Indications and Contraindications - Scans/Therapy

Tc-99m Sodium Pertechnetate – Indications

Thyroid imaging, thyroid uptake, salivary gland imaging, Meckel’s diverticulum, dacryoscintigraphy

Tc-99m Oxidronate (HDP) – Indications

Whole-body bone imaging, osteoblastic bone metastases, fractures, bone disease evaluation

Tc-99m Medronate (MDP) – Indications

Whole-body bone imaging, osteoblastic lesions, fractures, infection/inflammation of bone

Tc-99m Pentetate (DTPA) – Indications

Renal function/GFR measurement, renal flow studies, CSF leak/cisternography, brain death evaluation, lung ventilation

Tc-99m Macroaggregated Albumin (MAA) – Indications

Lung perfusion imaging, pulmonary embolism evaluation, right-to-left shunt evaluation

Tc-99m Sulfur Colloid (Filtered/Unfiltered) – Indications

Liver/spleen imaging, bone marrow imaging, gastric emptying, RES imaging

Tc-99m Mebrofenin (Choletec) – Indications

Hepatobiliary imaging, acute cholecystitis, biliary obstruction, gallbladder function

Tc-99m Mertiatide (MAG3) – Indications

Renal perfusion and function imaging, obstruction evaluation, diuretic renography

Tc-99m Pyrophosphate (PYP) – Indications

Acute myocardial infarction imaging, ATTR cardiac amyloidosis imaging, RBC labeling

Tc-99m Sestamibi (Cardiolite) – Indications

Myocardial perfusion imaging, parathyroid imaging, tumor imaging

Tc-99m Tetrofosmin (Myoview) – Indications

Myocardial perfusion imaging

Tc-99m Succimer (DMSA) – Indications

Renal cortical imaging, renal scarring evaluation, pyelonephritis evaluation

Tc-99m Exametazime (HMPAO/Ceretec) – Indications

Brain perfusion imaging, stroke evaluation, seizure focus localization, WBC labeling

Tc-99m Bicisate (ECD/Neurolite) – Indications

Brain perfusion imaging, stroke evaluation, dementia evaluation

Tc-99m Labeled RBCs (UltraTag/PYP) – Indications

GI bleeding studies, MUGA equilibrium blood pool imaging, cardiac function evaluation

Tc-99m HMPAO Tagged WBCs – Indications

Infection imaging, abscess localization, inflammatory disease evaluation

Tc-99m Tilmanocept (Lymphoseek) – Indications

Sentinel lymph node mapping, breast cancer and melanoma staging

I-123 Sodium Iodide – Indications

Thyroid uptake and imaging, thyroid function evaluation

I-131 Sodium Iodide – Indications

Hyperthyroidism therapy, thyroid cancer ablation, thyroid cancer whole-body imaging

I-123 Iobenguane (MIBG/AdreView) – Indications

Pheochromocytoma, neuroblastoma, adrenal medullary tumors

I-123 Ioflupane (DaTscan) – Indications

Differentiate Parkinsonian syndromes from essential tremor, dopamine transporter imaging

In-111 Chloride – Indications

Bone marrow imaging

In-111 Oxine Tagged WBCs – Indications

Infection imaging, osteomyelitis evaluation

In-111 Pentetate (DTPA) – Indications

CSF leak evaluation, cisternography

In-111 Pentetreotide (Octreoscan) – Indications

Somatostatin receptor positive neuroendocrine tumor imaging

Ga-67 Gallium Citrate – Indications

Infection imaging, lymphoma evaluation, sarcoidosis imaging

Tl-201 Thallous Chloride – Indications

Myocardial perfusion imaging, myocardial viability evaluation

Xe-133 Gas – Indications

Lung ventilation imaging

Cu-64 Dotatate (Detectnet) – Indications

SSTR-positive neuroendocrine tumors

F-18 FDG – Indications

Oncology imaging, neurology, myocardial viability

F-18 Florbetaben (Neuraceq) – Indications

Amyloid PET imaging for Alzheimer’s evaluation

F-18 Florbetapir (Amyvid) – Indications

Amyloid PET imaging for Alzheimer’s evaluation

F-18 Flutemetamol (Vizamyl) – Indications

Amyloid PET imaging for Alzheimer’s evaluation

F-18 Sodium Fluoride (NaF) – Indications

Bone metastases and bone turnover imaging

F-18 Fluciclovine (Axumin) – Indications

Recurrent prostate cancer with rising PSA

F-18 Flortaucipir (Tauvid) – Indications

Tau PET imaging for Alzheimer’s staging

F-18 Piflufolastat (Pylarify) – Indications

PSMA-positive prostate cancer staging and recurrence

F-18 Fluorodopa – Indications

Parkinsonian syndromes and movement disorders

F-18 Fluoroestradiol (Cerianna) – Indications

ER-positive breast cancer imaging

Ga-68 Dotatate (Netspot) – Indications

SSTR-positive neuroendocrine tumors

Ga-68 Dotatoc – Indications

SSTR-positive neuroendocrine tumors

Ga-68 Gozetotide (Illuccix/Locametz) – Indications

PSMA-positive prostate cancer imaging

N-13 Ammonia – Indications

Myocardial perfusion PET imaging

Rb-82 Chloride (Ruby-Fill/Cardiogen) – Indications

Myocardial perfusion PET imaging

F-18 FDG – Contraindications

Uncontrolled hyperglycemia

Rb-82 Chloride – Contraindications

Severe uncontrolled hypertension (relative)

Tc-99m MAA – Contraindications

Severe pulmonary hypertension, significant right-to-left cardiac shunt

Tc-99m Mebrofenin – Contraindications

Severe hyperbilirubinemia

Tc-99m MAG3 – Contraindications

Severe renal failure

Tc-99m RBCs – Contraindications

Severe anemia or inability to label blood cells

Tc-99m HMPAO WBCs – Contraindications

Severe leukopenia

I-131 Sodium Iodide – Contraindications

Pregnancy, breastfeeding, inability to follow radiation safety precautions

I-123 MIBG – Contraindications

Medications interfering with MIBG uptake (example: labetalol)

In-111 Oxine WBCs – Contraindications

Severe leukopenia or inability to perform blood labeling

In-111 DTPA – Contraindications

Active CNS infection

Xe-133 Gas – Contraindications

Severe COPD or inability to inhale gas

Ga-67 Gallium Citrate – Contraindications

Pregnancy (relative)

Tl-201 Thallous Chloride – Contraindications

Pregnancy (relative)

Lu-177 Dotatate (Lutathera) – Indications

SSTR-positive gastroenteropancreatic neuroendocrine tumors

Lu-177 Vipivotide Tetraxetan (Pluvicto) – Indications

PSMA-positive metastatic castration-resistant prostate cancer

Ra-223 Radium Dichloride (Xofigo) – Indications

Bone-only metastatic castration-resistant prostate cancer

Sr-89 Chloride (Metastron) – Indications

Painful osteoblastic bone metastases

Y-90 Microspheres – Indications

Unresectable hepatocellular carcinoma and liver-dominant metastases

Lu-177 Dotatate – Contraindications

Severe renal impairment, pregnancy

Lu-177 Pluvicto – Contraindications

Pregnancy, severe marrow suppression

Ra-223 Xofigo – Contraindications

Visceral metastases, pregnancy, severe marrow suppression

Sr-89 Metastron – Contraindications

Pregnancy, severe marrow suppression

Y-90 Microspheres – Contraindications

Uncorrectable lung/GI shunting, portal vein thrombosis (relative)