Background Information:

What are the other Names for the Procedure?

• Children's Nuclear Medicine Procedure
• Pediatric Nuclear Medicine Procedure

What is Nuclear Medicine in Children radiology procedure? (General Explanation)

• A nuclear medicine procedure is a noninvasive procedure that uses very small amounts of radioactive material to diagnose and treat various kinds of diseases, such as heart disease, cancers, endocrine, gastrointestinal, and neurological problems. This procedure is performed in children
• It provides details about the molecular activity in the body and thus helps detect diseases in its early stages
• A radiotracer can be sent to the organ via different ways. It can be injected, swallowed, or inhaled as a gas, which eventually goes to the target organ; special imaging device then detects the emission and produces images
• In image fusion, images are taken from the nuclear medicine procedure and superimposed with a CT or MRI scan to produce special images, in order to get more information and an accurate diagnosis

What part of the Body does the Procedure involve?

Physicians use the Pediatric Nuclear Medicine imaging procedure to evaluate organ systems, including the following organs:

• Kidneys and bladder
• Bones
• Liver and gallbladder
• Gastrointestinal tract
• Heart
• Lungs
• Brain
• Thyroid

Why is the Nuclear Medicine in Children radiology procedure Performed?

Nuclear Medicine Procedures in Children are performed for the following reasons:

• To diagnose congenital childhood diseases, or diseases that develop during childhood
• It can also be used to diagnose jaundice, GI bleeding, blockage in kidney, bone cancers, urine reflux from the bladder into the kidney, infections, epilepsy, abnormality in thyroid glands, and trauma

What is the Equipment used? (Description of Equipment)

• Nuclear Medicine Procedure in Children may use the following tools:
  • Positron emission tomography (PET) technique
  • Single photon emission computed tomography (SPECT) imaging technique
  • Gamma camera
• A gamma camera detects radiation and takes pictures of the target body part/site, from different angles
• The gamma camera is used in SPECT as well, which rotates around the body to produce 3-D images of the body
• A computer uses the data from the cameras and produces images

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the Pediatric Nuclear Medicine Procedure. 

What is the Cost of performing the Nuclear Medicine in Children radiology procedure?

The cost of the Nuclear Medicine Procedure in Children depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary. 

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding the Nuclear Medicine Procedure in Children and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently 

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=nuclear-pdi (accessed on 08/03/2014)

Prior to Nuclear Medicine in Children radiology procedure:

How does the Nuclear Medicine in Children radiology procedure work?

A Nuclear Medicine Procedure in Children works in the following manner:

• The patient is given radioactive material, which accumulates in the target organ
• After the radioactive material has accumulated, gamma camera, SPECT, or PET scan detects the radioactivity and takes the pictures
• During coronary arteries scan, images of blood flow to the heart at rest are taken. After the first scan at rest, patients are asked to perform certain exercises for the stress test, or are given medications to increase blood flow to the heart
• During exercise, blood flow to the heart increases and thus blockages of coronary arteries are easy to detect. Another scan is done and it is compared to the scan at rest, to locate the presence of any blockages

How is the Nuclear Medicine in Children radiology procedure Performed?

A Nuclear Medicine Procedure in Children is performed in the following manner:

• An intravenous (IV) line is inserted into the child’s arm
• A radioactive tracer is injected through an IV, orally, it is inhaled, or injected via catheter, depending on the nuclear medicine exam to be performed
• After the radiotracer injection, the physician will wait for the radiotracer to accumulate in the child’s body, which may take a few hours to even a few days
• During the imaging procedure, the child has to lie down on the movable imaging table in various positions (as required)
• The child may be asked to hold his/her breath during the procedure and the parents are encouraged to be around the child during the exam
• The IV line is removed at the end of the procedure

Where is the Procedure Performed?

Children's Nuclear Medicine Procedures are performed as outpatient procedures, at hospitals. 

Who Performs the Procedure?

Children's Nuclear Medicine Procedures are usually performed by a radiology technologist, under the supervision of a radiologist.

How long will the Procedure take?

The entire Nuclear Medicine Procedure in Children may take about 20 minutes to 4 hours.

Who interprets the Result?

The radiologist interprets the results from the Children's Nuclear Medicine Procedure and informs the primary care physician, who then informs the patient.

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to the Children's Nuclear Medicine Procedures:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray

What is the Consent Process before the Procedure?

A physician will request your consent for the Nuclear Medicine Procedure in Children using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the Nuclear Medicine Procedure in Children:

• The nuclear medical procedure is noninvasive and less expensive; it provides detailed information for the healthcare provider
• It provides details about both the structure and function, which is usually unobtainable with other imaging techniques

Following are the risks of the Nuclear Medicine Procedure in Children:

• Patients may develop an allergic reaction to radioactive material used in the procedure, though it is very rare
• The amount of radioactive material used in the procedure is very small, so the risk from radiation is very minimal compared to other procedures 

What are the Limitations of the Nuclear Medicine in Children radiology procedure?

Following are the limitations of the Nuclear Medicine Procedure in Children:

• Nuclear medicine scans do not provide resolution of structures as high (sharp) as other imaging techniques
• The procedure takes a long period of time, as radioactive material takes time to accumulate in the target organ or structure 

What are some Questions for your Physician?

Some of the basic questions that you might ask your health care provider or physician are as follows:

• What is the Nuclear Medicine Procedure in Children?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place, during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Nuclear Medicine in Children radiology procedure:

What is to be expected during the Nuclear Medicine in Children radiology procedure?

The following may be expected during the Nuclear Medicine Procedure in Children:

• The entire procedure is mostly painless except for slight pin-prick associated with the IV insertion
• The child may feel a cold sensation, when the radiotracer is injected through the IV line
• The child may feel some discomfort as they are supposed to stay still during the imaging process to avoid any blurriness of the image 

What kind of Anesthesia is given, during the Procedure?

• In a majority of cases, no anesthesia is given during the Nuclear Medicine Procedure in Children
• However, in some cases, such as in very small infants, general anesthesic may be considered

How much Blood will you lose, during the Procedure?

There is no blood loss involved during the Children’s Nuclear Medicine Procedure. 

What are the possible Risks and Complications during the Nuclear Medicine in Children radiology procedure?

The risks of Children’s Nuclear Medical Procedure include the following:

• Some children may develop an allergic reaction to the radioactive material used in the procedure, but this is a very rare occurrence
• The amount of radioactive material used in the procedure is very small; so the risk from radiation is very minimal compared to other procedures 

What Post-Operative Care is needed at the Healthcare Facility after Nuclear Medicine in Children radiology procedure?

There is no postoperative care necessary after a Nuclear Medicine Procedure in Children, at the healthcare facility.

After the Nuclear Medicine in Children radiology procedure:

What is to be expected after the Nuclear Medicine in Children radiology procedure?

• The child may resume his/her normal activities after the Nuclear Medicine Procedure, unless otherwise suggested by the physician.
• The child is advised to drink plenty of water for the first few hours after the procedure, in order to get rid of a small amount of radioactive material left in the body
• In small children, IV fluids may be given to flush out the radioactive material from the body

When do you need to call your Physician?

If the child is experiencing an allergic reaction from the contrast reaction; then, do contact the physician.

What Post-Operative Care is needed at Home after the Nuclear Medicine in Children radiology procedure?

There is no postoperative care necessary after the Nuclear Medicine Procedure in Children.

How long does it normally take to fully recover, from the Procedure?

The child needs no recovery time after the Nuclear Medicine Procedure in Children.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

No tissue is extracted from the patient, during the Nuclear Medicine Procedure in Children. 

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient. 

Who will you receive a Bill from, after the Nuclear Medicine in Children radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• A radiologist, performing the procedure
• Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Nuclear Medicine Procedure in Children is performed.