BONE SCAN A bone scan is used to look for abnormalities in bones. It can be helpful in diagnosing primary bone tumors, cancers that have spread to bones, or infections in the bone. A small amount of radioactive dye (isotope) is given through an IV line and travels around the body. This isotope is picked up by tumor cells, which allows for the tumor’s location in the body to be seen. Pictures are taken about 2-3 hours after the injection. The test is painless, but some children require sedation to lie still for the scan. The radioactive isotope leaves the body in the urine over 2–3 days. There is very little radiation exposure from a bone scan X RAY An X ray is a simple procedure that uses low levels of radiation to create pictures of the tissues, organs, and bones inside the body. Standard X rays, which might be called plain films, are taken of areas that might be affected by your child’s condition. Children have to be still for a moment to have X rays taken, but X rays don’t cause pain. To minimize exposure to radiation, a special gown or vest will shield parts of your child’s body that aren’t being imaged, and you may be asked to step out of the room or wear similar protection when the X ray is taken. CHEST X RAY Chest X rays have many uses. For instance, they can be used to look for enlarged lymph nodes inside the chest or lungs, to diagnose infections or spread of disease in the lungs, or to check the placement of tubes and that were put in for treatment. ULTRASOUND Ultrasound is a technique that uses the echoes from high-frequency sound waves to produce a picture of internal organs or tumors. It has many uses, including finding tumors in the belly, checking the health of the kidneys and bladder, and measuring the size of some organs (like the liver, gall bladder, and spleen). A type of ultrasound that looks at the way blood flows and the condition of the blood vessels, Doppler, can be used to diagnose clots in blood vessels. An ultrasound is a painless test that does not use radiation. The child lies on a table for a short time, and a clear jelly is smeared on the area being examined. (The jelly wipes off easily after the test.) A small, round handle is moved around on the jelly to get a clear picture of the tissue or organ being examined. Depending on the location of the ultrasound, the child may not be allowed to eat or drink for several hours or may need to have a full bladder before the test. VENOUS ACCESS DEVICE (VAD) A venous access device (VAD), sometimes called a central venous catheter or central line, is a temporary or long-term intravenous (IV) tube that can be used for the duration of your child’s therapy (keep in mind that “therapy” can be used interchangeably with “treatment”). It is placed in a large vein in the chest or the arm. These long, flexible catheters empty into or near the heart, allowing necessary treatments to be given within seconds. They can be used to administer medications, fluids, chemotherapy, blood products, and nutritional support as needed and to draw blood for testing. A surgery is performed to insert the VAD, and your child will be sedated or given general anesthesia for the procedure. It will be placed either before chemotherapy begins or within the first month of treatment. Not all children will need a VAD. This will be determined by you and your child’s healthcare team. The VAD will be removed when it is no longer needed. There are different types of VADs, such as an implanted port inserted under the skin near the collarbone; a tunneled central venous catheter (Broviac® or Hickman®) that has a tube; a lumen (either single or double) which comes out of your child’s chest; or a PICC (peripherally inserted central catheter) line, a central line inserted through a vein in the arm. Your child’s healthcare team will discuss each type with you and help you choose the best device for your child’s treatment.
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