Nuclear Medicine is a medical imaging specialty that is concerned with the safe use of very small amounts of a radioactive substance to show how different body systems are working.

The radioactive substance (called a tracer or a radioisotope) can be attached to different medicines and used for different purposes e.g. for diagnosis, to treat an illness or for research.

Why are nuclear medicine scans done?

Nuclear medicine imaging combines the use of radioactive substances, detectors (cameras) and computers to provide doctors with a way to see inside the human body.

Nuclear medicine scans are done for many different reasons:

• to see how different organs in the body are working;
• to look at the shape or structure of parts of the body;
• to analyze biologic specimens;
• to treat a disease;
• to manage disease;
• for early detection and management of disease.

Nuclear medicine studies can be performed on almost any organ of the body.

What is involved with a nuclear medicine scan?

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 asked to lay down on the scanning bed and seat belts will help your child remain still and safe, as the scanning bed is narrow and it moves. Before a nuclear medicine image can be obtained, your child needs to have the radiopharmaceutical administered. This can occur in one of three ways:

• intravenous needle (90% of studies);
• oral drink;
• oral tablet.

Once the tracer has been administered, the camera moves slowly over or around your child’s body.  Your child is required to keep very still while the camera is imaging. The average time for a nuclear medicine procedure is 30-45 minutes.

How does my child prepare for a nuclear medicine scan?

Preparation for a nuclear medicine scan depends on what type of scan your child is having and your child’s age. Some scans require fasting for the imaging and some scans require fasting for sedation to be given to help keep your child still. If your child requires an injection, a topical anaesthetic cream (AnGel or Emla) can be applied to hands or arms at the site where the injection will be. This will make the injection site numb so your child will not feel the sharp prick of the needel. The cream usually takes about 45 minutes to work so you will be required to attend the department about one hour earlier than your appointment. A lot of these decisions will be made at the time of booking or prior to the beginning the scan.

Sedation for studies is decided at the time of the study and the nurse or doctor will discuss this with you during your child’s appointment.

Rules for sedation:

• the patient must be between four months and three years of age;
• the patient is unable to remain still even with the use of distraction devices such as toys, books and DVDs and play therapists;
• the doctors and nurses must determine that the patient is medically safe for sedation.

Scans that may require sedation or distraction support are:

• Bone Scan.
• MIBG Scan.
• Thallium/Gallium Scans.

What we do to make the Nuclear Medicine study less stressful for you and your child.

The technologists, nurses and doctors in nuclear medicine are highly experienced and work with children of all ages and their parents or carers all the time.  They are very aware of the things that might upset parents and children. Before the study starts, the test and what it involves will be explained.  It is important that you are given a full explanation of what the test involves but it is usually the referring doctor who is best able to explain why the test has been ordered.

We have a selection of DVDs available, ranging from TV shows for pre-schoolers to movies for teenagers.

The Nuclear Medicine Department strives to obtain the nuclear medicine images without the use of sedation. Staff in nuclear medicine believe sedation should be used as a last resort. The study will be attempted by the use of other means first (e.g. distraction techniques as mentioned above, intervention by an educational play therapist, parental involvement).

Referrals for play therapists can be organised prior to your child’s scan by phoning 03 9345 4121.

What you can do to make the nuclear medicine study less stressful for your child.

It can be a great help to your child if the procedure is explained to them before they come to the scanning room.  Your child might find the following information calming:

• the scans do not take long;
• the scan will not hurt;
• a parent or carer can stay with the child during the scan (unless she is pregnant);
• an injection may sometimes be needed and if so, the staff are able to do things that make the injection less of a bother;
• often children can watch a favourite DVD while having their scans;
• am educational play therapy session before the scan might help you and your child to develop strategies to help your child cope;  if you or your child feel that coping with the scan may be an issue, an educational play therapy session may be of great benefit;
• see also the Kids Health Info factsheet:  Reduce children’s discomfort during tests and procedures.

Arriving for the appointment

Nuclear medicine is in the Medical Imaging Department on the lower ground floor of the East Building at The Royal Children’s Hospital, just near the green lifts. Go to the reception desk and they 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 appointment time.

After the scan

Unless your child has had sedation, you will be able to leave straight after the completion of the scan.  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 recovery after sedation.

The nuclear medicine physician will send the report to your referring doctor by telephone if urgent and the formal typed report is usually available within a week. If the result is required earlier or the physician believes that your child needs to see your referring doctor earlier, then they will make contact with them.

Please do not ask the technologist staff for results.  It is against the law for them to give you that information.

Nuclear medicine scan with general anaesthetic (GA)

Some Nuclear Medicine Scans at the RCH are performed under a general anaesthetic. This is rare for nuclear medicine but would usually occur if your child falls outside the sedation requirements or has a condition where sedation cannot be used. These children require admission to the RCH and must fast prior to imaging. Please contact the Medical Imaging Department for further information regarding general anaesthetic