Nuclear Medicine

Common Clinical Indications

• Cancer Staging

• Osteomyelitis/Infection

• Fractures

• Metabolic bone disorders/AVN 

Duration of study

• 4 hours

• (2 separate visits 3 hours apart) 

Prerequisites

• - Plain x-rays of area of interest

• -IV cannula 

Contraindications/preparation

• Patient to be well hydrated 

Other notes

• Latest scan start 11:30am. 

Common Clinical Indications

• Pulmonary Embolism

• Chronic pulmonary emboli

• LVR surgery workup 

Duration of study

• up to 30min 

Prerequisites

• Clear CXR

• Positive D-Dimer

• IV cannula 

Contraindications/preparation

• - Respiratory contact precautions (unable to vent patient)

• - Must be able to follow simple breathing instructions and lay flat for 30 mins 

Other notes

• Can be performed on pregnant women (reduced dose)

• If patient is breastfeeding they will need to express and discard for 24 hours post-imaging 

Common Clinical Indications

• Assess coronary artery disease

• Evaluation of shortness of breath, chest pain, family hx  cardiac disease

• Pre-op cardiac assessment 

Duration of study

• 4- 5 hours 

Prerequisites

• Cease caffeine for 24 hrs prior

• Withhold beta-blockers and calcium channel blockers for 48 hours prior

• IV cannula 

Contraindications/preparation

• Recent infarct or raised troponin within 72 hrs

• Current chest pain

Other notes

• If patient is over 130kg, the study will need to be conducted over two days as weight based dose 

Common Clinical Indications

• Hyper/hypothyroidism

• Thyroiditis

• Differentiation of nodules

• Localisation of ectopic tissue 

Duration of study

• 30min 

Prerequisites

• TFT’s

• Consider U/S simultaneously

• Ask about breastfeeding

IV cannula 

Contraindications/preparation

• CT contrast within the last 12 weeks

• Amiodarone

• Thyroxine (will need to be ceased for at least 6 weeks prior to imaging) 

Other notes

• If patient is for 131- Iodine therapy, they will require a thyroid scan prior to help determine the required dose 

Common Clinical Indications

• Evaluation of renal perfusion and obstruction

• ATN-Renal transplant 

Duration of study

• 60min 

Prerequisites

• Provide recent ultrasound/CT

• IV cannula 

Contraindications/preparation

• Patient will need to be well hydrated

• Allergy to Frusemide if query obstruction 

Other notes

• Tracer ordered specifically for each patient – what tracer the patient requires will depend on the clinical question 

Common Clinical Indications

• Cholecystitis

• Cholelithiasis

• Biliary dyskinesia

• SOD dysfunction 

Duration of study

• 90min 

Prerequisites

• Provide recent biliary ultrasound

• IV cannula 

Contraindications/preparation

• Patient to fast for min 4 hours but max of 16 hours (for gallbladder compliance)

• All opiates must be ceased for 24 hrs prior to imaging 

Other notes

• Fasting for <4 hours means gallbladder is still contracting

• Fasting for >16 hours means gallbladder is full of bile (too full)

Common Clinical Indications

• Delayed gastric emptying

• Gastroparesis

• Nausea, vomiting, early satiety 

Duration of study

• 120min 

Prerequisites

• Fasted from midnight

• Ceased gastric motility 

Contraindications/preparation

• Must be able to tolerate food without vomiting

• Must be able to eat a scrambled egg 

Other notes

• As the study involves a quantitation, if that patient vomits, then the study is no longer valid 

Common Clinical Indications

• Localisation of GI Bleed

Duration of study

• 2 hours 

Prerequisites

• CT Angiogram

• 18G IV cannula 

Contraindications/preparation

• Patient should have had a recent bleed/be actively bleeding 

Other notes

• Unable to perform study if patient won’t accept their blood back (mainly religious reasons)