PET/CT Exam-OMC FDG Brain

Atlantic Health works diligently to provide you with the care you need. These instructions will help you prepare for your upcoming PET/CT exam. Please be sure to read and follow these mandatory preparation instructions carefully to ensure you are eligible for the exam upon arrival. Dietary guidelines must be followed.

If you have any questions or need to cancel your appointment, please call the Nuclear Medicine department as soon as possible. The imaging material is ordered specifically for you 1-2 days prior and will need to be canceled.

Arrive at the hospital 30 minutes before your scheduled appointment to allow for registration and injection of the imaging material. Timing is crucial. Delayed arrival may result in the cancellation of your exam.

What to bring:

• Your insurance card(s) and photo identification
• Your prescription
• Current list of all medications (name, dosage, and frequency). Please include over-the-counter medications, vitamins, and herbal supplements.
• Copies of any recent prior PET, CT, MRI, or Nuclear Medicine bone scan studies sent to AHS via PowerShare or brought on a disc, including both images and written reports if completed outside AHS.

General instructions:

• Please follow the mandatory preparation instructions below.
• If your upcoming PET scan is concerning an epilepsy diagnosis, please bring your prescribing physician’s chart notes, EEG report, and most recent MRI image and report. You must have had a prior brain MRI. This allows the MRI to be fused to the PET scan at the time the radiologist reads the results.
• Wear comfortable, loose-fitting clothing with no metal snaps, buttons, zippers, sequins, belt buckles, or underwire bras. Please do not wear any jewelry and leave all valuables at home.
• If you are claustrophobic, obtain calming medication from your doctor prior to your appointment. We cannot provide these medications. Please arrange transportation if you intend to take this type of medication as you will not be permitted to drive yourself home.
• If you need a copy of your scan sent to your provider via PowerShare or need a disc copy made, please advise the technologist upon arrival.

Mandatory preparation instructions:

• No strenuous activity within the 48 hours prior to the scan (i.e., exercise including aerobics, jogging, yard work, physical therapy, sexual activity, long walks, weightlifting, massages, etc.).
• Do not eat nor drink anything except plain water within the 6 hours prior to your scan. Do not chew gum, eat mints, candy, or cough drops, or take vitamins during your fast.
• If you have an afternoon appointment, you may eat a protein breakfast 6 hours before your scheduled scan time. Do not eat any carbohydrates on the morning of your exam.
• Follow a high protein, low carbohydrate diet for 24 hours prior to your scan. For further guidance, see “Mandatory Dietary Guidelines” below.
• Do not consume coffee, caffeine, alcohol, or nicotine within the 12 hours prior to your scan.
• Diabetic Patients and Patients on Blood Sugar Lowering Medications: Please follow the guidelines below in addition to these.
• Take any prescribed medications the morning of your appointment if you do not need to take them with food.
• Recommendation: Stay well hydrated. Drink 4 cups of plain water in the 2-hour period before your scan and hydrate afterward.
• Recommendation: Do not take new oral steroids the morning of your scan to avoid high blood sugar. *Please consult your prescribing provider before skipping dose(s).

Diabetic patients and patients on blood sugar lowering medications:

This exam uses a radioactive tracer called Fluorine-18 FDG that acts like glucose in the body. The tracer may not work well if your blood sugar is not well controlled. Your glucose level needs to be under  200mg/dL at the time of your appointment. The Radiologist will be consulted if your levels are higher.

In addition to the instructions listed in the “Mandatory Preparation Instructions” section above, please:

• Check your blood sugar after the overnight fast to make sure it is under 200 mg/dL. If your blood sugar is higher, please call the Nuclear Medicine department.
• Take your regularly scheduled non-diabetic medications if you do not need to take them with food.
• Do not take insulin or other blood glucose-lowering medications within the 6 hours leading up to your exam. Please refer to the table below.
• If you have an insulin pump, the pump should be run at the basal rate during the 4 hours prior to the exam and disconnected at the time of the imaging.
• Please consult your diabetes care provider about any medication adjustments needed for this scan. See the medication requirements/ recommendations below.
• If your blood sugar is below 80 md/dL or you have symptoms of low blood sugar, please address your low blood sugar immediately. Do not let your blood sugar go so low that you are unsafe.
• After the scan, resume medications per your diabetes care provider’s instructions.

Diabetic and sugar-reducing medication recommendations:

Metformin or metformin combination medications		Discontinue Metformin 48 hours before your scan so that the images of your abdomen are clear. Metformin may also be called: Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet, Janumet, Metaglip, etc If you are getting a PET scan of the Brain, do not take Metformin on the morning of your scan.
All oral diabetes medications (not metformin or insulin)		For morning appointments, hold the morning dose. For afternoon appointments, you can take the morning dose as long as it is 6 hours before the exam.
Insulin injections		Do not take long or intermediate-acting insulin within the 6 hours leading up to your exam. You can take these the night before the exam. (Examples: Novalin, Humulin, Novolin, Lantus, Levimir) Do not take rapid insulin (examples: Humalog, Novalog) within the 4 hours before the appointment.
Insulin pump		Keep the pump at the basal rate for the 4 hours before the exam Disconnect the pump at the time of imaging
Injectables other than insulin (i.e., Victoza or Trulicity)		Do NOT take any injectable medications the morning of your scan.

Mandatory dietary guidelines:

Your glucose levels must be under 200mg/dL at the time of your scan. These guidelines will help you follow a high protein, low carbohydrate, and low sugar diet within the 24 hours before your scan.

	ALLOWED		AVOID
Proteins	Baked or grilled meat (no breading): chicken, turkey, beef, pork or fish Egg, chicken, or tuna salad Eggs or egg substitute Tofu, bean curd, tempeh		Beans/lentils
Fruits and vegetables	Asparagus Green beans Broccoli Cauliflower Lettuce Spinach Cabbage Mushrooms Carrots Onion Celery Tomatoes Cucumbers Zucchini		Potatoes Fresh nor canned fruit Jam, jelly, preserves Fruit juice Corn Peas
Dairy	Plain yogurt Cheese		Milk Yogurt with fruit or sugar
Carbohydrates			Breads, rolls, buns Crackers, chips, pretzels Cold and hot cereal Pasta Waffles, pancakes Rice Pastries Cake Cookies Pies
Sweets, nuts and sauces	Natural & unsweetened nuts and nut butters		Sugar Syrup Honey Candy  Baked Desserts Gravy/sauce  Natural nor artificial sweeteners
Beverages	Water		Soda (including diet soda) Fruit juice Alcohol Nutrition shakes Smoothies Caffeinated coffee Decaffeinated coffee
Fats	Oil, margarine and butter

What to expect:

• You will be with us for about 2 hours.
• You will receive an injection of a radioactive agent which targets disease. The scanner will take images of the radioactive tracer in your body.
• You will then wait in a quiet room for approximately 45-60 minutes.
• During the scan, you will lay on your back without moving for approximately 30 minutes.
• Your scan will be reviewed by a board-certified fellowship-trained radiologist within 24-48 hours and the results sent to your physician and available on MyChart. Your physician will then discuss your results with you.

Where to register:

Overlook Medical Center, 99 Beauvoir Ave, 4th Floor, Summit, NJ 07901
908-522-2067

Enter through the main entrance and register at Central Access. Then, go to Radiology’s Nuclear Medicine department on the 4th floor.