Below is a list of some frequently asked questions, but please feel free to contact us if you need additional information. We are always pleased to assist you.

What is a Nuclear Medicine Examination?
A nuclear medicine examination relies on specific radioactive isotopes or radiotracers designed to detect specific suspected pathology. Radioactive isotopes emit low dose radiation which can be detected and imaged by a special camera. The isotope is chosen to optimally detect what is clinically suspected.

Why has my doctor order a Nuclear Medicine Examination?
Your doctor ordered the nuclear medicine examination:

• Bone scan
• Lung scan
• Gallium scan
• Indium III WBC scan


For the reasons described under the specified examination.

Who performs and interprets a Nuclear Medicine Examination?
Your examination will be performed by a technologist with special training and expertise in nuclear medicine examinations. The technologist functions under the direct supervision of a radiologist. The radiologist will select the radioisotope tracer, the dosage, timing and positioning for the scan as indicated by your symptoms.

What is special about having your nuclear medicine examination at MMC?
Your Nuclear Medicine study at Mercy Medical Center will be interpreted by a Board Certified Radiologist. Radiologists are trained in the varying sensitivities and specifics of each radiotracer and in the potential for hazards related to the isotope that must be avoided. Radiologists are also trained for distinguishing potential artifacts that may be mistaken for pathology.

What should I do to prepare for a Nuclear Medicine Examination?
The preparation for each of the nuclear medicine examination differs and is described under the specified examination. For most nuclear medicine studies, there is no special preparation required.

What are the risks?
The risks are extremely minimal and described under the individual specific examinations.

What are the alternatives?
The alternative examination is described under each of the specific nuclear medicine examinations described.

What can I expect after the Nuclear Medicine Examination?
Rarely, localized pain or a bruise may occur at the site of injection. There are no major aftereffects of a nuclear medicine examination.

What happens to the results?
A written report of the results is sent to your referring physician and any other physician you request. Copies of the report can be obtained through your referring physician's office. The radiographs are the property of the institution as are biopsy slides or blood samples. Copies of the radiographs can be obtained by contacting the file room. There is a charge for obtaining film copies and mailing them to your physician.

Will other tests be ordered?
Probably yes, as nuclear medicine tests are in general very sensitive but not specific. The specific follow up examination is dependent on the type of nuclear scan initially performed and the suspected clinical condition.

Bone Scan
Why has my doctor ordered a Bone Scan?
A bone scan is very sensitive and may identify abnormalities in the bones and joints that may not yet be visible on x-rays.

What should I do to prepare for the Bone Scan?
It is important to be well hydrated by drinking several glasses of water or other fluids. No other preparation for the bone scan is needed.

How is the Bone Scan performed?
A radioisotope tracer containing a small amount of radioactive material is injected into a vein through a small needle. In some cases an initial scan will be performed immediately after the injection to determine the blood flow pattern to the part of the body being scanned. Following the injection, it takes two to three hours for the radioisotope to enter the bones. During this time you should drink several glasses of water or other fluids. After two to three hours, the scan is performed using a gamma camera, which detects the amount and location of the radioisotope in the bones. The scan with the gamma camera takes approximately thirty to sixty minutes.

What are the risks?
An allergic reaction to the injected radiotracer is extraordinarily rare. A small dose of radiation, similar to that obtained from an x-ray study occurs during the bone scan.

What are the alternatives to a Bone Scan?
In certain instances an MRI examination may provide information similar to that obtained from a bone scan.

What can I expect after the procedure?
There are no aftereffects from a bone scan. The radioactivity in the body disappears by 48 hours.

Will other tests be ordered?
Based on the results of the bone scan, other tests may be suggested including routine radiographs, and/or a CT, MRI or ultrasound.

Lung Scan
Why has my doctor ordered a Lung Scan?
A lung scan is ordered to determine if blood clots in the arteries of the lungs are the cause of chest pain, shortness of breath, or abnormal findings on x-rays or laboratory examinations.

What should I do to prepare for the Lung Scan?
There is no preparation required for a lung scan.

How is a Lung Scan performed?
There are two parts to a lung scan.

• The first part is known as the ventilation scan. For the ventilation scan a mask is placed over your face and you inhale a radioactive aerosol. A scan is then performed with a gamma camera, which identifies the distribution of the aerosol in the lungs.
• The second part of the examination is the perfusion scan. The perfusion scan involves an injection of a radioactive isotope tracer into a vein in the arm using a small needle. Immediately after the injection, scans are done with a gamma camera, which show the distribution of the injected radioisotope in the lungs.

What are the risks for a Lung Scan?
There are no significant risks associated with a lung scan. Radiation dose received from a lung scan is similar to that of a chest x-ray.

What are the alternatives to a Lung Scan?
A CT scan with injection of contrast agent or a pulmonary angiogram may be done as an alternative or in addition to the lung scan.

What can I expect after the procedure?
There are no after effects from the lung scan.

Will other tests be ordered?
A chest x-ray performed within six hours of the lung scan is needed for comparison. Additional tests including pulmonary angiography or a CT Scan may be suggested based on lung scan results.

Gallium Scan
Why has my doctor ordered a Gallium Scan?
A Gallium Scan is ordered when infection, inflammation, or tumor is clinically suspected.

What should I do to prepare for the Gallium Scan?
Gallium accumulates within the bowel. The nuclear medicine technologist prior to the scan, and 48 or 72 hours after the injection may recommend laxatives or enemas.

How is the Gallium scan performed?
A tracer dose of a radioisotope Gallium-67 citrate is injected in the vein through a small needle. A Gamma camera scan is obtained 48-72 hours later.

What are the risks for a Gallium Scan?
There are no immediate risks to a Gallium Scan. The radiation dose of a Gallium Scan is similar to that obtained from having a chest x-ray.

What are the alternatives to a Gallium Scan?
Radioactive Indium III labeled White Blood Cell scan, CT, or an MRI Examination may be alternatives.

What can I expect after the procedure?
No aftereffects are expected following a Gallium scan. Laxatives or enemas may be recommended 48 to 72 hours following he isotope injection.

Will other tests be ordered?
A radionuclide Bone Scan may be ordered to compare with the Gallium Scan. Usually, other imaging tests including a radiographic examination, a CT, MRI or an Ultrasound examination may be ordered based on the results of the Gallium Scan to further clarify the diagnosis.

Indium-111 White Blood Cell Scan
Why has my doctor ordered an Indium-111 White Blood Cell Scan?
An Indium-111 WBC Scan is ordered when an infection is clinically suspected.

What should I do to prepare for the Indium-III White Blood Cell Scan?
There is no preparation required prior to the scan.

How is an Indium III WBC Scan performed?
An Indium-111 WBC Scan involves the injection of radioactive white blood cells into the vein through a small needle followed by a Gamma camera scan to confirm or exclude a clinically suspected infection.

What are the risks of an Indium III White Blood Cell Scan?
There are no significant risks to the scan. The radiation dose received is similar to that obtained from a chest x-ray.

What are the alternatives to an Indium III White Blood Cell Scan?
Alternatives include Gallium Scan, CT Scan, aspiration and/or biopsy.

What can I expect after the procedure?
There are no after effects expected.

Will other tests be ordered?
Other tests including a bone scan and a sulfur-colloid bone marrow scan may be ordered for comparison with the Indium-111 WBC scan. CT, MRI and/or Ultrasound examinations may be suggested based on the results of the Indium-ill White Blood Cell scan.

Nuclear Stress Test (Thallium Stress Test)
Why did my doctor order a Nuclear Stress Test?

• If you are experiencing chest pain
• Have a family history of Heart Attack
• If you need an operation.


The stress test is designed to assess the health of your heart in an effort to see if any blood flow to the heart is blocked.

Nuclear Stress Test Prep
NO CAFFEINE 24 hrs. before the test day. This includes caffeine free soda and decaffeinated coffee. NO Soda because many of then still contain enough caffein to affect the test. NOTHING TO EAT OR DRINK 6 HOURS BEFORE THE TEST.

How is a Nuclear stress Test performed?
The Nuclear Stress Test is comprised of 3 parts.

• Part I - An IV line is started and a small amount of a radioactive isotope is injected. Images are obtained under the gamma camera.
• Part II - Is the stress portion. You will be either walking on the treadmill or be given medication that mimics exercise and a second injection is given through the IV line at this time.
• Part III - A second injection more images under the camera.


The test takes about 3 hours.

What are the risks of Thallium Stress Test?
There are no significant risks of the test. Isotopes are injected giving an exposure is similar to that of chest x-ray. The doctor monitors your EKG and a nurse monitors blood pressure during the stress portion. If, at any point, the doctor feels that you are at risk of any problem, he/she will stop the test. The medications effects are reversible.

What are the alternatives to the Nuclear Stress Test?
The alternatives to Nuclear Stress Test are a regular EKG stress test or a Stress Echo. These tests are usually not the preferred test as they only give similar information. The Cardiac Catheterization is a very good test but more invasive in comparison with the Nuclear Stress Test and is done ONLY if a doctor feels it is necessary.

What can I expect after the procedure?
There are not usually any after effects of the test. In some cases patients that take the medication may experience a headache at which time Tylenol is usually the answer.

Will other Tests be ordered?
In a small percentage of cases the patient is recommended for cardiac catheterization in order to confirm and to fix any heart problems.

Gastric Empty Study
Why did my doctor order a Gastric Empty Study?
The doctor probably suspects that you are digesting your food very slowly. This usually happens because the muscles in the walls of your stomach are less active than they should be. This is a common problem for people with diabetes but it can affect anyone. Common symptoms are nausea, bloating, gas pains, and even vomiting.

What do I have to do before the test?
The only preparation for the test is to have NOTHING to eat or drink for 6-12 hours. For this reason we usually tell patients not to eat after midnight and we try to schedule the test for the morning. Usually about 9:00 AM

How is the test performed?
You will be given scrambled eggs, milk, and two slices of bread to eat. The eggs have been treated with a radioactive tracer. Like getting an X-ray, you can’t see it, you can’t taste it, and it will not effect you. After you eat the eggs we will proceed to take images in our gamma camera. We will take one image every 15 minutes for 2 hours. The entire test takes about two and a half hours.

What are the risks of the test?
An allergic reaction to the tracer is extraordinarily rare. By eating the eggs, the patient is exposed to a small dose of radiation similar to that obtained from an X-ray study.

What are the alternatives to the test?
There are no alternatives to this test that give exactly the same information but similar information can be obtained with an upper endoscopy.

What can I expect after the procedure?
There are no aftereffects from a Gastric Empty Study. The radioactivity in the body disappears quickly and is gone in 48 hours.

Perhaps an Upper Endoscopy, CT, or MRI could be recommended.

THYROID UPTAKE AND SCAN
Why did my doctor order a Thyroid Uptake and Scan?
The doctor may suspect that your thyroid is not functioning properly. The thyroid regulates thyroid hormones in the blood and a simple blood test could show that the hormones are high or low. Another reason the doctor may have sent you for this test is if he felt a lump during an external examination of the neck

Is there anything I need to do before the test?
There are a few things that you need to make sure of, before you come for the test. You should make sure that you have not had CT contrast for 6 weeks before taking the pill because the contrast could alter the results of your test. Usually all thyroid medications are stopped by your endocrinologist. We usually try to lead people away from eating diets high in iodine, such as, shellfish, seaweed, and multi-vitamins with iodine in order to better our results. We also advise patients not to eat 1 hour after taking the pill so that it can be absorbed without competition from other foods.

How is a Thyroid uptake and scan performed?
A pill containing a very small amount of radioactive iodine is measured and then given to you to swallow. The next day (20 to 26 hours) the patient comes back the thyroid is measured to see exactly how much of the iodine accumulated in the thyroid. We also take some images of the thyroid to see exactly how and where the iodine is taken up. The uptake of the Iodine correlates directly with the metabolism of the thyroid and can tell if the thyroid is normal, overactive, or under active. If there is a nodule, it will also tell us information about the metabolism of that nodule as well.

What are the risks of the thyroid uptake and scan?
An allergic reaction to the tracer is extraordinarily rare, even if you are allergic, because of the extremely low amount. By taking the pill, the patient is exposed to a very small dose of radiation similar less than that obtained from an X-ray study.

What are the alternatives to a Thyroid Uptake and Scan?
The doctor could rely on a blood work alone. They can also do a sonogram but these tests are usually done along with the Thyroid Uptake and Scan.

Will other tests be ordered?
Depending on what the results of this test show, they could order a sonogram, CT scan or MRI. They may also order Radioactive Iodine therapy. In the rare cases that involve thyroid cancer, surgery may also be necessary with.

What can I expect after the test is done?
There are no after affects from this test. The radioactive tracer will disappear quickly and will be out of your system in 3-4 days.

OCTREOSCAN
Why did my doctor order an Octreoscan?
Octreoscan is a Nuclear Medicine Procedure designed to find tumors. The doctor usually orders this test if he suspects that you may have a carcinoid type of tumor. He decides this based on blood work or pathology reports from previous biopsy or surgery.