Name of the Procedure:

Common Name(s): Indium-111 Pentetreotide Scan
Technical/Medical Term: Indium In-111 Pentetreotide, Diagnostic, Per Study Dose, Up to 6 Millicuries (HCPCS Code A9572)

Summary

An Indium-111 pentetreotide scan is a diagnostic imaging procedure used to detect certain types of tumors in the body. The scan involves injecting a small amount of a radioactive substance (Indium-111 pentetreotide) into the bloodstream and using a special camera to capture images of the areas where the substance collects.

Purpose

This scan is used to locate and assess neuroendocrine tumors, such as carcinoid tumors and pancreatic islet cell tumors. The goal is to detect tumors early, determine their size and location, and monitor the effectiveness of treatment.

Indications

• Symptoms such as unexplained weight loss, diarrhea, flushing, and abdominal pain.
• Suspicion of neuroendocrine tumors based on other diagnostic tests.
• Monitoring the progress or recurrence of known neuroendocrine tumors.

Preparation

• Patients may be instructed to fast for a few hours before the procedure.
• Certain medications may need to be adjusted or stopped before the scan.
• A baseline blood test might be required to ensure renal function is adequate for handling the radioactive substance.

Procedure Description

1. An intravenous (IV) line is inserted into the patient’s arm.
2. Indium-111 pentetreotide is injected through the IV.
3. After injection, there is a waiting period (typically 24 hours) to allow the substance to circulate and bind to the tumor cells.
4. The patient then returns for imaging using a gamma camera to capture detailed pictures of the radioactive areas in the body.
5. The imaging process itself is generally painless and requires the patient to remain still for a period of time.

Duration

• Injection: Approximately 30 minutes.
• Imaging: Each imaging session may take 1-2 hours and is typically performed 24 hours after injection.

Setting

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

Personnel

• Nuclear medicine technologist.
• Radiologist specializing in nuclear medicine.
• Medical or nursing staff for patient preparation and care.

Risks and Complications

• Mild allergic reactions to the radioactive substance.
• Discomfort at the injection site.
• Rarely, radiation exposure might pose a very low risk of secondary cancers.

Benefits

• Accurate detection and localization of neuroendocrine tumors.
• Helps in planning appropriate therapeutic interventions.
• Provides valuable information for monitoring treatment efficacy.

Recovery

• Patients can usually resume normal activities immediately after imaging.
• Drinking plenty of fluids is encouraged to help flush out the radioactive material.
• Follow-up appointments may be scheduled to discuss results and further management.

Alternatives

• Other imaging techniques like CT scans, MRI, or PET scans.
• Blood and urine tests for tumor markers.
• Pros: Non-radioactive alternatives might reduce exposure risks.
• Cons: May not offer the same level of detail in detecting neuroendocrine tumors.

Patient Experience

• During injection: Mild discomfort from the IV insertion.
• During imaging: Need to lie still, which may cause minor discomfort.
• Post-procedure: Generally, no significant pain; normal activities can often be resumed immediately. Pain management is typically not necessary.