Barts and The London Endocrinology Centre
Endocrine orders are rare, so we may run a series of tests to pin point exactly where the disorder lies. You may receive one or more of the following tests:
Blood and urine tests
Samples of blood and urine are taken to look for levels of certain hormones. Samples of urine may be collected over a 24-hour period and sometimes it is necessary to not eat before having certain blood tests.
Biopsy
A small sample of cells can be taken and these will be examined under a microscope. A local anaesthetic may be given.
CT (computerised tomography) scan
CT scans are a series of x-rays which build a three-dimensional picture of the inside of the body. Sometimes a CT scan of the patient's entire body may be needed to support the diagnosis and treatment of specific illnesses.
The purpose of this scan is to take pictures of the parathyroid gland. A small needle is placed into a vein on the arm or hand and through this a slightly radioactive tracer is injected which passes into the thyroid.
Step 1: After 20 minutes a gamma camera is placed over the neck and picture is taken for approximately 10 minutes.
Step 2: A second injection is given and more pictures are taken for 20 minutes
Step 3: Approximately three hours after the second injection a third and a final picture is taken for a duration of 30 minutes as the camera moves around the neck.
This scan will take a picture of the thyroid gland and patients will receive an injection containing a small amount of radioactivity. A scan will be carried out 20 minutes after the injection and this involves lying down on a couch with the head, neck and shoulders propped up onto a pillow allowing the neck to be extended. Two pictures are taken; the first is called a marker picture to establish the position of the thyroid and will take 10 seconds. The second picture is of the thyroid and will last 10 minutes.
This scan is to find which areas of the body take up iodine and help doctors assess previous therapy and decide further appropriate treatment. On arrival, patients will have a blood test and then receive an injection containing a small amount of radioactive iodine into a vein in the arm. A scan is carried out and this involves lying down on a couch with the head, neck and shoulders propped up onto a pillow allowing the neck to be extended. The scan takes 30 minutes and will be repeated the following day and this second scan will take between 1 to 2 hours.
This test is done under a local anaesthetic and involves passing a fine tube into a vein that drains blood from the endocrine gland being investigated, this is all performed under x-ray control by a an experienced radiologist. At our hospitals, we regularly perform venous sampling from the pituitary gland (for the diagnosis of cushings disease), the adrenal gland (for the diagnosis of adreno medullary disorders) and from the neck for selected patients with high calcium levels in whom we are trying to locate the source of excess parathyroid hormone. We are one of the few centres in the country which has particular expertise in this type of test.