Nuclear Imaging Services

Gamma Camera Scanning

Nuclear Medicine uses small amounts of radioactive substances like Technetium (Tc99m) to look at images of the function of certain parts of the body to allow doctors to diagnose conditions. We use a machine called a gamma camera to take these images.

Some of the images we produce are of:

Bone Scans We can inject Technetium or FDG to look at abnormal turnover of bone which can occur with cancers, arthritis, infection and as a normal response to injury. This is a bone scan image.
Thyroid Scans We can use both technetium and radioactive iodine to take images and assess the function of the thyroid gland. This is the shape of a thyroid gland.
Kidney scans We can perform two different types of kidney scan.
A renogram looks at blood passing throught the kidneys and we can assess the function of the kidneys. The DMSA static kidney scan shows us the size and shape of the kidneys. It can show us if there is any scarring on the kidneys.
Brain Scans We can image the brain in two ways. Technetium HMPAO can be used to look at brain blood flow. DAT scans allow the early detection of Parkinson's disease.
Lung Scans After a patient has breathed in a radioactive gas we can take pictures of the breathing patterns of the lungs. We can then look at the blood flow to the lungs by injecting a radioactive material into the arm and taking more pictures of the lungs. These images will show whether a patient has a blood clot (pulmonary embolus) in the lungs.
White Cell Scans If there is an infection anywhere in the body thepatient's white cells in their bloodstream will go to that area to try to fight the infection. By labelling the patient's white cells with a radioactive material we can see where the white cells are collecting. If doctors suspect a patient has an infection in either a bone or a soft tissue area(abdomen or chest) we can take images to identify the areas of the infection.

Non imaging blood tests

In the Nuclear Medicine department in addition to the gamma cameras and the PET CT scanner we have a laboratory that performs non imaging blood tests.

We perform a variety of tests:

Red cell and Plasma volume estimation (RCPV) - This is a test that allows us to measure how many red blood cells a patient has and the amount of fluid they are in. It involves two radioactive injections into a vein in the arm and several blood samples. This test can identify a condition called Polycythemia Rubra Vera.

GFR using Cr51 EDTA - This is a test to look at kidney function. It can be important to know a patient's renal (kidney) function before they start on a course of treatment that may have a potentially damaging effect on the kidneys.This involves a radioactive injection into a vein in the arm followed by three blood samples.

Gastrointestinal Blood loss measurement - This is a test that allows us to measure whether there is blood loss from the bowel that could be causing anaemia.The test involves an injection of a radioactive solution into a vein in the arm followed by a stool collection for several days afterwards.

Thyroid Investigation and treatment

Nuclear Medicine at the Royal Liverpool Hospital provides a comprehensive regional thyroid service.

We hold a consultant led thyroid clinic twice a week on Tuesday and Thursday mornings in 'N' clinic on the ground floor of the hospital.

Diagnosis

There are several diagnostic investigations that are performed during the clinic attendances. These involve blood tests, isotope thyroid scans and thyroid uptake tests.

Patients can be referred to the clinic for several reasons:

Thyroid nodule or cyst
Overactive thyroid
Thyroid cancer

Therapy

We provide an outpatient therapy service for patients suffering from an over-active thyroid gland. Click here for information about thyroid therapy for an overactive thyroid.

We also treat thyroid cancer patients post surgery on an inpatient basis.

Nuclear Cardiology

Nuclear Cardiology is the branch of Nuclear Medicine that looks at the condition of heart muscle and how well it functions.

We can look at the heart in different ways:

Myocardial perfusion imaging after rest and stress. This is performed to show the blood flow to the heart muscle. This is performed on a gamma camera.

Reasons to perform this are:

Unexplained chest pain,
To look at the presence and extent of coronary heart disease , chest pain brought on by exercise (Angina)
The extent of injury after a heart attack (myocardial infarction)
To evaluate the results of by-pass surgery
To assess the risk to patients undergoing non-cardiac surgery

Muga scanning (multi-gated aquisition)

This is a test that shows how well the heart is beating. It can show if the heart is beating evenly and efficiently. It is performed on a gamma camera.

Reasons to perform this are:

If the patient is due to undergo non-cardiac surgery
If the patient is about to undergo chemotherapy that may harm the heart
If other tests (echocardiogram) do not show the heart function adequately

Myocardial Viability

This is a test to look at the condition of the heart muscle. It can be performed on a gamma camera or a PET CT machine.

PET CT

Our PET CT scanner is the first static scanner in Merseyside and Cheshire. The £1.8 million state of the art scanner is being used to diagnose certain types of cancer and other diseases.

We perform a variety of scans on this machine.

Whole body scans for primary and secondary cancers
Bone scans for primary and secondary cancers
Bone scans for infections
Heart scans for myocardial viability (condition of the heart muscle)

Research

This machine is used for a variety of research projects. We work with other specialists within the Royal Liverpool Hospital and also Clatterbridge Centre for Oncology to look at new ways to image certain conditions and new ways to treat them.

DEXA (Bone Densitometry)

The DEXA (Bone Density) unit is based in the Radiology department (X-ray) but is a part of the Nuclear Medicine department. The scans are performed by a nuclear medicine radiographer and reported by nuclear medicine Physicians.

A DEXA scanner uses x-rays to assess the bone mass of a patient. A patient lies on a couch and measurements of the hip and the lower spine are taken.

The level of bone mass can tell doctors if the patient has osteoporosis, osteopaenia or a normal level of bone density. It is important to know these figures to know the risk of the patient having a fracture.

A dexa scan of a hip and spine.

If you think you may require any of these investigations talk to your GP or Hospital Specialist.

Neuroendocrine Service

See separate section for Neuroendocrine Service

Easy Read Information

Nuclear Medicine uses small amounts of radioactive substances to look at how certain parts of the body are working.

This page gives more information about this work.