Department of Radiology,
Lister Hospital,
Stevenage,
Herts SG1 4AB
Email: Dr. Amerasekera
Tel: 01438 781 028
Fax: 01438 781 176
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Child Nuclear Medicine
Nuclear Medicine is a specialised procedure using a small amount of radioactive substance which allows us to investigate the bones or organs of the body, using a Gamma Camera linked to a computer. After the injection, your child will feel no ill effects and the procedure is not painful. The person who carries out the examination is a qualified Radiographer with specialised training training in Nuclear Medicine.
Childrens' diseases often differ significantly from those of adults. Nuclear medicine techniques are applicable in the diagnosis of a wide variety of paediatric diseases. The use of certain nuclear medicine techniques results in a lower radiation exposure to the child than conventional radiological techniques. Whenever nuclear medicine techniques are employed, the benefit to the child in question must be judged to be greater than the small potential risks.
Studies of the Kidneys
Newborn children may have abnormalities (malformations) of their kidneys. These problems may result from faulty development whilst in the womb. Some of these malformations do not cause serious complications. However, others may result in one or both kidneys having abnormal function or urine flow. When a structural abnormality is discovered in a baby's kidney or laboratory tests suggest that the kidneys are not operating correctly, a nuclear medicine study is commonly performed.
One of the more common developmental abnormalities in children is a partial or complete blockage to the flow of urine from the kidneys. This results in enlargement of the affected kidney and may cause the child pain or be found by the doctor during a routine examination. Ultrasound may demonstrate enlargement of the kidney. However, there are other problems that may simulate blockage to the flow of urine. When blockage of urine flow is suspected, the child may be evaluated by Isotope DTPA scan. In children with impaired kidney function the actual contribution of each kidney to total urine production can be measured. Children with impaired renal function may be monitored over time by nuclear medicine procedures. This monitoring may indicate whether the disease is improving or deteriorating. During preparation for Diuretic Renography.
It is important that the child have adequate fluid intake prior to the test. If the child fasts, then he or she may become dehydrated after the administration of the diuretic. Not only does this mean discomfort to the child, it alters the reliability of the examination. Children with vesico-ureteric reflux tend to suffer urinary tract infections more commonly. One of the predisposing factors to such infections is reverse urine flow (reflux) from the bladder to the kidneys. This condition is referred to as vesicoureteral reflux. Many children will grow out of the condition without any surgical therapy. However, others will have repeated infections that lead to discomfort and potential kidney damage. In order to monitor the progress of the patient, and to confirm the diagnosis of reflux, an objective examination is required.
The isotope cystogram has been developed particularly for use in monitoring both the presence of reflux and the effectiveness of therapy in children. The test may be performed in the outpatient setting. If reflux is present, the monitoring device, a gamma camera, can detect it. Computers make it possible to determine the degree of reflux as well. While similar tests are available in diagnostic radiology, the amount of radiation administered to the patient may be greater than that is administered during a nuclear medicine examination. Because of the low radiation dose children can be monitored periodically to see whether the reflux is resolving spontaneously. No specific patient preparation is required.
It is often beneficial for the child and parent to remain together during the study. If the parent can exert a calming influence on the child then the examination will proceed quickly with minimal discomfort.
At home
Just relax and go about your normal routine. Your child should continue to take any prescribed medicine. If there is any specific preparation for your child’s scan then a separate instruction sheet will be enclosed for you to follow.
At the Department
Report to the Nuclear Medicine Department, which is situated within the the imaging Department adjacent to Radiology on level 2.
Normally, your child will not be required to undress for the scan but may have to remove any metalic items.
On arrival in the Department, a local anaesthetic cream is put onto a vein, usually on your child’s arm or hand. This is left for 60 minutes to take effect, after which an injection of a small amount of radioactive substance is given. Pictures are taken using a Gamma Camera, whilst your child lies on the imaging couch.Your child will feel no discomfort but will be required to stay very still during the scan. You may bring your child’s favourite music tape to listen to whilst the pictures are taken.
After the injection you will feel no ill-effects and the procedure is not painful. The Radiographer will ask you to keep very still during the scan, as movement will blur the pictures.
The person who carries out the examination is a qualified Radiographer with specialised training in Nuclear Medicine. You can expect to be in the Department one and a half hours for the local anaesthetic cream and injection. The scan itself takes thirty minutes to an hour. Occasionally, emergency cases arise which cause unavoidable delays to booked patients. The radiation dose is very low. Your child will be mildly radioactive, however, for 24 hours after the injection. For 6 hours after the injection, your child should avoid close contact with pregnant women and other young children. Any other treatment or examinations outside the Radiology Department should be avoided on the day of the Nuclear Medicine scan. Your child may eat and drink normally. The Consultant Radiologist, a Doctor specialising in Nuclear Medicine, will study the pictures and send a report directly to your Doctor. That is why you may have to wait a few days for your results.
Copyright © 2000 - Dr. Douglas Amerasekera