Infection/inflammation GW

Question 1

RP for chronic cases

Answer 1

Ga67

Question 2

RP for acute cases

Answer 2

Tc99m exametazime HMPAO WBCs

In111 WBCs

Question 3

Indications for Ga67 imaging

Answer 3

Source of FUO
Osteomyelitis
Lung infection
Inflammatory processes (sarcoidosis)

Question 4

Ga67 dose

Answer 4

4-6 mCi
-depending on pathology
-up to 9 mCi for large patients

Question 5

Injection to imaging time for Ga67

Answer 5

4-72 hours

Question 6

When is bowel activity at minimum with Ga67

Answer 6

Earlier imaging

Question 7

How many photon energies does Ga67 have

Answer 7

4

93, 184, 296, 388
93 is most abundant

Question 8

What to remember about imaging time with Ga67

Answer 8

If camera can do multiple photo peaks, this will decrease imaging time
-this is actually the same case with In111 because it has 2 photopeaks

Question 9

Most prominent organ on Ga67 imaging

Answer 9

Liver

Question 10

When are kidneys seen on Ga67 imaging

Answer 10

First 48 hours
-if imaged during this time, pt must void first
- if it persists, indicates disease

Kidneys excrete 20-30% of the dose during the first 24 hours

Question 11

What increases Ga67 uptake

Answer 11

Blood transfusions
Chemo
Iron therapy
Recent trauma

Question 12

Ga67 excretion

Answer 12

First 48 hours: renally

After 48 hours: GI tract

Question 13

Prep for Ga67

Answer 13

Bowel prep: laxatives or enema

Question 14

Contraindications for bowel prep for Ga67

Answer 14

Pts who are acutely ill or cannot retain solid foods

Question 15

Best RP for imaging abdomen

Answer 15

In111 labeled WBCs

Question 16

Indications for In111 WBCs

Answer 16

Source of FUO
Inflammatory bowel disease
Osteomyelitis

Question 17

Medicines that can lower WBC tagging

Answer 17

Steroids
Aspirin
Antibiotics

Question 18

How long after labeling WBCs should they be administered

Answer 18

1-2 hours to ensure maximum cell viability

Question 19

When is imaging performed for In111 WBCs

Answer 19

1-4 hours or
16-30 hours

Question 20

Simultaneous dual tracer for osteomyelitis

Answer 20

In111 WBCs with 99mTc MDP

• must use different photopeaks ro differentiate the low energy tech photons from the In111 photons

Question 21

Most intense organ uptake for in111

Answer 21

Spleen

Question 22

99mTc labeled WBCs indications are similar to In111 but may be more sensitive for

Answer 22

Detecting inflammation or ischemia in small bowel and detecting acute osteomyelitis

Question 23

WBC and bone marrow imaging combined RPs

Answer 23

In111 WBCs 0.3-1 mCi

99mTc Sulfur colloid 10 mCi

Question 24

Injection to imaging time for WBC/bone marrow

Answer 24

SC - 30 minutes

In111 - 24 hours

Question 25

Must use freshly prepared SC for bone marrow imaging because

Answer 25

<2 hours old

Old SC can result in persistent blood pool and bladder activity

Question 26

When is imaging preformed with SC/in111 WBCs

Answer 26

Can be preformed at the same time

Or SC imaging can be preformed immediately after WBC imaging