NM imaging

Question 1

Bone imaging:
Tracer?
Presentation?
Preparation?
Imaging? (type, collimator)
Processing?

Answer 1

Tc99m HDP
Oncological: primary tumours/mets, non-onc: neoplasm, inflam, bone infarct…
Encourage patients to drink fluids between injection and scan.
WB scan, LEHR / SPECT/CT
Mask bladder

Dark regions show uptake

Question 2

Myocardial perfusion imaging
Tracer?
Presentation?
Preparation?
Imaging? (type, collimator)
Processing

Answer 2

Tc-99m-Tetrofosmin
Suspected Ischemia/obstruction stress/rest
Reviewed by cardiac nurse, 7 days prior
Chemical stress - stress first then rest.
ECG Gated SPECT
Bin images by section of the cardiac cycle
Ischemia shown by dark region

Question 3

Ventilation/Perfusion V/Q Lung scanning
Tracer?
Presentation?
Preparation?
Imaging? (type, collimator)
Processing

Answer 3

Perf: Tc-99m MAA Vent: technegas / Krypton
Presentation: Suspected PA, shortness of breath
Preparation: If technegas perf act = vent x 3.
SPECT / STATIC LEGP
Check count ratio

Question 4

DaTSCAN 
Tracer?
Presentation?
Preparation?
Imaging? (type, collimator)
Processing

Answer 4

I-123 Ioflupane
Differentiate Parkinsons/movement disorders or dementia
Admin thyroid blocker
Im 3-6 hours post admin, Im head above the ears
SPECT LEHR
Can quantify or visually observe, dots/commas.

Question 5

Renography
Tracer?
Presentation?
Preparation?
Imaging? (type, collimator)
Processing

Answer 5

Tc-99m MAG3 
Susp urinary tract blockage
Diuretic (furosemide) admin 15 mins in to imaging
Dynamic planar LEGP  + statics (60s)
60 x 1s, 204 x 10s. 
Plot uptake/retention over time

Question 6

Renal Cortex Imaging 
Tracer?
Presentation?
Preparation?
Imaging? (type, collimator)
Processing

Answer 6

99mTc-DMSA 
Assessing for cortical defects and scarring.
Planar LEHR 20s frames or SPECT
Draw roi around kidneys
Can assess relative function

Question 7

Cerebral Perfusion 
Tracer?
Presentation?
Preparation?
Imaging? (type, collimator)
Processing

Answer 7

Tc99m HMPAO
Assess cerebral disease, where functional impairment often precedes structural changes - sus dementia
The patient should avoid caffeine, alcohol and tobacco for 24-hours prior to the examination
SPECT LEHR

Question 8

Bile Acid retention
Tracer?
Presentation?
Preparation?
Imaging? (type, collimator)
Processing

Answer 8

75Se 23-seleno-25-homotaurocholic acid (SeHCAT)
chronic unexplained diarrhoea
halt medications which could delay passage of bile salts
intrinsic day 0 day 7 statics
Sum all counts in both images

Question 9

Thyroid scintigraphy 
Tracer?
Presentation?
Preparation?
Imaging? (type, collimator)
Processing

Answer 9

123I-Iodide 
thyroid lesions 
halt thyroxine medication / avoid high iodine foods
check calibration with thyroid phantom
Planar/SPECT LEHR Im 3 hours after admin
Planar quantification

Question 10

Renal scintigraphy 
Tracer?
Presentation?
Preparation?
Imaging? (type, collimator)
Processing?

Answer 10

Tc-99m DMSA
Suspected kidney failure
Administered IV
LEGP
Draw roi around each kidney, plot function
Sum counts retained in each kidney