Nuclear Medicine for Diagnostic

Bone scintigraphy is a whole-body imaging technique that helps doctors identify abnormalities in the skeleton. These may include early bone metastases, bone inflammation, abnormalities following joint replacement, or facial asymmetry.

Bone scintigraphy can detect the spread of cancer to the bones earlier than conventional X-rays in many cases, which may not show a lesion until it reaches a certain size. This earlier detection can be important for people with cancer.

Thyroid scintigraphy uses a small amount of radioactive material taken up by thyroid cells to produce images that help doctors assess the structure and function of the thyroid gland. Unlike ultrasound, which mainly shows the gland’s structure and thyroid nodules, scintigraphy also provides information about how active different areas of the thyroid are.

Your doctor may recommend thyroid scintigraphy to:

Cardiac amyloidosis occurs when abnormal proteins build up in the heart muscle, gradually impairing its ability to contract and potentially leading to heart failure. The condition can be missed or underdiagnosed because its symptoms may resemble other forms of heart failure. In the past, a definitive diagnosis often required a heart muscle biopsy, which is a specialised and invasive procedure.

Cardiac amyloidosis scintigraphy is a non-invasive test that can help doctors diagnose amyloidosis with a high degree of accuracy, without a biopsy in many cases.

Being able to diagnose amyloidosis without a biopsy is important because many forms of cardiac amyloidosis can now be treated. New therapies targeting the underlying disease process have significantly improved outcomes for patients diagnosed early.

Cardiac amyloidosis scintigraphy may be particularly considered for people with unexplained heart failure, thickened heart walls or other signs suggestive of cardiac amyloidosis.

For cardiac amyloidosis scintigraphy, you will swallow a small amount of a radioactive tracer and wait about one hour for it to be taken up. The scan itself then takes about 15 minutes.

Myocardial perfusion scintigraphy helps doctors assess blood flow to the heart muscle both at rest and during stress. By looking at how the radiotracer is distributed in the heart muscle, doctors can identify areas with adequate blood supply and areas showing reduced perfusion.

This technique is used to assess blood flow through the heart muscle, detect myocardial ischaemia, identify restenosis after stent placement and assess damage from a previous heart attack. It also provides information about heart function, including left ventricular ejection fraction and wall motion, helping doctors determine the most appropriate treatment approach.

Myocardial perfusion scintigraphy is usually performed together with a stress test. Images are taken at two stages – when the heart is at rest and when its activity is increased through exercise or an appropriate alternative. Comparing the two sets of images helps doctors determine whether blood flow to an area of the heart muscle changes when the heart is working harder.

Renal scintigraphy uses a small amount of radioactive material to assess the structure and function of each kidney, as well as how urine is produced and flows through the urinary system. Depending on the purpose of the examination, your doctor may recommend dynamic or static renal scintigraphy to obtain different information about kidney function.

Parathyroid scintigraphy helps localise the parathyroid glands before surgery. This information is important in the treatment of hyperparathyroidism because the glands are small and their anatomical location can vary. A parathyroid gland may sometimes be located in an unusual position in the neck or chest, making it more difficult to locate during surgery.

Parathyroid scintigraphy usually requires no special preparation. You can eat and take your medicines as advised by your doctor. However, before the scan, tell the nuclear medicine team about any medicines, vitamins or supplements you are taking, and let them know if you are pregnant, may be pregnant or are breastfeeding.

You should also bring your PTH and calcium test results, thyroid/parathyroid ultrasound results and any relevant imaging results to help your doctor perform and interpret the scan.

This technique is used in selected cases of breast cancer, melanoma, head and neck tumours and cervical cancer to identify the first lymph node to receive drainage from the tumour site before surgery.

First, a small amount of radiotracer is injected around the tumour. An initial scan is then performed to track the tracer and identify the sentinel lymph nodes.

After the first scan, you will rest in the department for about two hours. A second scan is then performed to confirm the location of the sentinel lymph nodes. Imaging at different time points allows doctors to follow lymphatic drainage and localise the nodes more accurately.

The total procedure time, including the waiting period between the two scans, is about three hours. The actual duration may vary depending on the location of the lesion and the individual’s lymphatic drainage.

Salivary gland scintigraphy assesses the function and secretion of the major salivary glands, including the parotid and submandibular glands.

This technique can be used to assess chronic inflammation or functional impairment of the salivary glands, as well as gland function before and after radiotherapy to the head and neck. Salivary gland scintigraphy can also provide additional information when the cause of persistent dry mouth is unclear, particularly when it is necessary to assess whether reduced salivary secretion is contributing to the symptoms.

Testicular scintigraphy helps doctors assess blood flow to the testicles and distinguish orchitis (infection or inflammation) from testicular torsion, a surgical emergency requiring immediate treatment, in patients with acute scrotal pain when clinical examination alone is inconclusive.

In people with differentiated thyroid cancer who have undergone thyroidectomy, an I-131 whole-body scan is used to assess for residual thyroid tissue or metastases. The results can help doctors determine whether low- or high-dose I-131 treatment is appropriate and assess the response to treatment.

A whole-body scan is usually performed about 4–6 weeks after surgery, as advised by your doctor.

To help ensure accurate scan results, you will need to follow certain preparation instructions: