Notice of PET/CT Scan for Foreigners

　Since September 2024, our hospital has been offering full-body cancer screenings using PET/CT with FDG for foreigners. Both Long-term residents and short-term visitors in Japan are eligible for the screening. For inquiries regarding this service, please contact the Division of International Medical Service Promotion.

　　Division of International Medical Service Promotion
　　　E-mail: hok-impact@nms.ac.jp
　　　TEL: 0476-99-1111 (Main Number)
　　　FAX:0476-99-1922

　　Consultation Hours
　　　Mondays to Fridays     8:30 am to 4:00 pm
　　　Saturdays                        8:30 am to 3:00 pm.
　　　Closed days of regular service:
　　　　Sundays, National holidays,
　　　　From December 30th to January 4th,
　　　　Foundation Day (April 15th) or its rescheduled date

What is a PET/CT (FDG) Scan?

　A PET/CT scan is a type of imaging test that can detect cancers and other diseases. Since cancer cells absorb much more glucose than normal cells, a glucose-like tracer (FDG) is injected into the body to detect the entire body for the presence of cancers.

PET/CT Examination and Its Advantages

Advantages and Disadvantages

✔　Early detection is possible.
✔　It allows for a comprehensive examination of the entire body in a single test, detecting many types of cancer.
✔　Depending on the type of cancer, it can provide a more accurate diagnosis compared to regular X-rays, CT scans, or MRI scans.
✔　It is safe and imposes minimal physical burden on the examinee.

However, depending on the type, location, and size of the lesions, it can be very difficult to make an accurate assessment. FDG can accumulate in inflamed areas or normal organs, so the accuracy is not always 100%. In patients with severe diabetes, the images often become unclear, and if the blood glucose level is 200 mg/dL or higher on the day of the examination, it may need to be postponed.

Cancers that are Easily Detected

　Cancers of the head and neck, thyroid, lung, breast, esophagus, colon, pancreas, uterus, and ovaries. Malignant lymphoma, malignant melanoma, and bone tumors.

Cancers that are Difficult to Detect

　Cancers of the stomach, liver, and bile ducts where FDG accumulation is low, as well as cancers of the brain, heart, kidneys, ureters, bladder, and prostate where FDG accumulation is high even under normal conditions.

PET/CT Scans are Recommended for:

✔　Those who want early detection of cancer
✔　Those with a family history of cancer

Not Suitable for:

✔　Individuals with extreme claustrophobia
✔　Those who have difficulty walking independently
✔　Those who have trouble using the toilet by themselves
✔　Individuals with cognitive impairment
✔　Those who have had an epileptic seizure within the past year
✔　Pregnant women or those who might be pregnant
✔　Breastfeeding women

PET/CT (FDG) Cancer Scan Course and Fee

Our hospital offers the following PET/CT (FDG) cancer scan course below:

※1 The test results report is in Japanese.

※2 The test results will be mailed to an address within Japan. Please provide the address at the time of application. If you prefer, we can also provide the test results in person at our hospital. Please let us know in advance.

※3 If you would like a doctor to explain the results, please contact us. Additional outpatient fees apply.

※4 However, if you cancel the examination on the day for personal reasons, the full examination fee 200,000 will be charged.

※5 If you have difficulty reading or writing Japanese, please bring someone who can speak Japanese with you. If you cannot find an accompanying person, the hospital can arrange an interpreter (for a fee). Since the number of interpreters is limited, please be sure to consult with us in advance.

Application for PET/CT (FDG) Screening

Applicant Side: Apply by email

　Please download the “PET/CT（FDG）Cancer Screening Application Form” from the link below, fill in the required information, and send the completed form along with the necessary documents to the following email address:

　　✔　PET/CT（FDG） Cancer Screening Application Form (Excel：259KB)
　　✔　Identification Document (Copy of Passport)
　　　　E-mail address. hok-impact@nms.ac.jp
　　　　The subject line: "Application for PET/CT (FDG) cancer Screening"

Hospital Side: Evaluation of Screening Suitability

　Based on the information provided, we will determine whether the examination can be accepted. If it can be accepted, we will send the necessary documents listed below by email.

　　✔　Informed Consent Form for PET/CT(FDG) Testing (PDF：556KB)
　　✔　Informed Consent Form for PET/CT Testing (For Attended) (PDF：597KB)

Hospital Side: Sending of Information and Appointment Form

　After confirmation of your appointment, we will send you a PET-CT (FDG) exam instruction sheet. The instruction sheet contains details such as your exam reservation slip and the schedule for exam day. Please be sure to read it in advance.

Applicant Side: On the day of the examination.

　On the day of the examination, please check the fasting time and check-in time on your reservation slip before arriving at our hospital.

About Cancellation

How to Notify of a cancellation

　If you need to cancel your appointment, please contact us by 3:00 pm on the day before your examination (or two days before if the day before is a Sunday or a holiday) at the number below:

　　Contact Number: 　Nippon Medical School　Chiba Hokusoh Hospital
　　　TEL: 0476-99-1111 (Main Number)
　　　Japanese ⇒ PET/CT Examination Room
　　　Japanese,English,Chinese ⇒ Division of International Medical Service Promotion

Cancellation Fees

・By 3:00 pm on the day before your examination (or two days before if your examination falls on a Sunday or a holiday)
　　　: Free
・After 3:00 pm on the day before your examination (or two days before if your examination falls on a Sunday or a holiday)
　　　: ¥49,720 (including tax, for FDG drug costs)

　If you do not show up on the day of your examination without prior notice, the same cancellation fee will be charged. If we are unable to confirm payment from you, we will charge the guarantor listed on your application form. Thank you for your understanding.

Issues Related to Equipment Malfunctions or Drug Transport Problems

　FDG drugs are transported on the day of the examination. We manage to ensure the thorough inspection of the examination equipment and the FDG transport system, but in the event of an unexpected equipment malfunction or accident during transport, the examination may be significantly delayed or cannot be performed. In such cases, we will discuss rescheduling the examination.

PET/CT (FDG) Screening Procedure

Reception

　On the day of the examination, upon arrival, please go to the Information Desk at your scheduled time. The coordinator will guide you to the Radiology Center reception.

Consultation

　Before the examination, we will conduct a medical interview, measure your blood glucose level, and provide necessary explanations.

Changing Clothes

　You will need to change clothes in the examination room. Please wear comfortable clothing that is easy to change out of. Any adhesive medication patches or heat pads should be removed when changing clothes. You will also need to remove belts, watches, jewelry, and dentures before the scan. Please avoid wearing accessories when you come to the hospital.

FDG Tracer Injection

　In the examination room, FDG tracer will be injected into a vein in your arm.

Resting

　After the injection, you will need to rest in a designated waiting area for about 60 minutes while the tracer spreads throughout your body. During this time, you cannot use your mobile phone or read books. If you are unable to remain still, the examination may not be possible.

Both the examination room and the waiting area are designed
with a calming mint green theme.

Scanning

　The imaging will be done using a PET/CT scanner, which combines a PET camera and a CT scanner. The scanning time is approximately 30 minutes.

PET/CT(Discovery IQ)

Resting

　After the scan, you will need to wait in a designated area for about 30 minutes until the radiation from the FDG in your body decreases.

Payment

　After all the examinations are completed, the coordinator will guide you to the Accounts desk for your payment.

Q&A

About Examinations

Q : What is a PET scan?
A :
In a PET scan, a radioactive drug called a positron emitter is injected into the body and a PET scanner is used to take pictures of the radiation emitted from inside the body. Unlike CT or MRI scans, which show structural changes such as organ shapes, PET scans show functional changes such as organ metabolism (cell activity).

Q : Does a PET scan eliminate the need for other tests?
A :
A PET scan does not detect all types of cancer. Some cancers can be difficult to detect. Depending on the disease, it may be used in combination with blood tests, endoscopy, or ultrasound to make a more accurate diagnosis.

Q : Can all types of cancers be detected with a PET scan?
A :
The effectiveness of PET scans varies depending on the type of cancer. The more difficult detecting very small cancers (less than 1 cm) becomes, the smaller they are. In addition, PET scans can detect benign conditions, such as inflammation, because the tracer can also be taken up by non-cancerous lesions. Not all abnormalities detected are malignant, and it can be difficult to distinguish between benign and malignant findings. A biopsy is often required to make a definitive cancer diagnosis.

Q : Is the examination painful?
A :
There may be some pain when the FDG is injected, but the examination itself is not painful. Sometimes, due to nervousness during the injection, a vasovagal reaction (such as a drop in blood pressure) can occur.

Q : How long does the PET scan take?
A :
After an explanation of the procedure and a brief interview, you will change into a gown and receive the tracer injection. After the injection, you will rest for about an hour before the scan, which takes about 25 minutes. After the scan, there is a waiting period of about 30 minutes. If necessary, a second scan may be performed, which takes about 10 minutes. The entire process, from check-in to completion, takes about three hours.

Q : Can I move my body during the examination?
A :
You cannot move your body during the examination.

Q : I have claustrophobia. Can I stop the examination halfway through?
A :
If you have severe claustrophobia, you may not be able to undergo the examination. Please inform us in advance. The examination involves entering a tunnel-like device with a diameter of about 70 cm for approximately 30 minutes.

Q : I'm concerned about radiation exposure.
A :
The amount of radiation exposure from a PET/CT scan is approximately equivalent to 1-4 times that of a barium swallow test, which is a low dose and not at a level that should cause concern. The FDG will go out of your body in several hours, so avoid close contact with infants, pregnant women, and breastfeeding women for several hours after the examination.

For More Information (Radiation Dose)
　The radiation exposure from the FDG tracer used in PET scans is considered to be less than that from a stomach X-ray examination, at approximately 3.5 mSv. This is about one-fifth to one-tenth of the radiation exposure from a full-body CT scan. While PET/CT scans include radiation exposure from the CT component, there is no risk of radiation damage to the body.
　For reference: Stomach barium X-ray: 4 mSv, Chest CT scan: 6 mSv, PET/CT: 10 mSv (according to data from Saku Central Hospital).
　The administered tracer is very short-lived and is excreted through the urine, so it is mostly eliminated from the body within one day.

Q : How can I obtain more accurate test results?
A :
Excess tracer is excreted in the urine. Drinking plenty of sugar-free beverages, such as tea or water, before the test can help produce clearer images and reduce radiation exposure. For examinees with diabetes, it may be difficult to obtain clear images necessary for diagnosis if fasting blood glucose exceeds 200.

For Women

Q : Menstruation
A :
For women with menstrual periods, the timing of the test may affect the clarity of certain areas. Please contact us for further details.

Q : Breastfeeding
A :
Try to avoid breastfeeding immediately after the test. **Breastfeeding is prohibited for 12 hours after the tracer injection.** Consider expressing and storing milk before the test.

Q : Pregnancy
A :
As with other radiological tests, we do not recommend PET scans during pregnancy due
to the potential for radiation exposure to the fetus.

Before Examination

Q : Are there any precautions I should take from the day before the examination?
A :
From the day before the examination until the examination is completed, avoid strenuous exercise and physical labor, and similar activities. Excessive exercise may cause accumulation in the muscles.

Q : Can I eat and drink on the day of the examination?
A :
Please finish your meal at least 6 hours before your appointment time. Eating within 6 hours of your appointment time will generate inaccurate results, and the examination cannot be performed. This includes candy, gum, fruit, soup, and juice. There are no restrictions on sugar-free tea or water.

Q : Can I take my usual medication?
A :
If you have diabetes, stop taking your diabetes medication and insulin 6 hours before your appointment time. Other medications prescribed by your physician can be taken as usual.

After Examination

Q : Are there any precautions after the test?
A :
After a PET scan, to minimize radiation exposure to others, please avoid crowded places as much as possible. Also, try to limit contact with infants and pregnant women as much as possible.

Other Information

Q : Do other tests interfere with the PET Scan?
A :
Vaccinations
　Vaccinations can accumulate in the lymph nodes and affect the images. Please schedule your PET scan beyond at least two weeks after receiving a vaccination.
Barium Tests
　Barium can interfere with CT images. Please schedule your PET scan beyond at least one week after a barium test.
Nuclear Medicine Tests
　Consider the effects of residual radiation in your body. It is recommended that you have the PET scan first and then schedule the nuclear medicine test on a different day.
Bone Density Tests
　Consider the effects of residual radiation in your body. It is recommended that you have the bone density test first
Contrast-enhanced CT Scans
　Residual contrast material may cause higher readings. Please schedule your PET scan the day before or after your contrast-enhanced CT scan.
Endoscopy
　Inflammation at the test site may cause FDG uptake. If you have an endoscopy on the same day, we will provide a reading report that takes this into account
Bronchoscopy
　Please schedule your PET scan beyond at least one week after a bronchoscopy.
Biopsy
　Please schedule your PET scan beyond at least one week after a biopsy.

Q : I don't speak Japanese. Can I still have the test?
A :
If you do not speak or read Japanese, please have someone who does accompany you.

If you are eligible for the following, please read the relevant sections carefully.

Diabetic Patients:
➤ If your blood glucose level is 200 mg/dL or over before the test, the test may not be conducted.
➤  Please remove your insulin pump and continuous glucose monitor before the test, and bring new ones with you. Confirm with your diabetes specialist whether it is safe to remove these devices for approximately one hour.

Home Oxygen Therapy:
➤ Please use your own oxygen cylinder. Ensure you bring enough oxygen to last until you return home.

Implanted Medical Devices:
➤ If you have a pacemaker or ICD, please make sure to inform us in advance.
➤ Please bring your pacemaker and ICD (Implantable Cardioverter Defibrillator) identification certificate.

Contact Details

　　Division of International Medical Service Promotion
　　　Nippon Medical School Chiba Hokusoh Hospital
　　　1715 Kamagari, Inzai, Chiba, 270-1694
　　　E-mail: hok-impact@nms.ac.jp
　　　TEL: 0476-99-1111 (Main Number)
　　　FAX:0476-99-1922

　　Consultation Hours
　　　Mondays to Fridays     8:30 a.m. to 4:00 p.m.
　　　Saturdays       　　　    8:30 a.m. to 3:00 p.m.
　　　Closed days of regular service:
　　　　Sundays, National holidays,
　　　　From December 30th to January 4th,
　　　　Foundation Day (April 15th) or its rescheduled date