Referring Doctors

CARDIOVASCULAR SYSTEMS

Myocardial Perfusion Imaging (STRESS THALLIUM)

  • Is used to assess the overall function of the heart muscle and the function of individual muscle walls.
  • Chest pain or shortness of breath without ischemia by ECG or markers.
  • High risk individuals (Diabetics, Hypertensive patients, smokers, Family history, hyperlipidemia, thrombogenic states, renal failure etc.
  • Baseline ECG abnormalities, Bundle branch blocks etc
  • Indeterminate TMT result
  • Risk stratification post- myocardial infarction (MI) /preoperative/general
  • Evaluation of possible coronary artery disease for non-cardiac perioperative risk assessment (Pre-anesthetic check up)
  • Indeterminate Conventional angiogram (25-75% stenosis) / Coronary CT
  • Evaluation of extent and severity of coronary artery disease.
  • To determine whether a patient is a candidate for revascularization
  • Diagnosis of heart failure with reduced left ventricular systolic function.
  • New or worsening symptoms of angina in a patient with known CAD
  • Risk assessment in post-revascularization for ischemic equivalent symptoms of chest pain, incomplete revascularization in an symptomatic individual, or after coronary artery bypass grafting (CABG)
  • Guide to rehabilitation therapy

MOGA

  • Evaluation of ventricular function (Ejection Fraction) & wall motion abnormalities
  • Assessment of cardiac toxicity

GENITOURINARY SYSTEM

Renal Dynamic Scan/ (DTPA/EC) Renography

  • Evaluation of renal function
  • Urinary tract obstruction (Hydronephrosis): Pelviureteric junction / vesicoureteric obstruction, megaureter (obstructive/non-obstructive/refluxing)
  • Renal transplant evaluation: vasomotor nephropathy/ rejection/drug toxicity/surgical complications.
  • Renovascular hypertension (Captropil /ACE-inhibitor renography)
  • Renal trauma/Surgical complications
  • Prospective renal donor
  • Acute/Chronic renal failure
  • Renal anomalies: Horseshoe kidney, Polycystic kidney, Ureterocele
  • Urethral valves
  • Urinary leak
  • Post-operative status: Post-pyeloplasty, Post-ureteral reimplantation, Post-ureteral reimplantation , Post-urinary diversion procedures (PCN, ileal loop diversion)
  • Obstructing pelvic mass (e.g., ca cervix)

Glomerular Filtration Rate (GFR) (DTPA)

  • Chronic glomerulopathies
  • Renal side effects of chemotherapy or nephrotoxic drugs such as cyclosporine and antibiotics
  • Estimation of single kidney GFR

DMSA Scan (Renal Cortical Scan)

  • Measurement of renal function in known obstruction.
  • Acute/Chronic pyelonephritis
  • Work up of vesicoureteric reflux (VUR)
  • Renal scar
  • Prospective renal donor
  • Relative functioning renal mass
  • Pre-surgical quantification before nephrectomy
  • Solitary/Ectopic renal tissue (e.g., single kidney, pelvic kidney, cross fused renal ectopia, discoid kidney)
  • Horseshoe/Pseudo-horseshoe kidney
  • Differential diagnosis of mass v/s prominent column of Bertin

Direct Radionuclide Cystography (DRCG)

  • Vesicoureteric reflux (VUR)
  • Diagnosis of familial vesicoureteric reflux
  • Evaluation of vesicoureteric reflux after medical therapy/deflux injection/ureteric reimplantation/antireflux surgery
  • Serial evaluation of bladder dysfunction for vesicoureteric reflux (e.g., neurogenic bladder)
  • Evaluation of posterior urethral valves for vesicoureteric reflux

Skeletal System

MDP Bone Scan

  • Metastatic work up for Prostate, Breast, Lung, Renal, Urinary bladder, HD, NHL and other cancers.
  • Primary bone tumors: Osteosarcoma, osteochondroma, Ewing’s sarcoma, multiple myeloma, osteoblastoma, giant cell tumour ect.
  • Soft tissue sarcomas, including rhabdomyosarcoma
  • Paraneoplastic syndromes: including hypertrophic pulmonary osteoarthropathy, algodystrophy, polymyalgia rheumatica, poly(dermato)myositis and osteomalacia.
  • Assessment prior to radionuclide therapy
  • Evaluate response to therapy, chemotherapy or radiation treatment for cancer.

Three-Phase / whole body Bone Scan (Rheumatology)

  • Cellulitis versus osteomyelitis, or assessing response to treatment.
  • Chronic inflammatory arthritis (sacroiliitis {backache}, RA, spondyloarthropathies and chronic recurrent multifocal osteomyelitis)
  • Osteoarthritis of the lumbar facet joints, hip, femorotibial and femoropatellar osteoarthritis, rhizarthrosis and tarsal osteoarthritis
  • (Avascular) osteonecrosis, which is most frequently located at the femoral head, femoral condyle and tibial plateau
  • Osteonecrosis of the jaw (ONJ)
  • Complex regional pain syndrome (CRPS) type I of the hand, hip, knee and foot
  • Evaluation of prosthesis for loosening or infection
  • Condylar hyperplasia of mandible
  • Suspected osteoid osteoma
  • Suspected occult stress fracture
  • Shin splint
  • Assessment of bone Graft Viability
  • Enthesopathies: including plantar fasciitis, Achilles tendinitis and bursitis
  • Tietze’s syndrome (costochondritis)
  • Polymyositis
  • Langerhans cell histiocytosis (LCH): single system LCH and multisystem LCH with bone involvement
  • Non-Langerhans cell diseases, such as Erdheim–Chester disease, Schnitzler syndrome, and Rosaï Dorfman disease

Bone scan in METABOLIC AND ENDOCRINE DISEASES

  • Paget’s Disease
  • Hyperparathyroidism
  • Renal Osteodystrophy
  • Hypertrophic Osteoarthropathy
  • Fibrous Dysplasia
  • Insufficiency Fractures

Bone scan in Pediatrics

  • Osteochondritis of the hip (Legg-Calvé-Perthes disease)
  • Transient synovitis of the hip
  • Osteoid osteoma
  • Battered child syndrome
  • Mandibular condylar hyperplasia
  • Bone infarction (sickle cell disease, thalassaemia)

ENDOCRINE SYSTEM

Thyroid Scan

  • Determination of functional status (hot or cold) of thyroid nodule
  • Differential diagnosis of hyperthyroidism
  • Detection of ectopic thyroid tissue
  • Evaluation of congenital hypothyroidism
  • Differential diagnosis of neck or mediastinal masses (substernal goiter)
  • Prior to lobar ablation in case of hemithyroidectomy

Parathyroid Scan (sestamibi scan)

  • Perchlorate Discharge Test

131-I Whole Body Scan (131-I WBS)

  • MIBG Scan (MIBG, Metaiodobenzyl Guanidine)

HEPATOBILIARY SYSTEM & SPLEEN

HIDA Scan

  • Biliary atresia v/s neonatal hepatitis “syndrome”
  • Functional biliary pain syndromes ( acute / CHRONIC upper abdominal pain)
  • Patients presenting with suspected acute cholecystitis or acute cystic duct obstruction
  • Biliary system patency/Biliary stent
  • Sphincter of Oddi dysfunction
  • Calculation of gallbladder ejection fraction (GBEF)
  • Bile leak
  • Assessment of biliary enteric bypass (e.g., Kasai procedure)
  • Afferent loop syndrome
  • Functional assessment of the liver before and after partial hepatectomy/liver surgery
  • Assessment for liver transplantation (pre and post)
  • Enterogastric (duodenogastric) reflux assessment
  • Esophageal bile reflux after gastrectomy

Sulpur colloid Liver-Spleen Scan

  • Cirrhosis Vs NCPF (Non cirrhotic portal fibrosis)
  • Focal nodular hyperplasia (FNH v/s hepatic adenoma)
  • Function of reticuloendothelial system (in pts with known/suspected liver disease)
  • Accessory spleens/splenosis/ploysplenia-asplenia syndrome

GASTROINTESTINAL SYSTEM

Meckel's Scan

  • Heterotopic gastric mucosa in Meckel's diverticulum/ gastrointestinal duplications/Barrett's esophagus
  • Evaluation of post-operative retained gastric antrum after Billroth II gastrojejunostomy
  • Assessment of viability of gastric patch after bladder reconstruction surgery
  • Assessment of viability of gastric pull-up after esophageal reconstruction surgery

GI Bleed Study

Gastroesophageal Reflux Study

Gastric Emptying Study (Gastric Emptying Time-GET)

CENTRAL NERVOUS SYSTEM

Brain Perfusion SPECT (ECD/HMPAO)

  • Ictal and inter-ictal SPECT: Epilepsy (Localization of seizure origin in patients with intractable epilepsy)
  • Craniosynostosis (to assess improvement in brain perfusion after surgery)
  • Herpetic encephalitis/ Vasculitis

Trodat scan

  • Differentiation of Parkinson's disease from other atypical Parkinsonian syndromes.
  • Brain SPECT for tumors (GHA Brain SPECT; 99mTc- Glucoheptonate)

Cisternography

  • Hydrocephalus (mainly communicating hydrocephalus)
  • CSF leak
  • CSF Shunt Study
  • Evaluation for CSF Shunt patency

ONCOLOGY

Scintimammography

  • Evaluation of breast cancer in patients in whom mammography is nondiagnostic, equivocal, or difficult to interpret (e.g., presence of scar tissue, mammographically dense breast tissue, implants, or severe dysplastic disease)

Lymphoscintigraphy for sentinel node

  • Breast cancer
  • Melanoma

MISCELLANEOUS

Lymphoscintigraphy

  • Diagnosis of lymphedema
  • Assessment of therapeutic interventions in lymphedema
  • Chyluria
  • Chyle leak (chyloperitoneum/chylothorax)

Dacroscintigraphy

  • Nasolacrimal drainage patency

Salivary Gland Scintigraphy

  • Salivary duct patency