Contact : +27 (0) 861 NUCLEAR [682 5327] or +27 (0)12 942 0845

Common Studies Performed Regularly

This is a list of common services offered by Nuclear Medicine—should any interested parties have queries about rarer treatments and procedures, please feel free to contact us or download relevant PDFs in the Specialty Specific Services or Scan Specific folder in the Info for Doctors section.

Synopsis of common studies offered (sorted by major systems)

Cerebrovascular: Brain imaging for stroke versus TIA; epileptogenic focus determination; dementia imaging; movement disorder imaging; infection; tumour imaging.

Cardiovascular: Myocardial perfusion studies to detect ischemia/infarcts in those at risk, extent of IHD, pre-operative risk stratification, risk stratification for major adverse cardiac events and/or sudden death; myocardial ventriculography to determine functional parameters e.g. LVEF— especially for patients requiring routine follow-up to monitor cardiac function (cardiotoxic chemotherapy)

Infection: To assess fever of unknown origin; localization of infection source; follow-up post-treatment.

Hepatobiliary: Cholecystitis diagnosis and evaluation; biliary atresia versus neonatal hepatitis; choledochal cyst evaluation; sphincter of Oddi dysfunction amongst others.

Oncology: Location of tumour of unknown primary; location of biopsy site; cancer staging & re-staging; detection of recurrence and residual disease; treatment monitoring et cetera (multiple general & tumour-specific agents)

Pulmonary: Ventilation-Perfusion scan to detect acute pulmonary thromboembolism in patients at risk with contra-indication to CTPA, pregnant patients, renal impaired patients, pre-menopausal females (5 odds ratio for getting breast cancer from a single CTPA) and patients with contra-indications to iodine contrast agents; quantitative lung function test (quantitative VQ scan) preoperatively to determine resectable portion of lung

Renal: Dynamic renography to detect ureteric obstruction, assess pre-operative/post-transplant baseline  renal function (multiple parameters), monitoring post-transplant patients, differentiation between ATN, acute rejection and cyclosporine toxicity, prediction of reversibility of RVH; cortical renography to determine renal split function, determine risk for scarring post-pyelonephritis, detecting degree of scarring  at follow-up 6 months post-pyelonephritis

Synopsis of common diagnostic services as related to specialist fields (in alphabetical order of speciality)

Accident and Emergency: Ventilation-Perfusion imaging; myocardial perfusion imaging; brain death determination in organ transplant donor (as well as organ viability); detection of gastro-intestinal bleeding and localisation of bleeding territory (especially in slow active bleeds).

Anaesthetics: Various pre-operative risk stratification studies involving the cardiovascular and genitourinary systems.

Cardiology/Cardiothoracic surgery: Myocardial perfusion imaging; cardiac viability determination; myocardial ventriculography for functional assessment and validation; MIBG assessment of sympathetic cardiac innervation.

General surgery: Sialography (salivary gland function); oesophageal transit; GORD assessment (especially in children); gastric transit  studies; detection of GIT bleeding and localization thereof (especially in slow active bleeds); protein-losing enteropathy detection; hepatobiliary imaging (especially for cholecystitis and biliary atresia); evaluation for cancer of unknown origin and biopsy site determination; evaluation of fever of unknown origin and infection source detection; detection of complications related to surgery/prolonged immobility e.g. bedridden patients.

Gynaecology: Various oncological indications for gynaecological malignancies incl. cervix, vulva, ovarian and endometrial cancers; ventilation-perfusion imaging for acute PTE in especially in pregnant and post-partum patients.

Internal medicine: Lacrimal gland function for Sjogren’s disease and dry eyes; all diagnostic/risk-stratifying indication more common to other fields; ciliary clearance (nasal and pulmonary); COPD evaluation; alveolar permeability; ventilation-perfusion scan for acute PTE; quantitative lung function studies; dynamic renography; cortical renography; myocardial perfusion imaging; cardiac viability; various oncological studies; various infection studies; various risk-stratifying studies.

Nephrology: Dynamic renography incl. diuretic renography for candidates at risk for RVH; cortical renography; all other diagnostic/risk-stratifying indications more common to other fields.

Neurology/Neurosurgery/Psychiatry: Determination of brain death; stroke/TIA evaluation; evaluation of dementia (especially Alzheimer’s disease); diagnosis of Parkinson’s disease; localization of seizure focus and fusion with MRI; determination of various psychiatric disorders; patency of VP-shunt; CSF leak localization; infection studies; tumour localization & differentiation.

Oncology: Localization of CUP; biopsy site determination; staging & re-staging; monitoring treatment; detection of residual disease/recurrence; determination of eligibility for various targeted radionuclide therapies.

Paediatrics/Paediatric surgery/Paediatric oncology: Ciliary clearance; oesophageal transit; GORD evaluation; gastric transit studies; dynamic renography (especially in suspected obstruction); cortical renography (to evaluate various attributes of pyelonephritis and scarring); direct and indirect cystourethrography; various oncological indications especially in childhood neuroendocrine tumours and lymphoma; assessment for eligibility for various targeted radionuclide therapies and metastatic bone pain palliation.

Pulmonology/Cardiothoracic surgery: Ventilation-Perfusion scan for acute PTE; Quantitative lung function studies; determination of biopsy site for suspected mediastinal/pulmonary tumour; differentiation of PCP versus Kaposi’s sarcoma versus lymphoma; all other diagnostic/risk-stratifying indications more common to other fields.

Rheumatology and pain management: To assess for eligibility for metastatic bone pain palliation and for radio-synovectomy; all other diagnostic/risk-stratifying indications more common to other fields.

Urology: Dynamic renography to detect urinary tract obstruction and intervention response as well as pre-nephrectomy assessment; cortical renography for relative renal function; bone metastatic stating and follow-up for prostate cancer; various oncological indications.


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