Bone Scintigraphy - Ideally (but not required): Recent Creatinine (for the - Discontinue thyroid meds

Indication: expected GFR) Procedure:

- For the detection of bone mets Procedure & Imaging: - Radiotracer: 7 mCi Tc99m-sestamibi (dual phase/isotope)
- Evaluation of muscular trauma & infections - Px position: Supine Imaging:
- Evaluation of lesions (benign/malignant – even after CT, - Radiotracer: 12 mCi Tc99m-DTPA via IV catheter (bolus) - Px position: Supine w/ hyperextended neck
MRI, UTZ, etc.) - Diuretic: Furosemide 20 mins during study – to check if Note: Px must refrain from swallowing as much as possible
Prep: there is obstruction (usually, after taking sequential - Salivary superimposition – Px have to drink water to
- No special prep images) evaluate/check
- Dye/CM 24hrs prior procedure is contraindicated - Dynamic phase + Excretory phase (sequential images) - Flow (dynamic image) for 1-minute Statics, Obliques
Procedure: - Scan duration: 40-45 mins (about an hour) (based on time/counts)
- Administration of radiotracer (20-30 mCi Tc99m-MDP/HDP) - Scan duration: usually 30 mins – 1 hr depending on
DMSA / Renal Cortex Scintigraphy
- Waiting time: 2-3 hrs (to localize radiotracer to the bone) thyroid activity (shorter if hyperactive)
Indication:
Note: Px are encouraged to drink fluids during waiting time - Collimator: Pinhole
- Common in pedia (male) – pregnancy UTI = congenital
& void prior scanning (resolution - kidney)
infection
Imaging: Parathyroid Scintigraphy
- To diagnose acute chronic pyelonephritis or kidney
- Px position: Supine for 30-40 mins (scan duration) Indication:
infection
Note: Unstable px must be settled - To localize the parathyroid adenoma and hyperplasia in
- Evaluate renal cortical scarring (extent)
- Planar: Ant & Post (static & whole body) | SPECT (tomo): 3D considerations of hyperparathyroidism
- Diagnosis of renal agenesis Prep:
GFR Prep:
- No special prep
Indication: - No special prep
- Ideally: old result, documentation of elevated serum
- Evaluate renal structure & function - Sedation for pedia Calcium (stones) and PTH
Prep: Procedure & Imaging:
- Discontinue thyroid meds
- Hydration: 300-500 mL water 30 mins prior scan - Px position: Supine Procedure:
Note: Px must void prior scanning (also, post-void + static) - Radiotracer: 5 mCi Tc99m-DTPA via IV injection (bolus) - Radiotracer: Dual Phase: Tc99m-sestamibi, Dual Isotope:
- Sedation for pedia - Waiting time: 2-3 hrs Tc99m-sestamibi + pertechnetate (Tl)
Procedure & Imaging: - Statics, Obliques (or Laterals - depending on physician) + Imaging:
- Px position: Supine possibly SPECT (tomo) - Px position: Supine w/ hyperextended neck
- Radiotracer: 3 mCi (+- 10%) Tc99m-DTPA via IV (bolus) - Scan duration: Almost an hour (easily done, almost same - Sestamibi: Dual phase (early & delayed) - more variation of
- Dynamic, Static w/ post-void w/ bone scan) discrepancy
- Image acquisition Note: Presence (intensity) left in the delayed part (washout
Captopril-augmented
- Scan duration: 6 mins (imaging only excluding tracer) is indication adenoma
Indication:
administration) - Scan duration: 2-4 hrs
- Evaluate and diagnose renovascular hypertension
Renal Scan - Condition of the px (check kidney from meds) Lung Perfusion Scan
Indication: Prep: Indication:
- Evaluate renal perfusion or blood flow to the kidneys - No special prep - To r/o pulmonary embolism
- Assess morphology (size) & function - 3-5 days prior administration, px is subjected to ACE (no - Examine lungs (blood flow, air distribution)
- Evaluate the viability of renal transplantation medications) Prep:
- Detect renal obstruction (nephrolithiasis) Procedure & Imaging: *same renal scan routine - Ideally: request, recent x-ray (not >24 hrs), RTPCR
Prep: - Administer 50 mg Captopril Procedure:
- Hydration: 300-500 mL water 30 mins prior scan - BP monitoring for 1 hr (about 5-6 times) - Radiotracer: ___ Tc99m-MAA/DPA (bolus)
Note: Px must void prior scanning - Px position: Supine Imaging:
- Sedation for pedia - Radiotracer: 5 mCi Tc99m-DTPA/Mag-3 via IV injection - Px position: Supine
- Ideally (but not required): Recent Creatinine (bolus) - Planar images
Procedure & Imaging: - Scan duration: Long (di ko na note yung exact time) - Scan duration: 30-40 mins
- Px position: Supine
Thyroid Scintigraphy Lung Ventilation Scan
- Radiotracer: 12 mCi Tc99m-DTPA via injection (bolus)
Indication: Indication:
- Dynamic phase + Excretory phase (sequential images)
- To assess general thyroid configuration (physiologic - To R/O pulmonary embolism
- Scan duration: 35-45 mins structure) & function - Examine lungs (blood flow, air distribution)
Diuretic - To determine degree of function (degree) of a palpable Prep:
Indication: thyroid nodule – physical assessment - Ideally: request, recent x-ray (not >24 hrs), RTPCR
- Assess the patency of the UB/kidney (e.g., presence of - To differentiate thyroiditis from Graves’ disease & other Procedure:
obstruction) forms of hyperthyroidism - Radiotracer: ___ Tc99m-MAA/DPA
- To differentiate the uterenal (?) collecting system (calyces, - To locate ectopic thyroid tissue and evaluate neck & Imaging:
pelvis, ureters substernal mass - Px position: Supine
Prep: *same w/ Renal - To evaluate congenital hypothyroidism - Planar images
- Hydration: 300-500 mL water 30 mins prior scan Prep:
- Scan duration: 1-2 hrs
Note: Px must void prior scanning - Ideally (for correlation): request, old result, thyroid function
- Sedation for pedia test, laboratory, RIA/EIA/ELISA method tests, thyroid utz Myocardial Perfusion
Indication:
- To diagnose CAD
- Evaluate the patency of CABG (undergone surgery/cardiac
procedure)
- Px w/ post-myocardial infarction (extension of
clot/blockages)
- To assess pre-operative risk assessment
- To evaluate px w/ abnormal heartbeat count
Prep:
- Fasting at least 4 hrs
- Discontinuation of meds/anything: depends on doctor
Procedure & Imaging:
- Radiotracer: ___ Tc99m-Sestamibi/Tl (stress, 💉just once,
scan, rest)
- Tc99m-Sestamibi: usually 1 or 2 day protocol
- Waiting time: 30 mins
- Stress: Treadmill/Pharmacologic
- Scan duration: 2-3 hrs (continuous)