Provider Nuclear Medicine and PET/CT Ordering Guide

Bone scan – total body, limited bone, 3-phase bone, SPECT/CT bone scan

• No prep needed

Cisternogram

• Only performed at Regional Outpatient Center.
• No Plavix® for 2 days; hold morning blood thinners.
• If patient is on Coumadin®, have labs drawn and discuss with radiologist prior to lumbar puncture.
• No blood thinners or aspirin for 2 days prior to exam.

DaTscan

• Patient should be well hydrated before scan.

GI Bleed Scan

• No prep needed.
• Not performed as an outpatient.

Gallium Scan

• No prep needed.

Gastric Empty

• 4 hour outpatient exam.
• NPO 4 to 6 hours before exam.
• No anti-nausea or pain medication 4 hours before exam.
• Medications affecting gastric motility stopped 2 days prior to exam.
• Diabetic patients need to bring glucose meter to appointment.

HIDA Scan

• No food by mouth (NPO) 4 hours and no pain medications 4 hours prior to exam.

I-123 MIBG

• Contact nuclear medicine for patient preparation.

In111/TC99 WBC (Leukocyte scan)

• No prep needed.

Liver RBC

• No prep needed.

Lung Scan (VQ scan)

• No prep needed.
• Chest x-ray within 24 hours of exam start.

Lymphoscintigraphy (only performed at SMC and PMC)

• No prep needed.

MUGA Scan

• No prep needed.

Meckle’s Scan

• No food by mouth (NPO) 4 hours prior to exam.
• No barium, laxatives or aspirin 5 days prior to exam.

Myocardial Perfusion (nuclear stress test)

• No food by mouth (NPO) 4 hours prior to exam.
• No caffeine or nicotine 24 hours prior to exam.
• No heart or blood pressure medications the day of exam.
• Bring a list of all medications to appointment.

Octreoscan

• Mild laxative (citrate of magnesium) day before exam.

PET/CT Bone Scan

• No prep needed.

PET/CT Brain Scan

• If exam is for seizure, no anticonvulsants the day of or any seizures at least 4 hours prior.

PET/CT Scan – Oncology

• Only performed at Regional Outpatient Center.
• No food by mouth (NPO) 4 to 6 hours prior to exam (water is fine).
• Patient well hydrated.
• No diabetic meds.
• No strenuous exercise 24 hours prior to exam.

Parathyroid Scan

• No prep needed.

Prostacints

• No prep needed.

Renal DMSA

• Patient well hydrated.

Renal ERPF (Triple renal scan)

• Patient well hydrated.

Renal Scan with Captopril

• Patient well hydrated.
• No ACE inhibitors or Lasix® 48 hours prior to exam.

Renal Scan with Lasix®

• Patient well hydrated.
• Patient off Lasix® for 48 hours prior to exam.

Thyroid Therapy – Hyperthyroid/Cancer

• Only performed at Regional Outpatient Center.
• Contact nuclear medicine for patient preparation.

Thyroid Uptake and Scan

• Only performed at Regional Outpatient Center.
• NPO after midnight.
• No fish oil 2 weeks prior to exam.
• Off thyroid medications as follows:
  • Methimazole/PTU 5-7 days prior;
  • Cytomel 10 to 14 days prior to exam;
  • Synthroid® 4 weeks prior to exam;
  • No iodinated contrast 4 weeks prior to exam.

Xofigo-Ra223 Therapy

• Need labs.
• Patient’s current weight.

Y-90 Sirshperes

• Current billirubin – work up with IR Radiologist.

Zevalin Therapy

• Need labs.
• Patient’s current weight.
• Pregnancy test – if applicable.
• Bone marrow biopsy results.