What is nuclear medicine? 

Nuclear Medicine is a branch of medical imaging that uses radiopharmaceuticals (a combination of Radio-isotopes and pharmaceuticals) for diagnosis and treatment (Note: Therapeutic use is not available at ESH) of various conditions including cancer. It involves the use of radiopharmaceuticals to assess the functions of various organs by tracking their path and or uptake using a specialised gamma camera. Being more useful for physiology, nuclear medicine scans complement the CT and MRI scans (which have higher resolution for anatomical details) for improved diagnosis.  

Sometimes gamma camera has an attached CT scanner for hybrid imaging (called SPECT-CT gamma camera), which increases the sensitivity and specificity of scans or in general terms improves diagnostic confidence. 

Currently, the Nuclear Medicine department at East Surrey Hospital provides diagnostic scans only. 

Referrals

GPs can request bone scans directly. Other nuclear medicine examinations may be requested by GPs where suggested in a previous radiological report. Reports are issued within seven days.

Any queries regarding the service should be directed to the Superintendent Radiographer, Rajyashree Sharma, on 01737 768 511 extension 6001 or 1608.

 

Most investigations within this Department require little or no patient preparation (see individual test section). However, for some tests, it is important that the patient is well hydrated. These cannot be performed on the same day as any test requiring nil by mouth. 

The iodine in contrast media used in radiology may block uptake by the thyroid of the radiopharmaceuticals used in thyroid or parathyroid tests. It is preferable to perform these tests before one which involves contrast media otherwise the radioactive test may have to be postponed for up to 8 weeks. Barium enema should be carried out after, for example, a whole-body bone scan, and gastric and liver study. 

 

Common Investigations 

Patients will visit the department twice. The first visit is for an injection only; cannulation prior to attendance is required for inpatients. The second visit, roughly three hours after, is for the scan itself. 

This examination should not be confused with a DEXA (bone densitometry) scan. 

Preparation 

No barium studies should have been performed in the previous 48 hours. 

After Care 

Increased fluid intake should be maintained for the rest of the day following injection to aid the excretion of the radioactivity. 

Treat all body fluids as a biohazard (for the first 24 hours after the injection). 

Time in Department 

First visit: 15 mintues 

Second visit: one hour 

 

V/Q lung SPECT 

The findings from a recent chest X-ray should be considered prior to requesting a lung scan. 

The lung scan comprises two parts. A ventilation scan involving the inhalation of a gas, and a second (perfusion scan) involving a small injection. In most cases, both sets of images will be acquired during the same attendance. 

For pregnant patients, a reduced dose perfusion scan only will be carried out in the first attendance. A ventilation scan will be carried out on a separate date where deemed necessary. 

Preparation 

A cannula should be sited prior to attendance. Ideally, this should be in the hand/ wrist to improve patient comfort during scanning. 

After Care 

Treat all body fluids as a biohazard for 24 hours. 

Time in Department 

45 minutes – when attending for both Ventilation and Perfusion Imaging. 

Sometimes these scans are done on 2 consecutive days rather than the same day to reduce radiation exposure. 

 

Renal studies 

 

DMSA 

Patients will visit the department twice for this study. The first visit is for an injection only. The second visit, roughly three hours after this, will be for the scan itself. This takes around 30 minutes. 

Preparation 

A cannula should be sited prior to attendance. Paediatric out-patients are requested to attend CAU prior to the appointment to facilitate this. 

After Care 

Treat all body fluids as a biohazard for 24 hours after injection; 

Encourage increased fluid intake and frequent emptying of bladder. 

Time in Department 

First visit – 15 minutes; 

Second visit – 30 minute