PET-CT Scan

What are some common uses of the procedure?

PET-CT scans are performed:

• To detect cancer cells
• To determine whether cancer cells have spread in the body
• To assess the effectiveness of a treatment plan, such as radiotherapy or chemotherapy
• To detect any recurrent tumours

After the PET-CT scan

• If you had an intravenous line or catheter inserted for the procedure, it will usually be removed unless you are scheduled for other procedure on the same day.
• You may be asked to wait in the rest room for approximately 20-30 minutes until the technologist and physician checks the images in case additional images are needed. Occasionally, some delayed scan is needed for better visualization of certain areas or structures.
• You will be expecting to be in the PET-CT Centre for 2-3 hours.
• You may resume your normal diet and activities after your scan.
• Radiotracer that had been injected in your body will lose its radioactivity over time. It may be pass out of your body through your urine and stool during the first few hours following the scan. Flush the toilet twice and wash your hands thoroughly after urinating. Avoid close contact with small children and pregnant women 24 hours following the scan.
• You will need to discuss your scan result with your physician who referred you for the exam according to the appointment given.

In the PET-CT Centre (on the scan day)

• You will be asked to change into our hospital gown and keep your belongings in the locker provided.
• You will then be resting in our warm and quiet room and our technologist will then inject the FDG radiotracer through your IV line.
• After FDG injection, you will have to wait for 50-60 minutes inside the room in order to get sufficient FDG distribution in your body. During this period, you should rest quietly and minimize your movement.
• You will then be asked to drink a cup of water and void before commencing the scan.
• In some circumstances, a catheter may be inserted into your bladder by our trained personnel.

During the PET-CT scan

• You will be directed to the scanner room 50-60 minutes after FDG radiotracer injection.
• You will be lie on a table which will pass slowly through a large opening in the scanner.
• You will be asked to lie perfectly still throughout the procedure, so that blurring does not occur.
• You will be closely observed at all times through a CCTV even though you will be alone in the room. If you have any discomfort during the scan, you can communicate with the technologist through the mounted intercom.
• The CT exam with or without IV contrast will be done first, followed by the PET scan.
• Total scanning time is approximately 30 minutes.

What will you expect when your physician ordered a PET-CT scan?

You will be given an appointment and receive specific instructions about some preparations that you must follow strictly before your scan. You should inform your doctor of the following when he / she ordered a PET-CT scans:

• Is there any possibility that you may be pregnant.
• What medications that you are currently taking, including vitamins and herbal supplements, recent illnesses and other medical conditions.
• If you are breastfeeding at the time of your exam, you should ask your doctor ordering the exam how to proceed. It may need to pump breast milk ahead of time and keep it on hand for use after PET radiopharmaceutical and CT contrast material are no longer in your body.
• If you are diabetic and what type of diabetic medications are you taking.
• If you have any history of asthma or allergies, especially to contrast material, medications, iodine or seafood.
• If you are claustrophobic.

How should I prepare for a PET-CT scan?

• You are not allowed to consume any food, sugar and any liquids that contained sugar 6 hours prior to your appointment. Instead you are encouraged to drink plenty of plain water. In other word, you are only allowed to drink plain water on your scan day.
• Do not consume alcohol, sweets, chewing gums and avoid strenuous exercise 1 day before your scan.
• Take your regular medications at your usual time, except insulin or metformin (discuss with your doctor if you are on insulin or metformin).
• Bring previous imaging films and results especially CT and MRI if you have any.
• Do not bring children and pregnant woman with you on the day of your scan.

How is the procedure performed?

If you choose to be admitted 1 day before the scan (Preferably to be admitted for better patient management)

• Your diet will be planned and ordered by our Dietitian. You can only consume the food that we provide to you.
• You will need to rest in the ward and avoid strenuous exercise.
• On the day of your scan, a nurse will insert an intravenous (I.V) line into your vein in your hand or arm and followed by IV drip administration of normal saline. You will then be resting in the ward until called down to the PET-CT Centre.
• You will be discharge from the ward once you had been called down to PET-CT Centre. Therefore please arrange someone to pick you up after the scan.

If you choose not to be admitted (Any physical activities may delay your scan time)

• You must plan your own diet and avoid food that contained sugar, high fiber and high carbohydrate.This diet plan must follow strictly 1 day before your scan. You may refer to the following diet:

You may eat the following:

Eggs, white bread, low fat plain yogurt, baked or boiled chicken, well-cooked potato, grilled or steamed fish and shrimp, clear soup or broth and all seafood. You may take egg sandwich as your breakfast, chicken chop as your lunch and fish and chips as your dinner.

Please avoid the following:

Red meat, whole meal or whole grain bread, oat, cereals, rice, noodles, yellow cheese, fruits or fruit juices and all vegetables.

• You need to be in our hospital by 9.00am on your scan day. Please present your appointment card and register in our registration counter.
• You will then be directed to our out patient department for observation, then to our PET-CT Centre.
• A nurse will insert an intravenous (I.V) line into your vein in your hand or arm and followed by IV drip administration of normal saline.

CT Scan

Our Computed Tomography (CT) is a 40 multislice scanner which allows us to do Radiotherapy planning and other radiological diagnostic imaging investigations.

What is Computerized Tomography (CT) Scan?

CT is a type of imaging that uses x-rays and a computer to construct pictures (images) of the tissues in your body. Images of your body tissues are taken in a very small slices or spirals of information over a short period of time.

What does this examination entail?

CT scan is painless. You will lie on the firm table that moves inside the doughnut-shaped CT scanner. The table will move into the open center of the doughnut as the x-rays are being taken. In order to obtain the best images possible, you will be asked to lie very still during the scanning and you may have to hold your breath for a brief period.

How long will the examination take?

Most CT scans take about 20 minutes.

Are there any risks to having a CT Scan?

A CT scan is a very low risk procedure but there are some things that you would need to let your doctors know or X-ray staff before having a CT scan:
• If you might be pregnant
• If you are allergic to iodine
• If you are diabetic
• If you have high blood pressure
• If you have kidney disease or have only one kidney
• If you have congestive heart failure
• If you have had any problem with examinations with contrast or other contrast exams in the past
• If you are currently undergoing chemotherapy or have had recently received chemotherapy recently

What is the type of contrast?

Oral Contrast:
Most patients having abdominal or pelvic CT scans will be asked to drink contrast media prior to scanning. This will “coat” the stomach and intestines to highlight them during scanning. Most patients may have some side effects from drinking the oral contrast. If the contrast media is white you may note white flecks in your stool for a day or two after scan.
Intravenous (IV) Contrast:
Depending on your symptoms and the part of the body to be scanned, an intravenous injection of the contrast will be administered. It is advisable that you fast a few hours before the exam. The contrast may cause you to have a slight nauseous sensation but this is only transient.
The contrast will be exerted via your kidneys. It is advisable to drink plenty of fluids after the examination.
Rectal Contrast:
This contrast is given rectally in order to highlight the rectum and lower portion of the large intestine. It is similar to an enema but with minimal discomfort.
*Please Note: You may receive more than one type of contrast.

Mammogram

Mammogram Screening is now available in our hospital.Every woman aged 40 and above would be advised to get a mammogram screening done every year. Mammogram Screening detects early breast cancer.

We are the mammogram panel for LPPKN and PERKESO.

What is a mammogram?

Mammogram is a specific type of imaging that uses a low dose x-ray system to examine breasts. It has the ability to detect groups or clusters of tiny specs of calcification and small densities or shadows on the breast. These findings will then raise the suspicions of an early breast cancer.

Why is it important to have a mammography examination?

Mammography is used to screen for problems in women with no symptoms. A mammogram can show changes too small to feel. It can help to diagnose a lump or other changes found during a breast examination.

What is the procedure like?

Examination uses x-rays of the breast, usually taken from two angles. For the 1st view, a beam is sent from above to a film holder placed under the breast, the 2nd is taken from the side toward the center. In order to achieve a distinctive image, gentle pressure is applied to the breast by a special device that flattens it. Although this may sound painful, it is only slightly uncomfortable and the discomfort is only for a few seconds.

Who should have a mammogram?

Women above 40

• Women 40 – 49 should have mammogram done every 1 – 2 years
• Women above 50 should have it done every year

Women with any of the following risk factors, may be at increased risk for developing breast cancer

• Certain genes (BRCA1 and BRCA2) passed on from your parents
• Breast cancer in the family, especially mother, daughter, or sister
• Personal history of cancer of the breast, endometrium, ovary or colon
• No term pregnancies or pregnancy later in life (aged 35 years or older)
• Early menstruation (younger than age 12 years) or late menopause (aged 55 years or older)
• Never breastfed a child
• Postmenopausal obesity
• Lack of exercise
• Dietary factors – high intake of red meat, saturated fat or alcohol
• Recent hormone therapy or recent use of birth control pills

Women with any of these signs

• Unexplained lump or thickening in the breast or in the armpit
• Puckers or dimples in the skin of the breast
• Discharge or bleeding that comes from the nipple
• A recent change in the nipple, such as a retracted nipple (a nipple that has pulled inward)
• A change in the skin of the breast

How do I prepare for a mammogram?

• Wear a 2 piece outfit for convenience
• Do not wear talcum powder, perfume or deodorant, creams or lotion as it may be shown on the films and give artifacts
• Bring along previous mammogram films if you have

When is the best time for a mammogram?

• For women of child bearing age, 1 week after menstruation
• For menopausal women, any time at the earliest convenience

Ultrasound

X-Ray

We provide general X–Ray investigations with our latest digital radiography system.