What is Nuclear Medicine?

Nuclear medicine is a form of sensitive imagingthat uses minimal amount of radioactive materialto diagnose and treat diseases such as cancers,heart diseases, gastrointestinal, brain andendocrine (thyroid, parathyroid) disorders.These tests can detect diseases at very earlystage before it can be seen on any other imagingmethods.

Diagnosis

Depending on the type of nuclear test, theradiotracer is either injected, swallowed orinhaled as a gas which eventually collects andaccumulates in the organ or area of the bodybeing imaged.

Treatment

Nuclear medicine also offers a wide range oftherapeutic procedures like radioactive iodine(I-131) therapy to treat thyroid cancer andbenign thyroid diseases. Nuclear medicine alsooffers treatment for bone pains from the spreadof cancer, thickening of blood, and tumoursoriginating from the endocrine and nervoussystem.

What are some common uses of theprocedure?

Radioactive materials are used in imagingprocedures to visualise the structure andfunction of different organs in the body. Thisprocedure can be used to diagnose and stage

cancers and see the response to therapy. It canalso identify and locate other abnormalities ordisorders of various organs.

Nuclear medicine therapies:• Radioactive iodine (I-131) to treat

overactive thyroid gland (hyper-thyroidism) and thyroid cancer.

• Radioactive materials to treat pain fromspread of tumour to the bones.

How can I prepare for the procedure?

Preparation for different scans varies fromfasting for some hours, discontinuing differentmedications, avoiding beverages and is basedon the scan that you will undergo. Physician canask about any medication that you are takingand advise discontinuing it. The doctor will alsoask about any allergy that you might have. Allwomen should always inform their physician ifthere is any possibility that they are pregnant orif they are breastfeeding. If required, apregnancy test will be performed before theprocedure.

How does the procedure work?

With ordinary x-ray examinations, an image ismade by passing x-rays through the body froman outside source. In contrast, nuclear medicineprocedures use a radioactive material called aradio-pharmaceutical or radiotracer, which isinjected into your blood, swallowed or inhaled.This radioactive material accumulates in theorgan or area of your body being examined,where it gives off gamma rays. A gamma

camera, PET scanner or probe detects thisradiation and with the help of a computercreates pictures.

How is the procedure performed?

Nuclear medicine imaging is usually performedon an outpatient basis, but can be performed onhospitalised patients.

You will be positioned on an examination table. Ifnecessary, a nurse or technologist will insert anintravenous line into a vein in your hand or arm.

It can take anywhere from several seconds toseveral days for the radiotracer to travel throughyour body and accumulate in the organ or areabeing studied. As a result, imaging may be doneimmediately, a few hours later, or even severaldays after you have received the radioactivematerial.

While the camera is taking pictures, you willneed to remain still for brief periods of time. Insome cases, the camera may move very closeto your body. This is necessary to obtain thebest quality images. If you are afraid of closedplaces, you should inform the staff.

Young children may require gentle wrapping orsedation to help them hold still. If your doctorfeels sedation is needed for your child, you willreceive specific instructions regarding when andif you can feed your child on the day of theexam. A doctors’ team will be available duringthe exam to ensure your child's safety whileunder the effects of sedation.

When the examination is completed, you may beasked to wait until the technologist checks theimages in case additional images are needed.Occasionally, more images are obtained forclarification or better visualisation of certainareas or structures. The need for additionalimages does not necessarily mean there was aproblem with the exam or that somethingabnormal was found, and should not be a causeof concern for you.

If you had an intravenous line inserted for theprocedure, it will usually be removed unless youare scheduled for an additional procedure thatsame day requires an intravenous line.

During radioactive iodine (I-131) therapy, whichis most often an outpatient procedure, theradioactive iodine is swallowed, either in capsuleor liquid form. Patients receiving high doseradioactive iodine are admitted, as perinternational recommendation till radiationexposure is within accepted limits.

What will I experience during and afterthe procedure?

Most nuclear medicine procedures are painlessand are rarely associated with significantdiscomfort or side effects.

When the radiotracer is given intravenously, youwill feel a slight pin prick when the needle isinserted into your vein.

When swallowed, the radiotracer has little or notaste. When inhaled, you should feel no

differently than when breathing room air orholding your breath.

With some procedures, a catheter may beplaced into your bladder, which may causetemporary discomfort.

Unless your physician tells you otherwise, youmay resume your normal activities after yournuclear scan. If any special instructions are nec-essary, you will be informed by a technologist,nurse or physician before you leave the NuclearMedicine department.

It may also pass out of your body through yoururine or stool during the first few hours or daysfollowing the test. You should also drink plentyof water to help flush the radioactive material outof your body, need to flush two times well afterpassing urine or stools.

Who interprets the results and how do Iget them?

Nuclear Medicine Physicians administerradionuclide therapies and interpret the images.Registered hospital patients will get their reportsfrom the medical record department in ServicesBuilding. The outside referred patients will gettheir reports the next day from the reception ofnuclear medicine

Is the scan dangerous?

Nuclear medicine tests are very safe becausevery small amount of radioactive material isused.

PGS/NUC/01/01/E

Patient Guide Series

NUCLEAR MEDICINEWhat happens afterwards?

You can go home as soon as the scan iscompleted. You need to follow the doctor’sinstructions after the scan.

What if I cannot keep my appointment?

You should contact the Nuclear Medicinedepartment as soon as possible on thetelephone numbers given below. The staff in theNuclear Medicine Department will be happy toanswer any questions you may have.

Where can you get help?

If you have any queries or problems related to yourprocedure, please contact the Nuclear MedicineDepartment at +92 42 3590 5000 Ext. 4192 or4193.

NOTES

Shaukat Khanum Memorial Cancer Hospital and Research Centre7A Block R-3, Johar Town, Lahore, Pakistan

Tel: +92 42 3590 5000 Ext 4192 - 4193| Fax: +92 42 3594 5150 www.shaukatkhanum.org.pk

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