In nuclear radiology, radioisotopes (compounds containing radioactive forms of atoms) are introduced into the body for the purpose of imaging organs, evaluating organ function, or localizing disease or tumors. Unlike regular x-rays in which x-ray beams are generated within a machine and projected through the patient, in isotope studies the radiation (gamma rays) originating from the “dye” that is administered. Special detector cameras are placed close against the area of interest for a period of time, and once enough gamma rays are “seen,” a computer creates an image showing where the isotope settled within the organ or body. Generally, nuclear medicine differs from most other imaging modalities in that the test primarily shows the physiological function of the system being studied as opposed to the anatomy. However, correlation with other imaging, clinical information, and laboratory results helps identify and confirm disease.
ACMH Hospital Nuclear Medicine department is staffed by three technologists with a combined experience of over 60 years. They operate with the latest equipment and the department is accredited by the American College of Radiology (ACR). This organization is comprised of a panel of experts who perform peer reviews every three years to ensure that the imaging is safe, effective, and accessible to those who need it.
How Do I Get An Appointment or More Information?
Our goal is to schedule your appointment in no more than three days from the time your physician orders your test. Your physician will give you a prescription and either their office or you may call personally to schedule. The number for appointment scheduling is 724-543-8131. The schedulers will give you specific instructions regarding preparing for your test when you or your doctor’s office call to schedule an appointment. If you have any questions regarding medications you may be taking, please check with your ordering physician.
What Are The Scheduling Hours?
Monday through Friday 6 am – 4:30 pm; Saturday hours may be available on an as needed basis for specific procedures.
On call for emergencies 24/7.
When Will I Know the Results?
The results of your imaging test will be “read” by a radiologist and the results will be sent to your referring doctor within 48 hours or sooner. The referring doctor will need time to review the results and develop a plan of care before contacting you.
How Does A Doctor Outside of the ACMH Hospital Network Get My Imaging Results
You may request a copy of your records be sent to another physician. The correct name and spelling of the physician, location, and fax number is helpful in expediting this transfer of records. If you prefer, a CD will be made with your images and interpretation report for you to pick up and take with you to an appointment with a physician outside of the ACMH network. We also maintain the ability to provide actual films as needed.
What Studies Are Done in Nuclear Medicine?
We have the capability to do a wide array of tests including, but not limited to, the following procedures:
1. Cardiolite Stress Test (also called cardiac or myocardial imaging)
A Cardiolite Stress Test takes pictures of your heart muscle to check blood flow through your coronary arteries and evaluate how well your heart muscle contracts between beats. Two injections of cardiolite are given intravenously, before and during exercise. This test will show how your heart performs when it needs to work hard. The test may take up to 4 hours to complete. Other than the minor discomfort from a needle stick, the test is painless. Please follow the test preparation given to you by your physician.
2. Bone Scan
A bone scan is a nuclear scan that identifies new areas of bone growth or breakdown. It can be done to evaluate damage to the bones, detect cancer that has spread (metastasized) to the bones, and monitor conditions that can affect the bones (including infection and trauma). A bone scan can often detect a problem days to months earlier than a regular x-ray test.
For a bone scan, a radioactive substance is injected into a vein in the arm. The tracer then travels through the bloodstream and into the bones. This injection needs to circulate for 3 hours before pictures are taken. (During this time the patient’s activities are unrestricted.) A special camera (gamma) takes pictures of the tracer in the bones. This helps show cell activity and function in the bones. Areas that absorb little or no amount of tracer appear as "cold" spots, which may indicate a lack of blood supply to the bone (bone infarction) or the presence of certain types of cancer. Areas of rapid bone growth or repair absorb increased amounts of the tracer and show up as bright or "hot" spots in the pictures. “Hot” spots may indicate the presence of a tumor, a fracture, or an infection. The length of the scan depends upon the type of imaging requested by your physician but may run anywhere from 45 up to 90 minutes.
3. Thyroid Scan
A thyroid scan uses a radioactive tracer, which is in capsule form and swallowed by the patient much like a Tylenol, and a special camera to measure how much tracer the thyroid gland absorbs from the blood. A thyroid scan is done to find problems with the thyroid gland. A thyroid scan may be done to check for thyroid nodules, or it may be done with a radioactive iodine uptake test (RAIU) to check how well the thyroid gland is working.
A thyroid scan can show the size, shape, and location of the thyroid gland. It can also find areas of the thyroid gland that are overactive or underactive. The camera takes pictures of the thyroid gland from three different angles. The radioactive tracer used in this test is either iodine or technetium.
The iodine testing procedure is a three step process. The initial visit takes 15 minutes to explain the procedure and administer the capsule. Then there is a 6 hour period during which the patient will have some dietary restrictions but enjoy unrestricted activity. After 6 hours, there is a 30 minute imaging session which will be followed by another 10 minute session which occurs 24 hours later.
The technetium thyroid scan is done with a radioactive injection into a vein and is completed in one visit.
4. Hepatobiliary Scan
A hepatobiliary scan (HIDA scan) is done to evaluate the function of the liver in making and excreting bile, the drainage system (bile ducts), and the gallbladder for possible blockage or malfunction. This will frequently be done together with gallbladder ultrasound for a more complete evaluation.
You will lie flat on your back on the imaging table. You will receive an injection of a radioactive substance in a vein in your arm. This material travels through the bloodstream, and is eventually cleared from the bloodstream by the liver. You will not feel anything from this injection.
During the scans the camera will be positioned over you. Images will be recorded for up to one hour or, on rare occasions, longer. For some patients, a second injection through the same single needle stick will be done later during the test. This can be done to either help the gallbladder show up better (using morphine), or to trigger it to empty (using CCK/cholecystokinin). Occasionally the injection of CCK later in the test will recreate the patient's symptoms, causing nausea or cramping, but this is nothing to be concerned about.
You should have had nothing to eat or drink (NPO) for at least 4-6 hours before beginning the test. You may take your regular medicines (with the exception of pain medications) with a sip of water.
The test takes about 90 minutes, occasionally longer.
5. White Blood Cell Scan or Leukocyte Scan
A WBC scan is a nuclear scan in which a radioactive material is attached to a sample of white blood cells. It is done to locate areas of infection or inflammation.
Blood will be taken from one of your veins. White blood cells are separated from the rest of the blood sample and then mixed with a small amount of a radioactive material (radioisotope) called indium-111 or Ceretec. The cells with the radioactive material are considered "tagged."
About 2 or 3 hours later, the tagged white blood cells are returned to your body through injection into a vein. The tagged cells gather in areas of inflammation or infection.
Approximately 2 to 24 hours later, your body is scanned while you lie on a table. The scanner detects the radiation given off by the radioactive white blood cells. A computer converts the detected radiation into an image that can be viewed on a screen or recorded on film.
This scan takes about 1 hour. At this time, you will be instructed whether or not you need to return for a second imaging session.
After the test is completed, no recovery time or special precautions are necessary. You typically may resume a normal diet, activity, and medications.
There is usually no need for fasting, special diets, or preliminary medications. You must sign a consent form and remove jewelry, dentures, or metal before the scan.
6. Thyroid therapy for hyperthyroidism or cancer
In accordance with your physician’s order, you will be contacted and instructed in preparation for this test.