A PET scan is a simple, non-invasive test that provides no side effects. The staff at SWFL Regional Imaging will inform the patient about any preparation required for the PET exam. It is important that patients not exercise extensively in the 24-hours prior to the scan. Patients will need to arrive at their appointment NPO (at least 6 hours) except for water. It is especially important that no sugar be ingested, because the glucose in foods would affect the uptake of the radioactive glucose used in the test. Medications should be taken as scheduled, however, only with a cracker if food is early afternoon, peak control time after morning insulin.

At the PET scan appointment, the patient will be escorted to our PET department. A small blood sample to check blood sugar (glucose) level may be obtained. Elevated glucose levels (over 200) will necessitate cancelling the exam. The patient will be given an injection of a small amount of radioactive glucosoe (FDG) into their bloodstream; most common route is using a vein in the arm. The patient will be asked to wait apporximately 60 minutes for the imaging drug to distribute in the body. Movement, reading, or any other activity during that time will affect the pattern of uptake of the drug, so the patient will be asked to rest quietly. After that, the patient will be escorted to the PET camera, which resembles a CT scanner - a large donut with a table that moves through the hole. Much like a CT, there are no loud noises during the picture-taking session, which will last approximately 30 minutes to an hour. The procedure involves exposure to radiation levels that are similar to standard nuclear medicine procedures, such as bone or heart scans. After the scan, the patient may leave. The radiologist will review the images, often comparing the functional images by PET with any CT or MR scans the the patient has had.

FDG provides a signal the the PET scanner detects--tissues that are under-using or over-using glucose. Cancer cells, because they are dividing faster than normal cells, use more glucose than normal tissures. The PET Scanner is able to demonstrate the distribution of the FDG in the body. The FDA has indicated FDG in positron emission tomography (PET) imaging:
to assist in the evaluation o fmalignancy in patients with known or suspected abnormalities found by other tests, or in patients with existing diagnosis of cancer.

Important information to know about referring a patient:
The basic principle behind PET scanning requires that information about the general health and status of the patient be gathered.

Diseases, infections, or surgeries can affect the use of glucose in tissues, so it is importnat that the staff at SWFL Regional Imaging has access to patient information, such as progress notes and a recent history and physical and any previous imaging studies (like CT, MR or Xrays) for comparison with the PET scan.

Patients with diabetes can have a PET scan--the FDG does not affect blood glucose levels. It is very important that we know that the partient is a diabetic for optimal scheduling and patient perparation. Diabetic patients must have good control of their blood glucose levels at the time of the PET scan for optimal results.

An insurance company may scutinize PET scans for coverage. Many private insurance carriers require a pre-authorization or pre-certification be obtained before the scan to assure coverage. In some cases, the insurance company may need detailed information about the usefulness of PET in order to make a decision about its use in a specific patient.

Medicare reimburses health care providers for PET procedures for a variety of patient clinical indications, which Medicare may impose certain conditions and restrictions for coverage.

PREPARATION INSTRUCTIONS:

Accuracy of the PET scan depends on several factors.
It is EXTREMELY IMPORTANT that the INSTRUCTIONS below are FOLLOWED:

• Nothing to eat or drink (except water) for AT LEAST six hours before the PET scan. If scan is scheduled at 1 p.m. or later, the patient may have a light breakfast EARLY in the morning (avoid sugar and if possible caffeine also), but only water and any prescribed medications may be taken within 6 hours of the test.
  
  
• IF THE PATIENT IS A DIABETIC, they may have a light breakfast (no sweets, no sugar, and try to avoid caffeine) six hours prior to the scheduled scan times, along with regular doses of diabetic drugs (insulin, glucophage, etc.). Patients that are brittle diabetics and cannot maintain glucose levels below 200, or have problems with hypoglycemia, must receive special instructions from their physician.
  
  
• Do no take chewing gum, nicorette gum, candy (including mints), or cough drops for AT LEAST 6 hours before the PET scan.
  
  
• Patients may take prescribed medications as scheduled with water; however only with crackers if food is required. Unless patient is on fluid restrictions for other reasons, have them drink at least 48 ounces of fluids the day before the PET scan, including two 8-ounce glasses of water the night before the scan, to prevent dehydration.
  
  
• DO NOT PERFORM ANY STRENUOUS OR VIGOROUS ACTIVITY (for example aerobics, jogging, etc.) for at least 24 hours prior to the PET scan.
  
  
• Sedation is almost never needed; however, if the patient is extremely claustrophobic or tends to be extremely nervous and fidgety, then they are to consult with their doctor about the advisability of taking a sedative before arriving at the facility. If a patient does require sedation, please arrange to have someone drive them to and from the center.
  
  
• The patient is advised to wear comfortable clothing with no zippers or snaps, such as a "jogging" outfit.
  
  
• Please do not have the patient bring children or pregnant women with them for the scan (due to the radioactive material that will be injected).
  
  
• If a CT is performed at the time of the PET, and the CT exam requires an oral contrast (thin barium solution) then this can be taken as directed; the CT drink will not interfere with the PET scan and can be taken as instructed.
  

About the PET Scan Appointment.

A Positron Emission (PET) scan is one of the most advanced imaging techniques in the world, and requires an order by a physician.

The Patient needs to bring with them on their appointment day:

• Current insurance card(s) and co-pay, if applicable.
  
  
• Photo I.D.
  
  
• Copies of films and reports from previous CT, MRI, or PET scans if not done with us. The radiologist's report wlll be delayed if these films and reports are not available
  
  
• The patient may wear their hearing aid, glasses, or dentures. However, leave other valuables at home.
  
  

Note: The injection compound that the patient receives is very time sensitive. It is important that they arrive on time (at the Punta Gorda location) in order to ensure a more accurate scan.