Kids Health Info

Nuclear Medicine - an overview

  • Nuclear Medicine is a medical imaging specialty that involves the use of radioactive pharmaceuticals for diagnostic imaging, therapy and research.

    Why are nuclear medicine examinations performed?

    Nuclear Medicine imaging combines the use of radiopharmaceuticals and gamma cameras, to provide images that can see inside the body.

    Nuclear Medicine studies are performed for many different reasons including:

    • to see how different organs in the body are functioning
    • to look at the shape or structure of parts of the body
    • for early detection, treatment, and management of diseases.

    Nuclear Medicine studies can be performed on most organs of the body.

    Nuclear Medicine studies routinely performed at RCH include:

    • Bone scan
    • Mag3 renal scan
    • DMSA renal scan
    • Gastric empty and gastro-intestinal transit studies
    • Thyroid scan and therapy
    • Brain perfusion (epilepsy)
    • GFR renal studies
    • MIBG whole body imaging

    Who is involved in a Nuclear Medicine examination?

    The Nuclear Medicine Team at The Royal Children’s Hospital includes:

    • Nuclear medicine technologists - perform the examination, including taking the images and administering the radioactive tracer.
    • Nuclear medicine physician - oversees the examination and compiles a report of the results for the referring physician(s).
    • Registered nurse - may be present to provide care for your child during the examination.
    • Educational play therapist - may be present to help with coping strategies before, during, and after the examination.
    • Students and visiting staff - are often present as observers as RCH is a tertiary institution (providing education to trainees).

    What is involved with a nuclear medicine examination?

    Your child will be invited into the camera room by a technologist and the procedure will be explained to you and your child. Your child will then be positioned on the scanning bed and seat belts may be placed around your child to help them remain still, but also for safety purposes as the scanning bed is quite narrow and can move. Before a Nuclear Medicine image can be obtained, your child requires administration of a radiopharmaceutical. This can occur in different ways for example:

    • intravenous (IV) needle (95% of studies at RCH)
    • oral drink
    • oral tablet.

    Once the tracer has been administered, imaging can be begin immediately, or after a delay – depending on the examination required. Imaging may include the camera moving slowly over or around your child's whole body, or a specific area of their body. Your child is required to keep very still whilst the camera is taking images. The average time for a Nuclear Medicine procedure is 30-45 minutes, but there may be multiple scans or sequences required over a longer period of time.

    How can my child prepare for a Nuclear Medicine examination?

    Preparation for a Nuclear Medicine examination depends on the type of scan your child is having, and your child’s individual needs. Some scans require fasting for the actual imaging sequences, and others require fasting for sedation. If your child requires an injection, a topical anaesthetic cream (AnGel or Emla) can be applied to the preferred, or best site (e.g. hands, inside elbows or feet) prior to injection by the technologist. This should make the injection site numb, and the injection should not bother the patient. The cream usually takes about 45 minutes to work so you will be required to attend the department earlier than your appointment time. 

    Sedation is not routinely used for all patients for all studies, and is decided at the time of the study. What is required of you and your child will be discussed at the beginning of your appointment with the Nuclear Medicine staff.

    A lot of these decisions will be made at the time of booking or prior to the beginning of the scan, and are dependent on your individual child, age and circumstances.

    Reasons for sedation:

    • If your child is unable to remain still and/or is distressed – even with the use of distractions such as toys, books and DVD's, and Educational Play Therapy.
    • Your child will be assessed to be medically safe for sedation. This is determined by the physician and nurse on the day of the study.

    Studies that may require sedation:

    • Bone scans
    • MIBG scans
    • Brain scans
    • Other scans as decided by the technologist performing the study.

    What do we do to make the Nuclear Medicine examination less stressful for you and your child?

    The Nuclear Medicine Team are very aware of the things that can upset children and their parents or carers. Before we start any study we will explain the test to you and what it involves. It is important that you are given an adequate explanation of what the test involves, and it is usually the referring doctor who is in the best position to explain why any test is being performed.

    We have a wide selection of DVD's for all ages; however your child may choose to bring one of their own in with them, or other devices that can be used to help as distraction such as an iPad.

    The Nuclear Medicine Department strives to obtain images without the use of sedation and believe sedation should be used as a last resort. We will attempt the study using other means first (parental involvement, distraction devices as mentioned above, Educational Play Therapy intervention), and are very experienced at deciding if and when sedation may be required, in consultation with the parent/carer.

    The Nuclear Medicine staff have developed strategies that will enable them to obtain the best quality studies for the physician, in a positive environment which aims to not upset or distress your child. We aim to provide high quality images, whilst the child and parent/carer feel that their emotional needs have been considered.

    Referrals for Educational Play Therapy can be organised prior to your child's scan by contacting 03 9345 5424. Please visit the Educational Play Therapy website to see how they can help with your child’s scan.  

    What you can do to make the nuclear medicine examination less stressful for your child?

    It can be of great help to your child if the procedure is explained to them prior to coming in for the study. It is important to reinforce that:

    • the scans do not take long
    • the scans are painless
    • a parent/carer can stay with the child during the scan
    • an injection may be required, and if so, staff have many techniques that can help make an injection less bothersome
    • most children can watch their favourite DVD while having their scans
    • Educational Play Therapy sessions prior to the scan can help many children and their parents develop coping strategies for the study. If you or your child feel that coping may be an issue, a play therapy session will be of benefit.
    • See the Kids Health Info factsheet:  Reduce children's discomfort during tests and procedures.

    Arriving for the appointment

    The Nuclear Medicine Department is part of the Medical Imaging Department on the lower ground floor of The Royal Children's Hospital. Enter from the main entrance on Flemington Road and follow the signs to the Medical Imaging Department (look for the GREEN lifts). Reception staff will direct you to the Nuclear Medicine waiting room where a Nuclear Medicine Technologist will meet you. If your child requires topical anaesthetic cream, you will be required to attend the department one hour prior to your examination time, and cream will be applied.

    After the scan

    You will be able to leave straight after the completion of the scan, unless your child has had sedation. If your child had sedation, they will be required to remain under the care of the department nurse until your child has fulfilled all the requirements of post sedation recovery. 

    A report will be prepared by the Nuclear Medicine Physician and sent to the referring doctor, and is usually available within a few days but can be received earlier if required.

    Nuclear medicine scan with general anaesthetic (GA)

    Some Nuclear Medicine studies at the RCH are performed under a general anaesthetic (GA). This is rare but would usually occur if your child falls outside the sedation requirements, or has a condition where sedation cannot be used. These children may require admission and must fast (have nothing to eat or drink) prior to imaging. Please contact the Medical Imaging department for further information regarding GAs.

    For more information

     

    Developed by the Royal Children's Hospital (RCH) Department of Nuclear Medicine. First published in April 2007.  Updated June 2016.


Disclaimer 
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.