Radiology

Diagnosis Procedures

We use nuclear medicine to diagnose and track the progression of disease. These tests can help us assess your cardiovascular, genitourinary, central nervous, respiratory, and endocrine systems; gastrointestinal tract; and musculoskeletal structure, among others. These scans all use radioactive tracers, called radiotracers. We give the radiotracer through pills, shots, or gas. Then we take images using a special camera. This approach lets us diagnose conditions without surgical procedures. If there are any dietary or medical restrictions or preparations, we will let you know in advance.

We offer positron emissions testing (PET) scans as well as a variety of other imaging tests. Our imaging tests help with diagnosing conditions in the cardiovascular system, central nervous system, endocrine system, gastrointestinal system, genitourinary system, respiratory system, and musculoskeletal structure. Below, we list the most common scans designed to provide information on specific systems and parts of the body:

Cardiovascular System

  • Cardiac amyloidosis imaging: Helps us detect amyloid deposits in your heart. We take images an hour after injecting the radioactive tracer. Imaging helps us identify transthyretin amyloidosis cardiac amyloidosis.
  • Gated blood pool (MUGA scan): Helps us assess your heart as it pumps blood. The test is also called nuclear ventriculography.
  • Myocardial perfusion scintigraphy: Allows us to assess cardiac sarcoidosis, an inflammatory disease that often attacks multiple organs, particularly the lungs, heart, and lymph nodes. We use two imaging techniques for this diagnosis. Both involve small amounts of a radioactive substance, or radiotracer. The radiotracer MIBI lets us evaluate the blood flow to the heart muscle. The PET FDG scan assesses inflammation in the heart. This procedure requires a 72-hour pre-test, high-fat, high-protein, and very low-carbohydrate diet. We will provide detailed instructions and information when you schedule your appointment.

Central Nervous System

  • Brain DaTscan: Helps us determine whether you have Parkinsonian syndrome or a similar condition such as essential tremor. Parkinsonian syndromes occur when the brain is not getting enough dopamine to perform certain functions. To perform this test, we inject you with the radioactive tracer, DaTscan, three hours before the imaging. Then we perform a single photon emission tomography scan, which shows us how the dopamine is distributed.
  • Brain perfusion scans: Shows us the blood supply and provides information on brain function. Single photon emission tomography (SPECT) combined with computed tomography (CT) produces images of the 3D distribution of the radiotracer. This technique helps us assess regional brain perfusion. We use brain perfusion scans to diagnose the following:
    • Carotid stenosis
    • Cerebral vasculitis
    • Epilepsy (seizure site)
    • Dementia (altered mental states)
    • Stroke or transient ischemic attack
    • Reoccurring headaches
    • Blood supply after brain trauma (subarachnoid hemorrhage)
  • Cisternography/cisternogram/radionuclide cisternogram: Helps us diagnosis a cerebrospinal fluid (CSF) leak through a hole in the membrane that covers the spinal cord and brain. This fluid can drain from the ear, the nose, or the spine. We inject a sterile radiotracer into the intrathecal space via a lumbar (lower spine) puncture to detect the location of the leak.
  • CSF shunt patency test: Helps us address pressure on the brain caused by excess fluid accumulation. We treat this condition by surgically placing a shunt system in the brain, which drains the excess fluid. The shunt regulates flow of CSF with catheter tubes that drain from the brain or spinal column to a valve and from the valve into the abdominal cavity (ventriculo-peritoneal shunt) or heart (ventriculo-atrial shunt). The shunt patency test allows us to assess any Issues with the shunt. We inject a sterile radiotracer into the shunt reservoir of the valve and take images of the flow of CSF through the shunt system to the drainage site.

Endocrine System

  • Parathyroid scan: Looks look at the small endocrine glands that produce parathyroid hormone and diagnose hyperparathyoidism. These hormones control the amount of calcium in the blood and within the bones. These glands are usually located near the thyroid gland in the neck.
  • Thyroid metastatic cancer survey: Also called iodine survey scans, are appropriate after the diagnosis and surgery of papillary or follicular thyroid carcinoma. The scan uses a radiotracer to see if you have any carcinoma in your thyroid. It also lets us assess the stage of any tumor. We use a combination of SPECT and CT scans.
  • Thyroid scan: Examines your thyroid.
  • Thyroid uptake/radioactive iodine uptake tests: help us diagnose thyroid conditions such as hypothyroidism.

Gastrointestinal System

  • Carbon-14 urea breath test or H-pylori breath test: Diagnoses Helicobacter Pylori (H. pylori), a stomach bacteria that causes inflammation in the stomach lining. This is one of the most common chronic infections in humans and can cause an ulcer. The test involves taking two breath samples after swallowing a radioactive tracer called Carbon-14 Urea.
  • Gastric emptying (solid/liquid) scan: Determine how long it takes your stomach to empty food into the small intestine after you eat. The scan uses a radiotracer in a standardized solid meal of scrambled egg whites with white toast, jelly, and water. We use this test for people who have experienced frequent vomiting, gastroparesis, abdominal pain, early satiety, and pre-operative evaluation.
  • RBC nuclear scan: Helps us assess gastrointestinal bleeding.
  • Hepatic artery infusion pump patency scan: Helps us assess the function of a pump used to infuse the liver with chemotherapeutic drugs through the hepatic artery. We inject a small amount of chemotherapy through the skin into the pump to see whether the tracer is shunted to other organs. We use a combination of SPECT and CT scans, with a radiotracer, to produce 3D images.
  • Hepatic artery microaggregated albumin (MAA) infusion: We perform thisprocedure before providing yttrium-90 (Y-90) microspheres therapy to treat liver tumors we cannot remove surgically. The infusions serve as a baseline evaluation. We do the infusion through a hepatic artery catheter. The MAA infusion scan measures the percentage of shunting (leakage) to areas outside the tumor to help us plan for your Y-90 infusion therapy. In addition, the beta radiation emitted from the Y-90 microspheres in the liver tumor reduces tumor size and increases survival time. We use a combination of SPECT and CT scans.
  • Hepatic artery infusion of Y-90 microspheres post-therapy scan: Helps us treat liver cancer. We deliver medicine through a hepatic artery catheter. The beta radiation emitted from the Y-90 microspheres in the liver tumor can shrink the tumor size and increase survival time. Sometimes, it shrinks the tumor enough that we can surgically remove the rest. After the procedure, we perform a SPECT with CT to assess the liver.
  • Hepatobiliary/gallbladder radionuclide scan: Detect disease and blockage in your gall bladder.
  • Intestinal motility studies (also known as transenteric, small bowel, and colonic transit scans): Provide information about how your bowels are functioning. We use this study if you experience unexplained constipation or diarrhea, experience constipation and upper gastrointestinal symptoms; or to assess your bowels prior to surgery.
  • Liver scans: We use several types.
  • Liver/spleen red blood cell scan: Helps us see if you have a blood vessel mass in your liver. To do this scan, we take a sample of your red blood cells and label with a radiotracer. This process can take an hour. Then we inject the radio-labeled red blood cells and perform a SPECT with CT, which can take 35 to 45 minutes.
  • Meckel's scan: Enables us to detect abnormally located gastric mucosa in the small intestine. This abnormality can cause local ulcers and bleeding. We inject a small amount of radiotracer into a vein in your arm and take images using a special camera.
  • Salivary gland scans evaluate the size, shape, and function of the salivary glands. They can help us determine the cause of salivary gland swelling (is it bacterial or viral); detect blocked salivary ducts; identify growths in the salivary glands (e.g., Warthin's tumor); and diagnose Sjogren's syndrome. We provide an intravenous injection of a radiotracer, then begin imaging.

Genitourinary System

Infection Imaging

  • Gallium scan: Helps us see infection, swelling, and cancer in your body.
  • White blood cell scan/labeled leukocytes/abscess scans: Lets us see if you have a collection of pus (abscess).
  • White blood cell (WBC) scan: Helps us detect abscesses and infection in soft tissues or bones in patients with a fever of unknown origin. We use your own WBCs, tagged with a radiotracer. This radiolabeling process takes two to three hours. We inject your own radiolabeled WBCs and, 24 hours later, conduct the scan. We use a WBC scan, together with a bone scan, to diagnose osteomyletis, a bone infection.
  • Bone scan: Involves three phases. We perform the first two phases while we are labeling your WBCs. The first phase involves using a radiotracer to perform a scan that assesses blood flow into the area. The second phase involves imaging the blood pool. We perform the third phase, using SPECT and CT scans, 24 hours after injecting you with your radiolabeled WBCs.

Lacrimal Drainage System (structures involved with tear production and drainage)

  • Dacryocystography (lacrimal scan): Help us assess how your tear ducts are working. We also use them to assess your body’s response to therapy, or surgery.

Lymphatic System

  • Lymphoscintigraphy helps identify the first lymph node of the site of a breast cancer, melanoma, or other metastatic lesion. This is called sentinel lymph node mapping. We use this scan to identify the sentinel node on the same day or the day before surgery. Then we remove the lymph node surgically to see if any of the tumor cells have spread (metastasized) to it. We also use this scan to observe lymphatic flow through the draining lymphatic system, usually if you have unexplained upper or lower extremity swelling suspected to be lymphedema. We inject a small amount of radiotracer just under the skin. You may experience pain for about five seconds. Once the radiotracer has drained the lymph node, we perform the scan. In cases of the head and neck, we use a single photon emission tomography combined with computed tomography scan.

Musculoskeletal Structures

Respiratory System

  • Lung scan/pulmonary ventilation/perfusion scan: A lung scan can be a ventilation scan or a perfusion scan. A ventilation scan looks at how air moves in and out of your lungs through the bronchi and bronchioles. A perfusion scan looks at how blood is flowing within your lungs. Lung scans help diagnose blood clots (pulmonary emboli).
  • Lung gallium scan: Shows any swelling (inflammation) in your lungs.
  • Lung quantitation: Evaluates how much blood your lungs are getting, by comparing one lung to the other. It also allows us to examine the functioning of different parts of the lung.

Tumors

  • Gallium scan: Allows us to see any inflammation in your lungs.
  • MIBG scan: Confirms tumors in the nerve tissue.
  • Octreoscan: Shows any primary and metastatic neuroendocrine tumors bearing somatostatin receptors. We inject a small amount of radiotracer into a vein in your arm or hand. This radiotracer binds to neuroendocrine tumors that have certain proteins called somatostatin receptors on the surface of the cancer cells. The procedure is usually done over three days. We perform a single photon emission tomography combined with computed tomography scan, which produces tomographic images to assess the 3D distribution of the radioactive tracer.
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