ONCOLOGY PROCEDURES

ONCOLOGY PROCEDURES

CAT onco01

BREAST SCINTIGRAPHY

DESCRIPTION

Evaluation of the existence, extension and staging of breast cancer.

PREPARATION

No previous preparation is needed.

INDICATIONS

  • Diagnosis of breast tumors.
  • Evaluation of axillary lymph node involvement.

DURATION OF
PROCEDURE

1 hour.

BREAST SCINTIGRAPHY

DESCRIPTION

Evaluation of the existence, extension and staging of breast cancer.

PREPARATION

No previous preparation is needed.

INDICATIONS

  • Diagnosis of breast tumors.
  • Evaluation of axillary lymph node involvement.

DURATION OF PROCEDURE

1 hour.

CAT onco02

META-IODO-BENZYL-GUANIDINE (MIBG) SCINTIGRAPHY

META-IODO-BENZYL-GUANIDINE (MIBG) SCINTIGRAPHIC SCAN

META-IODO-BENZYL-GUANIDINE (MIBG) TOMOSCINTIGRAPHY (SPET/SPET-CT)

DESCRIPTION

Evaluation of the existence of metabolic activity of the catecholamines pathway at the adrenal level and in neuroendocrine tumors.

PREPARATION

  • The thyroid gland must be stunned with 20 drops of potassium iodide 45-60 minutes before the I-123 tracer injection.
  • This preventive treatment must be started 5 days before the administration of the dose and must extend until 3 days after the end of the procedure if it is done with I-131.

INDICATIONS

Identification, location and evaluation of the extension of tumors of neuroectodermal tissue:

  • Poisonous or malignant pheochromocytoma, of intra or extra-adrenal localization.
  • Neuroblastomes.
  • Carcinoid tumors.
  • Medular thyroid carcinoma.
  • Paragangliomes.
  • MEN IIa and MEN IIb.

DURATION OF
PROCEDURE

2 days.

META-IODO-BENZYL-GUANIDINE (MIBG)
SCINTIGRAPHY

META-IODO-BENZYL-GUANIDINE (MIBG)
SCINTIGRAPHIC SCAN

META-IODO-BENZYL-GUANIDINE (MIBG)
TOMOSCINTIGRAPHY (SPET/SPET-CT)

DESCRIPTION

Evaluation of the existence of metabolic activity of the catecholamines pathway at the adrenal level and in neuroendocrine tumors.

PREPARATION

  • The thyroid gland must be stunned with 20 drops of potassium iodide 45-60 minutes before the I-123 tracer injection.
  • This preventive treatment must be started 5 days before the administration of the dose and must extend until 3 days after the end of the procedure if it is done with I-131.

INDICATIONS

Identification, location and evaluation of the extension of tumors of neuroectodermal tissue:

  • Poisonous or malignant pheochromocytoma, of intra or extra-adrenal localization.
  • Neuroblastomes.
  • Carcinoid tumors.
  • Medular thyroid carcinoma.
  • Paragangliomes.
  • MEN IIa and MEN IIb.

DURATION OF PROCEDURE

2 days.

CAT onco03

ONCOLOGIC PET-CT

DESCRIPTION

Study of oncologic patients.

PREPARATION

  • Fasting of at least 6 hours before performing the procedure is required. In general, it is advisable that patients take a light meal the night before the study and that they do not ingest anything until after it has been done.
  • On the day of the procedure, the patient will have to drink abundant water (0.5-1L). Juices, sugary solutions, sweets etc. are not allowed. Urine must not be retained. Intravenous glucose solutions should also interrupt at least 6 hours before the scheduled time of the procedure.
  • The patient should take his/her usual medication.
  • It is necessary to avoid doing physical exercises 2-3 days before the procedure since this could condition a high muscular uptake of the tracer.
  • Diabetic type II and hyperglycemic patients treated with oral antidiabetic medicines should take their usual medication early in the morning and preferably stay in bed at night before performing the test.
  • Type I or diabetic patients with subcutaneous/intravenous insulin therapy should take their usual medication early in the morning. To avoid possible hypoglycemia, these patients can take some light breakfast, with a minimum of 4 hours before the procedure.

INDICATIONS

  • Characterization of pancreatic masses.
  • Detection of:

    • Lung pulmonary nodules.
    • Evident tumors of unknown origin.
  • Detection of recurrences of:

    • Gliomas with high degree of malignancy.
    • Head and neck tumors.
    • Differential thyroid cancer (high TG and negative RCI).
    • Primary lung carcinoma.
    • Breast carcinoma.
    • Pancreatic carcinoma.
    • Colorectal carcinoma.
    • Ovarian cancer.
    • Malignant lymphoma.
    • Malignant melanoma.
    • Other carcinomas.
  • Staging of:

    • Malignant melanoma.
    • Locally advanced breast cancer.
    • Head and neck tumors.
    • Primary lung cancer.
    • Esophagus cancer.
    • Pancreatic cancer.
    • Colorectal cancer.
    • Malignant lymphomas.
  • Monitoring of the response to the treatment of:

    • Malignant lymphomas
    • Head and neck tumors.

DURATION OF
PROCEDURE

2-3 hours.

ONCOLOGIC PET-CT

DESCRIPTION

Study of oncologic patients.

PREPARATION

  • Fasting of at least 6 hours before performing the procedure is required. In general, it is advisable that patients take a light meal the night before the study and that they do not ingest anything until after it has been done.
  • On the day of the procedure, the patient will have to drink abundant water (0.5-1L). Juices, sugary solutions, sweets etc. are not allowed. Urine must not be retained. Intravenous glucose solutions should also interrupt at least 6 hours before the scheduled time of the procedure.
  • The patient should take his/her usual medication.
  • It is necessary to avoid doing physical exercises 2-3 days before the procedure since this could condition a high muscular uptake of the tracer.
  • Diabetic type II and hyperglycemic patients treated with oral antidiabetic medicines should take their usual medication early in the morning and preferably stay in bed at night before performing the test.
  • Type I or diabetic patients with subcutaneous/intravenous insulin therapy should take their usual medication early in the morning. To avoid possible hypoglycemia, these patients can take some light breakfast, with a minimum of 4 hours before the procedure.

INDICATIONS

  • Characterization of pancreatic masses.
  • Detection of:

    • Lung pulmonary nodules.
    • Evident tumors of unknown origin.
  • Detection of recurrences of:

    • Gliomas with high degree of malignancy.
    • Head and neck tumors.
    • Differential thyroid cancer (high TG and negative RCI).
    • Primary lung carcinoma.
    • Breast carcinoma.
    • Pancreatic carcinoma.
    • Colorectal carcinoma.
    • Ovarian cancer.
    • Malignant lymphoma.
    • Malignant melanoma.
    • Other carcinomas.
  • Staging of:

    • Malignant melanoma.
    • Locally advanced breast cancer.
    • Head and neck tumors.
    • Primary lung cancer.
    • Esophagus cancer.
    • Pancreatic cancer.
    • Colorectal cancer.
    • Malignant lymphomas.
  • Monitoring of the response to the treatment of:

    • Malignant lymphomas
    • Head and neck tumors.

DURATION OF PROCEDURE

2-3 hours.

CAT onco04

SCAN FOR THE DETECTION OF THYROID METASTASES

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 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.

SCAN FOR THE DETECTION OF THYROID METASTASES

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 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 onco05

SCINTIGRAPHY WITH SOMATOSTATIN RECEPTORS

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

SCINTIGRAPHIC SCAN WITH SOMATOSTATIN RECEPTORS

TOMOGRAPHY-SPECT-CT WITH SOMATOSTATIN RECEPTORS

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

 1 to 2 days.

SCINTIGRAPHY WITH
SOMATOSTATIN RECEPTORS

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

SCINTIGRAPHIC SCAN WITH
SOMATOSTATIN RECEPTORS

TOMOGRAPHY-SPECT-CT WITH
SOMATOSTATIN RECEPTORS

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

1 to 2 days.

Cat onco06

SCINTIGRAPHIC SCAN WITH TUMORAL AFFINITY OR METABOLIC
ACTIVITY TRACERS (THALLIUM CHLORIDE, 99mTc-MIBI)

TOMOSCINTIGRAPHY (SPET/SPET-TC) WITH TUMORAL
AFFINITY OR METABOLIC ACTIVITY TRACERS

DESCRIPTION

Evaluation of metabolic activity in tumors.

PREPARATION

No previous preparation is needed.

INDICATIONS

Evaluation of tumoral activity in general (pulmonary, muscular, breast, brain, etc.).

DURATION OF
PROCEDURE

4 hours.

SCINTIGRAPHIC SCAN WITH TUMORAL
AFFINITY OR METABOLIC ACTIVITY TRACERS
(THALLIUM CHLORIDE, 99mTc-MIBI)

TOMOSCINTIGRAPHY (SPET/SPET-TC)
WITH TUMORAL AFFINITY OR
METABOLIC ACTIVITY TRACERS

DESCRIPTION

Evaluation of metabolic activity in tumors.

PREPARATION

No previous preparation is needed.

INDICATIONS

Evaluation of tumoral activity in general (pulmonary, muscular, breast, brain, etc.).

DURATION OF PROCEDURE

4 hours.

CAT onco07

FUSION ONCOLOGIC SPET-TC

DESCRIPTION

Obtaining fusion images by combining the functional images of tomoscintigraphy or SPET with the anatomical images of CT in the study of oncological processes. In this way, greater accuracy is achieved in the location and characterization of the lesions detected by the planar or tomographic studies without fusing.

PREPARATION

Variable, according to tracer and pathology. Ask our personnel.

INDICATIONS

  • Localization of bone metastases due to lung, prostate, kidney, breast cancer and others (with diphosphonates).
  • Localization of differential thyroid cancer (with I-123).
  • Localization of lymphomas (with Ga-67).
  • Localization of neuroendocrine tumors (with octreotide or MIBG).
  • Localization of the sentinel lymph node (in breast cancer, head and neck cancer, melanoma, etc.).

DURATION OF
PROCEDURE

Variable, according to tracer and pathology.

FUSION ONCOLOGIC SPET-TC

DESCRIPTION

Obtaining fusion images by combining the functional images of tomoscintigraphy or SPET with the anatomical images of CT in the study of oncological processes. In this way, greater accuracy is achieved in the location and characterization of the lesions detected by the planar or tomographic studies without fusing.

PREPARATION

Variable, according to tracer and pathology. Ask our personnel.

INDICATIONS

  • Localization of bone metastases due to lung, prostate, kidney, breast cancer and others (with diphosphonates).
  • Localization of differential thyroid cancer (with I-123).
  • Localization of lymphomas (with Ga-67).
  • Localization of neuroendocrine tumors (with octreotide or MIBG).
  • Localization of the sentinel lymph node (in breast cancer, head and neck cancer, melanoma, etc.).

DURATION OF PROCEDURE

Variable, according to tracer and pathology.

CAT pet03

18F-SODIUM FLUORIDE (18F-NaF) PET-CT

DESCRIPTION

Study of bone metabolism.

PREPARATION

  • No previous preparation is needed.
  • No fasting required.

INDICATIONS

  • Study of:

    • Primary bone tumors.
    • Bone viability.
    • Bone necrosis.
    • Other benign bone disorders.
  • Bone staging of:

    • Prostate cancer.
    • Breast cancer.
    • Other neoplastic diseases with blastic bone metastases.

DURATION OF
PROCEDURE

1 hour.

18F-SODIUM FLUORIDE (18F-NaF) PET-CT

DESCRIPTION

Study of bone metabolism.

PREPARATION

  • No previous preparation is needed.
  • No fasting required.

INDICATIONS

  • Study of:

    • Primary bone tumors.
    • Bone viability.
    • Bone necrosis.
    • Other benign bone disorders.
  • Bone staging of:

    • Prostate cancer.
    • Breast cancer.
    • Other neoplastic diseases with blastic bone metastases.

DURATION OF PROCEDURE

1 hour.

Logo-SIMM-Largo

Josep Irla & Bosch Street, 5-7, Basement, Barcelona 08034, Catalonia, Spain
(+34) 93 204 6439, (+34) 93 205 7708 Fax (+34) 93 204 8641 info@simm.barcelona

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Logo-SIMM-Largo

Josep Irla & Bosch Street, 5-7, Basement, Barcelona 08034, Catalonia, Spain
Phones (+34) 93 204 6439 & (+34) 93 205 7708 Fax (+34) 93 204 8641
E-mail info@simm.barcelona

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