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If you are interested in scintigraphic examination of your patients, the following procedure should be followed:. After intravenous administration of a radiopharmaceutical, its uptake by myocardial cells occurs. The uptake is directly proportional to the perfusion in the myocardial area at the time of application. Accumulation of the radiopharmaceutical does not occur in necrotic or scarred areas of the myocardium. In ischaemic areas, accumulation is reduced. The examination is performed in two phases, first a stress phase and then a rest phase. Their comparison evaluates the presence of reversible or fixed defects of radiopharmaceutical accumulation. These correspond to ischemic or necrotic deposits in the myocardium or postinfarction scars. The examination starts with a stress test bicycle ergometry or pharmacological stress test, in collaboration with the cardiologist. The stress test is performed with a bicycle ergometer, where the patient is monitored throughout under the supervision of a cardiologist. The load is carried out until a set maximum is reached, according to age and sex. Once this maximum is reached, the patient is injected intravenously with a radiopharmaceutical. For pharmacological burden, substances with a direct vasodilating effect are used. Rapiscan, Dypiridamol, Adenosine, or Doputamine This substance is applied slowly for about 4 minutes. After the application is complete, a radiopharmaceutical is administered. The patient is monitored at all times. After the load has been performed and the radiopharmaceutical has been applied, the patient lies supine on the gamma camera table and we connect the leads to the ECG. The recording lasts about minutes and reflects the state of myocardial blood flow at peak stress. After its completion, the recording is performed in the prone position,to exclude artifacts. After 3 hours from the first application, a second dose of radiopharmaceutical is administered, and after 60 minutes the recording is gated again by the SPECT method — a resting study that lasts about 20 minutes. Imaging of the heart cavities by circulating labeled autologous erythrocytes in the bloodstream. Quantification of the recording allows determination of left ventricular ejection fraction, right ventricular ejection fraction. After about 10 minutes, the patient lies down on the gamma table and the gamma detector is set to the LF position and a gated static recording is started with the help of the ECG. This takes approximately 10 minutes. Cardiac amyloidosis is a group of diseases whose common feature is extracellular deposition of amyloid in the myocardium — insoluble pathological proteins. It can lead to the clinical syndrome of angina pectoris, and in some cases to myocardial infarction. The first stages of the examination are performed immediately after the application of the radiopharmaceutical approx. The patient is injected intravenously with the radiopharmaceutical in the supine position. The blood supply to the pathological process is assessed during an approximately minute scan. After the injection, the patient waits 3. The technician is informed of the time of the next scan. The patient does not have to spend this time in the nuclear medicine department. Before the second scan, the patient is urinated and cleansed of all metal objects. This part takes about 20 minutes. The intravenously injected radiopharmaceutical is trapped in the capillary bed of well-perfused lung parenchyma, whereas it does not reach the non-perfused lung parenchyma. This will appear on the scintigram of the lung as an area of radioactive effusion. This perfusion defect often takes the shape of a segmental effusion. This is to show the distribution of pulmonary capillary perfusion and to detect disturbances in blood flow through the pulmonary vasculature. Display of pulmonary alveolar ventilation distribution and detection of pulmonary ventilation disturbances. The radiopharmaceutical gas is inhaled from a special device by the patient in a closed system through an inhalation mask by mouth or nose. Perfusion defect without ventilation disturbance is typical for pulmonary embolism, perfusion defect with concomitant ventilation disturbance is not indicative of pulmonary embolism. Both examinations are performed at the same time at our clinic. Eight static scans are performed. The intensity and symmetry of radiopharmaceutical uptake in the nc. The radiopharmaceutical is injected intravenously into the patient. Examination of postsynaptic D2 receptors may be beneficial to differ. Differentiating dementia with Lewy bodies from other dementias. Chorigen, for thyroid blockage he gets it from us. Imaging early changes in bone tissue metabolism. The radiopharmaceutical accumulates to an increased extent in sites of increased bone metabolism, and to a reduced extent in osteolytic deposits. The examination is highly sensitive but poorly specific and cannot always distinguish the cause of metabolic changes in bone. It may also show a fracture, degenerative lesion, or metastasis. However, scintigraphy shows a metabolically active bone process several months earlier than X-rays, which is particularly important in the diagnosis of bone metastases. Perthes diagnosis of degenerative joint changes monitoring of postoperative conditions in endoprostheses diagnosis of suspected bionecrosis, sacroilitis …. The first phases of the examination are performed immediately after the application of the radiopharmaceutical about 10 minutes and the bone phase is examined after about 2 — 4 hours the time factor depends on the age and weight of the patient , the patient does not need to spend this time at the nuclear medicine workplace. The second recording takes about 20 minutes. After the injection, the patient waits hours for the radiopharmaceutical to be picked up in the bone structures. The technician is informed about the time of the next scan. The radiopharmaceutical is taken up by the lymphatic vessels and transported to the axillary lymph nodes after intradermal injection into the interstitial space of the dorsal limbs. The examination has 2 parts. After the application, we focus the device on the axillary area pelvis, axilla and follow the penetration of the radiopharmaceutical into this area with a dynamic study. This part takes about 30 minutes. After its completion, we follow this transport with a half-body recording. Afterwards, we let the patient exercise, ev. The patient is asked to exercise the limbs by walking. We complete the examination by calculating the accumulation of radiopharmaceutical in the regional nodes, i. The sentinel lymph node is the first sentinel lymph node that receives lymphatic drainage directly from the tumor. The aim of this method is to determine the number and localization of these nodes. Surgery is then performed and their histology is evaluated. If the sentinel lymph node does not contain metastatic cells, the other LUs in the catchment area do not have them either. The examination is mainly used in malignant melanoma and breast cancer. It is also used in carcinoma of the uterine cervix. The sentinel lymph node is demonstrated peroperatively using a special probe, therefore, possession of this probe at the time of surgery is a prerequisite for performing this examination. The first phase of the examination is performed immediately after the application of the radiopharmaceutical and the second phase of the marking is performed after about 2 hours, the patient does not need to spend this time in the nuclear medicine department. The radiopharmaceutical is applied to the patient in the supine position intracutaneously with several punctures in the scar area in malignant melanoma, or periareolarly — in breast tumour. Imaging is initiated immediately after application by dynamic recording of the sentinel node area to visualize lymphatic drainage. This takes approximately 15 minutes. In 2 hours after application, late static recordings are displayed in different projections. This part of the examination takes about 15 minutes. Surgery is usually performed the next day using a gamasonde, which uses pulses and a sound signal to identify the site of increased radiopharmaceutical accumulation. Using a radiopharmaceutical, the outflow parameters of the kidneys are assessed, the separated renal function the proportion of the right and left kidneys in the total function and the value of the total GF are calculated by computer. The kinetics and distribution of the radiopharmaceutical in the renal parenchyma, its intrarenal transport, excretion into the calyx-bladder system and its outflow into the ureters and bladder are monitored. The patient is injected intravenously in the supine position with the radiopharmaceutical. Immediately after the application, a dynamic recording is started, which lasts for 30 minutes. Intravenous application of furosemide during dynamic renal scintigraphy is used to monitor the response of the kidneys to its administration. In non-obstructive hydronephrosis, the outflow of retinated urine and the renographic curve decrease after furosemide diuretic administration. The examination can be performed in conjunction with dynamic renal scintigraphy, when visualizing the obstruction of the kidney, an intravenous diuretic is administered at about 20 minutes of the examination and the effect of the administration of this diuretic is observed for about 10 minutes. An ACE inhibitor induces a decrease in glomerular filtration rate and concomitant decrease in function in kidneys with hemodynamically significant a. This is reflected on dynamic renal scintigraphy — in particular, by a flattening of the functional segment and a delay in the peak of the curve of the affected kidney; prolonged transit is present in the parenchyma. Discontinue diuretics and ACE inhibitors 3 — 7 days prior to examination Drink approx. The examination starts with the administration of captopril in tablet form. After administration of the pill, we monitor the pressure at approximately 20 minute intervals. After 60 minutes of captopril, we place the patient on the gamma camera table and the next procedure is identical to dynamic renal scintigraphy. In case of pathological findings, we book the patient for examination without captopril administration. This follow-up examination can be performed in 10 days at the earliest. The radiopharmaceutical is taken up in the cells of the proximal tubules of the kidney and, depending on their functional state, is fixed there for a certain period of time. This allows us to view the functional renal parenchyma, assess the localization, shape and size of the kidney, calculate the separated function and detect lesions. After the intravenous application of radiopharmaceutical, which takes place without scanning, the examination takes about 2 hours the time factor depends on the age and weight of the patient , the patient does not need to spend this time at the nuclear medicine workplace. The radiopharmaceutical is administered intravenously and shaken out approximately 2 hours after administration. The patient lies supine and 6 static scans are performed at different angles of the gamma camera. The scanning takes about 20 minutes. The radiopharmaceutical is uptaken up in the thyroid tissue and its accumulation rate is proportional to its functional status. The shape, localization, cold nodules cysts, tumors and hot nodules hyperfunctioning tissue are assessed. The patient is injected intravenously with the radiopharmaceutical in a sitting position. The drug is then allowed to be absorbed in the thyroid parenchyma for about 15 minutes. The radiopharmaceutical is uptaken up in pathological parathyroid tissue parathyroid adenoma,or parathyroid hyperplasia. At the same time, the thyroid gland is imaged, but the radiopharmaceutical is flushed out more quickly in contrast to the pathological parathyroid gland. For a more accurate diagnosis, the examination begins with a thyroid examination. After the examination is completed, the patient is administered chlorigen and waits for about 1 hour. The effect of the chlorigen is checked under the gamma camera by placing the patient in the same position as during the thyroid examination. The effect should be seen so that we cannot see the thyroid tissue on the image. If the tissue is visible, we must continue the examination on another day. If no tissue is seen, we proceed with the administration of a second radiopharmaceutical to examine the parathyroid glands. We perform the first scan about 15 minutes after administration, again in the identical position as for the thyroid scan. The scan takes 5 minutes. The second scan is performed under similar conditions in about 2 hours. We use the principle of subtraction scintigraphy for the evaluation, and targeted SPECT is added to increase the sensitivity and specificity of the examination. This is a functional and morphological examination of the salivary glands and their ability to uptake radiopharmaceuticals. The intensity, rate and symmetry of accumulation of the radiopharmaceutical by the salivary glands and their response to salivation stimulus are assessed. The patient is injected with the radiopharmaceutical intravenously in the supine position. Immediately after application, we start a dynamic study focusing on the head region. In the middle of the examination, a salivation stimulus lemon juice using a tube or syringe is administered orally. After intravenous administration of the radiopharmaceutical, we monitor its uptake by hepatocytes, excretion into the bile ducts and its passage into the duodenum. The examination allows to evaluate in a non-invasive way mainly hepatocellular function, bile duct patency and gallbladder function. The patient lies supine on the gamma table and the radiopharmaceutical is administered intravenously. Once the gallbladder begins to be imaged at approximately 30 minutes into the scan the patient is given the brought chocolate. After the study is completed, we will take a 2 minute static image of the patient. We then repeat this static image at approximately hourly intervals as needed. The patient may eat in between scans. The radiopharmaceutical is uptaken up by Kupffer cells in the liver after administration and, due to the presence of phagocytic reticuloendothelial cells in the spleen, is also uptaken up in the spleen. The distribution of the radiopharmaceutical in the parenchyma of the liver and spleen is proportional to the phagocytic capacity of the RES. The patient is injected intravenously with the radiopharmaceutical either under the gamma camera dynamic study is started immediately after application or in sitting position. The examination itself starts 20 minutes after application. Six basic projections are taken. After intravenous injection of in vitro 99mTc-labeled autologous erythrocytes, their uptake occurs in the hepatic cavernous hemangioma. This appears as a saturated accumulation of radiopharmaceutical on scintigram. The patient is given an intravenous cannula and the HDP kit is injected. Approximately 20 min later, 20 ml of blood is drawn into a syringe and the 99mTc pharmacopeia is added to this blood. With occasional stirring, in about 10 min the blood is returned to the patient. The examination itself starts in 45 min at the earliest. The patient lies down on the gamma camera table and we take 6 basic static images and to increase the sensitivity and specificity of the examination, targeted SPECT is added. This part takes 20 minutes. The patient lies down on the gamma table and the radiopharmaceutical is injected intravenously. Immediately after completion of the application, dynamic scanning is started and the abdomen is carefully observed for any saturated accumulation of radiopharmaceutical indicative of positivity. The scan lasts approximately 60 minutes. The radiopharmaceutical is mixed into the diet and administered per os to the patient. The motility and gastric emptying capacity are monitored. After eating it, the patient lies down on the gammacamera table and we focus the device on the abdominal area. We start a dynamic study that lasts about 60 minutes and monitor gastric activity. At the end of the study, we take a 2-minute static image of the patient. In between scans, the patient cannot eat and only takes fluids. After intravenous injection of in vitro 99mTc-labeled autologous erythrocytes, their uptake occurs at the site of bleeding. This appears on the scintigram as a saturated accumulation of the radiopharmaceutical. The presence of blood in the stool on the day of examination is ideal. Evidence and determination of the site of bleeding, especially in the middle and lower GIT — polyps, diverticula. The patient lies down on the gamma table and we slowly inject the blood. We start a dynamic study that lasts 60 minutes. At the end of the study, we take a 2-minute static picture of the patient. We then repeat this static image at approximately hourly intervals as needed, in rare cases on a second day. The examination is used to image tissue with somatostatin receptor expansion, especially tumors of neuroendocrine origin. The radiopharmaceutical, as a somatostatin analogue, binds to somatostatin receptors. After the intravenous application of the radiopharmaceutical, which takes place without scanning, the examination takes about 1 hour, the second examination is in 3 hours after the application, the patient does not need to spend this time at the nuclear medicine workplace. The scan is repeated after 24 hours. The patient is injected with the radiopharmaceutical and the first scan is performed approximately 60 minutes after application. The patient lies down on the gammacamera table and we perform a full-body scan. This is repeated identically 3 hours after application. At 24 hours after application, we take static images of the chest and abdomen. The radiopharmaceutical, as a noradrenaline analogue, accumulates in the catecholamine secretory granules of neuroendocrine tissues. Pheochromocytoma neuroblastoma carcinoid medullary thyroid carcinoma gastrinoma insulin glucagonoma vipoma adrenal medullary hyperplasia. The radiopharmaceutical is injected intravenously into the patient and the first scan is performed 4 hours after application. The patient lies down on the gamma table and we take a full body scan. The scan takes about 30 minutes. The next part of the scan takes place 24 hours after application. The scanning time is approximately 1. Patients can make an appointment for an examination: by sending an application form by post, by phone, by e-mail, in person or via an online form. After submitting the form, we will contact the patient to arrange an appointment. For ordering and information about examinations, please contact individual MRI workplaces. Vivamed s. Reimana, Odd. Search Close this search box. Scintigraphic examination. If you are interested in scintigraphic examination of your patients, the following procedure should be followed: fill out the Radiopharmaceutical Examination Request Form twice, a sample request form can be found in the Documents section. The application form can also be filled out online, but in this case you need to print a copy, stamp it and give it to the patient to bring to the examination. We ask you to instruct your patient to do so. Radiopharmaceuticals are prepared individually for each patient, and failure to use them will invalidate the prepared dose that could be used for another patient. The examinations are non-invasive the general rule of examinations in nuclear medicine is an increased fluid intake, especially after the examination. Heart examinations. Principle of examination: After intravenous administration of a radiopharmaceutical, its uptake by myocardial cells occurs. Indications: determination of the extent and localization of myocardial ischemia detection of post-infarction myocardial scar unclear findings on resting and post-stress ECG diff. Radionuclide ventriculography MUGA scan. Principle of examination: Imaging of the heart cavities by circulating labeled autologous erythrocytes in the bloodstream. Indications: detection of cardiotoxicity of cytostatics in oncological patients cardiomyopathies Patient preparation: none Duration of examination: approx. Scintigraphy of amyloidosis of the heart. Principle of examination: Cardiac amyloidosis is a group of diseases whose common feature is extracellular deposition of amyloid in the myocardium — insoluble pathological proteins. Indications: diagnosis of cardiac amyloidosis Patient preparation: none Duration of examination: approx. Radiopharmaceutical: 99mTc — hydroxymethylene diphosphonate oxydronate Method of administration: Intravenous Examination methodology: The patient is injected intravenously with the radiopharmaceutical in the supine position. Examinations of the lungs. Perfusion scintigraphy of the lungs. Principle: The intravenously injected radiopharmaceutical is trapped in the capillary bed of well-perfused lung parenchyma, whereas it does not reach the non-perfused lung parenchyma. Radiopharmaceutical: 99mTc — serum albumin macroaggregate Method of application: Intravenous. Ventilation scintigraphy of the lungs. Principle: Display of pulmonary alveolar ventilation distribution and detection of pulmonary ventilation disturbances. Radiopharmaceutical: 81mKr Method of application: Inhalation Perfusion defect without ventilation disturbance is typical for pulmonary embolism, perfusion defect with concomitant ventilation disturbance is not indicative of pulmonary embolism. Indications: diagnosis of pulmonary embolism monitoring the effect of pulmonary embolism therapy dg. CNS examinations. Scintigraphy of presynaptic dopamine transporters - I DaTScan. Principle: Examination of postsynaptic D2 receptors may be beneficial to differ. Patient preparation: 24 hours before the examination discontinue antiparkinsonian drugs 1 hour before examination take 1 tbl. Chorigen, for thyroid blockage he gets it from us Duration of examination: Approx. Bone examination. Whole-body scintigraphy of the skeleton. Principle: Imaging early changes in bone tissue metabolism. Indications: dg. Perthes diagnosis of degenerative joint changes monitoring of postoperative conditions in endoprostheses diagnosis of suspected bionecrosis, sacroilitis … Patient preparation: None increased fluid intake Duration of examination: approx. Radiopharmaceutical: 99mTc — hydroxymethylene diphosphonate oxydronate Method of application: Intravenous Examination methodology: The patient is injected intravenously with the radiopharmaceutical in the supine position. Examination of the lymph nodes. Quantitative lymphoscintigraphy of the extremities. Principle: The radiopharmaceutical is taken up by the lymphatic vessels and transported to the axillary lymph nodes after intradermal injection into the interstitial space of the dorsal limbs. Scintigraphy of the sentinel lymph node. Principle: The sentinel lymph node is the first sentinel lymph node that receives lymphatic drainage directly from the tumor. Indication: detection of sentinel lymph node peroperatively Patient preparation: None, if the patient will be operated on the same day, then fasting Duration of examination: approx. Radiopharmaceutical: 99mTc — colloid Method of application: intradermal, periareolar Examination methodology: The radiopharmaceutical is applied to the patient in the supine position intracutaneously with several punctures in the scar area in malignant melanoma, or periareolarly — in breast tumour. Kidney examinations. Dynamic renal scintigraphy. Principle: Using a radiopharmaceutical, the outflow parameters of the kidneys are assessed, the separated renal function the proportion of the right and left kidneys in the total function and the value of the total GF are calculated by computer. Indications: assessment of renal function suspicion of kidney damage and outflow disorders Patient preparation: 30 minutes before the examination, drink about 0. Dynamic renal scintigraphy with furosemide test. Principle: Intravenous application of furosemide during dynamic renal scintigraphy is used to monitor the response of the kidneys to its administration. Dynamic renal scintigraphy with captopril test. Principle: An ACE inhibitor induces a decrease in glomerular filtration rate and concomitant decrease in function in kidneys with hemodynamically significant a. Indications: suspicion of renovascular hypertension in a. Static renal scintigraphy. Principle: The radiopharmaceutical is taken up in the cells of the proximal tubules of the kidney and, depending on their functional state, is fixed there for a certain period of time. Indications: diagnosis of solitary kidney shape anomalies of the kidney abnormal kidney placement, including renal migrans pyelonephritis — evidence of a cortical lesion especially in children focal processes — cysts, tumours Patient preparation: none Duration of examination: approx. Radiopharmaceutical: 99mTc — dimercaptoacetic acid Method of application: Intravenous Examination methodology: The radiopharmaceutical is administered intravenously and shaken out approximately 2 hours after administration. Examinations of the endocrine system. Scintigraphy of the thyroid gland. Principle: The radiopharmaceutical is uptaken up in the thyroid tissue and its accumulation rate is proportional to its functional status. The shape, localization, cold nodules cysts, tumors and hot nodules hyperfunctioning tissue are assessed Indications: hyperthyroidism thyroiditis determination of the size, shape, location of the thyroid gland detection of nodules Patient preparation: exclude medication affecting thyroid function at least 3 days before the examination thyreostatic drugs at least 1 month prior to thyroid hormone testing at least 3 months prior to the examination iodine preparations, including iodine contrast doses used in X-rays. Examinations Duration of examination: approx. Scintigraphy of the parathyroid glands. Principle: The radiopharmaceutical is uptaken up in pathological parathyroid tissue parathyroid adenoma,or parathyroid hyperplasia. Indications: suspicion of adenoma or hyperplasia of the parathyroid gland suspicion of ectopically deposited parathyroid gland dg. GIT examinations. Scintigraphy of the salivary glands. Principle: This is a functional and morphological examination of the salivary glands and their ability to uptake radiopharmaceuticals. Cholescintigraphy - scintigraphy of the gallbladder and bile ducts. Principle: After intravenous administration of the radiopharmaceutical, we monitor its uptake by hepatocytes, excretion into the bile ducts and its passage into the duodenum. Indications: functional disorders of gallbladder and bile duct motility acute cholecystitis dg. Liver and spleen scintigraphy. Principle: The radiopharmaceutical is uptaken up by Kupffer cells in the liver after administration and, due to the presence of phagocytic reticuloendothelial cells in the spleen, is also uptaken up in the spleen. Indications: deposits in the liver cirrhosis Patient preparation: none Duration of examination: approx. Scintigraphy of hepatic hemangioma. Principle: After intravenous injection of in vitro 99mTc-labeled autologous erythrocytes, their uptake occurs in the hepatic cavernous hemangioma. Indication: dg. Scintigraphic evidence of Meckel's diverticulum. Scintigraphy of gastric evacuation. Principle: The radiopharmaceutical is mixed into the diet and administered per os to the patient. Indication: Functional gastric disorders Patient preparation: fasting discontinue medications promoting gastric function diet risotto Duration of examination: approx. Scintigraphy localization of GIT bleeding. Principle: After intravenous injection of in vitro 99mTc-labeled autologous erythrocytes, their uptake occurs at the site of bleeding. Indication: Evidence and determination of the site of bleeding, especially in the middle and lower GIT — polyps, diverticula Patient preparation: none Duration of examination: approx. Tumour examinations. Scintigraphy of tumors containing somatostatin receptors using 99mTc-tektrotyde. Principle: The examination is used to image tissue with somatostatin receptor expansion, especially tumors of neuroendocrine origin. Indications: neuroendocrine tumours carcinoid paraganglioma Patient Preparation: day before administration of radiopharmaceutical liquid diet fasting takeaway diet Duration of examination: approx. Radiopharmaceutical: 99mTc — tectrotide Method of application: Intravenous Examination methodology: The patient is injected with the radiopharmaceutical and the first scan is performed approximately 60 minutes after application. Principle: The radiopharmaceutical, as a noradrenaline analogue, accumulates in the catecholamine secretory granules of neuroendocrine tissues. Indications: Pheochromocytoma neuroblastoma carcinoid medullary thyroid carcinoma gastrinoma insulin glucagonoma vipoma adrenal medullary hyperplasia Patient preparation: 2 days before application, on the day of application and 3 days after application thyroid blockade with chlorigen discontinuation of tricyclic antidepressants, some antihypertensives and cardiovascular drugs, sympathomimetics Duration of examination: This is a 2-day examination Radiopharmaceutical: I — metajodbenzylguanidine Method of administration: Intravenous Examination methodology: The radiopharmaceutical is injected intravenously into the patient and the first scan is performed 4 hours after application. Patient appointment. Patient's name. Patient's e-mail. Patient telephone. Type of examination. Attach file. Vivamed, s. Facebook-f Youtube Linkedin Rss. 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