CT SCAN

DEFINITION
A computerized tomography (CT) scan is a scan that combines a series of X-ray images taken
from different angles and uses computer processing to create cross-sectional images, or slices, of
the bones, blood vessels and soft tissues inside your body.
INDICATIONS
CT scans are used to study areas of the body and the arms or legs.

 Chest (thorax). A CT scan of the chest can look for problems with the lungs, the heart,
the esophagus, or the major blood vessel (aorta) or the tissues in the center of the chest.
Some common chest problems a CT scan may find include infection, lung cancer, a
pulmonary embolism, and an aneurysm. It also can be used to see if cancer has spread
into the chest from another area of the body.
 Abdomen. A CT scan of the abdomen can find cysts, abscesses, infection, tumors, an
aneurysm, enlarged lymph nodes, foreign objects, bleeding in the belly, diverticulitis,
inflammatory bowel disease, and appendicitis.
 Urinary tract. A CT scan of the kidneys , ureters, and bladder is called a CT KUB or CT
urogram. This type of scan can find kidney stones , bladder stones, or blockage of the
urinary tract . A special type of CT scan, called a CT intravenous pyelogram (IVP), uses
injected dye (contrast material) to look for kidney stones, blockage, growths, infection, or
other diseases of the urinary tract.
 Liver. A CT scan can find liver tumors, bleeding from the liver, and liver diseases. A CT
scan of the liver can help determine the cause of jaundice.
 Pancreas. A CT scan can find a tumor in the pancreas or inflammation of the pancreas
(pancreatitis).
 Gallbladder and bile ducts. A CT scan can be used to check for blockage of the bile
ducts. Gallstones occasionally show up on a CT scan. But other tests, such as ultrasound,
usually are used to find problems with the gallbladder and bile ducts.
 Adrenal glands. A CT scan can find tumors or enlarged adrenal glands.
 Spleen. A CT scan can be used to check for an injury to the spleen or the size of the
spleen.
 Pelvis. A CT scan can look for problems of organs in the pelvis. For a woman, these
include the uterus, ovaries, and fallopian tubes. For a man, the pelvic organs include the
prostate gland and the seminal vesicles.
 Arm or leg. A CT scan can look for problems of the arms or legs, including the shoulder,
elbow, wrist, hand, hip, knee, ankle, or foot.
 CT Scan Preparation

 If a patient is going to have a contrast injection, he or she should not have anything to eat
or drink for a few hours before the CT scan because the injection may cause stomach
upset. To receive the contrast injection, an IV is inserted into the arm just prior to the
scan. The contrast then enters the body through the IV.

 Prior to most CT scans of the abdomen and pelvis, it is important to drink an oral contrast
agent that contains dilute barium. This contrast agent helps the radiologist identify the
gastrointestinal tract , detect abnormalities of these organs, and to separate these
structures from other structures within the abdomen. The patient will be asked to drink
slightly less than a quart spread out over 1.5 to 2 hours.

During the CT scan

 CT scanners are shaped like a large doughnut standing on its side. You lie on a narrow,
motorized table that slides through the opening into a tunnel. Straps and pillows may be
used to help you stay in position. During a head scan, the table may be fitted with a
special cradle that holds your head still.
 While the table moves you into the scanner, detectors and the X-ray tube rotate around
you. Each rotation yields several images of thin slices of your body. You may hear
buzzing, clicking and whirring noises.
 A technologist in a separate room can see and hear you. You will be able to communicate
with the technologist via intercom. The technologist may ask you to hold your breath at
certain points to avoid blurring the images.

After the CT scan

After the exam you can return to your normal routine. If you were given a contrast material, you
may receive special instructions. In some cases, you may be asked to wait for a short time before
leaving to ensure that you feel well after the exam. After the scan, you'll likely be told to drink
lots of fluids to help your kidneys remove the contrast material from your body.
 POSITRON EMISSION TOMOGRAPHY (PET) SCAN

Introduction-

Positron emission tomography (PET) uses small amounts of radioactive materials called
radiotracers, a special camera and a computer to help evaluate your organ and tissue
functions. By identifying body changes at the cellular level, PET may detect the early onset
of disease before it is evident on other imaging tests.

Purpose-

 Detect cancer.
 Determine whether a cancer has spread in the body.
 Assess the effectiveness of a treatment plan, such as cancer therapy.
 Determine if a cancer has returned after treatment.
 Determine blood flow to the heart muscle.
 Determine the effects of a heart attack, or myocardial infarction, on areas of the heart.
 Identify areas of the heart muscle that would benefit from a procedure such
as angioplasty or coronary artery bypass surgery (in combination with a myocardial
perfusion scan).
 Evaluate brain abnormalities, such as tumors, memory disorders, seizures and other
central nervous system disorders.
 Map normal human brain and heart function.

Procedure performed-

When disease strikes, the biochemistry of an individual’s tissues and cells changes. In cancer, for
example, cells multiply at a much faster rate than normal cells, feeding on sugars like glucose. If
an individual has cancer or cancer is suspected, a nuclear medicine or molecular imaging
specialist performs a PET scan to see exactly what is going on inside that person’s body. During
a PET scan, a patient is injected with a very small amount of a radiotracer such as
fluorodeoxyglucose (FDG), which contains both sugar and a radioactive element. The radiotracer
travels through the body and is absorbed by the tissues or the organ being studied. The patient
then lies down on an examining table and is moved to the center of a PET scanner. The scanner
contains an array of detectors that receive signals emitted by the radiotracer. Using these signals,
the PET scanner measures metabolic activity while a computer reassembles the signals into
images.

How does PET/CT scanning work-

PET scanning is a molecular imaging procedure that allows physicians to obtain three-
dimensional images of what is happening in a patient’s body at the molecular and cellular level.
For a PET scan, a patient is injected with a very small amount of a radiotracer such as
fluorodeoxyglucose (FDG), which contains both a sugar and a radioactive element. The
radiotracer travels through the body and is absorbed by tumors or cancer cells. The patient then
lies down on an examining table and is moved to the center of a PET/CT scanner. The PET/CT
scanner contains a PET scanner and a CT scanner next to each other. The CT scan and the PET
scan are obtained one after the other. The PET scanner is composed of an array of detectors that
receive signals emitted by the radiotracer. Using these signals, the PET scanner detects the
amount of metabolic activity while a computer reassembles the signals into images. [For more
information on PET/CT scans and how they work, visit PET/CT Scanning: Get the Facts.]

Procedure Expectations –

The patient is injected with a radioactive glucose compound and 45 minutes later the scan
is obtained. For PET Brain scans, just the head is scanned. For PET Heart scans, just the chest is
scanned. For PET Tumor scans, generally the patient is scanned from the base of the brain to the
pelvis. For Melanoma and Multiple Myeloma, the patient is scanned head to toe. The scan will
take 20 – 30 minutes. All patients will have a blood sugar check (finger stick) just prior to their
injection.

Procedure Preparation –

The patient needs to be NPO (nothing by mouth) four hours prior to their injection. Patients can
follow their normal activity levels prior to the scan and can take their medications following their
physician’s instructions. Once the patient is injected, they will be asked to sit quietly with little
or no movement or talking because the radiopharmaceutical may distribute in the muscles rather
than the soft tissues. The patient will be asked to empty their bladder just prior to their scan. In
certain indications, patients may need to have a urinary catheter placed to keep the bladder empty
during the scan.

Procedure Limitations –
The table weight limit for a PET scan is 400lbs. Patients that have had previous Nuclear
Medicine exams may need to wait a day before receiving a PET scan, depending upon the
isotope they received in the previous exam. Patients with blood sugar levels above 180mg/dl
cannot have a PET scan because the radiopharmaceutical will not be taken up by the soft tissues.

Benefits-

 Nuclear medicine examinations provide unique information—including details on both

function and anatomic structure of the body that is often unattainable using other imaging
procedures.
 For many diseases, nuclear medicine scans yield the most useful information needed to
make a diagnosis or to determine appropriate treatment, if any.
 Nuclear medicine is less expensive and may yield more precise information than
exploratory surgery.
 By identifying changes in the body at the cellular level, PET imaging may detect the
early onset of disease before it is evident on other imaging tests such as CT or MRI.
 For additional benefits of CT exams, see Computed Tomography (CT).
 greater detail with a higher level of accuracy; because both scans are performed at one
time without the patient having to change positions, there is less room for error.
 Greater convenience for the patient who undergoes two exams (CT & PET) at one sitting,
rather than at two different times.

Risks-

 Because the doses of radiotracer administered are small, diagnostic nuclear medicine
procedures result in relatively low radiation exposure to the patient, acceptable for
diagnostic exams. Thus, the radiation risk is very low compared with the potential
benefits.
 Nuclear medicine diagnostic procedures have been used for more than five decades, and
there are no known long-term adverse effects from such low-dose exposure.
 The risks of the treatment are always weighed against the potential benefits for nuclear
medicine therapeutic procedures. You will be informed of all significant risks prior to the
treatment and have an opportunity to ask questions.
 Allergic reactions to radiopharmaceuticals may occur but are extremely rare and are
usually mild. Nevertheless, you should inform the nuclear medicine personnel of any
allergies you may have or other problems that may have occurred during a previous
nuclear medicine exam.
 Injection of the radiotracer may cause slight pain and redness which should rapidly
resolve.
 Women should always inform their physician or radiology technologist if there is any
possibility that they are pregnant or if they are breastfeeding. See the Safety page for
more information about pregnancy, breastfeeding and nuclear medicine exams.