State-of-the-Art Imaging Technology
The Seton Medical Center Department of Nuclear Medicine offers a full range of nuclear medicine procedures for our patient community, including cardiac imaging, oncology procedures, and the latest Positron Emission Tomography (PET) imaging. All procedures are performed at the medical center, where there is ample parking and easy access to the physician medical office buildings next door. Procedures need to be scheduled in advance, but in most cases, tests can be performed within a few days of being ordered. Results are usually available to your physician on the same day as the procedure is performed. At Seton Medical Center, we believe that Caring is Powerful Medicine.

PET Scanning for staging cancer patients
The Nuclear Medicine Department has been promoting the increased use of PET (Positron Emission Tomography) for identifying the presence and extent of cancer in the whole body. Because this newer test reflects functional metabolic activity, PET can identify sites of tumor more accurately than other imaging tests such at CT and MRI, which rely primarily on tissue structure, or anatomy.

PET has been particularly useful for cancers of the lung, esophagus, colon, and breast, as well as for melanoma and lymphoma, among others. PET scanning works by imaging a special radioactive tracer, called fluorodeoxyglucose (FDG), which accumulates in the body at sites of glucose metabolism. Since many cancers take up glucose more avidly than do the adjacent soft tissues, this makes the sites of cancer stand out as "hot spots" on the PET images.

The recent literature has shown that the use of PET scanning for patients with cancer is associated with a marked improvement in the quality of medical management. For example, 10-20% of lung cancer patients who otherwise would be referred for surgery will end up having distant and/or more extensive disease identified when PET scanning is used. The PET scan thereby identifies patients who would not benefit from curative intent surgery, redirecting the goals of treatment to supportive care, avoiding the unnecessary costs and morbidity of major surgery.

Combining the use of metabolic and anatomic imaging by using both PET and CT scanning, respectively, significantly improves the accuracy of localizing cancer sites in the body even further. This combined PET and CT imaging approach has been fostered at Seton Medical Center by the recent advent of PACS (see below). In addition, a new computer system just installed in the Nuclear Medicine Department permits the PET and CT scan images to be "fused" together, enhancing the accuracy of co-registration of these two imaging modalities. These efforts will help assure that the best and most appropriate treatment will be given to our patients with cancer at Seton Medical Center.

PACS
PACS, which stands for Picture Archiving and Communication System, is a system of storing medical images on a centralized computer available to a large number of other medical staff members throughout the hospital. At Seton Medical Center, we have recently implemented a new PACS system in the Nuclear Medicine and Radiology Departments. Not only is our PACS system accessible throughout the Medical Center, but images stored on it can even be accessed from anywhere via the web by authorized personnel.

In its relatively brief existence, this new resource has already revolutionized the way medical images can be reviewed by cooperating Nuclear Medicine and Radiology physicians, as well as by all of the medical staff. Prior to the advent of PACS, images had to be viewed on a piece of transparency film, stored in a particular location in a particular department. Now, with PC's connected to the PACS system located throughout the medical center, physicians may quickly and easily view any patient's diagnostic images concurrent with reviewing the rest of the patient's medical record in the chart, or immediately prior to examining and interviewing the patient.

This modern tool represents a significant improvement in streamlining the efficiency of visual access to important diagnostic imaging data at Seton Medical Center. As a result of PACS implementation, the quality of our patient care has been improved, an improvement to which many of our medical staff can already attest first hand.

Myocardial Perfusion SPECT Imaging

Nuclear imaging of heart blood flow is a useful test to non-invasively assess the extent, severity, and location of coronary artery disease. This test has been in used for approximately 25 years.

More recently, the imaging is performed three-dimensionally by using "SPECT," so that better information can be obtained about which parts of the heart do or do not have good blood flow. Also more recently, the study can be "gated" to the patient's EKG, allowing a three-dimensional "movie film" of the beating heart to be made. This data can be used to accurately assess the contractile (squeezing) function of the heart, concurrent with evaluating regional blood flow in the heart. This test is used in a variety of settings relevant to the evaluation of coronary artery disease, such as:

• patients who come into the Emergency Room with chest pain;
• patients with known coronary disease who might be having an acute episode of "reocclusion" of an artery that was known to be previously blocked;
• patients with known coronary artery disease who present with symptoms of worsening chest pain;
• and in multiple other scenarios among patients with known coronary artery disease where more objective information on the status of cardiac blood flow is needed.

The angiogram performed by the invasive cardiologist, often following a myocardial perfusion SPECT study, shows the anatomy of the heart's blood vessels, by identifying the location and severity of potential occlusions (blockages). The nuclear cardiac SPECT scan measures the functional extent of such occlusions by measuring the blood flow to the different areas of heart muscle, without actually visualizing the blockages themselves. Therefore, the nuclear study helps determine the need for the more invasive angiogram, and potentially for revascularization either by surgery or by interventional cardiology techniques.

At Seton Medical Center, our Nuclear Medicine Department has implemented gated cardiac perfusion SPECT imaging on all patients undergoing this test. This assures that the best and most comprehensive information about both the regional blood flow and regional contraction in the heart are available to the medical care team deciding the best way to proceed with the patient's evaluation.

Patient procedures generally require you to arrive at the department in the morning and return for images later that day. Patient preparation is important, so please be aware and follow all special instructions given to you prior to their tests. All nuclear imaging procedures require a written doctor’s order and health insurance approval before we can schedule an appointment.
 
For more information, please call the Department of Nuclear Medicine
at (650) 991-6685.

Department of Nuclear Medicine

Location: 1st Floor of Seton Medical Center

Hours: 8 a.m. – 5 p.m., Monday-Friday

Phone: (650) 991-6685
Fax: (650) 991-6445

At Seton Medical Center, where Experience Counts^sm, we look forward to providing these services to you and your family with both care and compassion.