Nuclear Medicine tests/treatment

What is a scintigraphy or isotope scan?

When performing scintigraphy or a radionuclide scan, a small amount of radioactive material is administered to the patient. We call these materials ‘tracers’. They are only slightly radioactive and have a short half-life (meaning that these materials will not produce radiation for a long time).

For most tests, the tracer is introduced into the bloodstream through a vein, but for some tests it is possible to inhale the tracer or even incorporate it into a meal or drink.

Depending on the organ requiring the test, the spread of the administered tracer in the body or in a specific organ is checked using a specific type of scanner, which is a so-called gamma camera or SPECT camera. This is done immediately after administration or a few hours, or even days, after. This test is termed a scintigraphy or radionuclide scan. In this way, images are produced that provide us with information about the functioning of the examined organs. It is difficult to obtain this information in other ways and it can assist the physician requesting the test in reaching a diagnosis.

Is the test painful, and is it dangerous?

These tests are not burdensome for the patient. Most tests are done by injecting a small amount of tracer in the vein on the inside of the elbow. This is generally well tolerated. As a rule, no allergic reactions occur and the amount of radiation is small, and certainly not higher than with regular radiology tests. However, radiation is avoided in the case of pregnant or breastfeeding women. To avoid any misunderstandings, it is therefore important that the requesting physician as well as the patient always make sure to report any pregnancy or breastfeeding.

The camera system is an open system. You will not be placed inside a tunnel. Most patients with claustrophobia tolerate the examination well. If you are worried about the test, do not hesitate to discuss it with our physician or nurse.

We perform various types of nuclear medicine tests:

• Parathyroid scan
• Bone scan
• DAT scan
• Ejection fraction
• Brain perfusion scan
• Lung ventilation/perfusion scintigraphy
• Stomach evacuation
• MIBI scan
• Renal scan
• PET/CT scan
• Renogram
• Thyroid scan
• Skeletal scintigraphy
• White-blood cell scan

Nuclear medicine treatment should not be confused with radiotherapy.

Radiotherapy consists of radiation therapy, either using devices (external radiotherapy) or with radioactive rods or granules that are implanted in a patient (brachytherapy).

Nuclear medicine therapy includes treatments with radioactive substances that are either injected (liquid solutions) or ingested (capsules or drinks). These radioactive substances then travel through the blood to certain organs, where they are then irradiated internally. In those instances, the radiation dose is, of course, much higher than with a nuclear medicine test. This is why the patients receive extensive and specific instructions, adjusted as per the radiation dose administered.

With some treatments, it is necessary to hospitalise the patient briefly to protect the environment against the radioactive radiation. We have two specially equipped therapy rooms.

Nuclear medicine treatments that we administer are:

• Treatment with 177Lutetium-PSMA
• Treatment with radioiodine
• Treatment with radium-223 dichloride

Maria Middelares General Hospital has three SPECT/CT cameras. Using this machine, it is possible to perform two tests at the same time: a scintigraphy (functional information) and a CT scan (anatomical information). This can be quite useful for some abnormalities or diseases. The SPECT-CT is a joint venture of the Nuclear Medicine and Radiology departments at the Maria Middelares General Hospital.

The latest device, which will be commissioned in 2021, has a collimator in the camera head that ensures that heart examinations can take place more accurately, resulting in less radiation exposure for the patient and a shorter duration of the examination.

For PET/CT scans, we work together closely with the PET Centre at the West Flanders campus in Groenige, where our physicians work one day a week in the PET Centre for patients who have been transferred there from the Maria Middelares General Hospital. Patients from St Vincent General Hospital in Deinze are referred to the Marie Curie PET Centre.