Cardiac Nuclear Medicine Sample Clauses

Cardiac Nuclear Medicine. The term emission tomography encompasses the two major imaging modalities used in nuclear medicine: single photon emission computed tomography (SPECT) and positron emission tomography (PET). Both SPECT and PET are used to detect radioisotopes which have been injected into a subject. SPECT is used to detect radioisotopes which emit a single gamma ray photon upon decay. A collimator filters gamma rays travelling in a specific direction which are then detected by a gamma camera. The paths of the emitted gamma rays can then be used to determine the site of radioisotope decay for image reconstruction. PET detects radioisotopes which upon decay emit positrons. The emitted positrons collide with surrounding electrons and annihilation occurs, resulting in the emission of two photons which travel in opposite directions. PET utilises an array of gamma cameras surrounding the subject to detect the gamma rays as they are emitted. Because the system detects two positrons at 180 degrees to each other (using coincidence circuitry to select those that arose from the same annihilation), the paths of the gamma rays can be used to determine the site of radioisotope decay without the use of collimators98. Numerous radiotracers have been developed for the detection of ischaemic or hypoxic tissue using SPECT or PET. Perfusion radiotracers are commonly used to image myocardial blood flow and characterise tissue at risk of ischaemia. The PET tracer 13NH3 is extracted from the blood by well perfused tissue and is converted to glutamine to become trapped within cardiac myocytes99,100. The SPECT tracer 99mTc-sestamibi is also extracted by well perfused myocardium and accumulates in the mitochondria of viable myocytes. The depolarisation of the mitochondrial membrane, which occurs with ischaemia induced injury, results in the decreased uptake of 99mTc-sestamibi100. Although imaging myocardial perfusion provides an indication of tissue at risk of ischaemia and hypoxia, these tracers rely on energy dependent processes to become trapped. These tracers therefore do not image perfusion alone and may underestimate perfusion in hypoxic regions of the myocardium where flow is normal, but energy is depleted5. The PET tracer 18F-Fluorodeoxyglucose (18FDG) is a glucose analogue used to assess tissue glucose metabolism. 18FDG is transported into cells by glucose transporters where it is phosphorylated to 18FDG-phosphate by hexokinase to become trapped in the myocardium101. While a small proporti...
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  • Radiation Therapy/Chemotherapy Services This plan covers chemotherapy and radiation services. Respiratory Therapy This plan covers respiratory therapy services. When respiratory services are provided in your home, as part of a home care program, durable medical equipment, supplies, and oxygen are covered as a durable medical equipment service.

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In most cases, this plan only pays for a rental DME up to our allowance for a purchased DME. Repairs and supplies for rental DME are included in the rental allowance. Preauthorization may be required for certain DME and replacement or repairs of DME. Medical Supplies Medical supplies are consumable supplies that are disposable and not intended for re- use. Medical supplies require an order by a physician and must be essential for the care or treatment of an illness, injury, or congenital defect. Covered medical supplies include: • essential accessories such as hoses, tubes and mouthpieces for use with medically necessary DME (these accessories are included as part of the rental allowance for rented DME); • catheters, colostomy and ileostomy supplies, irrigation trays and surgical dressings; and • respiratory therapy equipment. Diabetic Equipment and Supplies This plan covers diabetic equipment and supplies for the treatment of diabetes in accordance with R.I. General Law §27-20-30. Covered diabetic equipment and supplies include: • therapeutic or molded shoes and inserts for custom-molded shoes for the prevention of amputation; • blood glucose monitors including those with special features for the legally blind, external insulin infusion pumps and accessories, insulin infusion devices and injection aids; and • lancets and test strips for glucose monitors including those with special features for the legally blind, and infusion sets for external insulin pumps. The amount you pay differs based on whether the equipment and supplies are bought from a durable medical equipment provider or from a pharmacy. See the Summary of Pharmacy Benefits and the Summary of Medical Benefits for details. Coverage for some diabetic equipment and supplies may only be available from either a DME provider or from a pharmacy. Visit our website to determine if this is applicable or call our Customer Service Department. Prosthetic Devices Prosthetic devices replace or substitute all or part of an internal body part, including contiguous tissue, or replace all or part of the function of a permanently inoperative or malfunctioning body part and alleviate functional loss or impairment due to an illness, injury or congenital defect. Prosthetic devices do not include dental prosthetics. This plan covers the following prosthetic devices as required under R.I. General Law § 27-20-52: • prosthetic appliances such as artificial limbs, breasts, larynxes and eyes; • replacement or adjustment of prosthetic appliances if there is a change in your medical condition or if the device is not functional, no longer under warranty and cannot be repaired; • devices, accessories, batteries and supplies necessary for prosthetic devices; • orthopedic braces except corrective shoes and orthotic devices used in connection with footwear; and • breast prosthesis following a mastectomy, in accordance with the Women’s Health and Cancer Rights Act of 1998 and R.I. General Law 27-20-29. The prosthetic device must be ordered or provided by a physician, or by a provider under the direction of a physician. When you are prescribed a prosthetic device as an inpatient and it is billed by a provider other than the hospital where you are an inpatient, the outpatient benefit limit will apply. Enteral Formulas or Food (Enteral Nutrition) Enteral formula or food is nutrition that is absorbed through the intestinal tract, whether delivered through a feeding tube or taken orally. Enteral nutrition is covered when it is the sole source of nutrition and prescribed by the physician for home use. In accordance with R.I. General Law §27-20-56, this plan covers enteral formula taken orally for the treatment of: • malabsorption caused by Crohn’s Disease; • ulcerative colitis; • gastroesophageal reflux; • chronic intestinal pseudo obstruction; and • inherited diseases of amino acids and organic acids. Food products modified to be low protein are covered for the treatment of inherited diseases of amino acids and organic acids. Preauthorization may be required. The amount that you pay may differ depending on whether the nutrition is delivered through a feeding tube or taken orally. When enteral formula is delivered through a feeding tube, associated supplies are also covered. 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