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303 MEDIMAGE > 9. Nuclear Medicine > Flashcards

9. Nuclear Medicine Flashcards

1
Q

what does nuclear med utilize to investigate disorders

A

nuclear properties

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2
Q

what 3 disorders can nuclear med be utilized to investigate

A

metabolism and function
physiology and pathophysiology
anatomy

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3
Q

what is the source and what picks up the radiation

A

patient becomes source and camera picks up rad

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4
Q

does the machine emit rad

A

no

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5
Q

what are radiopharmaceuticals

A

compounds chemically labeled with specific radioactive material - radioisotope

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6
Q

what do radiopharm do in organs

A

concentrate in organ/organ system

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7
Q

what is a benefit of getting physiological info in nuc med

A

Physiological metabolic info so can image disease at earlier stage as the physiological/functional changes begins before anatomic changes

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8
Q

what does nuclear med demonstrate

A

physiologic or anatomic changes at molecular level

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9
Q

what images do nuclear med show

A

anatomic and functional images

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10
Q

what are nuclides

A

have exact nuclear composition

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11
Q

what must nuclides be in terms of existence

A

long existence

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12
Q

what does a stable atom mean in terms of forces

A

forces between particles and nucleus are balanced/equal

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13
Q

what does an unstable atom mean in terms of forces

A

If unstable, forces are unbalanced and has excess energy it gets rid of by emitting particles or/and energy and we use to image in nuc med

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14
Q

what do unstable nuclei emit

A

particles/photons

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15
Q

what is the process of unstable nuclei emitting particles/photons called

A

radioactive disintegration or radioactive decay

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16
Q

what is the most stable arrangement

A

ground state

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17
Q

what is the excited nucleon state

A

nucleons that are so unstable they have transient existence before transforming into another state

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18
Q

how are excited or metastable states denoted as

A

with a superscript m

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19
Q

what do isotopes have in terms of same number

A

same atomic number and same number of protons

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20
Q

what do isotones have in terms of same number

A

same number of neutrons

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21
Q

what do isobars have in terms of same number

A

same mass number

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22
Q

what do isomeres have in terms of same number

A

metastable state

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23
Q

what is the neutron number worked out from

A

mass number - atomic number

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24
Q

what are radionuclides

A

an atom with unstable nucleus characterised with excess energy

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25
Q

what is radioactivity determined by

A

determined by unstable nucleus - number of protons and neutrons

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26
Q

what is radioactive decay

A

when energy is imparted in an attempt to reach stability resulting in emission of gamma rays and/or subatomic particles such as alphas or beta through various decay processes

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27
Q

what happens to atoms after they release radiation

A

radioactive atom transforms into different nuclide via radioactive decay and this continues until nucleus forces are balanced

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28
Q

atoms go from metastable state to ground state by doing what and what can we see

A

atom goes from metastable state to ground state by emitting energy and we can see what energy is coming off

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29
Q

what is radiation

A

energy or particles that are released during radioactive decay

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30
Q

what does the radioactivity of a material refer to

A

rate at which it emits radiation

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31
Q

what is the activity of a specific sample of radioactive material determined by

A

by measuring number of disintegrations per unit time

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32
Q

disintegrations occur when what happens

A

when nucleus emits a particle or energy

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33
Q

radioactivity is measured in what unit

A

becquerels

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34
Q

one becquerel is what in terms of disintegration rates

A

1 disintegration per sec

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35
Q

what is rate of radioactive decay expressed in terms of

A

radioactive half life

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36
Q

what is the half life in nuc med

A

time for radioactivity to divide by half the original activity

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37
Q

does nuc med have an effect on physiological process and why

A

no as only nano and picomolar amounts are given - its only for direction and uptake only

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38
Q

what is the physical half life for nuc med

A

definite half life of radionuclide

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39
Q

what is the biological half life for nuc med

A

defined as time needed for half of the radiopharm to disappear from biological system

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40
Q

what is the effective half life for nuc med

A

defined as time required for an initial administered dose to be reduced by half as a result of both physical and biological elimination of a radionuclide

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41
Q

can we change the physical half life

A

no as its determined by the element itself

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42
Q

can we change the biological half life

A

we can change

eg if its excreted by kidneys can give patient more water to drink so excretes It faster from system so shorter bio half life so can also reduce the dose that the patient is getting - bio half life is also affected by metabolism in body

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43
Q

what is the relative effective half life in relation to physical and bio half life

A

effective will always be shorter than phy and bio half life

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44
Q

what is the equation for Te or effective half life

A

Te = (Tp x Tb)/(Tp +Tb)

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45
Q

the amount of radioactivity in a source is measured by what

A

the rate at which atoms undergo radioactive disintegration

46
Q

what is the traditional unit of radioactivity

A

curie

47
Q

what is a radiopharmaceutical

A

a sterile, pyrogen free radionuclide or radioactively labelled compound administered to a patient for diagnostic or therapeutic purposes

48
Q

do radiopharmaceuticals have pharmacological effect and why

A

It has no pharmacological effect due to the small amount of material administered

49
Q

__ + ____ = radiopharmaceutical

A

radionuclide + pharmaceutical

50
Q

radiopharmaceutical’s radionuclide component has what 4 characteristics

A

radioactive substance

emits gamma, beta or alpha rays by decaying to a stable state

gamma camera detects these gamma rays for imaging

has specific energy physical and biological half life

51
Q

radiopharmaceutical’s pharmaceutical component has what 4 characteristics

A

cold kit

specifically designed to target an organ or biologic process in the body

without the radionuclide attached we cannot image where the pharmaceutical went

has a biological half life

52
Q

what is the relationship between radionuclides and pharmaceuticals in terms of which is needed to be present for imaging to be possible

A

radionuc can be used and imaged without pharm

pharm cannot be imaged without radionuc

53
Q

what is a radiopharm kit

A

mini portable pharmacy which provides chem ingredients and accessories for hospital prep and admin

54
Q

what does the cold kit consist of

A

freeze dried reagents in an atmosphere of nitrogen for reconstitution with a radionuc

55
Q

are cold kits radioactive

A

no

56
Q

kits have analogues of what

A

analogues of what body uses for specific functions

57
Q

what are the 3 constituents of radiopharm kits

A

active ingredient
reducing agent
additives

58
Q

what is the active ingredient of radiopharm kit

A

compound to be labelled with the radionuclide

59
Q

if you dont reduce the radiopharm kit what happens

A

there wont be a labelling reaction

60
Q

what is the most common for nuc med routes of administration

A

IV

61
Q

why is intravenous administration common for nuc med

A

Intravenous is most common as it requires smaller volumes (pharmaceutical smaller doses and radioactive part use range of small to large)

62
Q

why is it important for smaller volumes to be used in administration

A

Want these things to be smallest volumes possible as we are handling radioactivity and getting irradiated ourselves so if you administer smaller volume, less time to administer to patient as less dose to us as MRTs

63
Q

what is a benefit of IV administration for nuc med in terms of absorbtion

A

IV also doesn’t get absorbed by GI tract and go straight to target organs so extracted from blood a lot faster than orally and limits radiation dose to non target organs

64
Q

what is a benefit of IV administration for nuc med in terms of contamination

A

IV a lot faster and controlled, orally may vomit and radiation contamination with everything

65
Q

what is instillation administration used to investigate in nuc med

A

ducts and tracts and glands

66
Q

what is intracavitary administration used to investigate in nuc med

A

administer directly into the tumor or disease were trying to target

67
Q

what is topical administration used to investigate in nuc med

A

skin lesions

68
Q

injection administration in nuc med needs what admin method

A

bolus - small volume

69
Q

what IV administration factors affect the scan

A

injection factors

70
Q

why is slow administration needed for some imaging such as MRPG

A

its a catecholamine/adrenaline analogue as if injected too fast it will cause fight or flight response

71
Q

what should we consider when administering injections into lines

A

Avoid preexist lines as radipharmac will adhere to sides of line

72
Q

gastric emptying rate can be determined by what process

A

administer a radiolabelled meal to the patient followed by sequential imaging

73
Q

what is the application of intrathecal administration

A

CNS

74
Q

what is the application of intra-articular administration

A

therapy for painful joints

75
Q

biochem nature of carrier molecule and radiotracer has effects on what 4 things

A

organ uptake
retention
tranportation
biodistribution

76
Q

localization mechanism is specific to what

A

targeted organs

77
Q

are radiopharm limited to a single mechanism and why

A

no require a combo of more than one mechanism

Localisation not limited to single mechanism, depends on processes in body already like particle trapping, antigen antibody reactions, If body removed damaged cells eg deliberately damage artificial RBC and put in body after tagging to see spleen activity

78
Q

the physicochem properties of the radiopharm influence what factors of ADME in terms of smaller sizes

A

smaller size impacts the elimiation in VQ studies/colloid

79
Q

the physicochem properties of the radiopharm influence what factors of ADME in terms of lipophillicity

A

affects the solubility and therefore the pathway the radiopharm can follow

80
Q

the physicochem properties of the radiopharm influence what factors of ADME in terms of ionization

A

charge of molecule plays a role in thyroid and renal imaging

81
Q

what are the 4 main ways that radiopharm are excreted

A

exhalation, renal, GIT (incl hepatoniliary) and GUS

82
Q

the distribution fo the radiopahrm depends on what 4 factors

A

perfusion to the organ or tissues

mechanism of uptake

underlying physiological principles

excretion

83
Q

the characteristics of the radiopharm determine the ADME based on what 2 factors

A

human physiology and function

84
Q

what is the ideal radiopharm characteristics in terms of type of emission, explain

A

Type of emission want is decay to gamma rays emitted for imaging but want radionuclides that emit B particles for treatment

85
Q

what is the ideal radiopharm characteristics in terms of photon energy, explain

A

Energy value between 100-250keV, if energy too high gamma pass straight through collimator and cause scatter but if too low acquisition time is too long, must be emitting correct range of energy

86
Q

what is the ideal radiopharm characteristics in terms of poly/monochromatic photon energy, explain

A

Want monochromatic so majority of photons are same energy and should be lot of these photons per unit area per unit

87
Q

what is the ideal radiopharm characteristics in terms of proton abundance, explain

A

High proton abundance = high proton flux so can image patient in reasonable timeframe and decent image quality

88
Q

what is the ideal radiopharm characteristics in terms of radioavailibility, explain

A

Radioavailibility = obtain easily in house through radionuclide generator

89
Q

what is the ideal radiopharm characteristics in terms of cost, explain

A

Inexpensive is relative as one unit dose of MPG is 200-400$

90
Q

what is the ideal radiopharm characteristics in terms of half life, explain

A

Controlled half-life, Tc has half-life of around 6hrs so it means theres enough time to image patient but not that long that they get too much radiation dose

91
Q

what is the ideal radiopharm characteristics in terms of effective half life, explain

A

Ideally the effective half life should be 1 and a 1/2 times the duration of the test (eg if bone scan is 3hrs, want effective half life to be around 6hrs)

92
Q

what is the ideal radiopharm characteristics in terms of high target:non target ratio, explain

A

Want target organ to take up most of radiopharmeutical and to miss the non target organs

93
Q

what is the ideal radiopharm characteristics in terms of safety, explain

A

Safety, radiopharm have to be non pyrogenic and not deliver too much rad dose to patient

94
Q

what is the ideal radiopharm characteristics in terms of preparation, explain

A

Preparation of radiopharm is done ourselves and should not take too long to prepare as still need to administer to patient without running out of radioactivity

95
Q

what is the ideal radiopharm characteristics in terms of what gamma and beta radiation can be used for

A

Radioisotope were using should be pure gamma emitter for imaging and Betas for therapy and should be nontoxic to patients

96
Q

what is the mineral form of bone

A

hydroxyapatite crystal

97
Q

what does bone scintigraphy utilize

A

physiology of bone formation and remodelling

98
Q

radiopharm is chemisorpted into what

A

chemisorption of the radiopharm to the hydroxyapatite crystalline structure

99
Q

what happens when bone is damaged

A

Bone gets laid down with osteoclasts/blasts remodelling the bone

Increased blood flow to that area

100
Q

increased blood flow in response to damaged bone is significant for what in terms of radiopharm

A

Increased perfusion/blood flow to that area so administer radiopharm in those areas, will have more radiopharm deposited at the injured sites so wont look the same

Bone remodelling and increased perfusion is what delivers radiopharm there

101
Q

how to tell where areas of abnormality are on bone scans

A

hot spots

102
Q

thyroid require what to produce thyroid hormones

A

iodine

103
Q

iodine is administered how in thyroid investigation

A

Administer iodine orally not IV and body interprets this as normal iodine to make hormones so iodine is trapped in thyroid and can see if thyroid is under or over active

104
Q

what is thyroid scintigraphy uptake based on

A

physiology of thyroid hormone production

105
Q

what are 2 examples of thyroid indications

A

diagnose hypo/hyperthyroidism

image nodules

106
Q

can 131I-sodium iodide be used for imaging and treatment

A

yes as it emits gamma and beta

107
Q

can 99mTc pertechanetate be used for treatment

A

no only emits gamma and not beta so good for imaging, not treatment

108
Q

what is used to do brain imaging

A

uses BBB as advantage and lipophilic agent to image the perfusion of the brain

109
Q

how is the brain imaged in nuc med

A

Administer lipophilic pharamaceutical with rapid first pass uptake

once in brain, its metabolised into its hydrophilic form and cannot diffuse out of BBB and can use to image

110
Q

what are adverse reactions defined as

A

unanticipated response to the non radioactive component of a radiopharm

111
Q

are nuclear med adverse reactions caused by radiation

A

no, over use of radioactivity not adverse reaction but is a reportable events

reactions are caused by pharmaceutical parts

303 MEDIMAGE (14 decks)

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