78609 Brain imaging, positron emission tomography (PET); perfusion evaluation

Name of the Procedure:

Brain Imaging, Positron Emission Tomography (PET); Perfusion Evaluation

Summary

A PET scan of the brain is an imaging procedure that helps measure the blood flow (perfusion) to various parts of the brain. This is achieved by injecting a small amount of radioactive dye, which helps visualize and assess how well blood is reaching different brain areas.

Purpose

The primary purpose of a brain PET scan with perfusion evaluation is to diagnose and monitor various neurological conditions. This can help:

• Evaluate brain perfusion in conditions such as strokes, tumors, or dementia.
• Determine the functional state of brain tissues.
• Guide treatment plans and monitor the effectiveness of therapies.

Indications

• Symptoms of cognitive decline or dementia.
• Unexplained neurological symptoms such as persistent headaches, seizures, or changes in consciousness.
• Assessment after a stroke.
• Suspected brain tumors or cancer.

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Avoid strenuous activities 24 hours prior to the scan.
• Refrain from caffeine, alcohol, and tobacco on the day of the scan.
• Inform the care team about all medications being taken, as some may need to be adjusted.

Procedure Description

1. Preparation: Upon arrival, a small catheter is placed into a vein, usually in the arm.
2. Injection: A radioactive tracer (dye) is injected into the bloodstream.
3. Waiting Period: The patient waits for about 30-60 minutes, allowing the tracer to circulate and be absorbed by the brain tissues.
4. Scanning: The patient lies on a table that slides into the PET scanner, a doughnut-shaped machine. The scanner captures detailed images of brain perfusion.
5. Imaging Process: The patient remains still during the scan, which takes around 30-45 minutes.
6. Completion: The catheter is removed, and the patient can usually go home immediately.

Tools/Equipment: PET scanner, radioactive tracer.

Anesthesia: Typically, no anesthesia or sedation is required.

Duration

The entire procedure, from preparation to scan completion, typically takes 1.5 to 2 hours.

Setting

The procedure is performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist
• Nuclear Medicine Technologist
• Nurses

Risks and Complications

• Exposure to a low level of radiation.
• Allergic reaction to the radioactive tracer (rare).
• Discomfort or bruising at the injection site.

Benefits

• Accurate diagnosis of brain conditions.
• Assessment of brain function and blood flow.
• Guidance for effective treatment planning and monitoring.

Recovery

• Most patients can resume normal activities immediately.
• Drink plenty of fluids to help flush out the radioactive tracer.
• Follow any specific instructions provided by the healthcare team.

Alternatives

• Magnetic Resonance Imaging (MRI)
  • Pros: No radiation exposure.
  • Cons: Longer procedure time, limited in functional assessment.
• Computed Tomography (CT) Scan
  • Pros: Faster, widely available.
  • Cons: Higher radiation exposure, less functional detail.

Patient Experience

• Minor discomfort from the initial injection.
• Must remain still during the scanning process.
• Most patients do not experience discomfort post-procedure.
• Any pain can be managed with standard over-the-counter analgesics if necessary.