Frequently Asked Questions

Nuclear Medicine Frequently Asked Questions

What is Nuclear Medicine?

Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to diagnose or treat a variety of diseases, including many types of cancers, heart disease and certain other abnormalities within the body.

Nuclear medicine or radionuclide imaging procedures are noninvasive and, with the exception of intravenous injections, are usually painless medical tests that help physicians diagnose medical conditions. These imaging scans use radioactive materials called radiopharmaceuticals or radiotracers.

Depending on the type of nuclear medicine exam you are undergoing, the radiotracer is either injected into a vein, swallowed or inhaled as a gas and eventually accumulates in the organ or area of your body being examined, where it gives off energy in the form of gamma rays. This energy is detected by a device called a gamma camera, a (positron emission tomography) PET scanner and/or probe. These devices work together with a computer to measure the amount of radiotracer absorbed by your body and to produce special pictures offering details on both the structure and function of organs and tissues.

Nuclear medicine also offers therapeutic procedures such as radioactive iodine (I-131) therapy that uses radioactive material to treat cancer and other medical conditions affecting the thyroid gland.

How does the procedure work?

With ordinary x-ray examinations, an image is made by passing x-rays through your body from an outside source. In contrast, nuclear medicine procedures use a radioactive material called a radiopharmaceutical or radiotracer, which is injected into your bloodstream, swallowed or inhaled as a gas. This radioactive material accumulates in the organ or area of your body being examined, where it gives off a small amount of energy in the form of gamma rays. A gamma camera, PET scanner, or probe detects this energy and with the help of a computer creates pictures offering details on both the structure and function of organs and tissues in your body.

Unlike other imaging techniques, nuclear medicine imaging studies are less directed toward picturing anatomy and structure, and more concerned with depicting physiologic processes within the body, such as rates of metabolism or levels of various other chemical activities. Areas of greater intensity, called "hot spots", indicate where large amounts of the radiotracer have accumulated and where there is a high level of chemical activity. Less intense areas, or "cold spots", indicate a smaller concentration of radiotracer and less chemical activity.

How is the procedure performed?

Nuclear medicine imaging is usually performed on an outpatient basis, but is often performed on hospitalized patients as well.

You will be positioned on an examination table. If necessary, a nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm.

Depending on the type of nuclear medicine exam you are undergoing, the dose of radiotracer is then injected intravenously, swallowed or inhaled as a gas.

It can take anywhere from several seconds to several days for the radiotracer to travel through your body and accumulate in the organ or area being studied. As a result, imaging may be done immediately, a few hours later, or even several days after you have received the radioactive material.

When it is time for the imaging to begin, the gamma camera will take a series of images. The camera may rotate around you or it may stay in one position and you will be asked to change positions in between images. While the camera is taking pictures, you will need to remain still for brief periods of time. In some cases, the camera may move very close to your body. This is necessary to obtain the best quality images. If you are claustrophobic, you should inform the technologist before your exam begins.

If a probe is used, this small hand-held device will be passed over the area of the body being studied to measure levels of radioactivity. Other nuclear medicine tests measure radioactivity levels in breath.

When the examination is completed, you may be asked to wait until the technologist checks the images in case additional images are needed. Occasionally, more images are obtained for clarification or better visualization of certain areas or structures. The need for additional images does not necessarily mean there was a problem with the exam or that something abnormal was found, and should not be a cause of concern for you. You will not be exposed to more radiation during this process.

If you had an intravenous line inserted for the procedure, it will usually be removed unless you are scheduled for an operating room procedure that same day.

How do I schedule my Nuclear Medicine exam?

Once your Primary Care Manager has entered an order for your nuclear medicine exam you can come to Nuclear Medicine or call to schedule your exam. We are located on the ground floor of Hospital Tower of Madigan Army Medical Center along the West Corridor in room G-33-26. Our hours of operation are from 7:30 a.m. - 4:30 p.m. If you would like to schedule over the phone please call (253) 968-1645.

How do I prepare for my Nuclear Medicine Exam?

Each one of our exams has a very specific set of preparation instructions that need to be followed to ensure that the exam can be performed correctly and to our standards. Failure to follow these instructions can result in the rescheduling of your appointment to a later time. Since there are numerous exams that are performed in Nuclear Medicine, all with different preparations, we would like you to contact us at (253) 968-1645 or come into Nuclear Medicine to receive your specific preparation instructions.

What can I expect when I visit the Nuclear Medicine Department?

You can expect to be greeted by professional courteous staff that will make your exam as comfortable as possible. Upon entering the clinic you will check in at the front desk. Please expect a 15-20 minutes wait once you have signed in before the start of your exam. Our radiopharmacist must prepare each dose individually once you have arrived. Once your dose is prepared, a Nuclear Medicine Technologist will perform your exam. When your exam is complete, our Nuclear Medicine Physicians will interpret your exam. Results will be accessible by your Primary Care Manager within 24 hours.

How long will my exam last?

There are many exams performed in Nuclear Medicine. They range from 20 minutes to 5 days. Since we have such a diverse range of exams it is best to visit us or call (253) 968-1645 for details specific to your exam.

When will I get the results of my examination?

Results will be accessible for your Primary Care Manager within 24 hours. Your Primary Care Manager will either call you or go over you results at your next follow up appointment.

What can I expect if my child has a Nuclear Medicine exam?

Nuclear Medicine relies on the patient to be still for long periods of time to acquire images. Young children may require gentle restraining to help them hold still. If your child is fed on a routine schedule, we may arrange for you feed them immediately before the pictures have started in hopes they will sleep through the exam. If the child cannot stay still, sedation can be used to ensure that there is no movement. Sedation is considered on a case by case basis and is done with an Anesthesiologist, Nurse, and a Nuclear Medicine technologist to ensure your child’s safety. If your Primary Care Manager feels sedation is needed for your child, you will receive specific instructions prior to the exam. Our nurse will talk to you specifically about all the preparations that are needed. Please call (253) 968-1645 for more information.

What are the benefits vs. risks?

Benefits

  • The information provided by nuclear medicine examinations is unique and often unattainable using other imaging procedures.
  • For many diseases, nuclear medicine scans yield the most useful information needed to make a diagnosis or to determine appropriate treatment, if any.
  • Nuclear medicine is less expensive and may yield more precise information than exploratory surgery.

Risks

  • Because the doses of radiotracer administered are small, diagnostic nuclear medicine procedures result in low radiation exposure, acceptable for diagnostic exams. Thus, the radiation risk is very low compared with the potential benefits.
  • Nuclear Medicine diagnostic procedures have been used for more than five decades, and there are no known long-term adverse effects from such low-dose exposure.
  • Allergic reactions to radiopharmaceuticals may occur but are extremely rare and are usually mild. Nevertheless, you should inform the nuclear medicine personnel of any allergies you may have or other problems that may have occurred during a previous nuclear medicine exam.
  • Injection of the radiotracer may cause slight pain and redness which should rapidly resolve.
  • Women should always inform their physician or radiology technologist if there is any possibility that they are pregnant or if they are breastfeeding their baby.

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