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Bone marrow imaging; limited area

CPT4 code

Name of the Procedure:

Bone Marrow Imaging: Limited Area
Common Names: Bone Scan, Bone Marrow Scintigraphy

Summary

Bone marrow imaging is a type of nuclear medicine scan that uses a small amount of radioactive material to create detailed images of bone marrow. The procedure focuses on a specific, limited area of the skeleton to identify abnormalities or diseases.

Purpose

Bone marrow imaging helps to diagnose and evaluate conditions affecting the bone marrow, such as infections, malignancies (e.g., leukemia, lymphoma), or bone marrow disorders (e.g., myelodysplastic syndromes). The primary goal is to detect abnormalities and guide subsequent treatment plans.

Indications

  • Unexplained bone pain
  • Fever of unknown origin
  • Anemia or leukopenia with unclear cause
  • Monitoring the progression of bone marrow diseases like leukemia
  • Evaluation of treatment response in bone marrow conditions

Preparation

  • No fasting usually required.
  • Patients should inform the doctor of any allergies, particularly to contrast materials or medications.
  • Notify the medical team if pregnant or breastfeeding.
  • There may be a need for blood tests to assess kidney function prior to the scan.

Procedure Description

  1. A small amount of radioactive tracer is injected into a vein.
  2. After waiting for the tracer to accumulate in the bone marrow (usually a few hours), the patient lies on an examination table.
  3. A special camera (gamma camera) moves over the targeted area to capture images of the bone marrow.
  4. The patient must remain still during imaging for accurate results. The procedure is generally painless.

Duration

The entire process, including waiting time after the tracer injection, can take 3-4 hours. The actual imaging part takes approximately 30-60 minutes.

Setting

This procedure is typically performed in a hospital's nuclear medicine department or an outpatient imaging center.

Personnel

  • Nuclear Medicine Technologist
  • Radiologist or Nuclear Medicine Physician
  • Nursing staff for patient preparation and support

Risks and Complications

  • Rare allergic reaction to the radioactive tracer.
  • Mild discomfort or bruising at the injection site.
  • Minimal radiation exposure, generally considered safe, but cumulative effects should be considered in those requiring multiple scans.

Benefits

  • Provides precise images of bone marrow, aiding in accurate diagnosis.
  • Helps in detecting bone marrow disorders early, leading to better management.
  • Non-invasive with a quick recovery time.

Recovery

  • Most patients can resume normal activities immediately.
  • Drink plenty of fluids post-procedure to help flush the radioactive material from the body.
  • Follow-up appointments depend on the results and the treating physician's recommendations.

Alternatives

  • Bone marrow biopsy: More invasive with a higher risk of discomfort but can provide more specific cellular information.
  • MRI or CT scans: Useful for detailed anatomical imaging but may not show functional aspects like nuclear imaging.
  • Blood tests: Can provide information on bone marrow function but lack detailed imaging.

Patient Experience

  • Typically, the procedure is painless, with minor discomfort from the injection.
  • Patients may feel anxious or claustrophobic during imaging, but modern systems aim for patient comfort.
  • Pain management is usually not required, but patients can discuss concerns with the healthcare team beforehand.

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