Nuclear Medicine

VCU Health Radiology uses advance nuclear imaging for a closer look at organ and deep tissue function

Conventional x-rays are used primarily to study soft tissues and the skeletal system. But for a closer look at the body’s organ and tissue function and blood circulation, VCU Heath uses advanced nuclear imaging.

Nuclear medicine is a subspecialty within the field of radiology (medical imaging) that uses very small amounts of radioactive materials to diagnose disease and other abnormalities. Because the doses are so small, the risks you might normally associate with radiation exposure is very low.

In conventional diagnostic imaging, an external source of energy such as x-rays, magnetic fields, or ultrasound waves is used to produce images of the body’s anatomy. In nuclear medicine, the energy source is a radioactive material that is introduced into the body. The materials, called radiopharmaceuticals or radiotracers, get incorporated – or “taken up” – in a specific tissue or organ and are then detected by an external scanning device or specialized camera to provide images and information on organ function and cellular activity. 

Because disease begins with microscopic cell changes, nuclear medicine scans have the potential to identify disease in an earlier, more treatable stage, often before conventional imaging and other tests are able to reveal abnormalities.

The Procedure

A nuclear medicine scan consists of three phases: the administration of a radioactive tracer, taking images with specialized cameras or scanners and the interpretation of those images.

The amount of time between administration of the radiotracer and the taking of the images may range from a few moments to several hours to a few days – depending on the body tissue being examined and the radiotracer being used.

Depending on the type of nuclear medicine scan you are undergoing, the radioactive tracer is injected into a vein, swallowed by mouth or inhaled as a gas, and eventually collects or is absorbed in the area of your body being scanned. The radioactive tracer produces an energy signal that can be detected by a specialized camera or scanner (gamma camera, SPECT or PET scanners).

By measuring the behavior of the radioactive tracer in the body during a nuclear scan, VCU Health nuclear medicine radiologists can assess and diagnose various conditions – such as tumors and infections – and assess organ function and blood circulation.

Nuclear medicine scans are used to diagnose many medical conditions and diseases. Some of the more common tests include the following:

• Renal scans examine the kidneys to find abnormalities such as abnormal function or obstruction of renal blood flow.
• Thyroid scans evaluate thyroid function or better evaluate a thyroid nodule or mass.
• Bone scans evaluate any degenerative and/or arthritic changes in the joints, to find bone disease and tumors, and/or to determine the cause of bone pain or inflammation.
• Gallium scans diagnose active infectious and/or inflammatory diseases, tumors, and abscesses.
• Heart scans identify abnormal blood flow to the heart, determine the extent of damage to the heart muscle after a heart attack, and/or to measure heart function.
• Brain scans investigate problems within the brain and/or in the blood circulation to the brain.

Nuclear medicine safety

Because the doses of radiotracer are very small, diagnostic nuclear medicine procedures result in minimal radiation exposure. Thus, the radiation risk is very low compared to the potential benefit of the study.

Nuclear medicine specialists at VCU Health use the “ALARA” principle (As Low As Reasonably Achievable) to carefully select the amount of radiotracer that will provide an accurate test with the least amount of radiation exposure to the patient. The actual dosage is determined by the patient’s body weight, the reason for the study, and the body part being imaged. In addition, newer imaging technologies are constantly emerging to reduce radiation exposure to patients while maintaining the diagnostic accuracy of the test.

Nuclear medicine procedures have been performed for more than 50 years on adults and for more than 40 years on infants and children of all ages without any known adverse effects.

Preparing for your nuclear medicine exam

Typically, no advance preparation is required for a nuclear medicine exam; however, some exams require that you do not have anything to eat or drink prior to the procedure. You will receive specific instructions (see below) based on the type of scan you are undergoing.  

Generally speaking:

• If your stomach area is being evaluated, you may be asked to skip a meal prior to your test
• If your kidneys are being evaluated, you may be asked to drink plenty of water prior to your test

During the exam, you will lie on a scanning table. A specialized nuclear imaging camera is used to facilitate imaging specific parts of the body, and a nearby computer console processes the information gathered from the examination. Please refer to the patient instructions below for some of the more common scans done here at the VCU Health Nuclear Medicine Division.

• Bone Scan
• Cisternogram
• DaTscan Imaging
• First Pass Scan
• Gallium Imaging
• Gastrointestinal (GI) Bleeding Scan
• HIDA Hepatobiliary Scan
• I-123 MIBG Imaging
• Liquid Gastric Emptying
• Liver/Spleen Scan
• Lung VQ (Ventilation/Perfusion)
• Lymph Gland Imaging
• Meckel's Diverticulum Imaging
• MUGA (Multi Gated Acquisition Scan)
• Myocardial Perfusion Imaging (MPI)
• Octreotide Imaging
• Parathyroid Imaging
• PET/CT Scan
• Prostascint Imaging
• Renal Function Scan
• Solid Gastric Emptying Scan
• Tagged White Blood Cell Imaging
• Thyroid Imaging
• VCUG (Voiding Cystourethrogram)
• Whole Gut Transit Imaging

After your scan

When the procedure is completed, you may be asked to wait until our VCU Health technologists checks the images in case additional scans are needed. If you had an IV line inserted for the procedure, it will be removed.

Through the natural process of radioactive decay, the small amount of radiotracer in your body will lose its radioactivity over time. In many cases, the radioactivity will dissipate over the first 24 hours following the test and pass out of your body through your urine or stool. You may be instructed to take special precautions after urinating, to flush the toilet twice and to wash your hands thoroughly. You should also drink plenty of water to help flush the radioactive material out of your body.

Unless your physician tells you otherwise, you may resume your normal activities after your nuclear medicine scan.

Exam results: All nuclear medicine scans are read and interpreted by a VCU Health radiologist specialty trained in nuclear medicine imaging and dedicated to the specific area of interest for your study.  Rapid results are essential not only for your peace-of-mind, but also for your physician to begin planning treatment immediately, if necessary.  After the scan has been read the results are sent to your physician, who will discuss them with you.

Plan your visit

The Nuclear Medicine Department is located in the Gateway Building, 2^ndFloor, 1200 East Marshall Street. Click here for directions and parking to VCU Health Gateway Building.

Phone: (804) 828-6828

Hours: Mon – Fri 7 a.m. – 5 p.m. 

Advanced scheduling is required for all nuclear medicine exams. Please call us to schedule or if you have questions regarding your nuclear medicine exam.