Thesis

38 Part I Chapter 2 chemotherapy), and the specific reason for the examination or provisional diagnosis. Outpatients should also bring the results of all other relevant examinations that have already been performed (laboratory, radiological, scintigraphic, or other). Patient preparation When making an appointment, the patient should be informed of how the examination is performed and of its estimated duration. Also, it should be explained that the patient may eat and drink. Patients should be informed of the need to report a pregnancy, any delay in menstrual cycle, or active breastfeeding. An information leaflet and/or display in the waiting room of the nuclear medicine service should be available, and all information should preferably be accessible through the website of the institution. Prior to tracer injection, the nuclear medicine physician or technologist must explain the purpose of the examination, the expected benefits, and provide answers to any remaining questions. The patient is informed of how the examination will be performed (e.g. multiple planar acquisitions, additional SPECT/CT, etc), taking into account the specific clinical problem. Relevant information that may assist in interpretation of imaging findings are checked with the patient, including: 1. History of fractures, trauma, osteomyelitis, cellulitis, edema, arthritis, neoplasms, metabolic bone disease, or limitation of function 2. Current symptoms and physical findings 3. Results of prior bone scintigraphy or other imaging studies such as conventional radiographs, CT, MRI (it is strongly recommended to obtain hard copy or computer files of previous examinations) 4. History of recent nuclear medicine studies 5. Laboratory results 6. History of therapy that might affect the results of bone scintigraphy (see Precautions) 7. History and dates of prior orthopedic surgery (e.g. presence and location of prosthetic implants) 8. History of anatomic or functional renal/urinary tract abnormalities 9. Contraindications for hydration At this time, an assessment should be made of the physical condition of the patient and whether current symptoms (e.g. pain, immobility, etc) may hamper optimal image acquisition. For patients with severe pain, an appropriate analgesic strategy should be implemented in consultation with the treating/referring physician. In addition, the scanning parameters may be adapted to accommodate the patient (see

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