Start planar imaging three hours post-injection. Imaging should begin immediately after the patient empties his/her bladder if catheterization is not indicated.

Equipment setup
Use a large field of view (LFOV) gamma camera equipped with a low-energy, high-resolution collimator. The energy setting should have a 20% window width centered at the 140 keV ^99mTc peak.

Planar image acquisition
Perform a posterior and anterior whole body mode scan using a scan speed of 8 to 10 cm/min. Alternatively, obtain anterior and posterior spot views of the chest, abdomen and pelvis. Image acquisition should be set at 10 minutes per view, with a 256 x 256 matrix in analog or digital word mode. If needed, delayed images of the extra-hepatic abdomen should be acquired for a preset time of 15 minutes at 18 to 24 hrs post-injection.

Bladder catheterization should be strongly considered in men with benign prostatic hypertrophy (BPH) or any patient who cannot empty the bladder. If a Foley catheter is not medically indicated, in many cases a small diameter catheter, such as a pediatric feeding tube, can be used to improve bladder drainage during the imaging procedure.

If a patient can’t be catheterized, allow the patient sufficient time to empty the bladder thoroughly before acquiring the planar study. After the planar scan, allow the patient to get off the table and void again. Then immediately acquire the pelvic SPECT while the bladder is nearly empty.