Overview
Bone scanning is a nuclear medicine procedure utilizing radiopharmaceuticals to identify skeletal abnormalities. This protocol outlines the standard procedure for conducting bone scans in clinical settings.
Pre-Procedure Requirements
Patient Preparation
- Ensure adequate hydration (1-2 liters of fluid)
- No specific dietary restrictions
- Remove metallic objects and jewelry
- Obtain relevant clinical history
Equipment and Materials
- Tc-99m MDP/HDP radiopharmaceutical
- Gamma camera with LEHR collimator
- Emergency equipment readily available
- Documentation materials
Procedure Steps
1. Radiopharmaceutical Administration
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Dose: 20-30 mCi Tc-99m MDP/HDP
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Route: Intravenous injection
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Documentation: Record time, dose, and injection site
2. Imaging Protocol
Phase 1: Flow Study (Optional)
- Begin imaging immediately post-injection
- 2-second frames for 60 seconds
- Focus on area of interest
Phase 2: Blood Pool Images
- Acquire 3-5 minutes post-injection
- Static images of relevant areas
- 500-1000K counts per image
Phase 3: Delayed Images
- Acquire 2-4 hours post-injection
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Whole Body Scan:
- Scan speed: 10-15 cm/min
- Matrix: 256 x 1024
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Spot Views:
- 500-1000K counts
- Focus on areas of interest
Image Processing and Analysis
Required Views
- Anterior whole body
- Posterior whole body
- Lateral skull (if indicated)
- Oblique views of suspicious areas
Quality Control
- Check for motion artifacts
- Ensure proper positioning
- Verify image quality and counts
Documentation Requirements
Essential Elements
- Patient demographics
- Radiopharmaceutical details
- Imaging parameters
- Technologist notes
- Any unusual findings or technical issues
Safety Considerations
- Monitor for adverse reactions
- Practice ALARA principles
- Follow radiation safety protocols
- Ensure proper waste disposal
References
SNMMI Guidelines for Bone Scintigraphy