INFORMATION FOR PATIENTS
Radiopharmaceutical
Radiopharmaceuticals are expensive and cannot be stored after preparation – they need to be administered within a few hours of preparation – so if you are unable to attend an examination, please call +421 33 595 33 83 or +421 948 032 957 a few days in advance so that another patient can be scheduled for the examination. Thank you.
Instructions before the examination
Pregnant women are examined only for vital signs, if you are breastfeeding your child, special precautions must be taken - stop breastfeeding for a certain period of time, the time depends on the type of examination (please inform us about this fact before the examination!).
Before undergoing a scintigraphic examination, each patient will pass through the nuclear medicine outpatient clinic, where he/she will be examined by a doctor and given basic information. The patient will then sign an informed consent form. We will answer any questions you may have adequately. In order to reduce radiation exposure to your surroundings, especially to children, close contact with children is not recommended on the day after your examination. This means not taking them in your arms and not sleeping in the same room with them. In general, it is advisable to keep as much distance from them as possible. Anyone can come with you to the examination as a guide, but it is not advisable for children and pregnant women to accompany you.
Preparation: no preparation is necessary. Possible alimentary/pharmacological blockage of the thyroid gland should be avoided. If necessary, preparation can be consulted directly with the nuclear medicine department.
After administration of the radiopharmaceutical (99mTc pertechnetate), thyroid scintigraphy is performed at an interval of 15-30 min, followed by SPECT scintigraphy if necessary. SPECT/CT examination.
Preparation: no preparation is necessary. During the examination, the thyroid gland is blocked by administering potassium perchlorate (Chlorigen, Chloritech).
Course of the examination: after application of the radiopharmaceutical (99mTc pertechnetate) with an interval of 20 min, a local scan is performed in the thyroid area. Subsequently, repeated local scans are performed on the neck and chest area after intravenous administration of 99mTc Sestamibi. 2.5-3 h after the application (different rates of radiopharmaceutical washout from the thyroid and parathyroid glands), SPECT/CT scanning is performed. The duration of the whole examination is approximately 4 hours.
Preparation: 4-6 hours before the examination, the patient should not put anything in his/her mouth (do not eat, drink, brush teeth, chew gum).
Immediately after the intravenous injection of the radiopharmaceutical, a dynamic scan of the salivary glands is performed for 45 min. In the middle of the examination, the patient receives a salivation stimulus (lemon juice, in case of citrus allergy menthol candy).
Preparation: the patient arrives at the ward fasting. 24 hours before the examination, he/she should not take drugs affecting the motility of the digestive tract (Ganaton, Costi, Degan…). The patient will bring 1l of orange juice.
Examination procedure: dynamic scanning of the oesophagus for 3 minutes immediately after swallowing a small amount of radioactive substance. The patient then drinks 2-3 dcl of orange juice. After drinking the juice, we perform a dynamic scan on the epigastric area for 30 min.
Preparation: the patient arrives at the ward fasting. 24 hours before the examination, he/she should not take drugs affecting the motility of the digestive tract (Ganaton, Costi, Degan…). The patient will bring 2 toasted breads with jam and scrambled egg whites made of 2 eggs.
The course of the examination: after ingestion of a solid bite labeled with a small amount of radioactive substance, followed by a dynamic scan on the epigastric area for 90 min. At the same time, local images of the epigastric region are taken immediately after ingestion of the food, at the end of the dynamic scan and 3 and 4 h after ingestion of the food. The duration of the whole examination is approximately 4,5 hours.
Preparation: on the first day of the examination the patient comes fasting, on the second day of the examination no preparation is necessary.
The examination is a two-day examination. On the first day of the examination, after intravenous injection of radiopharmaceutically labelled erythrocytes, repeated local imaging of the abdominal cavity and SPECT/CT scanning are performed. On the second day of the examination, one more SPECT/CT scan of the abdominal cavity is performed, lasting approximately 45 min.
Preparation: not necessary.
Procedure: After administration of a colloidal radiopharmaceutical of the appropriate particle size intradermally or subcutaneously, depending on the location of the primary tumour, the radiopharmaceutical accumulates in the area of the first – sentinel lymph nodes of the lymphatic drainage area. This is followed by local imaging, supplemented by SPECT/CT scanning if necessary. The nuclear medicine physician marks the approximate location of the sentinel node on the skin with a marker. Perioperatively, the surgeon detects the lymph node using a gamma probe. Histologization of the sentinel node can help to optimize the surgical procedure in terms of radicality and reduce postoperative complications.
Preparation: the examination does not require special preparation. Adequate hydration before the examination is necessary
Examination procedure: Immediately after intravenous injection of radiopharmaceutical (99mTc-DTPA or MAG3) followed by dynamic scanning of the kidney area for 30 min. If radiopharmaceutical retention in the renal pelvis is suspected, Furosemide is injected intravenously between the 15th-20th minute of the scan. The patient is then urinated followed by a short one-minute scan to assess for possible retention of the radiopharmaceutical in the renal pelvis.
Preparation: the examination does not require special preparation. Sufficient hydration before the examination is necessary.
Approximately half an hour after the intravenous injection of the radiopharmaceutical, local imaging of the abdominal cavity in several projections follows. The examination is supplemented by tomographic scanning (SPECT) if necessary. SPECT/CT examination. The total duration of the examination is approximately 3 hours.
Preparation: not necessary.
Approximately one hour after intravenous administration of the radiopharmaceutical, a full-body scan is performed. Subsequently, the whole-body scan may be supplemented by additional, local scanning and SPECT/CT scanning at the discretion of the nuclear medicine physician.
Preparation: the patient should not take certain drugs that affect dopaminergic transporters in the brain (some antidepressants, drugs that stimulate the central nervous system…). Adjustments to treatment are made in collaboration between the referring physician and the nuclear medicine physician after prior consultation at the workplace. No preparation is necessary on the day of the examination.
The course of the examination: on arrival at the department, the patient is given Lugol’s solution, or in case of allergy to iodine, potassium chlorate tablets (Chloritech, Chlorigen) are administered to block the thyroid gland. 3-4 hours after intravenous application of radiopharmaceutical is followed by tomographic scanning on the brain area for 45 minutes. The duration of the entire examination is 5-6 hours.
Preparation:No special preparation is required. On the day of the examination, the patient should not wear compression stockings or any constricting underwear.
The examination has two parts. The radioactive substance is injected into the interdigital area of both examined limbs (upper, possibly lower limbs). Immediately after the application of the radiopharmaceutical, a resting scan on the area of the examined limbs follows. This first part takes approximately 45 minutes. After the first part of the examination is completed, the patient performs physical activity. In the case of the lower limbs examination, the patient walks along the corridor, up the stairs…, in the case of the upper limbs examination, the patient squeezes the compressive physiotherapy balls. After the end of the exercise, the area of the examined limbs is scanned again. The total duration of the examination is 4-5 hours.
Preparation: not necessary, the patient can eat and drink before the examination. After administration of the radioactive substance, fluid intake should be increased (at least 0.5 l). It is necessary to urinate more frequently after the examination. Food and fluids should be brought with you. Any medication the patient is taking can be taken.
The patient is injected with a small amount of radioactive substance in an intravenous injection. The examination itself is carried out during the injection and 3-5 hours after the injection. The examination takes approximately 20-40 minutes.
Preparation: not necessary
Procedure: the patient is injected with a small amount of radioactive substance in an intravenous injection. The examination itself is carried out immediately after the injection and takes approximately 20 minutes.
Preparation: not necessary
During the examination, the patient inhales a small amount of radioactive gas. The examination takes approximately 10 minutes.
Preparation: do not eat for 4 – 6 hours before the examination. From the referring physician it is necessary to bring the examination of inflammatory parameters – KO + dif, CRP.
Course of the examination: after a quantity of approximately 50 ml of blood has been taken, white blood cells are then separated from the blood in the laboratory and subsequently labelled with a radioactive substance. The labelled white blood cells are then returned to the circulation by intravenous injection. The test itself is carried out over two days, and scans are taken repeatedly at 1, 4 and 24 hour intervals. The individual scans take between 10 and 20 minutes.
Preparation: do not eat for 2 hours before the examination and drink only small amounts of fluids. Not valid for diabetics who follow their daily regimen. As instructed by your cardiologist or internist, discontinue nitrates 24 hours before the examination and beta-blockers or heart rate-lowering drugs two days before the examination. Other medications do not need to be discontinued. Comfortable athletic shoes, clothing, food, fluids, and any medications the patient normally takes should be brought to the examination.
Examination procedure: as part of the examination, a small amount of radioactive substance is injected into the patient by intravenous injection during the ergonometric exercise on a stationary bicycle. The exercise itself takes approximately up to 15 minutes. After the end of the physical load, the scan continues for approximately 20 minutes. In some cases, a resting scan is necessary, which can be performed on the same day or on another day with a minimum interval from the exercise.
Frequently Asked Questions
After completing the examination in the nuclear medicine outpatient clinic, the patient goes to the waiting room, which is located in a closed area. Before the examination, the patient is given an intravenous injection of a small amount of radioactive substance. The dose administered is in most cases comparable to or lower than that of an X-ray. The patient does not leave the ward after the radiopharmaceutical has been injected.
The actual examination under the gammacamera is carried out at different intervals after the application of the radiopharmaceutical, depending on which organ is being examined and what the examination is about.
Doctors in the nuclear medicine department will evaluate and describe the result of the examination usually within 7 working days. The result is always sent by post or handed over to the patient personally. The result is then presented to the doctor who referred you for the examination.