Radiology

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) accredited 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 you have allergies to contrast (dye).

Denise plays an essential role on our imaging team as a PET Technologist. With a caring approach and strong technical expertise, she helps provide patients and physicians with the detailed scans needed for accurate diagnosis and treatment planning. Denise understands that imaging can sometimes feel overwhelming, so she takes the time to guide each patient through the process with compassion, reassurance, and a friendly smile.

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.

Getting Ready for your PET Scan

To help your doctor get the best results, it is important to prepare 24 hours in advance of your scan date and time.

• Avoid sugary foods and carbs (bread, rice, pasta, candy, or soda), because they change how your body utilizes sugar- and that will affect your scan results.

• 6 hours before your scan, do not eat or drink anything except water. You are allowed to take your morning medications, except diabetic medications.

PET scans look at how your body uses sugar, so eating the wrong foods/drinks will result in the need to reschedule the scan.

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 (such as a CT scan the same day)

What to Expect

When you arrive at Missouri Cancer Associates for your PET scan, our medical staff will take your blood sugar and start an IV to inject the radiotracer. You will be asked to remain seated in the PET prep area for 45-60 minutes while your body distributes the tracer throughout your body. You will then be asked to use the restroom to empty your bladder.

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 12 – 30 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 eliminate it from your body.

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

CT Scans

What is a CT Scan?

A CT scan (short for Computerized Tomography) takes many images utilizing X-rays and uses a computer to create detailed images of the inside of your body. A Radiologist reviews these images and shares the results with your doctor. Your doctor uses this information to help plan your treatment and check if your current care is working. You may have more CT scans later to see how things are going.

What to Expect

Before your CT scan

• Drink 20 ounces of water or clear juice.
• Don’t eat anything for 4 hours before your scan.

Depending on the type of scan ordered, you might need a blood test (iSTAT) to make sure your kidneys are working well.

During the scan:

• You will lie down on a table that moves through the open-ended scanner.
• You may have an IV started or have your port accessed, if your doctor orders contrast.
• You will need to take off metal items like jewelry, glasses, or belts and empty your pockets.
• The contrast helps highlight certain parts of your body like blood vessels or organs. It may be:
• Swallowed: If your stomach or throat is being scanned.
• Injected: If your liver, kidneys, or blood vessels are being scanned. You might feel a warm sensation or taste something metallic.

Depending on what is ordered, the scan may take about 10-30 minutes. You may be asked to hold your breath for a few seconds to help get quality images without motion.

After the CT Scan

If you had IV Contrast

• Drink plenty of fluids like water, clear juice, decaf coffee or tea, or broth. This helps your body get rid of the contrast.
• Don’t take NSAIDs (non-steroidal anti-inflammatory drugs) for 24 hours. These include:
• Aspirin
• Aleve
• Motrin
• Celebrex
• Naproxen
  (Ask your doctor if you’re not sure what counts as an NSAID.)
• If you have diabetes and take medications like:
• Metformin
• Glucophage
• Avandamet

Stop taking them for 48 hours after your scan. Call your doctor if you have questions.

• If you are breastfeeding, throw away your breast milk for 24 hours after the injection.

If you were given Oral Contrast (or Both Oral and IV)

• Oral contrast can sometimes cause constipation.
• If you don’t have a bowel movement within 48 hours, you can try a mild laxative like:
• Milk of Magnesia
• Lactulose
  If that doesn’t help, contact your doctor to ask about using an enema.

Getting Your Results

• Your doctor will receive the CT scan report.
• If you want a copy of the report or a CD of your scan, contact our Medical Records Department to request it. You will be asked to sign a release of information, if not already on file with our practice.

Questions?

Your MCA staff is here to help.
If you have any questions or concerns about your CT scan, please talk to your doctor or ask a member of our team.

PYLARIFY PET SCAN

Based on the initial diagnosis assessment or if the prostate cancer has come back (also known as a recurrence), it’s important to know if and where the prostate cancer has spread—or metastasized. That’s where imaging comes in. It can play a vital role in helping to detect and monitor prostate cancer progression. However, not all imaging scans are the same. While many of the current options—such as bone, CT, and MRI scans—provide some important information, they also have limitations.

What is Pylarify? 

PYLARIFY® is an advanced diagnostic imaging agent used with PET/CT scans to find tumors in the prostate, lymph nodes, bones, and other organs, typically better than other types of imaging scans. In May 2021, the U.S. Food and Drug Administration approved the use of PyL (PYLARIFY®) PET/CT with PyL greatly enhances the specificity and resolution of prostate cancer imaging to a degree that was unimagined just a short time ago. 

A PET scan is often combined with a CT scan for better diagnostic accuracy. Compared to conventional imaging, a PET/CT scan with PYLARIFY® (piflufolastat F 18) injection provides you and your doctor with a clearer image of where the prostate cancer is and helps your doctor make more informed treatment choices.

Is Pylarify right for me?

Pylarify is indicated for men with prostate cancer that have moved to another part of the body (metastasis) who are candidates for initial definitive therapy and also for Men with suspected recurrence of prostate cancer based on elevated serum prostate-specific antigen (PSA) levels.

How does Pylarify work?

PYLARIFY® attaches to prostate-specific membrane antigen (PSMA), a protein found on the surface of most—approximately 95%—prostate cancer cells. By targeting PSMA, PYLARIFY® can give your doctor a clear image and additional information on the location and extent of cancer.cells. By targeting PSMA, PYLARIFY® can give your doctor a clear image and additional information on the location and the extent of the cancer.

For more information: https://www.pylarify.com/patient

Pluvicto

What is PLUVICTO® (lutetium Lu 177 vipivotide tetraxetan)?

PLUVICTO is a prescription that is a targeted treatment called radioligand therapy (RLT) for PSMA+ mCRPC used to treatment with prostate-specific membrane antigen­–­positive metastatic castration-resistant prostate cancer (PSMA-positive mCRPC) already treated with:

• hormone therapy or
• hormone therapy and chemotherapy

RLT is a different type of therapy utilizing radiation that is injected or infused and targets a biomarker called PSMA.PLUVICTO is designed to find and attack PSMA+ cells. PSMA is found on many prostate cancer cells and also some healthy cells.

What to expect for each dose throughout treatment

Dosing

PLUVICTO is given up to 6 doses via IV injection every 6 weeks.

Dosing 

Before Each Dose 

Laboratory tests (PSA, CMP, CBC) will be performed 17 days prior to the date your PLUVICO dose is scheduled. Bloodwork will be reviewed by the Radiation Oncologist to ensure the values are within range to proceed with the injection. 

After Each Dose is Administered

Your body, blood, and urine give off radiation for a while after getting PLUVICTO. Always follow your doctors’ instructions to help reduce overall exposure to yourself and others. Drink plenty of water before and after each dose and urinate as often as possible. This will help reduce the amount of radiation in your body.

Important radiation Safety Information 

Safety information that is provided must be adhered to while undergoing PLUVICTO treatment. 

• Limit close contact (less than 3 feet) with people and household animals for 3 days after your injection. You may return to work after 3 days.Limit close contact with children less than 10 years of age or pregnant women for 14 days.
• Do not handle or prepare meals for others for 3 days after injection.
• Have sole use of a bathroom. Toilets must be used in a seated position for each use, to avoid splashing, flushing two times with the lid down. 
• Sleep in a separate bedroom from household members for 3 days, from children or from pregnant women for 14 days.
• Plan to use protection. After each dose, there should be no sexual activity for 7 days. Use effective birth control over the entire course of treatment and for 14 weeks after the last dose. 
• Laundry precautions. Wash laundry separate from others in the household for 7 days and run the wash cycle 2 times for each load. 
• Special precautions for trash and those patients that require assistance by a care provider will be provided by the healthcare team.

What are the most common side effects of PLUVICTO?

The most common side effects of PLUVICTO include:

• Decreased blood cell counts 
• Tiredness 
• Dry mouth 
• Nausea 
• Appetite loss 
• Joint pain 
• Constipation 
• Back pain

These are not all of the possible side effects of PLUVICTO. Visit PLUVICTO Side Effects for more information.

Understanding Targeted Radiation

Radiation from PLUVICTO does not stay in your body long.Within 2 days, over half of the radiation will leave your body.Within about 14 days, most of the radiation (greater than 99%) will be gone..

Can PLUVICTO be taken with other treatments?

Your doctor will decide on the best treatment plan for you. It’s important to discuss all treatments and medications with your doctor. This will help ensure there are no interactions.

Whaupport and resources are available during PLUVICTO treatment?

Novartis Patient Support™ can connect you with financial assistance, support groups, and educational materials. Contact Novartis Patient Support for more information at 1-844-638-7222, Monday-Friday, 8:00 AM – 8:00 PM ET, excluding holidays to speak to a live Novartis Patient Support agent about what

Getting Your Results

• Your doctor will receive the PET/CT scan report.
• If you want a copy of the report or a CD of your scan, contact our Medical Records Department to request it. You will be asked to sign a release of information, if not already on file with our practice.

Questions?

Your MCA staff is here to help
If you have any questions or concerns about your CT scan, please talk to your doctor or ask a member of our team.

Patient Preparation 

There is no preparation for this exam.  You may eat and drink whatever you would like and may take your medications as prescribed by your physician. 

Hydration is recommended but not necessary.  A couple of extra glasses of fluid would be sufficient.

The exam takes a total of 2 hours.  One hour is in the prep room after injection and the scan takes approximately 30 minutes. 

If you are claustrophobic please tell your physician or nurse when you are scheduled so they can make accommodations for your claustrophobia.

What Side Effects do I need to consider? 

Side effects of PYLARIFY® were minor and rare. The most common side effects were headache (2% of patients), unusual taste (2% of patients), and fatigue (1% of patients). In addition, a hypersensitivity reaction was reported in 1 patient (0.2%) with a history of allergic reactions.