INFORMATION FOR DOCTORS
Scintigraphic examination
If you are interested in scintigraphic examination of your patients, the following procedure should be followed:
- fill out the Radiopharmaceutical Examination Request Form twice, ( a sample request form can be found in the Documents section). The application form can also be filled out online, but in this case you need to print a copy, stamp it and give it to the patient to bring to the examination). In addition to all the necessary data, please also include the patient’s telephone contact, your telephone contact or e-mail address, this will shorten the time of the appointment, or dispatch of the results.
- Send the patient with the completed application form (or just the completed application form) to our clinic, where he/she will be booked and instructed on the further procedure of the examination,
- in the case of acute examinations, these can be carried out within a few hours after a telephone consultation with the doctor of the clinic,
- there are almost no contraindications for nuclear medicine examinations, generally only pregnancy and lactation, we examine all age categories of patients,
the duration of the examination itself is individual and depends on the type of examination, - in case the patient is unable to attend the examination on the scheduled date, we ask you to cancel the examination by phone well in advance, about 1-2 days before the scheduled examination. Ev. We ask you to instruct your patient to do so. Radiopharmaceuticals are prepared individually for each patient, and failure to use them will invalidate the prepared dose that could be used for another patient.
- The examinations are non-invasive
- the general rule of examinations in nuclear medicine is an increased fluid intake, especially after the examination.
Examinations
Heart examinations
Principle of examination:
After intravenous administration of a radiopharmaceutical, its uptake by myocardial cells occurs. The uptake is directly proportional to the perfusion in the myocardial area at the time of application. Accumulation of the radiopharmaceutical does not occur in necrotic or scarred areas of the myocardium.In ischaemic areas, accumulation is reduced. The examination is performed in two phases, first a stress phase and then a rest phase. Their comparison evaluates the presence of reversible or fixed defects of radiopharmaceutical accumulation. These correspond to ischemic or necrotic deposits in the myocardium or postinfarction scars.
Indications:
- determination of the extent and localization of myocardial ischemia
- detection of post-infarction myocardial scar
unclear findings on resting and post-stress ECG
diff. dg. chest pain - assessment of the effect of treatment – thrombolytic, PTCA, CABG
Patient preparation:
fasting in the morning on the day of the examination
diabetic patient light breakfast
24 h. before the examination discontinue antiischemic treatment
48 h before examination discontinue beta-blockers, nitrates, Ca channel blockers
Duration of examination:
approx. 4 hours (including a break between examinations of 3 hours, the patient does not need to spend this time in the nuclear medicine department)
Radiopharmaceuticals:
99mTc – tetrofosmin
Examination methodology:
The examination starts with a stress test (bicycle ergometry) or pharmacological stress test, in collaboration with the cardiologist.
The stress test is performed with a bicycle ergometer, where the patient is monitored throughout under the supervision of a cardiologist. The load is carried out until a set maximum is reached, according to age and sex. Once this maximum is reached, the patient is injected intravenously with a radiopharmaceutical.
Contraindications to stress testing are acute coronary syndrome, acute pulmonary embolism,orthopaedic problems, spinal pain, advanced age, patient’s non-cooperation and cardiac arrhythmias.
For pharmacological burden, substances with a direct vasodilating effect are used. (Rapiscan, Dypiridamol, Adenosine, or Doputamine) This substance is applied slowly for about 4 minutes. After the application is complete, a radiopharmaceutical is administered. The patient is monitored at all times.
After the load has been performed and the radiopharmaceutical has been applied, the patient lies supine on the gamma camera table and we connect the leads to the ECG. Using the gated SPECT technique (ECG-synchronized tomographic recording), his myocardial area is examined. The recording lasts about 15-20 minutes and reflects the state of myocardial blood flow at peak stress. After its completion, the recording is performed in the prone position,to exclude artifacts.
After 3 hours from the first application, a second dose of radiopharmaceutical is administered, and after 60 minutes the recording is gated again by the SPECT method – a resting study that lasts about 15- 20 minutes.
Examinations of the lungs
Principle:
The intravenously injected radiopharmaceutical is trapped in the capillary bed of well-perfused lung parenchyma, whereas it does not reach the non-perfused lung parenchyma. This will appear on the scintigram of the lung as an area of radioactive effusion. This perfusion defect often takes the shape of a segmental effusion. This is to show the distribution of pulmonary capillary perfusion and to detect disturbances in blood flow through the pulmonary vasculature.
Radiopharmaceutical:
99mTc – serum albumin macroaggregate
Method of application:
Intravenous
Principle:
Display of pulmonary alveolar ventilation distribution and detection of pulmonary ventilation disturbances. The radiopharmaceutical ( gas ) is inhaled from a special device by the patient in a closed system through an inhalation mask by mouth or nose.
Radiopharmaceutical:
81mKr
Method of application:
Inhalation
Perfusion defect without ventilation disturbance is typical for pulmonary embolism, perfusion defect with concomitant ventilation disturbance is not indicative of pulmonary embolism.
Indications:
diagnosis of pulmonary embolism
monitoring the effect of pulmonary embolism therapy
dg. dyspnoea
assessment of pulmonary perfusion status in bronchopulmonary diseases
Contraindications:
right – left shunt
severe pulmonary hypertension
severe dyspnoea
Patient preparation:
None
Duration of examination:
approx. 15 – 30 minutes
Examination methodology:
Both examinations are performed at the same time at our clinic. After intravenous application of the radiopharmaceutical in the supine position, a mask is placed over the patient’s mouth for gas inhalation. Eight static scans are performed. The sensitivity and specificity of the examination is increased by the SPECT method.
CNS examinations
Principle:
The radiopharmaceutical’s active ingredient, joflupane, is a cocaine analogue that binds to the dopamine transporter and that is found on presynaptic nerve endings. The intensity and symmetry of radiopharmaceutical uptake in the nc. caudatus and putamen are assessed.
Indications:
differentiation of Parkinson’s disease and Parkinson’s plus syndrome group diseases (here the pathological finding on the scintigram) from other forms of Parkinson’s syndromes and essential tremor
Patient preparation:
24 hours before the examination discontinue antiparkinsonian drugs
1 hour before the examination take 1 tbl. 1 hour before the first antiparkinsonian test, 1 hour of Chorigen, for thyroid blockage (he will receive it from us)
Duration of examination:
Approx. 3.5 hours (time after the radiopharmaceutical injection and the scan itself is 3 hours, the patient does not need to spend this time in the nuclear medicine department)
Radiopharmaceutical:
123I – joflupan (DaTSCAN)
Method of application:
Intravenous
Examination methodology:
The radiopharmaceutical is injected intravenously into the patient. Approximately 3 hours after application, the patient is placed on the gamma table on his/her back and the head is fixed using a fixation device to reduce the risk of movement. Using SPECT methodology, the scan is performed, which takes approximately 30 minutes.
Principle:
Examination of postsynaptic D2 receptors may be beneficial to differ. dg. between idiopathic Parkinson’s disease and multisystem atrophy or progressive supranuclear palsy. Differentiating dementia with Lewy bodies from other dementias.
Patient preparation:
24 hours before the examination discontinue antiparkinsonian drugs
1 hour before examination take 1 tbl. Chorigen, for thyroid blockage (he gets it from us)
Duration of examination:
Approx. 2.5 hours (the time after the radiopharmaceutical application and the scan itself is 2 hours, the patient does not need to spend this time in the nuclear medicine department)
Radiopharmaceutical:
123I – IBZM
Method of application:
Intravenous
Examination methodology:
The radiopharmaceutical is injected intravenously into the patient. Approximately 2 hours after application, the patient is placed on the gamma table on his/her back and the head is fixed using a fixation device to reduce the risk of movement. Using SPECT methodology, the scan is performed, which takes approximately 30 minutes.
Bone examination
Principle:
Imaging early changes in bone tissue metabolism. The radiopharmaceutical accumulates to an increased extent in sites of increased bone metabolism, and to a reduced extent in osteolytic deposits. The examination is highly sensitive but poorly specific and cannot always distinguish the cause of metabolic changes in bone. It may also show a fracture, degenerative lesion, or metastasis.
However, scintigraphy shows a metabolically active bone process several months earlier than X-rays, which is particularly important in the diagnosis of bone metastases.
Indications:
dg. benign and malignant bone tumours
monitoring of bone metastases at time intervals
detection of traumatic bone changes
diagnosis of osteomyelitis
diagnosis of M.Perthes
diagnosis of degenerative joint changes
monitoring of postoperative conditions in endoprostheses
diagnosis of suspected bionecrosis, sacroilitis …
Patient preparation:
None
increased fluid intake
Duration of examination:
approx. 2.5 – 5 hours. The first phases of the examination are performed immediately after the application of the radiopharmaceutical (about 10 minutes) and the bone phase is examined after about 2 – 4 hours (the time factor depends on the age and weight of the patient), the patient does not need to spend this time at the nuclear medicine workplace. The second recording takes about 20 minutes.
Radiopharmaceutical:
99mTc – hydroxymethylene diphosphonate (oxydronate)
Method of application:
Intravenous
Examination methodology:
The patient is injected intravenously with the radiopharmaceutical in the supine position. The blood supply to the pathological process is assessed during an approximately 10-minute scan. After the injection, the patient waits 2-4 hours for the radiopharmaceutical to be picked up in the bone structures. The technician is informed about the time of the next scan. The patient does not have to spend this time in the nuclear medicine department. Before the second scan, he/she is urinated and cleansed of all metallic objects. This part takes about 20 minutes. When the sensitivity and specificity of the scan increases, targeted SPECT is added.
Examination of the lymph nodes
Principle:
The radiopharmaceutical is taken up by the lymphatic vessels and transported to the axillary lymph nodes after intradermal injection into the interstitial space of the dorsal limbs.
Indications:
dg. swellings of the extremities
speed and intensity of lymphatic drainage
Patient preparation:
none
Duration of examination:
approx. 90 minutes
Radiopharmaceutical:
99mTc – colloid
Method of application:
into the interstitium by punctures into the interstitial spaces
Examination methodology:
The examination has 2 parts. In the first part, the patient lies on his/her back and the radiopharmaceutical is injected subcutaneously into the dorsum of the extremities. After the application, we focus the device on the axillary area (pelvis, axilla) and follow the penetration of the radiopharmaceutical into this area with a dynamic study. This part takes about 30 minutes. After its completion, we follow this transport with a half-body recording. Afterwards, we let the patient exercise, ev. The patient is asked to exercise the limbs by walking. After about 30 minutes of weight-bearing, the patient lies down on his/her back again and we check by scanning how the transport of the radiopharmaceutical in the limbs has changed.
We complete the examination by calculating the accumulation of radiopharmaceutical in the regional nodes, i.e. by determining the percentage of radiopharmaceutical at the end of both scans.
Principle:
The sentinel lymph node is the first sentinel lymph node that receives lymphatic drainage directly from the tumor. The aim of this method is to determine the number and localization of these nodes. Surgery is then performed and their histology is evaluated. If the sentinel lymph node does not contain metastatic cells, the other LUs in the catchment area do not have them either. The examination is mainly used in malignant melanoma and breast cancer. It is also used in carcinoma of the uterine cervix.
The sentinel lymph node is demonstrated peroperatively using a special probe, therefore, possession of this probe at the time of surgery is a prerequisite for performing this examination.
Indication:
detection of sentinel lymph node peroperatively
Patient preparation:
None, if the patient will be operated on the same day, then fasting
Duration of examination:
approx. 2.5 hrs. The first phase of the examination is performed immediately after the application of the radiopharmaceutical and the second phase of the marking is performed after about 2 hours, the patient does not need to spend this time in the nuclear medicine department.
Radiopharmaceutical:
99mTc – colloid
Method of application:
intradermal, periareolar
Examination methodology:
The radiopharmaceutical is applied to the patient in the supine position intracutaneously with several punctures in the scar area in malignant melanoma, or periareolarly – in breast tumour. Imaging is initiated immediately after application by dynamic recording of the sentinel node area to visualize lymphatic drainage. This takes approximately 15 minutes. In 2 hours after application, late static recordings are displayed in different projections. Once the sentinel node is located, this site is marked on the patient’s skin in 2 projections. This part of the examination takes about 15 minutes.
Surgery is usually performed the next day using a gamasonde, which uses pulses and a sound signal to identify the site of increased radiopharmaceutical accumulation.
Kidney examinations
Principle:
Using a radiopharmaceutical, the outflow parameters of the kidneys are assessed, the separated renal function (the proportion of the right and left kidneys in the total function) and the value of the total GF are calculated by computer. The kinetics and distribution of the radiopharmaceutical in the renal parenchyma, its intrarenal transport, excretion into the calyx-bladder system and its outflow into the ureters and bladder are monitored.
Indications:
assessment of renal function
suspicion of kidney damage and outflow disorders
Patient preparation:
30 minutes before the examination, drink about 0.5 l. of fluid
discontinue diuretics the day before the examination
urinate before the examination
Duration of examination:
approx. 30 minutes
Radiopharmaceutical:
99mTc – diethylenetriamine pentaacetic acid
99mTc – mercaptoacetyltriglycine
Method of application:
Intravenous
Methodology:
The patient is injected intravenously in the supine position with the radiopharmaceutical. Immediately after the application, a dynamic recording is started, which lasts for 30 minutes.
Principle:
Intravenous application of furosemide during dynamic renal scintigraphy is used to monitor the response of the kidneys to its administration. In non-obstructive hydronephrosis, the outflow of retinated urine and the renographic curve decrease after furosemide (diuretic) administration.
Indications:
dg. obstructive and non-obstructive hydronephrosis
Examination methodology:
The examination can be performed in conjunction with dynamic renal scintigraphy, when visualizing the obstruction of the kidney, an intravenous diuretic is administered at about 20 minutes of the examination and the effect of the administration of this diuretic is observed for about 10 minutes.
Principle:
An ACE inhibitor induces a decrease in glomerular filtration rate and concomitant decrease in function in kidneys with hemodynamically significant a.renalis stenosis. This is reflected on dynamic renal scintigraphy – in particular, by a flattening of the functional segment and a delay in the peak of the curve of the affected kidney; prolonged transit is present in the parenchyma.
Indications:
suspicion of renovascular hypertension in a.renalis stenosis
onset of hypertension before the age of 30 or after the age of 55
diastolic blood pressure greater than 130mm/Hg
hypertension resistant to therapy
abdominal murmur
Patient Preparation:
Discontinue diuretics and ACE inhibitors 3 – 7 days prior to examination
Drink approx. 0.5 l of fluid 30 minutes before the examination
urinate before the examination
Duration of examination:
approx. 1.5 hours
Examination methodology:
The examination starts with the administration of captopril in tablet form. Before administration, we measure the patient’s blood pressure. After administration of the pill, we monitor the pressure at approximately 20 minute intervals. After 60 minutes of captopril, we place the patient on the gamma camera table and the next procedure is identical to dynamic renal scintigraphy. In case of pathological findings, we book the patient for examination without captopril administration. This follow-up examination can be performed in 10 days at the earliest.
Principle:
The radiopharmaceutical is taken up in the cells of the proximal tubules of the kidney and, depending on their functional state, is fixed there for a certain period of time. This allows us to view the functional renal parenchyma, assess the localization, shape and size of the kidney, calculate the separated function and detect lesions.
Indications:
diagnosis of solitary kidney
shape anomalies of the kidney
abnormal kidney placement, including renal migrans
pyelonephritis – evidence of a cortical lesion ( especially in children )
focal processes – cysts, tumours
Patient preparation:
none
Duration of examination:
approx. 2.5 hours. After the intravenous application of radiopharmaceutical, which takes place without scanning, the examination takes about 2 hours (the time factor depends on the age and weight of the patient), the patient does not need to spend this time at the nuclear medicine workplace.
Radiopharmaceutical:
99mTc – dimercaptoacetic acid
Method of application:
Intravenous
Examination methodology:
The radiopharmaceutical is administered intravenously and shaken out approximately 2 hours after administration. The patient lies supine and 6 static scans are performed at different angles of the gamma camera. When the sensitivity and specificity of the examination increase, targeted SPECT is added. The scanning takes about 20 minutes.
Examinations of the endocrine system
Principle:
The radiopharmaceutical is uptaken up in the thyroid tissue and its accumulation rate is proportional to its functional status. The shape, localization, cold nodules (cysts, tumors) and hot nodules (hyperfunctioning tissue) are assessed
Indications:
hyperthyroidism
thyroiditis
determination of the size, shape, location of the thyroid gland
detection of nodules
Patient preparation:
exclude medication affecting thyroid function
at least 3 days before the examination thyreostatic drugs
at least 1 month prior to thyroid hormone testing
at least 3 months prior to the examination iodine preparations, including iodine contrast doses used in X-rays. Examinations
Duration of examination:
approx. 20 minutes
Radiopharmaceutical:
99mTc – pertechnetate
Method of application:
Intravenous
Examination methodology:
The patient is injected intravenously with the radiopharmaceutical in a sitting position. The drug is then allowed to be absorbed in the thyroid parenchyma for about 15 minutes. After this time, the patient is placed on his/her back and the gamma camera is set on the neck area. When the sensitivity and specificity of the examination increase, targeted SPECT is added.
Principle:
The radiopharmaceutical is uptaken up in pathological parathyroid tissue (parathyroid adenoma,or parathyroid hyperplasia). At the same time, the thyroid gland is imaged, but the radiopharmaceutical is flushed out more quickly in contrast to the pathological parathyroid gland.
Indications:
suspicion of adenoma or hyperplasia of the parathyroid gland
suspicion of ectopically deposited parathyroid gland
dg. elevated PTH values
Patient preparation:
identical to thyroid examination
Duration of examination:
approx. 3 hours
Radiopharmaceutical:
99mTc – tetrofosmin
99mTc – methoxy-isobutyl-isonitrile
Method of application:
Intravenous
Examination methodology:
For a more accurate diagnosis, the examination begins with a thyroid examination. After the examination is completed, the patient is administered chlorigen and waits for about 1 hour. The effect of the chlorigen is checked under the gamma camera by placing the patient in the same position as during the thyroid examination. The effect should be seen so that we cannot see the thyroid tissue on the image. If the tissue is visible, we must continue the examination on another day. If no tissue is seen, we proceed with the administration of a second radiopharmaceutical to examine the parathyroid glands. We perform the first scan about 15 minutes after administration, again in the identical position as for the thyroid scan. The scan takes 5 minutes. The second scan is performed under similar conditions in about 2 hours. We use the principle of subtraction scintigraphy for the evaluation, and targeted SPECT is added to increase the sensitivity and specificity of the examination.
GIT examinations
Principle:
This is a functional and morphological examination of the salivary glands and their ability to uptake radiopharmaceuticals. The intensity, rate and symmetry of accumulation of the radiopharmaceutical by the salivary glands and their response to salivation stimulus are assessed.
Indications:
Sjogren’s syndrome
Inflammation
abcesses
cysts
lymphatic infiltration
Patient preparation:
the patient brings a lemon to the examination
1 hour before the examination do not eat, drink, chew gum
Duration of examination:
approx. 40 minutes
Radiopharmaceutical:
99mTc – pertechnetate
Method of application:
Intravenous
Examination methodology:
The patient is injected with the radiopharmaceutical intravenously in the supine position. Immediately after application, we start a dynamic study focusing on the head region. In the middle of the examination, a salivation stimulus (lemon juice using a tube or syringe) is administered orally.
Principle:
After intravenous administration of the radiopharmaceutical, we monitor its uptake by hepatocytes, excretion into the bile ducts and its passage into the duodenum. The examination allows to evaluate in a non-invasive way mainly hepatocellular function, bile duct patency and gallbladder function.
Indications:
functional disorders of gallbladder and bile duct motility
acute cholecystitis
dg.cholestasis
dg.neonatal icterus
sphincter of Oddi dysfunction
Patient preparation:
fasting
Bring 50 g. chocolate or liquid cheese in a casing
on the day of the examination discontinue medications affecting gallbladder motility
Duration of examination:
approx. 2 – 3 hours
Radiopharmaceutical:
99mTc – trimethyliminodiacetic acid
Method of application:
Intravenous
Examination methodology:
The patient lies supine on the gamma table and the radiopharmaceutical is administered intravenously. Immediately after application, a dynamic study focusing on the patient’s abdomen is started, lasting approximately 60 minutes. Once the gallbladder begins to be imaged (at approximately 30 minutes into the scan) the patient is given the brought chocolate. After the study is completed, we will take a 2 minute static image of the patient. We then repeat this static image at approximately hourly intervals as needed. The patient may eat in between scans.
Principle:
The radiopharmaceutical is uptaken up by Kupffer cells in the liver after administration and, due to the presence of phagocytic reticuloendothelial cells in the spleen, is also uptaken up in the spleen. The distribution of the radiopharmaceutical in the parenchyma of the liver and spleen is proportional to the phagocytic capacity of the RES.
Indications:
deposits in the liver
cirrhosis
Patient preparation:
none
Duration of examination:
approx. 40 minutes
Radiopharmaceutical:
99mTc – colloid
Method of application:
Intravenous
Examination methodology:
The patient is injected intravenously with the radiopharmaceutical either under the gamma camera (dynamic study is started immediately after application) or in sitting position. The examination itself starts 20 minutes after application. Six basic projections are taken. To increase the sensitivity and specificity of the examination, targeted SPECT is added.
Principle:
After intravenous injection of in vitro 99mTc-labeled autologous erythrocytes, their uptake occurs in the hepatic cavernous hemangioma. This appears as a saturated accumulation of radiopharmaceutical on scintigram.
Indication:
dg. hepatic hemangioma
Patient preparation:
fasting
Duration of examination:
approx. 1.5 hours
Radiopharmaceutical:
99mTc – labelled autologous erythrocytes
Method of application:
Intravenous
Examination methodology:
The patient is given an intravenous cannula and the HDP kit is injected. Approximately 20 min later, 20 ml of blood is drawn into a syringe and the 99mTc pharmacopeia is added to this blood. With occasional stirring, in about 10 min the blood is returned to the patient. The examination itself starts in 45 min at the earliest. The patient lies down on the gamma camera table and we take 6 basic static images and to increase the sensitivity and specificity of the examination, targeted SPECT is added. This part takes 20 minutes.
Principle:
Meckel’s diverticulum in 20% contains a functional ectopic gastric mucosa that uptakes the radiopharmaceutical.
Indications:
suspected bleeding Meckel’s diverticulum
suspicion of ectopic gastric mucosa
Patient preparation:
fasting
Duration of examination:
approx. 60 minutes
Radiopharmaceutical:
99mTc – pertechnetate
Method of application:
Intravenous
Examination methodology:
The patient lies down on the gamma table and the radiopharmaceutical is injected intravenously. Immediately after completion of the application, dynamic scanning is started and the abdomen is carefully observed for any saturated accumulation of radiopharmaceutical indicative of positivity. The scan lasts approximately 60 minutes. To increase the sensitivity and specificity of the examination, targeted SPECT is added to the Principle.
Principle:
The radiopharmaceutical is mixed into the diet and administered per os to the patient. The motility and gastric emptying capacity are monitored.
Indication:
Functional gastric disorders
Patient preparation:
fasting
discontinue medications promoting gastric function
diet (risotto)
Duration of examination:
approx. 1.5 hours
Radiopharmaceutical:
99mTc – colloid
Method of application:
Oral
Examination methodology:
The radiopharmaceutical is mixed into the patient’s diet. After eating it, the patient lies down on the gammacamera table and we focus the device on the abdominal area. We start a dynamic study that lasts about 60 minutes and monitor gastric activity. At the end of the study, we take a 2-minute static image of the patient. We then repeat this static image at approximately hourly intervals as needed. In between scans, the patient cannot eat and only takes fluids.
Principle:
After intravenous injection of in vitro 99mTc-labeled autologous erythrocytes, their uptake occurs at the site of bleeding. This appears on the scintigram as a saturated accumulation of the radiopharmaceutical. The presence of blood in the stool on the day of examination is ideal.
Indication:
Evidence and determination of the site of bleeding, especially in the middle and lower GIT – polyps, diverticula
Patient preparation:
none
Duration of examination:
approx. 60 minutes,in rare cases also on the next day (only scanning)
Radiopharmaceutical:
99mTc – labelled autologous erythrocytes
Method of application:
Intravenous
Examination methodology:
The patient is given an intravenous cannula and the HDP kit is injected. Approximately 20 min later, 20 ml of blood is drawn into a syringe and the 99mTc pharmacopeia is added to this blood. With occasional stirring, in about 10 min the blood is returned to the patient. The patient lies down on the gamma table and we slowly inject the blood. We start a dynamic study that lasts 60 minutes. At the end of the study, we take a 2-minute static picture of the patient. We then repeat this static image at approximately hourly intervals as needed, in rare cases on a second day.
Tumour examinations
Principle:
The examination is used to image tissue with somatostatin receptor expansion, especially tumors of neuroendocrine origin. The radiopharmaceutical, as a somatostatin analogue, binds to somatostatin receptors.
Indications:
neuroendocrine tumours
carcinoid
paraganglioma
Patient Preparation:
day before administration of radiopharmaceutical liquid diet
fasting
takeaway diet
Duration of examination:
approx. 4 hours. After the intravenous application of the radiopharmaceutical, which takes place without scanning, the examination takes about 1 hour, the second examination is in 3 hours after the application, the patient does not need to spend this time at the nuclear medicine workplace. The scan is repeated after 24 hours.
Radiopharmaceutical:
99mTc – tectrotide
Method of application:
Intravenous
Examination methodology:
The patient is injected with the radiopharmaceutical and the first scan is performed approximately 60 minutes after application. The patient lies down on the gammacamera table and we perform a full-body scan. This is repeated identically 3 hours after application. To increase the sensitivity and specificity of the examination, targeted SPECT is added. At 24 hours after application, we take static images of the chest and abdomen.
Principle:
The radiopharmaceutical, as a noradrenaline analogue, accumulates in the catecholamine secretory granules of neuroendocrine tissues.
Indications:
Pheochromocytoma
neuroblastoma
carcinoid
medullary thyroid carcinoma
gastrinoma
insulin
glucagonoma
vipoma
adrenal medullary hyperplasia
Patient preparation:
2 days before application, on the day of application and 3 days after application thyroid blockade with chlorigen
discontinuation of tricyclic antidepressants, some antihypertensives and cardiovascular drugs, sympathomimetics
Duration of examination:
This is a 2-day examination
Radiopharmaceutical:
123I – metajodbenzylguanidine
Method of administration:
Intravenous
Examination methodology:
The radiopharmaceutical is injected intravenously into the patient and the first scan is performed 4 hours after application. The patient lies down on the gamma table and we take a full body scan. The scan takes about 30 minutes. The next part of the scan takes place 24 hours after application. We first perform a full-body scan followed by a targeted SPECT. The scanning time is approximately 1.5 hours.
Patient appointment
Patients can make an appointment for an examination: by sending an application form by post, by phone, by e-mail, in person or via an online form. After submitting the form, we will contact the patient to arrange an appointment.
