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Thallium tl-201 thallous chloride, diagnostic, per millicurie

HCPCS code

Name of the Procedure:

Thallium-201 Scan
Technical/Medical Term: Thallium Tl-201 Thallous Chloride, Diagnostic, Per Millicurie (A9505)

Summary

A Thallium-201 scan is a diagnostic imaging procedure used to evaluate blood flow to the heart muscle. This test involves injecting a small amount of radioactive thallium into the bloodstream and taking images to detect areas with poor blood flow or damaged heart tissue.

Purpose

The Thallium-201 scan helps diagnose coronary artery disease, heart muscle damage, and other heart-related issues. The primary goals are to:

  • Identify areas with reduced blood flow.
  • Determine the severity of heart disease.
  • Monitor the effectiveness of treatments for heart conditions.

Indications

  • Symptoms like chest pain, dizziness, or shortness of breath.
  • Known coronary artery disease.
  • Assessment before or after heart surgery.
  • Unexplained fatigue or abnormal ECG results.

Preparation

  • Avoid caffeine and nicotine for at least 24 hours before the test.
  • Fast for at least 4 hours prior.
  • Inform the doctor of any medications being taken; some might need to be adjusted.
  • Undergo preliminary blood tests and ECG, if necessary.

Procedure Description

  1. Patient Preparation: The patient will change into a hospital gown and an IV line may be inserted.
  2. Tracer Injection: Thallium-201 is injected into a vein, typically in the arm.
  3. First Imaging Session: After the injection, the patient will lie down on a table for initial imaging with a gamma camera.
  4. Exercise or Medication Stress Test: The patient will either exercise on a treadmill or receive a special medication to mimic the effects of exercise on the heart.
  5. Second Imaging Session: More images will be taken to compare how the heart functions under stress versus at rest.
  6. Monitoring: Throughout the procedure, vital signs and ECG are monitored.

Duration

The entire procedure usually takes between 2-4 hours, including preparation and imaging.

Setting

Performed in a hospital's nuclear medicine department or an outpatient clinic equipped with the necessary imaging technology.

Personnel

  • Nuclear medicine technician
  • Cardiologist
  • Nurse
  • Occasionally, a radiologist or technologist operating the imaging equipment

Risks and Complications

  • Mild reactions to the radioactive tracer, such as local pain or rash.
  • Heart-related symptoms during the stress test like lightheadedness or chest pain.
  • Rare risks include adverse reactions to the stress-inducing medication if used.

Benefits

  • Provides clear images of heart function and blood flow.
  • Helps in diagnosing and planning treatment for heart conditions.
  • Non-invasive with minimal discomfort, offering crucial diagnostic information.

Recovery

  • Most patients can resume normal activities immediately after the procedure.
  • Drinking plenty of fluids helps flush out the radioactive tracer.
  • Follow-up consultations to discuss the results and any additional treatment or testing needed.

Alternatives

  • Stress Echocardiography: Uses ultrasound instead of a radioactive tracer.
  • Cardiac MRI: Provides detailed images without radiation but may be contraindicated in patients with metal implants.
  • CT Angiography: Another non-invasive imaging option, involving iodine-based contrast and radiation.

Patient Experience

During the procedure, the patient might feel slight discomfort from the IV and the stress test. Some may experience mild symptoms akin to exercise-related fatigue. Post-procedure, any discomfort typically resolves quickly, and pain management is rarely necessary.

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