Octreoscan protocol

1. Preparation
   1. Patient must follow preparation as outlined on octreotide scan guideline handout
   2. If patient is on short acting octreotide, they must be off of it for 24 hours
   3. If patient is on long acting octreotide, they must be off of it for 4-6 weeks.
2. Isotope administration
   1. Patient will receive a 6mCi intravenous injection of In¹¹¹ To assay the dose, use a dose calibrator using a copper dipper.
3. Camera Parameters Planar imaging
   1. MELP collimators used for imaging
   2. 8 cm/min table speed
   3. Matrix: 256X1024
   4. Zoom: 1
   5. Camera peaked at In¹¹¹ with a 15% window
4. Camera Parameters SPECT
   1. MELP collimators used for imaging
   2. Camera peaked at In ¹¹¹ with a 15% window with scatter window
   3. Matrix: 64X64
   4. Zoom: 1
   5. Time: 35 sec per stop
   6. Views: 32 per bed
   7. Detector configuration 180
   8. Orbit non circular
   9. Mode step/shoot
5. Scanning protocol
   1. Patient will be scanned supine position and scanned, 4 and 24 hours post injection, from the superior aspect of the skull to the feet.
   2. 2 to 3 bed SPECT imaging with CT imaging for attenuation correction.
   3. Additional imaging as requested by radiologist.
6. SPECT/CT Reconstruction
   1. Nuclear Medicine Parameters
      1. Iterative OSEM 2D (4 subsets, 8 iterations)
      2. Gaussian 6.0 filter

• Chang’s Attenuation Coefficient 0.15

1. CT Parameters
   1. Abd Window
   2. Body 5.0 B30s Med Smooth

• 5 mm Slice

7. Post processing/Display/Achieve
   1. All acquired images will be adjusted for optimal viewing and appropriate labeling.
   2. All SPECT images will be displayed in coronal and sagittal planes with and without CT fusion and NM MIP
   3. Images will be sent to the PAC’s system and Syngo Via for archiving/physician review