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Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries

HCPCS code

Name of the Procedure:

Common Name: Brain SPECT Scan
Technical/Medical Term: Technetium Tc-99m Exametazime, Diagnostic Imaging, per Study Dose, up to 25 Millicuries (HCPCS A9521)


A Technetium Tc-99m exametazime scan is a type of diagnostic test that uses a small amount of radioactive material to capture detailed images of the brain. This procedure helps doctors diagnose and monitor conditions affecting brain function and blood flow.


The primary purpose of a Technetium Tc-99m exametazime scan is to evaluate brain abnormalities such as stroke, tumors, infections, or dementia. Using this imaging technique, doctors can assess brain activity, blood flow, and metabolic activity to identify issues that might not be visible with other imaging methods.


  • Symptoms such as unexplained headaches, seizures, or cognitive impairments
  • Suspicion of stroke, brain tumor, or infection
  • Assessment of brain function in conditions like Alzheimer's disease or other dementias
  • Monitoring the effects of treatment for brain-related conditions


  • Fasting: Patients may need to fast for a few hours before the procedure.
  • Medication Adjustments: Certain medications might need to be paused or adjusted temporarily.
  • Pre-Procedure Tests: Sometimes, other imaging tests such as MRI or CT scans are done prior to the procedure for comparative analysis.

Procedure Description

  1. Radioactive Tracer Injection: A small amount of Technetium Tc-99m exametazime is injected into a vein.
  2. Waiting Period: The patient waits for approximately 30-60 minutes as the tracer travels to the brain.
  3. Imaging: The patient lies still under a special gamma camera that takes detailed pictures of the brain.
  4. Completion: Once the images are captured, the procedure is completed.


The entire procedure typically takes about 60-90 minutes, including the waiting period.


The procedure is usually performed in a hospital's nuclear medicine department or at an outpatient imaging center.


  • Nuclear Medicine Technologist: Performs the injection and operates the imaging equipment.
  • Radiologist or Nuclear Medicine Physician: Interprets the images and provides a diagnosis.
  • Nurse: May assist with patient care during the procedure.

Risks and Complications

  • Common Risks: Mild discomfort or swelling at the injection site.
  • Rare Risks: Allergic reaction to the radioactive tracer, although it is very uncommon.


  • Provides detailed images of brain function and structure.
  • Helps in early detection and accurate diagnosis of various brain conditions.
  • Non-invasive with minimal discomfort.


  • Most patients can resume normal activities immediately after the procedure.
  • Drinking plenty of fluids helps flush out the radioactive material from the body.
  • Follow-up appointments may be scheduled to discuss results and next steps.


  • MRI or CT Scans: Useful for structural imaging but not as effective for functional analysis.
  • PET Scans: Similar in function but usually more costly.
  • EEG: Measures electrical activity in the brain but does not provide detailed images.

Patient Experience

  • During the tracer injection, a slight sting might be felt.
  • The waiting period before imaging can be boring but is usually painless.
  • Lying still during the imaging process is crucial but can be uncomfortable for some; relaxation techniques or mild sedation may be offered to ensure comfort.

Pain management and comfort measures, such as ensuring a comfortable setting and clear communication throughout the procedure, help make the patient experience as pleasant as possible.

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