PET: positron emission tomography.

CT: computed tomography, a computer-based imaging method.

CT produces cross-sectional images that provide anatomical and structural information about the body. It involves exposure to ionising radiation.

PET/CT combines the high sensitivity of PET to functional changes with the excellent anatomical resolution of CT.

Cells take up the radiopharmaceutical according to their metabolic activity: the more active the metabolism, the greater the uptake. Most malignant tumours grow rapidly and therefore have increased metabolic activity, taking up more of the selected radiopharmaceutical than surrounding healthy tissue. Metabolic changes in malignant tumours typically precede anatomical changes.

PET/CT can often detect malignant abnormalities earlier than conventional ultrasound, CT or MRI examinations. It can reveal characteristics relevant to treatment that other examination methods cannot detect. Small tumours that do not yet cause symptoms can also be identified, potentially enabling faster and more effective care.

The literature has not reported allergic reactions to the radiopharmaceuticals used for PET examinations. A painless PET/CT examination involves a radiation dose of approximately 4–10 mSv.

PET/CT provides diagnostic information about primary tumours, regional lymph node metastases and distant metastases. It can help select optimal treatment, assess the extent of disease, plan radiotherapy, evaluate the effectiveness of cancer treatment, characterise residual abnormalities after treatment and monitor disease. It can also help identify the best site for a tissue biopsy and assist surgical planning.

• Do not eat during the 6 hours before the examination. Drink plenty of fluids containing neither sugar nor sweeteners, such as still mineral water.
• You may take your medication as usual. During your consultation with our staff, make sure you clarify which medicines you take.
• Avoid physical activity, active sports and heavy physical work during the 48 hours before the examination.
• Bring your most recent discharge summaries and outpatient records, including records of surgery, histology and treatment, as well as reports and CD/DVD images from previous radiological and nuclear medicine examinations.

If you have diabetes:

• If you have diabetes, please make sure you tell our staff when booking.
• It is important to keep your blood glucose between 4 and 11 mmol/l. High blood glucose alters the distribution of the radioactive glucose analogue used for the examination and may lead to misleading results.
• If your diabetes is treated with tablets, you may take your medication as usual.
• If your diabetes is treated with insulin, you may administer your insulin and eat as usual. The radioactive tracer used for PET can be administered 4 hours after the insulin injection. Please bring your insulin and some food to eat after the examination.

On the day of the examination:

• We recommend wearing layers.
• Metal objects on clothing may cause artefacts in the images. Please avoid clothing with metal parts such as zips, buckles, sequins, clasps or metal buttons.
• Do NOT bring jewellery or valuables. Remove piercings and body jewellery.
• If your removable dentures contain metal, they must be removed for the examination. Please do NOT secure them with adhesive.
• If you are breastfeeding, express enough milk for one day before the examination. Breastfeeding must be interrupted for 24 hours after the examination, and milk expressed during that period must be discarded.
• If you have a stoma, empty the stoma bag immediately before the examination if it is full. Please bring a spare bag in case it needs replacing.
• If you have urinary problems and use a catheter, urine bag, nappy or pad, please empty or replace it with a clean one immediately before the examination and bring spare supplies.

To protect people under 18 and pregnant women, avoid close proximity or physical contact with them, including breastfeeding, hugging and sleeping together, for 24 hours after the examination.

On arrival, please report to reception to confirm your personal and billing details, register, and complete and sign the consent form for a privately funded PET/CT examination. Please arrive at the agreed time; otherwise, we may be unable to perform your examination.

Please make sure you bring the following documents:

• Identity card.
• Address card.
• Hungarian social security (TAJ) card.
• Previous medical reports, in printed or electronic form.
• Images and reports from previous imaging examinations, on CD/DVD.

Your condition and suitability for the examination are assessed in a designated area. A qualified staff member reviews and copies your documents, records your medical history using the assessment questionnaire, measures your weight and height, and checks for any contraindications. They then explain the remaining stages of the examination. Your blood glucose is always checked before the radiopharmaceutical is administered. If it exceeds 11 mmol/l, your examination may need to be rescheduled.

After the assessment, the radiopharmaceutical required for PET is injected.

Please ask any questions before the radiopharmaceutical is administered. Afterwards, staff minimise close contact with you for their own radiation protection, while continuing to provide any assistance you need.

After the injection, you must rest quietly for 10–120 minutes while the radiopharmaceutical distributes throughout your body. You must not undertake physical or mental activities during this period, including talking, reading or walking.

You may use the designated toilet at any time during the waiting period. Once the waiting period is over, a qualified staff member will ask you to use a separately designated toilet and empty your bladder, replace your pad and empty your stoma bag if it is full. This is necessary because the radiopharmaceutical passes through the kidneys into the bladder, and a full bladder can limit accurate assessment of the pelvic region.

Take particular care not to contaminate yourself or your surroundings with urine. This is important both for radiation protection and for the diagnostic quality of the images.

During the scan, which takes approximately 10–15 minutes, you must lie still on the examination bed as it moves horizontally through the scanner. Depending on the examination, your arms must be kept straight beside your body or held together above your head. Even small movements can reduce image quality and require part or all of the scan to be repeated. Microphones and speakers in the examination room and scanner allow you to communicate with our staff.

• The PET/CT examination itself is completely painless.
• The radiopharmaceutical used has no pharmacological effect on the body, and the procedure presents no risk of an allergic reaction.
• At the activity normally administered, radiation exposure is similar to that of a contrast-enhanced diagnostic CT examination of the same body regions.
• The oral CT contrast agent diluted with water, used to improve visualisation of the bowel, can very rarely cause loose stools or diarrhoea. Please drink it slowly in small amounts.

For 24 hours after the examination, avoid close physical contact with pregnant people or children and avoid attending public events or venues such as cinemas and theatres.

Take particular care to protect young children and pregnant women. If being in the same place is unavoidable, keep as much distance as possible and stay for as short a time as possible.

If you are breastfeeding, discard any milk expressed during the 24 hours after the examination.

Drink plenty of fluids, at least 2–3 litres, and empty your bladder frequently.

When using the toilet, take care not to contaminate yourself or your surroundings with urine.

The radiopharmaceutical used for the examination fully decays and/or is eliminated from the patient’s body within 24 hours.

To speed up administration, our institute accepts electronic, cashless payment only: by bank card or bank transfer.

• Bank card: you can pay on site immediately before the examination.
• Bank transfer: the “Transfer details” card given to you before the examination contains the information needed to make payment.

Bank transfer details:

Account holder:

Medicopus Nonprofit Kft.

Account number:

10403909-50526587-53811008

Payment reference:

Patient’s name.

Email address:

medicopus.diagnosztika@sic.medicopus.hu

Images and written report:

• Images: we provide your images in digital format immediately after the examination.
• Written medical opinion (report): the images are analysed by a nuclear medicine specialist. The written assessment is generally not available immediately. It is usually sent by email and post within 2 working days and automatically uploaded to the EESZT system.

You may also collect the report in person. Please make sure you tell our staff during your examination if you would like to do so.

On request, a relative or legal representative may collect the results in person with written authorisation.

An unsuccessful examination incurs a fee of HUF 20,000 for administration, reserved scanner time and availability.

What counts as an unsuccessful examination?

• The patient cannot tolerate the examination because of claustrophobia or panic.
• Body size prevents the patient from fitting safely into the scanner’s 78 cm internal bore, or their weight exceeds the scanner’s load limit.
• Interrupted examination: the examination cannot be completed because of illness, pain, panic or another reason. In such cases, the images obtained up to that point are generally insufficient for diagnostic evaluation.

When is the fee waived?

In certain exceptional circumstances, our institute may waive the examination fee entirely on compassionate or professional grounds. No fee is charged in the following situations:

• if an unexpected technical fault prevents the examination;
• if an unexpected serious condition requiring immediate emergency care arises during the examination and the patient must be taken to hospital;
• if the reporting nuclear medicine specialist decides that additional or repeat images are required to clarify the diagnosis.

When must the examination fee be paid?

We cannot waive the examination fee in the following cases:

• if a serious abnormality that does not require immediate emergency intervention is discovered during the examination; in this case, we recommend an urgent specialist consultation;
• if the examination must be stopped because of panic or illness, but sufficient images suitable for diagnostic evaluation have already been obtained;
• if the examination yields results of limited diagnostic value, meaning that the images do not provide complete or sufficiently detailed diagnostic information. In such cases, the diagnostic value and level of detail may be lower than expected, and image quality may also be reduced.

Our staff provide immediate assistance if you become unwell and call an ambulance if necessary. If a diagnostically usable examination has been performed, the applicable fee must still be charged in these circumstances.