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Frequently Asked Questions |
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Frequently Asked Questions |
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This page features answers to questions you may have about your child's visit to the Division of Nuclear Medicine. For more information, see Nuclear Medicine Tests and Procedures. And if you have any further questions, please don't hesitate to contact us at 617-355-7010.
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Nuclear medicine is a medical specialty that employs short-lived radioactive elements and specialized cameras to visualize blood flow and functional and metabolic activity within organs and lesions. This information can often augment the anatomical data obtained from X-rays, computed tomography (CT) scans and magnetic resonance imaging (MRI) studies. Back to top
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Unlike other imaging technologies that diagnose disease based on anatomy or structural appearance, nuclear medicine determines the cause of a medical problem based on organ function. Nuclear medicine procedures can be digitally combined with computed tomography (CT) scans or magnetic resonance imaging (MRI) studies to give the most complete picture of the tissues or lesions being evaluated. Back to top
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| An open view of the PET scanner. |
By means of an intravenous tube or other method, a patient is given a radiopharmaceutical, a pharmaceutical substance that contains an extremely short-lived radioactive element (a tracer) that is absorbed into the patient's cells much like glucose from food. Unlike glucose, however, the tracer is not immediately converted into energy; it remains in the cell long enough to permit imaging by a special camera, which maps the tracer's flow and distribution within the body or within a specific organ or tissue. A powerful computer system then converts this information into images that physicians use for diagnosis.
At Children's Hospital, we have two types of equipment that can "see" radioactive tracers: gamma cameras, which can create two- and three-dimensional images, and a positron emission tomography (PET) scanner, which creates three-dimensional images. The main difference between the two is the type of radiopharmaceutical used. Three-dimensional images taken with a gamma camera are known as SPECT (single photon emission computed tomography) scans.
Nuclear medicine imaging procedures can vary depending on a number of factors:
- The radiopharmaceutical used depends on which part of the body is being observed. For instance, certain radiopharmaceuticals that contain phosphate (such as technetium 99m methylene diphosphate) migrate to and become concentrated in the bones. After this agent is injected intravenously, all the bones in the body can be imaged.
- The radiopharmaceutical can be given intravenously, orally or by catheter or other means. For studies of the gastrointestinal tract, for example, the radiopharmaceutical is taken with food; for studies of the lungs, it is inhaled through a breathing mask.
- In some nuclear medicine examinations, images are obtained immediately after the radiopharmaceutical is administered. In other imaging studies, a waiting period is necessary to allow the tracer time to reach the desired organ or lesion. The amount of time this takes can vary, but it is usually less than an hour.
- The movement and positioning of the camera vary with the type of scan. For all tests, the patient must lie on an imaging bed. In a planar scan, which produces a two-dimensional image, the camera remains stationed over a specific part of the body or moves slowly across it. For a SPECT image, the camera rotates around the patient to take many pictures, which together are used to construct a three-dimensional image. In PET imaging, the patient is surrounded by a ring of detectors.
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Nuclear medicine procedures can provide early diagnosis of many diseases and have become essential to specialists in urology, orthopedics, oncology, cardiology and neurology. They can determine whether certain organs are functioning normally, monitor the effects of surgery or medical treatment and identify tumors deep within the body. For example, nuclear medicine can show whether or not the heart muscle is receiving adequate amounts of blood in patients with congenital heart disease or following cardiac surgery. It can assess the blood flow to the brain and tell doctors whether kidneys are functioning normally. In young athletes, nuclear medicine can locate bone stress before it can be seen on an X-ray; it can also detect infection within the bones. In addition, nuclear medicine can assess the function of renal, cardiac and liver transplants. Back to top
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Radiopharmaceuticals can target a specific organ or lesion with enough radiation to destroy the abnormal tissue. Common pediatric applications include the treatment of hyperthyroidism (overactive thyroid) and thyroid cancer. Researchers are developing new and innovative treatments that may be available in the future. Back to top
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Positron emission tomography (PET) is a highly sensitive technology that generates three-dimensional images of biochemical changes too subtle to discover by other means. It is extremely useful in detecting and treating cancer, neurological disorders and heart conditions.
PET scans, which superbly document chemical and functional changes in organs, can be particularly useful when they are digitally combined with the anatomical images generated by computed tomography (CT) or magnetic resonance imaging (MRI). For example, a neurologist can see the exact location in the brain where a seizure originated; an oncologist can determine which parts of a tumor are growing the fastest.
Children's Hospital Boston is the only facility in New England that has a PET scanner dedicated solely to children. Back to top
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Preparation for a nuclear medicine test begins well before the actual appointment; depending upon the type of scan, you may receive instructions and a brochure that explains what to expect. The day before the exam, a nurse, technologist or clinical intake coordinator may call and speak with you by phone. The division's child life specialist, Tricia Ashe, is also available to help you before, during and after the procedure. You can reach her at 617-355-7010.
When your child comes in for a study, a technologist may insert an intravenous tube. The technologist also checks blood-sugar levels when appropriate and then administers the radiopharmaceutical. Your child must lie quietly for 30 to 60 minutes while the tracer circulates within his or her body. Sometimes sedation is needed to help a child lie still. The division has three acute-care nurses certified in pediatric advanced life support who assist physicians in administering the anesthesia; these nurses also monitor your child before and after the procedure. Back to top
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Yes. Nuclear medicine has been used on children and babies for more than 40 years with no known adverse effects from the low doses employed. Your child will be exposed to very small amounts of radiation that are within the range of doses received during routine diagnostic radiographic procedures. At Children's Hospital Boston, we are committed to ensuring your child receives the smallest radiation dose needed to obtain the desired result. Back to top
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Although the cameras and PET scanners are large pieces of equipment that may seem intimidating, they simply take pictures of the body without touching the patient. The patient needs only to lie still; if he or she moves, the images may be blurry and may need to be repeated. When the radiopharmaceutical is administered intravenously, there is the usual discomfort of a needle stick. In certain tests that involve your child's bladder, placement of a catheter may be required. This may be uncomfortable, although it is not painful. Our technologists and our child life specialist, Tricia Ashe, are especially helpful in preparing children, in an age-appropriate manner, for these procedures. You can reach them by calling 617-355-7010. Back to top
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Because nuclear medicine procedures are minimally invasive, painless and well tolerated, and because sedation could interfere with certain bodily functions, we do not use sedation in most cases. If sedation is needed to help a child lie still, we are well prepared to administer it. The division has three acute-care nurses certified in pediatric advanced life support; they assist physicians in administering the anesthesia and monitor your child before and after the procedure. In exceptional circumstances, the hospital's pediatric anesthesiologists will administer general anesthesia. Back to top
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Our staff are specially trained to deal with children and help ease any anxieties they have. We place a great deal of importance on making sure children and their families are well informed about the procedure in advance, so that they know what to expect. In some cases, you will receive a phone call before your visit from a nurse or technologist. When you arrive for your child's appointment, a technologist will greet you and explain the procedure in detail. If you are concerned that your child may be afraid, you may want to contact Tricia Ashe, our child life specialist, before your visit by calling 617-355-7010. She can suggest ways to help prepare your child and may also be available to assist your child during the examination using age-appropriate play and other distraction techniques. In addition, we have a library of suitable videos and DVDs that children can watch while being examined. You are invited to bring your child's favorite programs as well. Back to top
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It is helpful to be honest with your child about the test. Explain in simple terms why he or she needs the test, what will happen and what you and your child can do to best prepare for it. Our physicians, technologists, nurses and child life specialist are available to answer any questions you have about our tests; please call the Division of Nuclear Medicine at 617-355-7010. Back to top
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Your child can resume regular activity after the scan, unless he or she has been sedated. In that case, special instructions will be provided. Back to top
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After the images are processed, a nuclear medicine physician will evaluate and interpret the results of the test, and will send them to the referring doctor within hours. If your physician has not received the results of the test, please ask him or her to call the Nuclear Medicine Division at 617-355-7010 and we will be happy to provide the results. Back to top
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Nuclear medicine was first used in patients more than 60 years ago. Children's Hospital Boston has had a Nuclear Medicine Division since 1970. Nuclear medicine is now a well-established medical specialty, practiced every day in countries throughout the world.
The National Institutes of Health (NIH) promotes research in nuclear medicine, and new advances occur continually. Patients for generations to come will benefit from the constant refinement of nuclear medicine equipment and procedures and the development of new radiopharmaceuticals and imaging devices.
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Nuclear medicine physicians at Children's Hospital Boston have received appropriate training in the specialty of nuclear medicine and are certified by the American Board of Nuclear Medicine. In addition, our physicians have special expertise in evaluating disorders and diseases that occur in children. Back to top
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