Missouri Cancer Associates’ Technologists are dedicated to providing diagnostic services such as: CT scans, PET/CT scans, and X-rays in a safe environment. We are an ACR (American College of Radiology) accredidated facility that ensures you will always have the highest standard of care.

MCA’s combined team of Physicians and Technologists coordinate your state-of-the-art imaging services to provide a long term individualized care plan for you. Their expertise in the imaging and treatment of cancer is second to none.

Your physician may order studies that will require you to be NPO (nothing my mouth) for up to six hours before your scheduled scan. Please comply with the patient instructions that you are provided to ensure you have the best scan possible. If you are diabetic or claustrophobic you may have special instructions regarding your medication schedule or need to be pre-medicated prior to your scan. Be sure to notify your physician if have allergies to contrast (dye).

PET Scans

What is a PET Scan?

A Positron Emission Tomography (PET) scan is an imaging test revealing how your tissues and organs function. A tracer (radioactive drug) is injected into your body. From there, the tracer travels through the body and collects where there are high levels of chemical activity. These ‘activity levels’ are often a result of cancer and are shown on the PET scan in bright spots. This scan can also educate you and your physicians on how your body is responding to treatment.

Prepare for a PET Scan

To help your physician obtain the quality results from your PET scan it is important for you to plan in advance. The test may be swayed by what you eat or drink, so please avoid consuming anything other than water and prescribed medications six hours prior to the scan. The final meal before your scan needs to be high protein foods and lots of water. Carbohydrates and sugary foods alter results, as PET scans read your sugar metabolism. Finally, avoiding exercising 24 hours before your scheduled PET scan. Exercise could cause the tracer’s reading to be inaccurate.

Before your scan, please inform your medical team if you are:

  • Diabetic
  • Pregnant or breastfeeding
  • Taking steroid medication
  • Over 400 pounds
  • Claustrophobic
  • Unable to lie on your back for an extended amount of time
  • Receiving a high density contrast

What to Expect

When you arrive at Missouri Cancer Associates for your PET scan, our medical staff will take your blood sugar and begin an IV line containing a tracer. Depending on what your care team is looking for, the tracer needs to be given uptake time of approximately 45 minutes prior to your scan.

Next, you will be taken to the PET scan where you will be asked to lie on your back on the scan table. From there, the scan table will enter the scanner that is open at each end where the scan will take place. The PET scan will take 20 – 40 minutes. Please remember to remain still, as movement can affect the results of the test.

After the PET Scan

Once the test is complete, a tiny trace of the radioactive sugar injected into your body will remain. We strongly encourage you to drink plenty of water to help remove the tracer from your body.

Your physician will then research and study the results from your PET Scan and discuss them with you at your next appointment.

CT Scans

What is a CT Scan?

A computerized tomography (CT) scan takes several X-rays and uses computer processing technology to create images of what’s happening inside your body. At MCA, our CT Technologists utilize the scanner in combination with oral and/or IV contrast to enhance the images of you. These images are interpreted by a Radiologist. Your Physician and their medical team will use the results to create a treatment plan for you. These scans also inform your physician where the cancer is located and if your current care plan is working. Often subsequent scans are performed to track process.

What to Expect?

Prior to your CT scan, please be mindful of what you eat and drink. Please consume 20 oz. of water or clear juice and do not ingest (eat) anything for 4 hours before your scan. Depending on the type of CT scan ordered, you may need to have blood work done to ensure your kidneys are functioning properly and contrast can be utilized if ordered by your physician. After the necessary amount of oral contrast is consumed, you will be taken back for the scan. You will be asked to lie down on the scan table and an IV will be started or your port may be accessed. Depending on which part of your body is being scanned, you may be asked to:

  • Take off some or all of your clothing and wear a hospital gown
  • Remove metal objects, such as a belt, jewelry, dentures and eyeglasses, which might interfere with image results

The contrast used appears white on images, which can help emphasize blood vessels, intestines or other structures. Contrast material might be given to you:

  • By mouth: If your esophagus or stomach is being scanned, you may need to swallow a liquid that contains contrast material. This drink may taste unpleasant.
  • By IV injection: Contrast agents can be injected through a vein in your arm to help your gallbladder, urinary tract, liver or blood vessels stand out on the images. You may experience a feeling of warmth during the injection or a metallic taste in your mouth.

The machine takes images of your body as the table moves through the scanner which is open at each end. You may be asked to hold your breath to ensure motion-free images are obtained. This process usually takes 20 minutes.

Remember, your MCA staff is here for you. If you have any questions or concerns regarding your upcoming CT scan, please ask your doctor.

After the CT Scan

For patients who received intravenous contrast:

  1. Drink plenty of liquids and drinks. Drinks should be non-dehydrating, such as water, clear juices, decaffeinated coffee / tea, or clear liquids such as broth. This helps in getting rid of IV and oral contrast.
  2. Do not use NSAID’s for 24 hours following IV contrast administration. Examples of NSAID’s are: Aspirin, Alleve, Amigesic, Celebrex, Clinoril, Daypro, Dolobid, Feldene, Indocin, Lodine, Motrin, Naproxen, Naprosyn, Orudis, Relafen, Tolectin, Toradol, Vioxx, and Voltaren.
  3. If you are DIABETIC and taking Avandamet, Glucophage, Glucophage XR, Glucovance, Metformin, or Metaglip, discontinue your medication for 48 hours after the examination. Contact your referring physician if necessary.
  4. If you are breastfeeding, discard breast milk for 24 hours after injection.

For patients who got oral contrast only or both Oral and IV contrast:

  1. Oral contrast Barium can sometimes cause constipation. If you don’t pass stool in the next 48 hrs, use of a mild laxative such as Milk of Magnesia or Lactulose may help. Please contact your primary care or CT scan ordering physician for possible enema.

CT Scan Report will be available for your ordering physician’s review. If you need a copy of the report or a CD of the CT scan, please contact our Medical Records Department to request a release of information.



Missouri Cancer Associates is proud to offer Axumin TM (fluciclovine F 18) injection PET scan for the detection of recurrent Prostate Cancer.

Axumin™ imaging, showing area of biochemical recurrence in red. Blue inset is the FACBD-fluciclovine compound structure. 



U.S. FDA approved Axumin (fluciclovine F 18) injection is indicated for positron emission tomography (PET) imaging in men with suspected prostate cancer recurrence based on elevated blood Prostate Specific Antigen (PSA) levels following prior treatment (prostatectomy or external beam radiation therapy).  

Prostate cancer is the second leading cause of cancer death in men. While most primary prostate cancer can be successfully treated, the disease recurs in up to one-third of patients. In some patients, recurrent disease is detectable only by a rise in prostate-specific antigen (PSA) levels, yet the location of the recurrence cannot consistently be located by conventional imaging, severely limiting treatment guidance for these patients.

Axumin was developed to target the increased amino acid transport that occurs in many cancers, including prostate cancer. It is labeled with the radioisotope F18, enabling it to be visualized in the body with PET imaging.  

Axumin can detect recurrent disease with PSA levels in the range of 1-10 ng/ml, which is the?reason this scan is such an important advancement. 

Being able to detect metastatic disease early offers two important therapeutic advantages. First, the knowledge of where the cancer is located can help the Urologist determine the best treatment options, such as Intensity Modulated Radiation Therapy (IMRT) to that specific area while limiting damage to other areas of the body. The second offers a deeper insight into the disease process itself—revealing if cancer has recurred or not, if so, to what degree, thus leading to earlier treatment of the disease. 

Recurrent cancer signaled by a rising PSA is not always due to metastases. Sometimes cancer remains near or in where the prostate used to be, so the rising PSA could also come from cancer recurring in the prostate gland after radiation or in the prostate fossa after surgery (the fossa is the area of the body where the prostate was located prior to surgical removal). This is known as a “local recurrence.” 

In addition to prostate cancer, a number of benign (not cancerous) conditions can cause a man’s PSA level to rise. The most frequent benign prostate conditions that cause an elevation in PSA level are prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH) (enlargement of the prostate). There is no evidence that prostatitis or BPH leads to prostate cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well.  

PSA levels can also be elevated due to cancer metastasizing to the lymph nodes or bones. This is called a “systemic recurrence.” Systemic recurrences can spread throughout the body—a process that ultimately leads to death in more than half of prostate cancer patients. 

Thus, knowing the location of the recurrence answers an extremely important question: whether the recurrent disease is aggressive enough to metastasize. 

This knowledge frees the Urologist to implement a much more aggressive approach.  

How Does Axumin Work? 

Conventional diagnostic imaging with a CT scan and/or bone scan is typical of limited utility until PSA values rise to 10-20 ng/ml. Standard bone scans use a radioactive substance, called a radionuclide, or tracer, that will collect within the bone tissue at spots of abnormal physical and chemical change.  

Axumin exploits the fact that prostate cancers absorb amino acids at a much more rapid pace than normal cells do. The scan can detect biochemical recurrence to evaluate suspected nodal or metastatic disease where confirmation or exclusion of pelvic and/or distant disease would directly influence patient management.

Axumin™ can detect recurrent disease with PSA levels in the range of 1-10 ng/ml, which is the reason this scan is such an important advancement.

Important Safety Information   

The most common adverse reactions were injection site pain and/or redness, and dysgeusia (abnormal taste in the mouth). Although not yet observed, hypersensitivity reactions, including anaphylaxis, may occur in patients who receive radiopharmaceuticals, so emergency resuscitation equipment and personnel should be immediately available. Axumin use contributes to a patient’s overall long-term cumulative radiation exposure, and safe handling practices should be used to minimize radiation exposure to the patient and healthcare providers.

As with any imaging agent, image interpretation errors can occur. Interpretation of scans requires additional training for the radiologists reading this type of scan.  A negative image does not rule out recurrent prostate cancer (if lesions are small, they may be below the resolution of the PET camera) and a positive image does not confirm its presence, as fluciclovine uptake may occur with other cancers and is also seen in tissue affected by benign prostatic hypertrophy (BPH) in primary prostate cancer. Clinical correlation, which may include histopathological evaluation of the suspected recurrence site, is recommended.  


1.Axumin (Fluciclovine F 18 Injection) package insert.? Blue Earth Diagnostics Ltd. ? August 2016.



Missouri Cancer Associates maintains an accredited facility status granted by The American College of Radiology (ACR) in both PET and CT imaging. Learn more about this accreditation.

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