Indication	Scan	Comments
	Arthritis & joint symptoms	Bone scan	Helps assess distribution, activity and extent
	Back and neck pain	Bone scan	Useful in determining whether focal abnormalities are present (facet joint arthritis, fractures) or to determine the level and location of symptoms
	Bile leak or obstruction	HIDA scan
	Biliary disease	HIDA scan	This scan detects gallbladder dysfunction and abnormal excretion patterns in the biliary tree
	Bone metastasis	Bone scan	High sensitivity & moderate specificity in PLANAR scans and high sensitivity and specificity with SPECT-CT
	Cerebrovascular disease	Neurolite Brain scan	Useful in determining whether significant ischaemia is present in early dementia or cognitive impairment. Poor specificity in dementia
	Chest pain	Myocardial Perfusion Study	To assess for presence of significant myocardial ischaemia
	Cholecystitis –acute	HIDA scan	This scan will demonstrate obstruction of the cystic duct
	Cholecystitis –chronic	HIDA scan	In cases where U/S is negative this scan can detect acalculic cholecystitis
	Constipation		Colonic Transit Study
	Coronary artery disease	Myocardial Perfusion Study	To assess for extent or distribution of significant myocardial ischaemia
	Dementia	Neurolite Brain scan	Useful in determining whether significant ischaemia is present
	Dry Mouth	Salivary Scan	Assess function of salivary glands
	Fracture	Bone scan	Useful when x-ray negative but clinical moderate or high risk. SPECT-CT distinguishes subtle degenerative disease from small stress injuries -especially useful in the feet or spine.
	Gastric motility disorder	Gastric Motility Study	In diabetes or in those with prior surgery
	Haemangiomas	Red cell scan	Only lesions greater than 2cm in size can be reliably detected. Smaller lesions (>1cm) can be detected with SPECT-CT
	Heart Failure	Gated heart study	Calculates the left ventricular ejection fraction accurately and reliably. Most reliable as a serial study in those on chemotherapy
	Hepatic lesions	RED CELL or HIDA or Liver/SPLEEN SCAN with SPECT_CT	All three scans are used and it is best to discuss each case with a nuclear medicine physician
	Hyperparathyroidism	Parathyroid scan	Depicts hypertrophied parathyroid tissue. Poor sensitivity and specificity on planar scans but much better when done as  a dual isotope SPECT-CT scan. Should be combined with neck ultrasound
	Hypertension	DTPA renal scan	By comparing baseline and post-captopril scans can detect renal artery stenosis
	Hyperthyroidism	Thyroid scan	Can differentiate Graves disease from other causes
	Infection	White cell scan or leukoscan	Better than gallium for more recent infection and for joint prostheses. May need to be done in conjunction with bone scan
	Infection –chronic	Gallium	Requires injection and scan 48hrs apart
	Inflammatory bowel disease	White cell scan
	Inflammatory disease –chronic	Gallium	Requires injection and scan 48hrs apart
	Joint pain	Bone scan	Can be regional or whole body
	Joint prosthesis	Bone scan	To assist in the detection of loosening, stress fracture, or infection. SPECT-CT has improved the accuracy of this scan.
	Liver dysfunction	HIDA scan	Can demonstrate biliary atresia and hepatic dysfunction
	Liver lesions	Discuss  with Dr	There are multiple scans used and it is best to discuss each case with a nuclear medicine physician
	Lymphoma	Gallium	Not all lymphomas are seen on gallium scans
	Meckel’s diverticulum	Meckel’s Study	Detects ectopic gastric mucosa
	Multinodular goitre	Thyroid scan	Usually best in combination with thyroid ultrasound
	Oesophageal reflux	Oesophageal motility study	Helps differentiate gastro-oesophageal reflux from motility disorders.
	Pain –musculoskeletal	Bone scan	May help localize focal bone/joint pathology where the symptoms are not specific.
	Preoperative cardiac assessment	Myocardial Perfusion Study	To assess for presence of significant myocardial ischaemia. Strong prognostic value.
	Pulmonary embolus	Lung scan	High accuracy rate if no underlying lung disease. Scan of choice in young and those with renal impairment. Lower radiation exposure than CT scan but if underlying lung disease consider CT pulmonary angiogram first. In pregnancy it is the scan of choice but if CXR is abnormal then CTPA is scan of choice -more info here.
	PUO	Gallium	Requires injection and scan 48hrs apart
	Renal function	DTPA renal scan	Relative and qualitative function but not absolute function
	Renal infection	DMSA renal scan	Shows parenchymal change such as site of recent infection
	Renal location	DMSA renal scan	Shows location of kidneys and split function
	Renal Obstruction	DTPA renal scan	Gives information about relative (R v L) function and whether obstruction is functionally significant
	Renal scarring	DMSA renal scan	Shows parenchymal change such as scarring
	Salivary function	Salivary scan	Assess hypofunction or gland failure
	Spleen	Liver-spleen scan	Detects ectopic splenic tissue, absent spleen, and splenic infarcts
	Thyroid metastases	Iodine scan	Should be discussed with nuclear physician
	Thyroid nodule	Thyroid scan	Hot v cold nodules. Usually best in combination with thyroid ultrasound
	Watery Eyes	Dacrocystogram	Assesses the patency of the lacrimal ducts