standard meal and the stomach contents imaged over time. Computer analysis of the data can determine the percent of retained contents 1-4 hours and the T1/2 time ( the time for the content to empty by one half). 
  • Patient Preparation: Nothing by mouth (NPO) for 8 hours. Patients will have to consume the meal provided within 10 minutes. Diabetic patients should bring their insulin. Please be aware that this study may not be finished for over 4 hours. If vomiting occurs during the examination, the examination is terminated and must be rescheduled.
  • Examination Time: Consumption of the meal and initial imaging will take about 15 minutes. Follow up imaging will take place at 60, 120 and 240 minutes. Each imaging session will take 5-10 minutes.  Patients can wait in the waiting room between acquisitions.
• Cisternogram: A diagnostic procedure to evaluate the pathways of the cerebral spinal fluid. A radioactive tracer is injected into the lumbar intrathecal space and its flow through the head is evaluated. The imaging is performed periodically for multiple days. If the imaging agent is found to enter the ventricles, this indicates normal pressure hydrocephalus. 
  • Patient Preparation: No preparation prior to arrival.  A lumbar puncture must be performed to administer the tracer.
  • Examination Time: The interview process, preparation and lumbar puncture will take approximately 1 hour. Post lumbar puncture monitoring will vary, but could be up to 2 hours. Imaging will be performed at 4-6 hours, 24 hours, 30 hours, 48 hours and possibly at 54 and 72 hours. The need for delayed imaging will depend on the CSF flow rate. As a result you will be returning over multiple days. Each set of images will require about 30 minutes.
• Bone Scintigraphy: A diagnostic study used to evaluate the distribution of active bone formation in the body. Whole body, limited, SPECT, and three phase imaging are all techniques that may be used. These techniques all require the intravenous injection of a radioactive tracer with imaging performed 2-5 hours post injection. The three phase technique includes blood flow images and early imges, which are completed within 10 minutes after injection. All patients under 35 years of age and having low back pain will receive SPECT of that area.
  • Patient Preparation: Patients should be well hydrated. They will be instructed to drink extra fluids between the time of injection and  the time of delayed imaging. They should continue this for the next 24 hours. The patient will be asked to urinate immediately before delayed imaging is begun. 
  • Examination Time: Approximately 2-5 hours.

Registration
A member of our Pre-Registration staff may call you to pre-register you for this appointment. If contacted, this will save you time on the day of your appointment. Our Pre-Registration staff will ask you to verify your basic information, including insurance information. If you would like to call us directly to pre-register, please call 413-447-2455 one to three days prior to your appointment. The hours for the Pre-Registration Department are Monday through Friday from 8:10 a.m. until 8:15 p.m.  

If you have any questions about your exam or if you wish to reschedule your exam to a new day or time, please call the Central Scheduling Department at 413-447-2451 and they will be happy to assist you. The hours for the Central Scheduling Department are Monday through Friday from 7:30 a.m. until 5:00 p.m.  

If you would like to have an English language interpreter at the time of your appointment, please inform us at the time you book your appointment or call the Central Scheduling Department to arrange for one. 

How do I obtain results?
Your images will be reviewed and read by our board certified radiologists and a report will be sent to your doctor. This generally takes 24 to 48 hours after your examination. Your doctor will inform you of the results.