Hacettepe University Faculty of Medicine
Department of Nuclear Medicine
Department of Nuclear Medicine was established by Coşkun Bektik, M.D. in 1968 and it began to offer service as an independent department in 1970. The department grants Nuclear Medicine Specialist diploma at the end of an education program of 4 years and it aims to train qualified staff with vast theoretical knowledge and a tendency for practice.
The physical infrastructure of our department was renewed in 2001 in parallel to the restoration of Hacettepe Hospitals. With its renewed structure, out unit continues to practice modern and advanced methods of diagnosis and treatment. Our department has been granted the accreditation of European Union of Medical Specialists Section and Board of Nuclear Medicine (UEMS/EBNM) as a Nuclear Medicine Training Center in 2003. Our department was awarded as the Center of Excellence for Nuclear Medicine by International Atomic Energy Agency in 2004.
Nuclear medicine specialization has been delivered by Hacettepe University Department of Nuclear Medicine since 1975 and 54 physicians completed their specialist trainings by 2014.
Department of Nuclear Medicine is located on the ground floor of Hacettepe Adult Hospital. Outpatient clinic services of general nuclear medicine are provided here for patients referred from different departments of our hospital for various tests. Furthermore, radioactive iodine treatment for outpatients diagnosed with hyperthyroidism is also provided in this department.
Department of Nuclear Medicine is located on the ground floor of Hacettepe Adult Hospital. Furthermore, Oncology unit affiliated to the department is located on the 1st floor in Hacettepe Oncology Hospital. Imaging services are offered with a total of 7 gamma cameras including a PET/CT camera, a SPECT/CT hybrid imaging cameras and 3 SPECT cameras. Furthermore 2 uptake devices, 1 gamma probe, 1 gamma counter, 1 xenon ventilation unit, 1 dobutamine infusion pump, 1 stress ECG device and 2 USG services are available in the department. SPECT-CT device in Oncology unit is among the very first devices installed in Turkey. It can combine anatomical and functional imaging in the same device in order to enhance the accuracy of diagnosis.
All of the daily, weekly and monthly quality controls of the devices in our department are conducted under the supervision of Medical Physicist. Approximately over 10,000 scintigraphy studies which are mainly on Nuclear Cardiology, Nuclear Oncology, Nuclear Nephrourology and endocrine system are conducted in Department of Nuclear Medicine. In addition to diagnostic scintigraphy studies, radionuclide treatments for various purposes (treatments of hyperthyroidism and thyroid cancer with I-131, neuroblastoma and feokromositoma treatments with I-131 MIBG, radionuclide treatment of metastatic bone pain, radionuclide synovectomy for hemophilia and rheumatoid arthritis, radioimmunotherapy (Y-90 labeled antiCD-20 antibody), radioembolization (Y-90 microsphere) are given.
Myocardial Perfusion Scintigraphy is conducted to research how well blood flows through heart muscle.
Heart muscle is supplied by special blood vessels called coronary arteries. If coronary arteries narrow down or are blocked (which is called coronary arterial disease) your heart cannot be supplied with sufficient oxygen. This condition may not indicate any symptoms or chest pain can occur.
Stress/Rest Myocardial Perfusion Imaging is a test which can measure the blood supply to the heart in 2 different conditions one of which is under stress (for instance, exercising) and the other is resting. In such cases, a scarce amount of radioactivity is applied for the test and then the images of heart are taken with an instrument rotating around the chest (gamma camera). These images allow comparing the blood flow in the heart during stress and rest. Resting study is sometimes conducted within the same day with the stress study while sometimes a different day is reserved for it.
Stress test
Stress test is given while the patient walks on a treadmill. If your physician decided that you cannot do this, stress test on medication will be conducted through the administration of medication that could mimic exercise (such as dipiridamole, dobutamine) so that your heart rate is increased. Small electrodes will be placed on your chest before the stress test begins. These electrodes allow taking ECG which enables monitoring heart rhythms.
The exercise you will make is easy at the initial stage. It gets more difficult in the next minutes. Your heart rate and blood pressure will increase as it gets difficult. This is perfectly normal. Your ECG and blood pressure will continuously be monitored during your exercise. In the event that you feel any discomfort during the stress test, inform the responsible person. A scarce amount of radioactive substance will be administered through vascular access short before or after the end of stress test. This radioactivity will be retained in your heart in proportion to the blood flow in your heart muscle. Stress images are taken 5-30 minutes after administration of radioactivity. Imaging lasts 15-20 minutes.
Rest test
In the event of using Thallium-201 in the stress test, there is no need for a 2nd injection for the rest test and the images of heart are taken again after 3-4 hours of stress test. In the event of using Tc-99m-MIBI, a separate injection is needed for the rest test. The rest test is given either within the same day with or in a different day than the stress test and images are taken 30 min.-1 hour after the injection.
Considerations before myocardial perfusion scintigraphy
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• Please arrive for the appointment with comfortable clothes on. If you are required to exercise, you should definitely bring along trainers and sports suit.
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• Please remember to stop taking the medication that you were requested to do so in the correct time you have been instructed.
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• The radioactive substance administered to you for imaging your heart vanishes away by its own, and it is also disposed by the usual functions of your body. Drinking plenty of fluid after the test will facilitate removing the substance from your body.
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• Please remember to lay down without any movement during the imaging of stress and rest tests. Motion disrupts the quality of imaging, which could lead to misinterpretation.
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• You can continue your normal activities after the test is completed. Please start back using the medication that you had temporarily stopped taking due to the test.
You do not need to keep an empty stomach for the tests. The injection is generally administered into the blood vessel on your arm.
Please come back to our center on the given appointment time for vone scintigraphy and wait in the waiting lounge. You should have plenty of fluid intake and go to the toilet frequently while waiting. At least 2-4 hours are required between the injection and imaging so that the medication administered can be accumulated in bones.
You do not need to keep an empty stomach for the tests.
After an injection into the blood vessel on your arm, the imaging is taken for thyroid scintigraphy.
You do not need to keep an empty stomach for the tests.
Generally an injection is administered into the blood vessel on your arm for DMSA renal scintigraphy and images are taken under the camera after approximately 4 hours.
You do not need to keep an empty stomach for the test but you are recommended to drink plenty of water before the test. Therefore, bring 1 liter of drinking water while coming to our center.
Generally an injection is administered into the blood vessel on your arm for DTPA renal scintigraphy and the patient is monitored for approximately 30 minutes under the camera. Do not move during the test.
You should keep an empty stomach for 2-4 hours for the test. You should bring a small carton of milk or orange juice and a feeding bottle for babies. The patient will lay down under the camera for 1 hour and the images will be taken after drinking the milk into which the medication is added.
You should keep an empty stomach for 2-4 hours for the test. For babies, your physician may ask you to administer the medication to be prescribed 1 week before the test.
Your test will begin after the injection into your blood vessel on the arm for hepatobiliary scintigraphy. Do not change your position at all during the entire test.
You should keep an empty stomach for 2-4 hours for the test. You will drink a low dose of radioactive iodine in liquid form. If you have any, please remove your denture before the test. You should not have anything other than water for 3 hours after drinking the radioactive iodine for its absorbtion in the body. The imaking will take place 2 days after idodine administration. If deemed necessary by your physician, imaging can be carried out later than 2 days.
Your physician will instruct you to stop taking any thyroid medication you are on a while before the test. Furthermore, you should follow a low-iodine diet and pay attention to certain issues starting from 2 weeks before the test so that the images can be successful. You will be given the diet as well as a text including the issues that you shpuld pay attention by Nuclear Medicine Department.
You do not need to keep an empty stomach for the tests. Your test will start after waiting for a while following the injection into the blood vessel on your arm for both tests. Do not change your position or move your head at all during the entire test. Brain perfusion scintigraphy can be given in special conditions for epilepsy patients.
You do not need to keep an empty stomach for the tests. You should drink LUGUL solution in the recommended dose starting 3 before the test and continue for 7-10 days after the test for protecting your thyroid gland. This is very important in respect to not bringing any harm to the functions of thyroid gland. Furthermore, if any, you should stop taking certain medication that you are on before a specific period prior to the test. You can consult with your physician in order to learn which medication you should stop using. Imaging will be carried out in 2 separate days corresponding to 24th and 48th hours after an injection to a blood vessel on your arm.
You do not need to keep an empty stomach for the tests. Imaging will be carried out in 2 separate days corresponding to 4th and 24th hours after an injection to a blood vessel on your arm.
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• You should definitely keep an empty stomach for at least 5 (five) hours before you arrive.
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• Bring 1.5 l drinking water along.
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• Keep your mobile telephone that we can contact you on.
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• In the event that you should cancel your appointment, you should definitely notify us via the telephone number given below in 24 hours advance.
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• The patient should not have any other scans or tests before or after the imaging within the same day of PET/CT. The patient should immediately leave the hospital and go home in order to rest after PET/CT.
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• Patient should arrive with comfortable clothes on and without any metal accessories for PET/CT.
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• Keep an empty stomach and do not chew a gum for 4-6 hours before the test.
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• You can take your medication with a little amount of water.
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• Your blood glucose level will be checked by receiving 1 drop of blood after your official procedures are completed in our department.
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• For a healthy evaluation of your PET/CT scan, you should bring along the following while coming: a written summary of your disease (epicrisis), documentation about your disease and previous test (computer tomography, magnetic resonance imaging, ultrasonography, mammography, etc.)
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• IF YOU HAVE DIABETES; please have a light breakfast on the time to be stated. Then, use the medication or insulin injection you are on for your diabetes. And arrive for your PET/CT appointment on the time scheduled for you.
All patients who are not diagnosed with diabetes should keep an empty stomach after midnight, and should follow a fat and protein rich diet at the evening before the test. Therefore, you are recommended to have meals such as scrambled eggs and pepperoni at the evening before the test and should not eat anything as of midnight.
All of patients with diabetes on oral ant diabetics should keep an empty stomach after midnight. You are recommended to follow a fat and protein rich diet at the evening before the test. Please use your oral antidiuretics in the regular dose in the morning before you arrive for the test.
Patients with diabetes who are on insulin should follow their usual diet and insulin program; you are recommended to have a protein rich dinner or breakfast.
You should keep an empty stomach for 2-4 hours for the test. You will drink radioactive liquid iodine. If you have any, please remove your denture before the test. You should not have anything other than water for 3 hours after drinking the radioactive iodine for its absorption in the body. Your physician may ask you to stop using your thyroid hormones and medications that you are on, if any. Furthermore, you should follow a low-iodine diet and pay attention to certain issues starting from 2 weeks before the test so that the treatment can be successful. The measures required in this respect are given below. Information regarding the diet that should be followed can be obtained from our department.
You are not allowed to use the following before iodine treatment
X-ray with medication (consult with your physician for the duration you will not be allowed)
Linctuses and vitamin prepared which include iodine
Medical dressing and mouthwash which include iodine
Hair dye
Appointments are booked in Secretariat of Department of Nuclear Medicine that is located on the ground floor (Floor Z) of Hacettepe Adult Hospital or Nuclear Medicine Department Secretariat located on the 1st floor (1 floor above the ground floor) in Hacettepe Oncology Hospital.
Please bring request slip from Hacettepe University Hospitals, your official referral and/ or health report while arriving for receiving an appointment.
“Clinic Information” and “Physician Name” sections on your request slip should have been duly completed. Furthermore, teletelephone number of the department you were referred from and your nuclear medicine number, if any, should be mentioned on the document.
Department of Nuclear Medicine
It is located on ground floor in Hacettepe Adult Hospital. It is located on the left side right towards the direction of main hallways of Adult Hospital after entering from door No. 7. Secretariat of Information Desk is located in the Patient Entrance of Nuclear Medicine Department. Cardiology, nephrology, SPECT/gamma camera which takes the images of endocrine system and other organs, iodine uptake measurement device, stress ECG device, gamma probe and RIA laboratory are on this floor.
Telephone:
+90 (312) 305 13 22 (Department)
+90 (312) 305 19 73 (Outpatient Clinic)
Oncology Nuclear Medicine
It is located on the 1st floor of Hacettepe Oncology Hospital. SPECT gamma cameras, one of which is SPECT-CT, is available here for imaging oncology patients.
Telephone:
+90 (312) 305 28 61
Oncology PET-CT Unit
It is located on the - 2nd floor of Hacettepe Oncology Hospital.
Telephone:
+90 (312) 305 43 13