Nuclear Medicine


Part 1 | Part 2 | Part 3 | Part 4

Lower Columbia Nuclear Medicine and PET (Positron Emission Tomography) Imaging is an imaging practice providing a wide range of diagnostic and therapeutic procedures for patients in the Lower Columbia Region. Our goal is to provide excellent medical imaging in a patient sensitive manner. Our staff of Board Certified Nuclear Medicine physicians and technologists strive to ensure that procedures and results are provided in the most accurate, timely and caring manner possible.

Nuclear Medicine

Lower Columbia Nuclear Medicine and PET Imaging provides a wide range of nuclear functional imaging and therapeutic procedures encompassing the musculoskeletal, gastrointestinal, nervous, genitourinary, cardiovascular, endocrine and respiratory systems.

PET (Positron Emission Tomography) Imaging

Lower Columbia Nuclear Medicine and PET Imaging provides PET Imaging for the diagnosis, staging, and restaging of various cancers, evaluation of cardiac viability, and for brain imaging to help diagnose Alzheimer’s disease and to localize seizure focus.

SPECIAL NOTE: All isotopes are special orders. If an exam must be canceled, please notify Nuclear Medicine 24 hours prior to the exam.

Procedure Guidelines


General Considerations

  • Almost all nuclear medicine procedures require intravenous injections of radioactive pharmaceuticals.

  • Pregnancy and breast feeding  is a strong relative contraindication to nuclear medicine scanning. Cases will be assessed individually by attending and nuclear medicine physicians.

Procedure List

Use the links below for specific test information.

Nuclear Medicine Procedures

Cardiovascular Procedures

Endocrine Procedures
Ejection  Fraction/Wall Motion  (MUGA)

Thyriod (Technetium 99m) Scan
SPECT Myocardial Perfusion Imaging with chemical stress Thyroid 1-123 Uptake and Scan
SPECT Myocardial Perfusion Scan with Treadmill stress Thyroid Cancer
Parathyroid

Gastrointestinal Procedures

Genitourinary Procedures
Hepatobiliary Renal Imaging (MAG-3)
Hepatobiliary (with CCK) GB Ejection Fraction Renal with Furosemide (Lasix)
Liver/Spleen Renal Imaging with Captopril
Liver SPECT  
Hepatic Hemangioma with SPECT Miscellaneous Proceduresiscellaneous Procedures
Gastric Emptying Scan  Gallium
GI Bleed

Meckel's Diverticulum (Ectopic Gastric Mucosa) Nervous System Procedures
Functional Brain SPECT

Respiratory Procedures

Skeletal Procedures
Lung Ventilation and Perfusion Bone (3 phase, limited or whole body)
Lung Quantification g Quan Bone SPECT
 

Therapeutic Procedures
1-131 Therapy, Hyperthyroidism
1-131 Therapy Thyroid Ablation/Metastases
Strontium-89 Therapy, Palliation of Pain From Bony Metastasis
 
 

Positron Emission Tomography (PET)
PET Oncology PET Brain
PET Cardiac

Cardiovascular Procedures

Ejection  Fraction/Wall Motion  (MUGA)

Clinical Indications Drug intervention studies (chemotherapy), cardiomyopa­thies, CAD, CHF, valvular heart disease.
Patient Preparation NPO 4 hours prior to exam
Time Frame 1 hour
Conflicting Examination or Medications None
   

SPECT Myocardial Perfusion Scan with Chemical Stress

Clinical Indications Chest pain, EKG changes, acute/old MI, CAD, pre and post CABG/angioplasty, inadequate level of exercise, COPD and severe peripheral vascular disease, presurgical clearance.
Patient Preparation Restrict xanthine medications (36-48 hours); NPO 4 hours prior to exam, no caffeine 24 hours prior to test.
Time Frame 2 - 4 hours
Conflicting Examination or Medications Allergy to aminophylline, resting hypotension, unstable angina, caffeine or nicotine, xanthine medications.

 SPECT Myocardial Perfusion Scan with Treadmill Stress

Clinical Indications Chest pain, EKG changes, rule out acute/old MI, CAD, pre and post CABG/angioplasty.
Patient Preparation Discontinue beta-blockers, calcium antagonists, and nitrates, if possible. NPO 4 hours prior to test. No caffeine 24 hours prior to test.
Time Frame 2 - 4 hours
Conflicting Examination or Medications Beta-blockers, calcium antagonists, nitrates, and caffeine.

Endocrine Procedures

Thyroid (Technetium 99m) Scan

Clinical Indications Thyroid nodule, substernal thyroid or mediastinal mass.
Patient Preparation None
Time Frame 1 hour
Conflicting Examination or Medications Synthroid - must be off 3-4 weeks prior to the exam. Iodine containing medications. Contrast agents, 2-3 months.

Thyroid 1-123 Uptake and Scan

Clinical Indications Hyperthyroidism (thyrotoxicosis), multinodular goiter, grave's disease, abnormal thyoid lab work, autonomous thyroid nodule.
Patient Preparation NPO 4 hours prior to dose (first appointment), TSH, T3, T4 should be done within 30 days of test.
Time Frame

2 hours over 2 days with 3 appointments:
DAY 1:
Appointment #1 - 30 minutes, Appointment #2 - 1 hour
DAY 2:
Appointment #3 - 30 minutes

Conflicting Examination or Medications

Thyroid Med Discontinue List:
• Radiographic contrast agents – 6 weeks
• Myelogram – 1 year
• Antithyroid drugs (PTU and Tapazole/methimazole) – 1 week
• Levothyroxine (Synthroid) – 6 weeks
• Triiodothyronine (Cytomel) – 2 weeks  

Thyroid Cancer

Clinical Indications Thyroid carcinoma, metastasis.  
Patient Preparation Patient receives I-131 oral dose 48-72 hours prior to scan. Serum pregnancy test (beta HCG) done within 3 days before test for all females in child bearing age (12-55, no exceptions). TSH will be done on all patients within 3 days before the test.  
Time Frame 2-1/2 hours, 48 hours apart:
Appointment #1 - 15 minutes
Appointment #2 - 2 hours, 15 minutes  
Conflicting Examination or Medications Thyroid Med Discontinue List:
• Radiographic contrast agents – 6 weeks
• Myelogram – 1 year
• Antithyroid drugs (PTU and Tapazole/methimazole) – 1 week
• Levothyroxine (Synthroid) – 6 weeks
• Triiodothyronine (Cytomel) – 2 weeks  

Parathyroid

Clinical Indications Hypercalcemia, renal stones or failure, history of para­thyroid tumors, bone disease, preoperative evaluation for parathyroidectomy (for hyperparathyroidism), elevated parathyroid hormone level.  
Patient Preparation None
Time Frame 2 - 4 hours  
Conflicting Examination or Medications None

Next (Part 2)