THYROID SCAN BONE SCAN POST CAPTOPRIL LUNG VENTILATION/PERFUSION SCAN
I-131 WHOLE BODY SCAN COLLOID LIVER SCAN DMSA RENAL SCAN RBC BLOOD POOL SCAN
DMSA (V) WHOLE BODY SCAN HEPATOBILIARY BRAIN SPECT SCAN MECKEL’S DIVERTICULUM IMAGING
PARATHYROID SCAN DTPA RENOGRAM VENTRICULAR SHUNT PATENCY MILK SCAN (GE Reflux)
DACRYOSCINTIGRAPHY
LYMPHOSCINTIGRAPHY
MUGA SCAN
STRESS THALLIUM
MIBG SCAN

thyroid1 THYROID SCAN

Pre Requisite :2-4 days prior to test off Antythyroid medication.
Time Required : 30 min.
Procedure : Tc99m Pertechnetate is injected intravenously, blood flow, blood pool and after 20 minutes static images will be acquired for anterior neck.
Indications :
•Determination of thyroid size, function and position.
•Evaluation of functional status of thyroid nodules.
•Differentiating Thyroiditis from Grave’s disease.
•Evaluation of Thyroid and neck masses.
•Quantitative thyroid uptake.
•Detection of ectopic thyroid eg. Lingual thyroid.
•To detect restrosternal extension in MNG or large goiters.

 
I-131 WHOLE BODY SCAN

Pre Requisite:3-4 weeks post total thyroidectomy, Off medication post surgery. Avoid Iodine intake 4-5 days prior the study. 3-4 hrs fasting.
Time Required:Scan Time 30 – 45 minutes.
Procedure : Day1 : I 131 capsule is given orally. Day 3 : I 131 Whole body scan is performed.
Indications :
•Detection of residual tissue in thyroid bed and local or distant thyroid mets after total thyroidetomy for Ca thyroid.
•Assessment of response to I- 131 therapy for Ca thyroid.

 
DMSA (V) WHOLE BODY SCAN

Prerequisite : No Prequisite.
Time Required:Scan Time 45- 60 minutes.
Procedure : Tc99m DMSA – V is injected intravenously, 2 hrs delayed whole body scan is acquired.
Indications :
•To detect medullary Ca thyroid metastases.

 
PARATHYROID SCAN

Prerequisite : No Prequisite.
Time Required: Scan Time 30 – 45 minutes.
Procedure : 4 mCi of 99mTc(O4-) is injected intravenously and sequential dynamic images and static blood pool and 20th minute are acquired for anterior neck. Without moving the patient 20 mCi of 99mTc Sestamibi is injected intravenously and static images at 20th minute (Early) and 45 mins (delayed) are acquired for the ant. neck.
Indications :
•Evaluation of primary or secondary hyperparathyroidism.
•Parathyroid adenomas or hyperplasia prior to surgical removal.

 
STRESS & Rest MYOCARDIAL PERFUSION IMAGING (THALLIUM SCAN)

Prerequisite : Off beta blockers 48 prior the study. 4hrs fasting. No medication on the day of scan.
Time Required: Scan Time 30 – 45 minutes .
Procedure : Patient has to undergo physiological / pharmacological stress. 99mTc Sestamibi is injected when patient achieves 85% THR . 45 mins post injection scan is performed. Almost after 1hour 99mTc Sestamibi is again injected to the patient in the resting position(SOS post nitrate) . 45 mins post injection scan is performed.
Indications :
•Diagnosis of coronary artery disease.
•Prognosis of known coronary artery disease.
•Risk stratification in known or suspected CAD.
•Suspected restenosis after CABG.
•Evaluation of PTCA / stent, anti – angina drugs.
•Pre – operative cardiac risk assessment.
•Assessment of myocardial viability.

 
Bone Scan BONE SCAN

Prerequisite: No Prequisite.
Time Required: Scan Time 30 – 45 minutes .
Procedure : 20 mCi of Tc 99m M.D.P. is administered intravenously and after 2.5 hours anterior and posterior images is acquired of the whole skeleton.
Indications :
•Screen for bone metastases in patient with malignancy.
•Infection (osteomyelities vs. cellulitis).
•Evaluation of suspected fracture and stress fractures.
•Evaluation of avascular nerosis and vascularity of bone graft.
•Evaluates response to chemo, or radiation treatment for cancer.
•Evaluation of prosthesis for loosening or infection.
•Evaluation of nonspecific X-ray/ MRI bone signals.
•Metabolic bone disease.

 
COLLOID LIVER SCAN

Prerequisite: No Prequisite.
Time Required: Scan Time 30 – 45 minutes .
Procedure : Tc 99m Phytate is injected intravenously and following that images in multiple projections (anterior, anterior with costal marker, posterior, right and left laterals and right and left oblique) were acquired of the abdomen.
Indications :
•To assess hepatocellular dysfunction in diffuse liver disease liver disease.
•Suspected chronic liver disease (7cirrhosis).
•Assess hepatic function in chronic alcoholics.
•Evaluation of splenomegaly.

 
HEPATOBILIARY SCINTRAPHY (HIDA SCAN)

Prerequisite: No Prequisite.
Time Required: Scan Time 2 – 24 hours
Procedure : Patient is primed with syp Gardinal 5mg/kg for 5 days prior to the study. 2 mCi 99m Tc Mebrofenin is injected intravenously after skipping one normal feed. Dynamic images are obtained for 20 minutes. Second set of dynamic images are obtained post feed for 20 minutes. Delayed static images may be acquired till 24hours.
Indications :
•Evaluation of suspected acute cholecystitis.
•Congential abnormalities of biliry tract disorders.
•Evaluation of commonbile duct obstruction.
•detection of bile extravassion (biliry leaks).

 
DTPA RENOGRAM (GLOMERULAR FUNCTION) / EC (MAG-3) RENOGRAM (GLOM+ TUBULAR FUNCTION)

Prerequisite: Good Hydration.
Time Required: Scan Time 45mins – 2 hours.
Procedure:Tc99m DTPA is injected IV after ensuring good hydration of the patient. I.V. lasix is given after 10 mins of tracer injection. Sequential dynamic images are obtained for 31 minutes followed by post void and 1hour delayed image.
Indications :
•Evaluation of differential renal function.
•Evaluation of obstructive uropathy.
•Evaluation of unequal sized kidney / ? agenesis of kidney.
•Indirect radio nuclide cystography of VU reflux.
•Follow up renal transplantation.

 
POST CAPTOPRIL RENOGRAM (SUSPECTED RENAL ART. STENOSIS)

Prerequisite: Good Hydration. Off medications 2-3 days prior study.
Time Required: Scan Time 45mins for each scan.
Procedure:
A) Baseline : 4 mCi of Tc DTPA is injected intravenously after ensuring good hydration of the patient. Dynamic images are obtained for 31 minutes .
B) Post Captopri l: Patient is given Tab. Enalepril & similar imaging protocol is followed 2 hours after the Baseline study.
Indications :
•Evaluation of reno – vascular hypertension.

 
DMSA RENAL SCAN (CORTICAL FUNCTION)

Prerequisite: Good Hydration.
Time Required:Scan Time 15mins.
Procedure: Tc99m DMSA is injected intravenously after ensuring good hydration of the patient. Static images in posterior, LPO & RPO views are acquired at 2.5 hrs post injection.
Indications :
•Diagnosis of acute pyelonephritis.
•Diagnosis of renal scarring.

 

BRAIN SPECT (Cerebral perfusion scan)

Prerequisite: No pre requisite.
Time Required: Scan Time 30mins.
Procedure: Tc99m ECD in injected intravenously & immediate spect images of skull is acquired.
Indications:
•Alzheimer’s disease.
•Differential diagnosis of various forms of dementia.
•Detection of epileptogenic foci.

 
Ventricular shunt patency study (cisternography)

Prerequisite: No pre requisite.
Time Required: Scan Time 30mins.
Procedure:
Indications :
•Study of CSF dynamics.

 
LUNG VENTILATION/PERFUSION SCAN

Prerequisite: Preferably over night fasting.
Time Required: Scan Time 45mins.
Procedure: Lung Ventilation: 99m Tc DTPA- Aerosol is given through nebulizer for inhalation for 10 minutes and static images are acquired in multiple projections (Posterior, Anterior, RPO, RAO, LAO, LPO, Left lateral and Right lateral). Lung Perfusion: Tc 99m M.A.A. is injected intravenously in supine position and same imaging protocol is followed as for Lung Ventilation.
Indications :
•Pulmonary thromboembolism.

 
RBC BLOOD POOL SCAN

Prerequisite: No Pre Requisite.
Time Required: Scan Time 45mins – 24 hrs.
Procedure: Invivo RBC Labeling Method: 20 minutes after the intravenous administration of stannous pyrophosphate (cold Kit), 10 mCi of 99m Tc (O4-) is injected intravenously by positioning the patient supine covering the anterior abdomen & Perfusion images (2sec/fr x 60 frames) followed by dynamic images (1min/fr x 60 frames). There after delayed static images are acquired. If required TOMO images may be acquired.
Indications :
•Liver hemangiomas.
•Detection and localization of gastrointestinal bleeding.

 
MECKEL’S DIVERTICULUM IMAGING

Prerequisite: 2-4 hrs fasting.
Time Required: Scan Time 45mins.
Procedure: 99mTc is injected intravenously under the camera and dynamic images are acquired for 30 minutes immediately thereafter of the anterior abdomen, followed by static images of the LAO , RAO views and post void static image of the abdomen.
Indications :
•Detection and localization of Meckel’s diverticulum.

 
MILK SCAN (GE Reflux)

Prerequisite : No Pre Requisite.
Time Required: Scan Time 45mins.
Procedure : 99mTc-DTPA is fed orally to the baby mixed in 5 ml milk. & then unlabelled 50 ml milk is given to wash the esophagus and sequential dynamic images are acquired for 30 minutes (10sec/frame) immediately thereafter. Static anterior & posterior abdomen image was taken after 1 hour.
Indications :
•Detection of GE reflux in infants having LRTI.

 
MIBG SCAN

Pre Requisite : No Pre Requisite.
Time Required: Scan Time 45mins.
Procedure : Orally one tea spoon twice a day of Colloidal Iodine solution is started 2 day prior to injection and throughout the study. 131 I MIBG (Meta Iodo Benzyl Guanidine) is injected intravenously and whole body views of the upper torso (Anterior and Posterior ) are acquired at 4, 24 & 48 hours.5mins .
Indications :
•Pheochromocytoma.
•Neuroblastoma.
1)TESTICULAR SCAN
•Differentiating epididymitis from torsion.
2)Salivary gland scan
•Stenosis of salivary gland for dryness of mouth.
3)Lymphoscintigraphy
•To differentiate lymphoedema from venous pathology.

 
MUGA SCAN

Technique
In vivo RBC Labeling method: Twenty minutes after the intravenous administration of stannous pyrophosphate, 25 mCi of 99m Tc (O4-) is injected intravenously. Gated dynamic images are acquired for 45 deg LAO, ANTERIOR and 70 deg LAO.

INDICATION: To evaluate LVEF ( Ejection Fraction)

 
DACRYOSCINTIGRAPHY

Technique
With patient lying supine under the gamma camera,100microCi of 99mTc O4- was instilled at the outer canthus of both the eyes with the help of a micropipette.The patient was instructed to blink frequently when sequential dynamic images were acquired for both the eyes immediately for 15 mins (128X128 matrix at the rate of 15 Secs/frame). Static images were acquired at 15 mins , 1 hour & at 2 hours post instillation

INDICATION :For assessing the patency of nasolacrymal duct in patients having epiphora  

 
Lymphoscintigraphy

Technique
Technique: 0.2 mCi of 99mTc-Sulphur colloid each is administered in two web spaces of both the lower limbs and immediate post injection dynamic and 30 mins, 3hrs static images are acquired for the lower limbs, anterior knees, thighs, anterior pelvis and anterior abdomen.

INDICATION : To differentiate lymphoedema from venous pathology.  

 
Direct Cystogram

Technique
2 mci 99mTc-DTPA is administered into the bladder via supra pubic puncture under aseptic conditions followed by an appropriate volume of sterile normal saline. The filling and voiding images are acquired continuously with the patient lying supine followed by post void static image.

INDICATION: To rule out VU Reflux