REF000 - Referring to Nuclear Medicine (HUTH)

NB: This procedure does not apply to referrals for PET/CT which is provided by a private company (Alliance Medical).

• Referrals to Nuclear Medicine should be by an electronic (via Lorenzo) request. Paper requests will be accepted when electronic requesting is not available (e.g. referrals from outside of the HUTH Trust)
• Check the referral criteria for the procedure you are requesting to ensure you are entitled to refer and that the procedure is suitable for the clinical question
  • In general referrals are only accepted from UK Registered Medical Practitioners. Referrals from non-medical staff will be accepted only from those previously approved. A list of approved non-medical referrers is kept in the nuclear medicine department (SOP E029)
  • Check the contraindications including any medication which might interfere with the procedure
  • Some procedures require the administration of other, non-radioactive pharmaceuticals as an essential part of the procedure. These are specified in the referral criteria. Your request for an investigation will be taken as implying agreement to the administration of the specified supplementary drug. If you are unhappy about your patient being given these drugs or you feel they are contraindicated this must be clearly stated on the request.
  • Links to referral criteria for each type of nuclear medicine procedure are provided below. These include valid clinical indications, contraindications, and any supplementary drugs used in the procedure. Please contact the Nuclear Medicine Department on 01482 622125 or hyp-tr.nucmed-hri@nhs.net for advice on any procedure or clinical indications not covered by this document.
• If you are entitled to refer and the clinical indications are valid for the procedure you are requesting, complete a referral via Lorenzo or by paper request if you are referring from outside HUTH.
  • Contact the nuclear medicine department for paper referral forms. These differ from those used in radiology.
  • You MUST provide sufficient information for the ARSAC licence holder to justify the radiation dose to the patient
• If a referral needs to be cancelled, cancel it in Lorenzo (electronic requests), but in all cases (electronic or paper referrals) telephone the nuclear medicine department on 01482 622125 to inform us of the cancellation.

As referrer you must provide the following information on the request:

• Sufficient medical data (such as previous diagnostic information or medical records) relevant to the procedure requested to enable the ARSAC Licence holder to decide whether there is a sufficient net benefit to the patient. (Requirement under the Ionising Radiation [Medical Exposures] Regulations).
• The clinical question
• The suggested procedure (e.g. Bone Scan, Myocardial Perfusion Scan)
• Sufficient information to identify the patient
  • for paper requests, ensure the full name, address, date of birth, and a numeric identifier (e.g. NHS number) are included
• Whether the patient is pregnant or breastfeeding
  • Therapy Procedures
    • Pregnant patients must not be referred for therapy procedures
    • Ensure that the patient is aware of the importance of not being pregnant at the time of the therapy procedure and discuss appropriate contraception if necessary
    • Ensure that the patient is aware of the need to avoid becoming pregnant after the therapy for a period of time dependant on the therapy (6 months for I131 therapy)
• Any relevant medication (see referral criteria for any medication which might interfere with the procedure and indicate if it can be stopped)
• If the patient has a catheter or is incontinent
• Any language or communication difficulties
• Any conditions that might make it difficult for the patient to comply with the procedure (e.g. difficulties in lying flat)
• Any medical or other potential risks to staff
• Name of clinical trial/research project (if applicable)
• Sufficient information to identify you as referrer
  • For Lorenzo requests, ensure the request is made under your own login
  • For paper requests you must sign and legibly PRINT your name and job title

Bone Scans

Cardiac Amyloidosis Imaging

Lung Ventilation/Perfusion Imaging

Myocardial Perfusion Scintigraphy

Radionuclide Ventriculography/MUGA

Renal Imaging (Static)/DMSA

Renograms (Dynamic)

Other procedures are currently under review and will be added to this page as reviews completed. In the meantime, for procedures not listed above, see https://www.heynm.org.uk/pdfs/e008a-referral_criteria-procedures_under_review.pdf

Radioiodine Treatment of Thyrotoxicosis Referral Criteria

Radioiodine Ablation (Ca Thyroid) Referral Criteria

Other therapy procedures are currently under review and will be added to this page as reviews completed. In the meantime see https://www.heynm.org.uk/pdfs/e008a-referral_criteria-procedures_under_review.pdf