ENDOCRINOLOGY PROCEDURES

ENDOCRINOLOGY PROCEDURES

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cinetica

gammapara

gammasupra

CAT endocrino01

THYROID IODINE UPTAKE AND KINETIC STUDIES

QUANTIFIED THYROID SCINTIGRAPHY

THYROID UPTAKE

DESCRIPTION: Evaluation of iodine effective mean time in the thyroid gland. Determination of thyroid uptake both total and in 6 regions of interest.

PREPARATION: The patient must not be in a situation of iodic saturation, either because of intravenous or intrathecal scans with iodized contrast (pyelography, CAT scan with contrast, myelography and some angiographies) at least 3 weeks before the procedure or because of treatment with Amiodarone at least 6 months before it. If possible, the patient should not be having antithyroid medication (propylthiouracil (PTU) and tapazole) for at least 3 days before the procedure. Other isotopic explorations must be avoided during the procedure.

INDICATIONS: Dosimetric calculation of 131I dose for hyperthyroidism.

DURATION OF PROCEDURE: 1 hour.

CAT endocrino02

PARATHYROID SCINTIGRAPHY

PARATHYROID TOMOSCINTIGRAPHY
(SPET/SPET-CT)

DESCRIPTION: Localization of the parathyroid glands.

PREPARATION: No preparation is required. It is recommended that the patient has not received studies with iodine contrasts at least 3 weeks before the procedure. While the images are being taken, the patient should not move his/her neck and must nor swallow saliva, and if necessary, should be immobilized with sandbags.

INDICATIONS: Detection and localization of adenomas and hyperplasias of parathyroid glands. Evaluation of the status of parathyroid glands within hypercalcemia and hyperparathyroid disorders. Detection of ectopic parathyroid glands.

DURATION OF PROCEDURE: 3 hours.

CAT endocrino03

SUPRARENAL CORTEX SCINTIGRAPHY
(WITH OR WITHOUT STOPPING)

DESCRIPTION: Functional evaluation of the suprarenal glands’ cortex (nor-cholesterol follows the metabolic pathway of adrenal steroids).

PREPARATION: As a prevention, the thyroid gland must be blocked with 20 drops/3 times per day of potassium iodide, starting  5 days before the administration of the dose and extending until 3 days after the procedure is finished. Some medications can produce pharmacological interaction with nor-cholesterol and it is advisable to remove them during the procedure: 

  • Tricyclic Antidepressants (Amitriptyline, Imipramine). 
  • Sympathomimetics (Phenylephrine, Phenylpropanolamine, Pseudoefrin, Ephedrine). 
  • Antihypertensives/cardiovascular drugs (Labetalol, Reserpine, Ca-channel blockers). 

In case of hyperaldosteronism, the gland must be stopped with 4 mg/day of dexamethasone (fortecortin 1 1 mg-comprimit/6 hours) from 7 days before the administration of nor-cholesterol, and until the end of the imaging session. Withdrawal should be progressive (progressive dose reduction in 5 days). Contraindications of stopping are those of corticoids: bleeding, alterations of the coagulation, gastroduodenal ulcers, glaucoma. The acquisition of images is performed on the 2nd and 4th day (always before the 5th day).

INDICATIONS: Diagnosis of the adrenal cortex pathology: localization of adenoma/adrenal hyperplasia, diagnosis of Cushing syndrome of adrenal origin, the differential diagnosis between adenoma and adrenal hyperplasia (Conn), study of adrenal masses seen with other imaging techniques (TAC, NMR, ECO): incidentalomas.

DURATION OF PROCEDURE: 7 days.

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gammatiro

rastreigiode

somato

CAT endocrino04

THYROID SCINTIGRAPHY

DESCRIPTION: Evaluation of the morphology and functionality of the thyroid gland.

PREPARATION: No fasting is required. A brief and specific recollection of information that includes thyroid palpation should be performed. Thyroid substitute medications should be removed in patients taking thyroid replacement therapy (children diagnosed with neonatal hypothyroidism, others), and in order to visualize the thyroid gland (thyroxin [T4] for at least 7 days before the scan, triiodothyronine [T3] for at least 3 days before the scan). The patient must not be in a situation of iodic saturation, either because of intravenous or intrathecal scans with iodized contrast (pyelography, CAT scan with contrast, myelography and some angiographies) at least 3 weeks before the procedure or because of treatment with Amiodarone at least 6 months before it.

INDICATIONS: Morphological evaluation of the thyroid gland. Thyroid location and evaluation of thyroid ectopies. Study of goiter, endothoracic goiter and thyroid nodules. Diagnosis of subacute thyroiditis. Evaluation of thyroid post-surgical remnants.

DURATION OF PROCEDURE: 30 minutes.

CAT endocrino05

THYROID-METASTASES DETECTION SCAN

123I SCINTIGRAPHIC SCAN
(WITH OR WITHOUT rhTSH)

131I SCINTIGRAPHIC SCAN
(WITH OR WITHOUT rhTSH)

123I TOMOSCINTIGRAPHY (SPET/SPET-CT)

DESCRIPTION: Evaluation of the metabolic activity of thyroid tissue remnants of differentiated thyroid neoplasms.

PREPARATION: The patient must suspend his/her hormonal treatment (thyroxin [T4] for at least 21 days, triyodothyronine [T3] for at least 10 days). If hormonal suppression is not advised, TSH can be stimulated with two intramuscular injections in two consecutive days of rhTSH (Thyrogen). The patient must not be in iodic saturation, either because of  intravenous or intrathecal scans with iodized contrast (skinography, TAC with contrast, myelography and some angiographies) at least 3 weeks before the procedure, or because of  treatment with amniodarone at least 6 months before the procedure.

INDICATIONS: Evaluation of functioning thyroid tissue remnants after a thyroidectomy. Study of the spread of differentiated thyroid carcinoma. Detection of recurrences of differentiated thyroid carcinoma.

DURATION OF PROCEDURE: 3 days.

CAT endocrino06

SOMATOSTATIN-RECEPTORS SCINTIGRAPHY

111In OR 99mTc-OCTREOTIDE
SCINTIGRAPHY-SPECT-CT

SOMATOSTATIN-RECEPTORS
SCINTIGRAPHIC SCAN

SOMATOSTATIN-RECEPTORS
TOMOGRAPHY-SPECT-CT

DESCRIPTION: Evaluation of somatostatin receptor activity in tumors.

PREPARATION: No scans with barium or iodine contrast should be performed during the procedure. For the study of abdominal tumors, it is advisable to use laxatives, and even the use of enemas.

INDICATIONS: Evaluation of tumors that express somatostatin receptors (extension study, follow-up, control of therapeutic response and recurrence detection) in neuroendocrine tumors, such as carcinoid, enteropancreatic tumors and tumors derived from the neural crest (medullary of thyroid, neuroblastomas, paragangliomas and pheochromocytomas). Evaluation of other types of neoplasms that may have expression of somatostatin receptors, such as breast cancer, lung cancer, lymphomas and thyroid cancer.

DURATION OF PROCEDURE: 2 days.

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hiperinsdopa

pet-tc hiperisnulinisme congenit nens

18F-DOPA PET-CT FOR THE PEDIATRIC
EVALUATION OF CONGENITAL
HYPERINSULINISM

DESCRIPTION: Evaluation of congenital hyperinsulinism in children.

PREPARATION: A 4-hour fasting is required. Depending on child’s age, anesthesia is to be administered.

INDICATIONS: Differential diagnosis of congenital hyperinsulinism at pediatric age, differentiating focal and diffuse pancreatic forms.

DURATION OF PROCEDURE: 1 hour.

THYROID IODINE UPTAKE AND KINETIC STUDIES

QUANTIFIED THYROID SCINTIGRAPHY

THYROID UPTAKE

DESCRIPTION

  • Evaluation of iodine effective mean time in the thyroid gland. 

  • Determination of thyroid uptake both total and in 6 regions of interest.

PREPARATION

  • The patient must not be in a situation of iodic saturation, either because of intravenous or intrathecal scans with iodized contrast (pyelography, CAT scan with contrast, myelography and some angiographies) at least 3 weeks before the procedure or because of treatment with Amiodarone at least 6 months before it.

  • If possible, the patient should not be having antithyroid medication (propylthiouracil (PTU) and tapazole) for at least 3 days before the procedure.

  • Other isotopic explorations must be avoided during the procedure.

INDICATIONS

Dosimetric calculation of 131I dose for hyperthyroidism.

DURATION OF PROCEDURE

1 hour.

PARATHYROID SCINTIGRAPHY

PARATHYROID TOMOSCINTIGRAPHY
(SPET/SPET-CT)

DESCRIPTION

Localization of the parathyroid glands.

PREPARATION

  • No preparation is required. 
  • It is recommended that the patient has not received studies with iodine contrasts at least 3 weeks before the procedure. 
  • While the images are being taken, the patient should not move his/her neck and must nor swallow saliva, and if necessary, should be immobilized with sandbags.
  •  

INDICATIONS

  • Detection and localization of adenomas and hyperplasias of parathyroid glands. Ç
  • Evaluation of the status of parathyroid glands within hypercalcemia and hyperparathyroid disorders.
  • Detection of ectopic parathyroid glands.
  •  

DURATION OF PROCEDURE

3 hours.

SUPRARENAL CORTEX SCINTIGRAPHY
(WITH OR WITHOUT STOPPING)

DESCRIPTION

Functional evaluation of the suprarenal glands’ cortex (nor-cholesterol follows the metabolic pathway of adrenal steroids).

PREPARATION

  • As a prevention, the thyroid gland must be blocked with 20 drops/3 times per day of potassium iodide, starting  5 days before the administration of the dose and extending until 3 days after the procedure is finished. 
  • Some medications can produce pharmacological interaction with nor-cholesterol and it is advisable to remove them during the procedure:
    • Tricyclic Antidepressants (Amitriptyline, Imipramine). 
    • Sympathomimetics (Phenylephrine, Phenylpropanolamine, Pseudoefrin, Ephedrine). 
    • Antihypertensives/cardiovascular drugs (Labetalol, Reserpine, Ca-channel blockers).
  • In case of hyperaldosteronism, the gland must be stopped with 4 mg/day of dexamethasone (fortecortin 1 1 mg-comprimit/6 hours) from 7 days before the administration of nor-cholesterol, and until the end of the imaging session. Withdrawal should be progressive (progressive dose reduction in 5 days). Contraindications of stopping are those of corticoids: bleeding, alterations of the coagulation, gastroduodenal ulcers, glaucoma. The acquisition of images is performed on the 2nd and 4th day (always before the 5th day).

INDICATIONS

Diagnosis of the adrenal cortex pathology:

  • Localization of adenoma/adrenal hyperplasia
  • Diagnosis of Cushing syndrome of adrenal origin
  • Differential diagnosis between adenoma and adrenal hyperplasia (Conn)
  • Study of adrenal masses seen with other imaging techniques (TAC, NMR, ECO): incidentalomas.

DURATION OF PROCEDURE

7 days.

THYROID SCINTIGRAPHY

DESCRIPTION

Evaluation of the morphology and functionality of the thyroid gland.

PREPARATION

  • No fasting is required. 
  • A brief and specific recollection of information that includes thyroid palpation should be performed. 
  • Thyroid substitute medications should be removed in patients taking thyroid replacement therapy (children diagnosed with neonatal hypothyroidism, others), and in order to visualize the thyroid gland (thyroxin [T4] for at least 7 days before the scan, triiodothyronine [T3] for at least 3 days before the scan). 
  • The patient must not be in a situation of iodic saturation, either because of intravenous or intrathecal scans with iodized contrast (pyelography, CAT scan with contrast, myelography and some angiographies) at least 3 weeks before the procedure or because of treatment with Amiodarone at least 6 months before it.

INDICATIONS

  • Morphological evaluation of the thyroid gland. 
  • Thyroid location and evaluation of thyroid ectopies. 
  • Study of goiter, endothoracic goiter and thyroid nodules. 
  • Diagnosis of subacute thyroiditis. Evaluation of thyroid post-surgical remnants.

DURATION OF PROCEDURE

30 minutes.

THYROID-METASTASES DETECTION SCAN

123I SCINTIGRAPHIC SCAN
(WITH OR WITHOUT rhTSH)

131I SCINTIGRAPHIC SCAN
(WITH OR WITHOUT rhTSH)

123I TOMOSCINTIGRAPHY
(SPET/SPET-CT)

DESCRIPTION

Evaluation of the metabolic activity of thyroid tissue remnants of differentiated thyroid neoplasms.

PREPARATION

  • The patient must suspend his/her hormonal treatment (thyroxin [T4] for at least 21 days, triyodothyronine [T3] for at least 10 days).
  • If hormonal suppression is not advised, TSH can be stimulated with two intramuscular injections in two consecutive days of rhTSH (Thyrogen).
  • The patient must not be in iodic saturation, either because of  intravenous or intrathecal scans with iodized contrast (skinography, TAC with contrast, myelography and some angiographies) at least 3 weeks before the procedure, or because of  treatment with amniodarone at least 6 months before the procedure.

INDICATIONS

  • Evaluation of functioning thyroid tissue remnants after thyroidectomy. 
  • Study of the spread of differentiated thyroid carcinoma. 
  • Detection of recurrences of differentiated thyroid carcinoma.

DURATION OF PROCEDURE

3 days.

SOMATOSTATIN-RECEPTORS SCINTIGRAPHY

111In OR 99mTc-OCTREOTIDE
SCINTIGRAPHY-SPECT-CT

SOMATOSTATIN-RECEPTORS
SCINTIGRAPHIC SCAN

SOMATOSTATIN-RECEPTORS
TOMOGRAPHY-SPECT-CT

DESCRIPTION

Evaluation of somatostatin receptor activity in tumors.

PREPARATION

  • No scans with barium or iodine contrast should be performed during the procedure. 
  • For the study of abdominal tumors, it is advisable to use laxatives, and even the use of enemas.
  •  

INDICATIONS

  • Evaluation of tumors that express somatostatin receptors (extension study, follow-up, control of therapeutic response and recurrence detection) in neuroendocrine tumors, such as carcinoid, enteropancreatic tumors and tumors derived from the neural crest (medullary of thyroid, neuroblastomas, paragangliomas and pheochromocytomas). 
  • Evaluation of other types of neoplasms that may have expression of somatostatin receptors, such as breast cancer, lung cancer, lymphomas and thyroid cancer.

DURATION OF PROCEDURE

2 days.

PET-CT FOR THE PEDIATRIC EVALUATION
OF CONGENITAL HYPERINSULINISM
WITH 18F-DOPA

DESCRIPTION

Evaluation of congenital hyperinsulinism in children.

PREPARATION

  • A 4-hour fasting is required.

  • Depending on child’s age, anesthesia is to be administered.

INDICATIONS

Differential diagnosis of congenital hyperinsulinism at pediatric age, differentiating focal and diffuse pancreatic forms.

DURATION OF PROCEDURE

1 hour.

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Josep Irla & Bosch Street, 5-7, Basement, Barcelona 08034, Catalonia, Spain
(+34) 93 204 6439 & (+34) 93 254 0470 Fax (+34) 93 204 9641 info@simm.barcelona

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Logo-SIMM-Largo

Carrer Josep Irla & Bosch, 5,7, Basement, Barcelona 08034, Catalonia, Spain
Phones (+34) 93 204 6439 & (+34) 93 254 0470 Fax (+34) 93 204 9641
Email info@simm.barcelona

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