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Your nuclear medicine scan

Read more about Your nuclear medicine scan

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Information for patients about nuclear medicine scans at North Bristol NHS Trust.

What is a nuclear medicine scan?

A Nuclear Medicine scan is a way of producing images that involves the administration of a small amount of radiation into your body. This radiation can be picked up by special cameras (gamma cameras) to make images that help your doctor diagnose and treat various medical conditions.

Are there any risks from the radiation?

The amount of radiation involved is small. We can assure you that all efforts to minimise radiation are taken. The benefit to you of having the scan to help with a diagnosis will outweigh any risk from the radiation. Your referring doctor will have considered this carefully before asking us to carry out this examination.

Do I need to prepare for the scan?

Each type of nuclear medicine examination will have a different preparation. Please read your appointment letter carefully as it will specify what the preparation for your particular scan will be.

What is involved?

The isotope is usually injected into a vein in your arm but for some examinations it may be swallowed or breathed in the form of a gas. This depends on the type of examination being performed.
The injection of the radioactive substance is similar to having a blood sample taken. You will not feel any ill effects, drowsiness or sickness, and it will not affect your ability to drive a car.
For some examinations scanning begins immediately and for others there is a delay between the injection and the images. Some examinations have both immediate and delayed scans.
If there is a long period of delay between the injection and the scan you will be able to leave the department during this interval. This can be confirmed with the radiographer or technologist who will be looking after you.
During the scan you will have to keep still for periods of time, ranging from a few minutes, up to an hour.
You can normally leave your clothes on but we may ask you to remove any metallic objects.

What about breastfeeding?

Some of the radioactive substances are excreted in breast milk. Therefore, if you are breastfeeding it is important to contact us as soon as you receive your appointment letter. We will give you simple guidance about what to do beforehand and written instructions on the day of attendance. For the majority of scans there will be no need to stop feeding your child.

What if I am receiving renal dialysis?

Please ring us as soon as you receive your appointment letter if you are having renal dialysis. It may be necessary to alter the days you have your treatment to fit in with the scan.

What about caring for children and pets?

For most nuclear medicine examinations, we ask that you avoid prolonged close contact with children or pregnant women for some time following your scan.

If your scan requires specific instructions, these will be discussed with you on the date of the appointment. If you are the sole carer of small children, it may be advisable to ask someone to help you on the day of your examination. If this is difficult, please ring the department for advice.

Your pets will not be affected.

What if I need someone with me?

You will be able to bring someone with you to the appointment (e.g., relative, friend or carer), provided they are not pregnant and are over 18 years old. Due to the radiation used for our scans, we may ask you to attend alone for some parts of the procedure.

If you would like more information about having someone with you during your procedure, please call us in advance so that we can advise you further.

What if I can’t attend the appointment?

The radioactive injection required for this examination is ordered especially for you. If you are not able to attend, please let us know at least the day before your appointment to ensure that we have enough notice to cancel the injection or to allocate it to a different patient on our waiting list.

If I am taking tablets or other drugs, do I stop taking them?

For some nuclear medicine procedures, we may need to get a list of your medications to ensure that we obtain the best results possible, as some medications affect our scans. If the procedure you are scheduled for requires us to check your medication, this will be detailed in your appointment letter.

What if I am pregnant?

If you are or if you think you may be pregnant, please contact us before your appointment date by phoning 0117 414 1814. Becoming pregnant soon after a nuclear medicine scan is not a cause for concern.

Do I need to do anything after the scan?

When you leave the department after your scan you will be given information about the type of radioactive substance you have received and specific precautions to observe following the procedure. You should keep this with you following the scan in case you need to see a doctor or dentist for any reason in the time specified on the information sheet. You should show them the information before you receive any treatment.

We usually recommend you drink plenty of fluids and empty your bladder regularly as this will help your body to clear the radioactivity.

You may also need to avoid prolonged contact with children under 18 and anyone who is pregnant. If you are breastfeeding specific instructions will be given to you.

For most scans, it is advisable that you do not have a blood or urine test following the radioactive injection.

If your work involves close contact with other people and/or you are involved in radiosensitive work, we may advise you not to return to work until the day following your investigation.

It is very unlikely that you will feel any side effects after the scan, but if you do think that you have, please let the Nuclear Medicine department know.

Will I be able to travel abroad after the scan?

It is perfectly safe for you to travel abroad after your scan, but many airports and sea ports are now equipped with very sensitive detectors. Therefore, the very small amount of radiation left in your body could set off a detector as you pass through security.

If you intend to travel abroad within the days following your appointment, please let the Nuclear Medicine department know, and additional documentation can be provided to you to facilitate your travel plans.

How will I get the results?

The results will not be available at the time of your scan. The images will be examined in detail by a specialist doctor, who will issue a report. This will be sent to the doctor that referred you for the scan. You will hear about the results and any further care plans from their clinic.

Further information

British Nuclear Medicine Society

Information for Patients and Carers.

British Nuclear Medicine Society

Public Health England

Information on Ionising Radiation Exposure of the UK Population.

Welcome to GOV.UK

Royal College of Radiologists

Information for Patients.

Homepage | The Royal College of Radiologists

NHS Constitution

Information on your rights and responsibilities

NHS Constitution for England - GOV.UK

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Requesting

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Request Forms

Each of our Pathology disciplines has its own specific request forms. These are available to order from our Pathology Consumables page Consumables Ordering | North Bristol NHS Trust, however, copies of forms are also available to print below.

NBT Blood Sciences Request Form.pdf42.69 KB

NBT Blood Transfusion Request Form.pdf318.07 KB

NBT Blood Transfusion Ante Natal Request Form.pdf324.31 KB

NBT Cellular Path Request Form.pdf64.6 KB

NBT Microbiology Request Form.pdf123.37 KB

Sample acceptance and rejection

It is the policy of North Bristol NHS Trust that all samples taken for laboratory investigations and accompanying request forms will be labelled to a minimum standard which minimises the risk of harm to patients. The Specimen Labelling Policy (CG-163) is attached below.

Key points are:

The patients primary identifier is the NHS number and this must be used wherever possible.
In normal circumstances, unlabelled or inadequately labelled samples will not be processed. There is a recognition that there are certain circumstances where samples are unrepeatable. The circumstances and actions in this case are documented within the policy.
Each request received by the laboratory is considered an agreement between the requestor and laboratory for provision of Pathology Services.

Requests can be made in Sunquest ICE, however where this is unavailable, dedicated NBT Pathology Request forms are obtainable which should be completed in full.

Samples may be rejected when received in the wrong container, underfilled/overfilled, insufficient, haemolysed, clotted, contaminated or when subject to incorrect storage, temperature, transport or time-dependent requirements. See the individual test information pages for special requirements and precautions.

The reason for rejection of a sample should be clear on the report for that specimen.

[attachments]

Test Information

Includes details of sample types, volumes, special precautions, turnaround times & reference ranges.

Vulval diseases

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Vulval diseases

The vulva is the area surrounding the opening of the vagina. It includes the labia (the inner and outer vaginal lips) and the clitoris. We offer a comprehensive service for women with vulval problems such as itching, pain and visible skin changes or lumps as well as already diagnosed vulval skin conditions.

We are a multi professional team made up of a consultant gynaecologist with special interest in vulval disease, Dr Susannah Hogg, and dermatologist. We might want to refer you to our pelvic health physiotherapy team with expertise in treating vulval pain conditions, and some women might benefit from psychosexual counselling.

What to expect at your appointment?

It is useful not to apply any creams on the day of your first visit unless it is necessary to keep you comfortable for the day. The clinician seeing you will take a detailed history of your problem, the treatment you have received so far, and medical history. Please bring any medications and all creams you might be using.

The first visit will usually involve a vulval examination with good lighting and magnification to see any subtle skin changes. Occasionally we might want to take a small skin biopsy to help make the right diagnosis. This is done under local anaesthetic. Usually, women can continue with their normal daily routine afterwards and should not be too sore.

We will then discuss and develop a treatment plan with you.

Further information and support

Lichen sclerosus - NHS

Lichen planus - NHS

We recognise that vulval problems can be very distressing. The Vulval Pain Society is a UK registered charity supporting vulval pain sufferers.

The Vulval Pain Society

Ambulatory Gynaecology

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Ambulatory Gynaecology

Many people can have a procedure in a clinic while they are awake. This is known as ambulatory care. Our ambulatory suite is a dedicated area of Gynaecology Outpatients.

The procedures done in the ambulatory setting are considered minor procedures and can be done without a general anaesthetic (you will be awake)_or staying in hospital.

Outpatient hysteroscopy is a procedure that enables an internal examination of women with abnormal bleeding from the uterus. It is done by a gynaecologist or specialist nurse hysteroscopist. Other procedures currently offered include hysteroscopic removal of endometrial polyps or fibroids, endometrial ablation, difficult coil fittings or retrievals, manual vacuum aspiration (a procedure to remove pregnancy tissue from inside the womb), and minor vulval procedures.

Some of the common benefits of an ambulatory procedure include avoiding general anaesthetic, quicker treatment, speedy recovery in your home, and less invasive treatment which avoids surgical scars.

What to expect at your appointment?

On the day of your procedure, you can eat and drink as normal. We encourage you to eat something before you come in. Consider taking a simple pain killer such as paracetamol and/or ibuprofen (if you can) around an hour before your appointment. You may be asked for a urine sample to complete a pregnancy test.

A nurse will be with you during your procedure. We have several options for local anaesthesia available depending on the procedure and your own requirements. You should organise for someone to collect you after the procedure to take you home.

Further information

Hysteroscopy

NovaSure endometrial ablation

IUS (intrauterine system) or hormonal coil - NHS

©North Bristol NHS Trust. This edition published January 2025. Review due January 2028. NBT003775

Emergency Gynaecology

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Emergency Gynaecology

In this service we see women with pelvic pain; early pregnancy problems such as pain, bleeding, and hyperemesis gravidarum (severe nausea and vomiting); pelvic infection; and vulval abscess including Bartholin’s.

There is a daily emergency clinic based in the Cotswold Centre accessed by GP referral where we can do ultrasound scans. There is a nearby dedicated Gynaecology inpatient ward, Cotswold Ward.

Further information

Contact Gynaecology

Phone: 0117 414 6768

Cotswold Ward
Phone: 0117 414 6785

Cardiac Resynchronisation Therapy (CRT)

Read more about Cardiac Resynchronisation Therapy (CRT)

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This page is a general guide for patients and their families who want to learn more about Cardiac Resynchronisation Therapy (CRT). Please ask any questions you have during your pre-op assessment, when you get your CRT implant, or at your next follow-up appointment.

The heart

The heart's main job is to pump blood and oxygen throughout your body. It has four parts: two on the top called the right and left atria, and two on the bottom known as the right and left ventricles.

The electrical system of the heart

The conduction system sends electrical signals through your heart, making it beat. It makes sure these signals reach every part of your heart at the right time so your heartbeats are organised and happen at a healthy speed. If this system gets damaged or doesn’t work properly, then your heart may not pump effectively. This can happen because of issues with the electrical signals, or if the heart has been damaged by disease like high blood pressure, or problems with the valves. This can lead to heart failure.

What is heart failure?

Heart failure refers to various problems that make it hard for the heart to pump blood effectively. When this happens you might start to feel breathless, tired, less able to exercise, and have swelling in your feet and ankles because of fluid building up. These symptoms can make you feel unwell. You might also have serious heart rhythm issues, which can be life-threatening. Heart failure doesn’t mean your heart will stop beating soon; it means you need treatment to help manage your symptoms and keep your heartbeat steady. You may have been given medication to help with your symptoms, and your heart specialist might have also recommended a treatment called Cardiac Resynchronisation Therapy (CRT).

What is CRT?

CRT is a proven treatment option for some people with heart failure. It involves a device that sends small electrical signals to the heart’s lower chambers, helping them to beat in a more coordinated way. This can improve the heart's ability to pump blood and oxygen to your body. A CRT system has two main parts:

The heart device, which is a small computer with a battery in a tiny titanium case about the size of a pocket watch.
Special wires, called leads, that are placed inside your body to send information from your heart to the heart device, and to send electrical signals to your heart.

Once the device is put in, your doctor will use a special computer (called a programmer) to set up the CRT and gather information that will help with your heart failure treatment. You will need to visit a clinic from time to time so they can check how your device is working.

Risks

Every medical procedure has some risks. For CRT the exact risks depend on the type of device used and your general health. Possible complications from this therapy and the procedure to insert the device include:

Infection.
Bleeding or bruising.
A collapsed lung.
Fluid buildup around the heart (which can compress it).
The device not working properly.
Parts of the device moving, which might need another procedure to fix.

Preparing for the procedure

Eating and drinking

If your procedure is in the morning, you should not eat or drink anything after 02:00. You can have small sips of water until the procedure.
If your procedure is in the afternoon, you should not eat or drink anything after 07:00, but you can still have water after that time.

Once your procedure is over you can eat and drink normally.

Medication

Before your procedure, you will have a pre-op assessment with a cardiology nurse. They will talk to you about your medications at that appointment. Please keep taking all your medications until then. If you need to stop any of them before your procedure, they will tell you.

The procedure

The device is placed in your chest, usually under your left collarbone. This happens in a special area of the hospital called the Cardiac Cath Lab.

You will lie on your back on the table for the procedure, and be connected to monitors and covered with sterile sheets.
You can have medication to help you relax but you will stay awake. You will also be given antibiotics to prevent infection.
The area where the device will be inserted will be cleaned and numbed, so it wont hurt.
A small cut will be made on the left side of your chest, and a thin tube inserted into a large vein. Using this tube and an X-ray camera, the doctor will carefully guide leads into your heart.
These leads will be tested and connected to the device.
A small pocket will be created under your skin to hold the device, and the device will be carefully placed inside.
The cut will be closed with stitches that dissolve on their own and a special glue, then a bandage will be put over.
The procedure usually takes a few hours.

After the procedure

After the procedure, you will spend a little time in the recovery area. You will either stay overnight in a ward, or go back to the ward you were in before.

Looking after the wound

Your wound might feel sore and look bruised for a couple of weeks which is normal. If you have pain, you can take painkillers. Keep the wound clean and dry for about 7-10 days, after this you can take off the dressing. The scar should heal in about six weeks.

Using your arm

It is important to be gentle with the arm on the same side as the CRT device. Use it normally, but avoid raising it above your shoulder or lifting heavy objects. This is because over time new tissue will grow around the lead in your heart, helping to hold it in place. Until that tissue forms there is a slight chance that the lead could move out of position (this would mean we need to reopen the wound to fix it).

If you have any questions about how to use your arm, please ask for help.

Follow-up

Once your wound is fully healed, you can mostly return to your normal routine. Your CRT device will need to be checked regularly to make sure it is working properly.

After the device is put in, you will have a check-up 24 hours later, and then another one six weeks after that, where the wound will also be looked at. After that, you will need check-ups every six months. Each check-up takes about 15 to 20 minutes. It's important to remember that these appointments are just for checking the CRT and are separate from any other visits you have with your cardiologist.

When you come in for a check-up, they will keep an eye on your heart rate. An external device will be placed on your chest to read the CRT. If you have had any symptoms since your last visit, make sure to tell the technician. You might notice your heartbeat feeling a little different during the check—maybe a bit faster or slower. If you ever feel uncomfortable, tell the technician right away. They can adjust the CRT to help it work better for you.

At the end of the check, you will learn if there are any issues, and you will be told when your next appointment will be (in either three or six months). You will also get an appointment letter once it is booked.

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Prehabilitation and Rehabilitation: Get support

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If you need help to access the services here your cancer clinical nurse specialist or cancer support worker will be happy to help you.

Exercise cancer prehabilitation to rehabilitation 12 week programme at your local leisure centre

Your local leisure centre may offer the exercise cancer prehabilitation to rehabilitation programme. Your local exercise instructor will assess you for this programme.

If you live in Bristol:

You can self refer to the Energise cancer prehabilitation and rehabilitation exercise programme.

You can do the programme at Horfield Leisure Centre. Contact details can be found on this page: Energise cancer rehabilitation exercise classes

If you live in North Somerset:

You can self refer to Steps to Get Active groups at Hutton Moor Leisure Centre.

You can self refer here: Get Active | Better Health North Somerset
Phone: 07917 116 154
Email: info@neurogroupexercise.com

For more information visit:

Steps to Get Active | Better Health North Somerset

If you live in South Gloucestershire:

Ask any health professional to refer you to the exercise cancer prehabilitation to rehabilitation: Healthy Lifestyle on Referral Scheme - Active Centres

For more information about local activities visit Move More | One You South Gloucestershire

Online exercise classes

These are different online exercise classes from Penny Brohn UK:

Depending on your diagnosis and needs you may be able to access specialist support from an allied health professional. The team is made up of:

Physiotherapists.
Dietitians.
Occupational therapists.
Speech and language therapists.
Therapy assistants.
Specialist cancer exercise instructors.

The Proactive Project

This service provides outpatient specialist cancer physiotherapy, dietetics, speech and language therapy, and occupational therapy to adult patients under the care of a North Bristol NHS Trust consultant. Please use the service contact details above if you would like to complete a self referral.

Phone: 0117 414 5550
Email: proactiveproject@nbt.nhs.uk

Preparing for surgery with University Hospitals Bristol and Weston NHS Foundation Trust (UHBW)

The prehabilitation service at UHBW is currently only available to patients undergoing surgery in the following areas: upper gastrointestinal, hepatobiliary, colorectal, thoracic, and head and neck. You cannot self-refer to this service, please contact your cancer clinical nurse specialist if you would like to discuss a referral.

Email: prehab@uhbw.nhs.uk
Phone: 0117 342 7349 (voicemails are checked weekly)

Preparing to come to hospital | University Hospitals Bristol NHS Foundation Trust

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Prehabilitation and Rehabilitation: Stop smoking

Read more about Prehabilitation and Rehabilitation: Stop smoking

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If you smoke, the best thing you can do for your health is to go smoke-free. It’s never too late to quit smoking. Stopping will improve your mental and physical health and wellbeing, and improve the health of the people around you. The number of people who have stopped smoking is increasing – you can do it too.

Find our more about the benefits of quitting smoking: Benefits of quitting smoking - Better Health - NHS

Ways to quit

Many people try to quit smoking with willpower alone, but it's much easier to go smoke-free with the right help. The NHS is here to help you stop smoking, and you can get free support in a way that works for you. Nicotine withdrawal as you stop smoking can be difficult to manage but you can get free access to medication or vapes.

Get help to quit:

Every local area has a community stop smoking service. You can self-refer by phone, text or email - you don’t need to see your GP to get help. The services offer safe and effective support to stop smoking. If you contact your local service you’ll usually get a phone call within 2 – 3 days and will be offered friendly support, nicotine replacement medication, or a vaping kit.

Find support in your area: Find stop smoking support services - NHS

Vapes are one of the most effective tools to stop smoking. Vaping is much safer than smoking and there is a national scheme called Swap To Stop. Adults who smoke can access free rechargeable vape kits to help them quit smoking. If you live in Bristol, North Somerset or South Gloucestershire, you can get a kit posted to you by registering at: Smoke free Bristol

You can also see your GP to discuss stopping smoking, and if you prefer digital support we recommend the free NHS Quit Smoking app.

More information to help you to stop smoking:

How to stop smoking? | Give up smoking | Cancer Research UK

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Prehabilitation and Rehabilitation: Feeling tired? (fatigue)

Read more about Prehabilitation and Rehabilitation: Feeling tired? (fatigue)

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What is fatigue?

Fatigue is a feeling of tiredness or exhaustion. It can be caused by the cancer itself, or the side effects of treatments. As many as 9 out of 10 people with cancer get cancer-related fatigue.

Cancer-related fatigue usually gets better after treatment finishes. But it may continue for months or even years. Everyone is different and there is no way to know how long fatigue may last for each person.

Some common effects of fatigue include:

Difficulty doing simple things, such as brushing your hair or getting dressed
Feeling you have no energy or strength
Difficulty concentrating and remembering things
Difficulty thinking, speaking or making decisions
Feeling breathless after light activity
Feeling dizzy or lightheaded
Difficulty sleeping (insomnia)
Losing interest in sex
Feeling low in mood and more emotional than usual.

This may have an impact on your work, relationships and social life, but there are things that can help. It is possible to manage fatigue. Here are some resources to support you to manage fatigue here:

If you need more support, your cancer clinical nurse specialist or cancer support worker may refer you to a Physiotherapist, an exercise programme or to an Occupational Therapist to help with managing tiredness.

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Prehabilitation and Rehabilitation: Nutrition and diet

Read more about Prehabilitation and Rehabilitation: Nutrition and diet

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Nutrition has a real impact on your body’s ability to manage health and resilience for treatment

It is important to eat well when preparing for, during, and after treatment, and when you are living with cancer.

Choosing a wide variety of foods and well-balanced meals can help you feel better and optimise your energy levels. Trying to lose weight is generally not encouraged.

‘Eating well’ means choosing a wide variety of foods, which provide enough nutrients to maintain a good nutritional status and maintain your weight. Eating well will also help you to keep up your strength and energy levels, support your immune system, and improve your general well-being.

General advice on ‘eating well’ can be found here:

Difficulty eating and unplanned weight loss

You may have difficulty eating before, during, and after treatment for a variety of reasons including:

Dry mouth.
Taste and smell changes.
Nausea and vomiting.
Diarrhoea.
Constipation.
Swallowing difficulties.
Poor appetite.
Fatigue.

Managing at home

These pages have some information about how you can manage difficulty eating and unplanned weight loss at home, including how to boost calories and protein in your diet to

If you are having difficulty eating, let your doctor or nurse know, as they may be able to help with symptoms or refer you to the dietitian.

Referral to a dietitian

You can refer yourself to a dietitian who can help with the following:

Eating well to support your future health.
Managing weight after finishing of cancer treatment.
Coping with a poor appetite, or unintentional weight loss.
Nutritional support for cancer/treatment related side-effects.
Altered texture diets due to swallowing difficulty
Making dietary changes because of cancers affecting the gastrointestinal tract.

There are some referral criteria which will be discussed with you.

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