SCHEDULING A PET/CT SCAN at What information will the scheduler need?
In addition to demographic information, the schedulers are trained to request information that is pertinent
to an accurate test for your patient. We strongly recommend the use of the listed ICD-9 codes provided by
Required clinical data to schedule a PET/CT scan
• Recent radiology scans (MRI, CT, Nuclear Medicine and Chest X-Ray) reports and hard copy ﬁlms.
• Radiology ﬁlms from outside facilities, request patients to bring day of exam.
• The date and location of any Radiation Therapy or Chemotherapy treatments.
• If the patient is diabetic, current medications and how well controlled.
• Patient’s height and weight. The equipment cannot accommodate patients over 450 pounds.
• Written physician order for the PET/CT scan. Recommendations for patients currently undergoing treatment
• Recent biopsies, surgeries dates, pathology reports and last dates of radiation treatments should
be documented in the patient’s progress notes.
• Patients should be out two weeks from last chemotherapy, two weeks from steroids (example:
Prednisone) and bone marrow stimulators (example: Neupogen™). Diabetic Patient
• Diabetic patients are scheduled within the period of time that their blood sugar is under best control.
• If a patient is diabetic, call (877) 688-6122, 24 hours in advance and ask for a Nuclear Medicine
• The technologist will work directly with the patient concerning fasting and/or oral medicine
• If the patient is insulin-dependent, the scan should be arranged in the late morning or early afternoon. Non-Diabetic Patient
• No food four hours prior to the appointed scan time.
• Drink 24-30 ounces of water over two hours before the scan. Black decaffeinated coffee (no cream,
no sugar) is acceptable along with the water.
• Avoid all other beverages except plain water for at least four hours before the exam. What other information do I need to give the patient?
• Instruct the patient to wear comfortable clothing.
• The patient should plan to be at the imaging center from 2 to 3 hours.
• The pet scanner does not make any noise during the imaging exam.
• The patient may resume normal activities once they complete the PET/CT scan.
• 24 hour advance notice for rescheduling or cancellation of PET/CT exam is recommended.
• Technologist should be informed if there is any possibility of pregnancy and/or nursing.
• Patients having a history of claustrophobia should consult with their referring physician. Scheduling other Radiology Exams (same day)
• CT (a.m.) -- IV contrast okay, NPO four hours.
• Nuclear Medicine (am) – all Nuclear Medicine studies must be completed before the PET/CT scan.
• US, MRI, x-ray and mammograms can be scheduled either before or after the PET/CT scan. Brief Explanation of PET/CT What is PET/CT?
Positron Emission Tomography (PET) is a camera that produces powerful images of the human body and allows the physician
to see what is happening inside your body. PET/CT is a non-invasive procedure that provides unique information about the
body’s metabolism, cell function and exact location of a disease – information not available through CT or MRI alone.
Research has shown that PET/CT can effectively pinpoint the source of many of the most common cancers. PET/CT can
give physicians important early information about cardiac and neurological diseases, streamlining testing and decreasing
the need for invasive biopsies. Because PET/CT scans are pictures of the body’s chemistry, many diseases can be seen in
FDG PET/CT Scan PET/CT Facts • Safe • One image shows all body
• Earlier diagnosis of disease • Shows how the body responds
avoids needless pain to the patient. PET/CT Beneﬁ ts • Earlier diagnosis • Monitoring effects of therapy • Elimination of invasive procedures • Replacement of multiple tests
What important patient questions PET/CT might answer.
• Can tell the difference between scar
To schedule a patient appointment, please call MGH Progressive Medical Imaging at 765-673-0370 or fax form to 765-673-0375 PET/CT Scanning MEDICARE APPROVED Alzheimer’s PET/CT Scanning Breast Cancer
• Staging, restaging and monitoring during therapy
Cervical Cancer Colorectal Cancer Epilepsy
• Pre-surgical evaluation of refractory seizures
Esophageal Cancer Head & Neck Cancer
(Excluding Central Nervous System or Thyroid Cancers)
• Diagnosis, staging and restaging of non-small cell lung
Lymphoma (Hodgkin’s & non-Hodgkin’s) Melanoma
• Identify extent of local and regional disease spread in
patients with high risk melanoma, or in suspected
Thyroid Cancer To schedule a patient appointment, please call MGH Progressive Medical Imaging at 765-673-0370 or fax form to 765-673-0375 PET/CT SCANNING Clinical Indications (cont.) REIMBURSEMENT BY PRIVATE PAYER
Many private insurance carriers pay for PET/CT scans in select clinical indications on a case-by-case
evaluation. Medicare approved clinical indications (as listed on the other side) are typically approved for
reimbursement by private payers. Pre-authorization is still required for those indications as well as the ones
listed below to qualify. To determine coverage for your patient’s particular indication, please contact the
PET/CT scheduling ofﬁce and they will submit for pre-authorization of the study. The PET/CT scheduling
ofﬁce will contact you directly should additional information be required or in the event that the procedure
• Differentiate recurrent tumor from radiation necrosis
• Differentiate primary CNS lymphoma from toxoplasmosis
• Identify involved lymph nodes or distant metastatic disease
• Exclude local and metastatic recurrence of disease
• Differentiate Alzheimer’s disease from multi-infarct dementia
• Evaluate local extent of disease and exclude distant metastases.
• Measure treatment response of primary tumors prior to surgical intervention.
• Restaging of residual or recurrent disease following deﬁnitive therapy. Ovarian Cancer
• Detect recurrent/residual tumor prior to surgical exploration or additional chemotherapy
• Evaluation of rise in CA125 values with negative CT ﬁndings
• Differentiation of benign processes such as pancreatitis, mucinous cyst adenoma and
• Rule out distant metastases for preoperative evaluation. Thyroid Cancer • Detect metastatic or locally recurrent disease in patients with elevated thyroglobulin
after deﬁnitive initial treatment and negative I-131 examination. Unknown Primary • Localization of primary site and staging extent of metastatic disease.
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