Scintigraphy is a modern method of radionuclide visualization of internal organs, which is distinguished by its informativeness and reliability of the results obtained. Scintigraphic examination is non-invasive and atraumatic. The essence of the study: a radiopharmaceutical (RP) is introduced into the human body, then tissues and organs are visualized in photographs, which make it possible to determine the condition of the organs, identify pathological changes and anatomical and topographical features.
Historical information
Gyorgy de Hevesy is the founder of scintigraphy; he received the Nobel Prize for this greatest discovery. In the mid-90s, radionuclides began to be used in medicine. Various techniques have emerged that make it possible to determine the presence of a radiotracer in organs, and monitoring its movement and distribution has become real. Scanning, radiographic testing and radiometry began to be widely used.
A completely new stage in medicine was the development of a scintillation gamma camera; decades later, this examination method began to be called scintigraphy. Many medical textbooks also contain other names for the technique, for example, gamma scintigraphy.
Features of scintigraphic research
Content:
- Historical information
- Features of scintigraphic research
- Popularity of scintigraphy
- Indications for the procedure
- How to prepare for diagnosis?
- Stages of scintigraphy
- Contraindications and adverse reactions
Scintigraphic diagnostics are carried out to find hidden pathologies in the body using radioactive substances. The drug that is introduced into the human body is called a radiotracer or radiopharmaceutical. It consists of 2 main parts: a marker (isotope) and a vector molecule. The organ or tissue being examined “absorbs” the vector (special particle). The tag performs an important function - it produces gamma rays, which are recorded by a gamma camera.
Gamma cameras can be stationary or mobile. Each of the cameras consists of: a detector, replaceable lead collimators, photomultipliers and a computer, on the monitor of which images of the distribution of a special drug in the area under study appear. The images obtained during the examination are called scintigrams.
Increased or decreased accumulation of radiotracer in a specific organ or tissue can be seen in the image. An increased amount of the drug will be indicated by “hot” foci on the scintigram, and “cold foci” indicate a reduced accumulation of the drug. Radiopharmaceuticals do not have a negative toxic effect on the patient’s well-being, since a small dose of the drug is administered.
Equipment
Our clinic has modern scintigraphy equipment. It forms a three-dimensional image and visualizes foci of pathology with the highest clarity. Its advantages are:
- extremely low radiation doses;
- precise localization of pathology;
- the ability to choose the optimal image format – volumetric or cross-sectional;
- visual control of tissue biopsy;
- assessment of the data necessary for accurate dosage calculations for radioisotope treatment.
Popularity of scintigraphy
Scintigraphic studies are widespread in America and European countries. In the United States, more than 17 million radionuclide studies were conducted in 2007. More than 15 million patients have successfully undergone scintigraphic diagnostics and been cured of serious diseases. In European countries over the same period (2007), specialists conducted more than 12 million studies.
Today in America more than 13 thousand gamma cameras are working properly. In the Russian Federation, scintigraphy is not as popular as in other countries. Only 200 gamma cameras were installed. In one year, about 1 million patients are sent for diagnostics.
Indications for the procedure
Radionuclide examination is prescribed for patients who have been diagnosed with congenital or acquired pathologies or chronic diseases. It is also advisable to carry out the procedure to clarify the degree of damage to internal organs and the activity of pathological foci. Scintigraphy is often performed to assess the effectiveness of the therapy.
Gamma scintigraphy is used to examine:
- lungs;
- lymphatic system;
- spinal cord and brain;
- digestive system;
- organs of the excretory system;
- heart;
- vessels;
- skeletal system...
Using the procedure, you can identify diseases: myocardial contractions, pulmonary embolism, inflammatory and infectious processes, tumors, Alzheimer's and Parkinson's diseases. Using a scintigram, a specialist will be able to see hidden diseases and changes in the thyroid gland, kidneys, liver and other vital organs.
How to prepare for diagnosis?
Features of preparation depend on what kind of scintigraphy will be performed. You need to carefully prepare for the examination of the thyroid gland, skeleton, heart and lungs. The doctor often stops taking medications that can negatively affect the final diagnostic results. It is necessary to temporarily discontinue medications that accumulate and remain in tissues and organs.
When examining the thyroid gland, it is not recommended to take medications containing iodine a month before the procedure. You can eat any food during the examination of the heart, lungs, skeleton and thyroid gland. During scintigraphy, the patient should not feel hungry or thirsty, so it is advisable to eat something before starting the procedure. In order for the results of the heart study to be reliable, the gallbladder must be emptied (the patient must eat several cubes of chocolate before starting the procedure). But the organs of the gastrointestinal tract are examined exclusively on an empty stomach. You should not eat food 8-12 hours before the procedure.
Bone
scintigraphy ( osteoscintigraphy ) is a modern screening study for assessing pathological changes in the skeleton with minimal radiation exposure to the patient. It should be noted that this method makes it possible to identify pathological changes in bone tissue before the appearance of radiological signs of the disease.
Three-phase osteoscintigraphy (dynamic 3-stage study) is used primarily for the diagnosis of benign formations , while the phases of blood flow, blood filling of the tissue and examination of the bones themselves are assessed.
Most often (mainly in cases of proven malignant neoplasms), a multiphase technique is not required and only the third phase is performed - static scintigraphy of the bones of the whole body.
Indications for bone scintigraphy
- Diagnosis, staging, response to therapy and follow-up of tumor (primary tumors - Ewing's sarcoma, osteosarcoma, etc., metastatic lesions as a result of breast, prostate, lung cancer, etc.) and non-tumor diseases (osteomyelitis, Perthes' disease, aseptic necrosis, metabolic bone diseases).
- Osteoporosis.
- Fibrous dysplasia.
- Stress fractures.
- Infection of a prosthetic joint.
- Sacroiliitis.
- Injuries.
Purpose of the study
Identification of the localization of zones of benign/malignant disorders of “bone” metabolism.
Preparing for bone scintigraphy
No special preparation is required. You must have 1 liter of drinking water with you , which must be drunk within 1 hour after administration of the radiopharmaceutical. Immediately before the test, you must empty your bladder.
The study is carried out 2-3 hours after the administration of the radiopharmaceutical. Takes from 30 to 45 minutes.
There is a list of drugs that can affect the quality of scintigraphic images of skeletal bones , these include: bicalutamide, estrogens, bisphosphonates, denosumab, corticosteroids, hematopoietic growth factors, iron supplements, methotrexate, nephrotoxic chemotherapy, nifedipine. Therefore, it is necessary to warn the radiologist before the study about taking these drugs .
Using the combined SPECT/CT system “Bright View XCT” from Philips, studies are carried out in the “whole body” mode. Normal bone scintigram in anterior and posterior projection.
Multiple secondary tumor foci in the bones
If necessary (to eliminate topographic inaccuracy of radiopharmaceutical accumulation), the study can be supplemented with combined SPECT/CT scanning.
The combined use of radionuclide imaging and X-ray computed tomography methods significantly improves the quality of diagnosis, since it allows for precise anatomical localization of the lesion detected using SPECT.
Skeletal scintigraphy. Tumor metastasis to the rib
SPECT
CT
SPECT/CT
When appearing for the study, you must have with you:
- direction;
- passport;
- SNILS;
- compulsory medical insurance or voluntary medical insurance policy;
- replacement shoes;
- (MANDATORY!) results of previously performed radiation studies (CT, MRI, PET/CT, SPECT) and research results recorded on CD or DVD
- (MANDATORY!) medical documentation: conclusions of specialists (oncologist, traumatologist), extracts from the medical history, outpatient records and levels of tumor markers ).
In the absence of the above documents, the interpretation of scintigraphy data may be incomplete.
You can sign up for the study and get detailed information by calling: (812) 24-600-06 ( from 09:00 to 12:00 on weekdays ).
IMPORTANT! Cancellation of a planned study must be made no later than 24 hours before the study.
REMINDER FOR A PATIENT planning to undergo a radionuclide (radioisotope) study
Stages of scintigraphy
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A radiotracer is injected into the patient’s body, and it enters the organs through the bloodstream. When the substance has completely spread throughout the organs, pictures will be taken, which are recorded and processed by a computer. Images can be: dynamic, static, synchronized and tomographic. Using the images, the specialist studies the anatomical location, parameters, shape and other features of the area under study.
The dosage of the drug directly depends on the internal organ or system being examined. For a detailed and informative diagnosis of the heart, skeleton and brain, a large dosage of radiopharmaceuticals is required. Even a large amount of radioactive substance does not have a negative effect on the patient’s health, because the radiopharmaceuticals continuously disintegrate and are quickly eliminated from the body.
The duration of the procedure can vary from 15-20 minutes to 2.5-3 hours. The skeletal examination takes the most time – 2.5-3 hours. You can examine the heart within 50-60 minutes. It will take at least half an hour to diagnose the kidneys, liver and biliary tract. The thyroid gland can be examined in 20-40 minutes. The duration of the manipulation depends on how quickly the radiopharmaceuticals accumulate in the organ or system being examined.
The main advantage of the technique is its information content and low radiation dose. During the procedure, the patient receives less radiation than with radiography. Allergies to medications occur very rarely. To make sure that the patient does not have an allergic reaction to the radiopharmaceutical, an allergy test is done.
Decoding the results takes from 15 to 30 minutes. The specialist describes the condition of the organs, the pathologies found and writes his conclusion. Next, the patient is sent to the attending physician, who will make an accurate diagnosis and prescribe a course of treatment.
Scintigraphy of the thyroid gland with 99mTc-pertechnetate
Diagnosis of thyroid cancer (TC) is a single dynamic process that combines physical examination data with a whole arsenal of the most informative diagnostic tools, one of which is radionuclide testing of the thyroid gland (thyroid). Radionuclide testing today remains the main method for obtaining images, assessing the functional activity of the thyroid gland and identified solitary nodular formations.
Indications:
- Assessment of the functional state of thyroid nodules identified by any examination method in primary patients;
- Timely detection of recurrent thyroid cancer in the projection of the bed of the removed gland and/or lobes in patients with a history of thyroid cancer;
- Detection of regional and distant metastases of thyroid cancer in patients after radical treatment;
- Suspicion of the presence of a retrosternal goiter;
- Search for an atypically located thyroid gland;
- Determination of the connection between tumor formations palpated in the neck area and the thyroid gland.
Contraindications and adverse reactions
Scintigraphy is contraindicated in patients with allergies to radioactive substances and pregnant women. If a woman is feeding her baby with breast milk, it is necessary to stop feeding for at least 24 hours to allow the medication to leave the body.
Side effects after the procedure include: allergies, increased or decreased blood pressure, frequent urination. At the first occurrence of symptoms, you should inform your doctor and undergo a course of symptomatic treatment.
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The clinic is located in the Central Administrative District (CAO) of Moscow. The metro stations “Novoslobodskaya”, “Tverskaya”, “Chekhovskaya”, “Belorusskaya” and “Mayakovskaya” are within walking distance.