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R1 > Nuc Med > Flashcards

Nuc Med Flashcards

1
Q

What is I-123 MIBG scan used for?

A

to find/confirm presence of neuroendocrine tumor (pheochromocytoma, neuroblastoma, paraganglioma)

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2
Q

What is patient pre-treated with prior to I-123 MIBG scan? Why?

A

saturated solution of potassium iodide (SSKI, Lugol’s)

decrease thyroid uptake of I-123

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3
Q

What is pre-treatment for Meckel diverticulum scintigraphy? Why?

A

Cimetidine (histamine H2 blocker) –> inhibit acid secretion by parietal cells

limit release of pertechnetate by gastric mucosal cells

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4
Q

What radiopharmaceutical is used to assess glomerular filtration?

A

Tc-99m DPTA

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5
Q

What radiopharmaceutical is used to assess effective renal plasma flow?

A

Tc-99m MAG3

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6
Q

What radiopharmaceutical is used to assess renal cortical integrity?

A

Tc-99m DMSA

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7
Q

What is renal cortical imaging test used for?

A

differentiate: renal scar vs pyelonephritis

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8
Q

What is Ga-68 DOTATATE imaging used for?

A

detects somatostatin receptors –> find neuroendocrine tumors

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9
Q

What is the normal biodistribution of Ga-68 DOTATATE?

A
  • high spleen
  • medium liver
  • renal excretion
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10
Q

What radiopharmaceutical is a lipophilic brain perfusion agent used for planar and SPECT brain scintigraphy?

A

Tc-99m HMPAO

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11
Q

Tc-99m heat-damaged red blood cells –> used for what?

A

ID spleen tissue

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12
Q

What is Rb-82 used for?

A

myocardial perfusion imaging

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13
Q

What is the mechanism of Rb-82 localization to myocytes?

A

Na+/K+/ATPase pump incorporates Rb-82 into myocardium

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14
Q

What type of radiation is detected by PET scan?

A

positron –> 2 photons detected in coincidence

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15
Q

instant thin layer chromatography is used to test what parameter of radiopharmaceutical quality assurance?

A

radiochemical purity

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16
Q

MIBG scan –> positive in what conditions? (6)

A
  • neuroblastoma
  • carcinoid tumor
  • paraganglioma –> pheochromocytoma
  • medullary thyroid carcinoma
  • ganglioneuroma
  • ganglioneuroblastoma
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17
Q

MIBG scan –> what pharmaceutical? what radioisotope?

A
  • MIBG (norepinephrine analog)

- Iodine-123 or I-131

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18
Q

what is required prior to 90Y ibritumomab tiuxetan (Zevalin) radioimmunotherapy? why?

A

pretreatment infusion with unlabeled monoclonal Ab (rituximab) –> bind extra-tumoral binding sites ie. circulating lymphocytes –> zevalin –> higher % of binding to tumor

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19
Q

If hallway gets contaminated with radioactivity –> ok to remove cordon around the area –> below what level of radioactivity?

A

2x background

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20
Q

bone scintigraphy –> what are the 3 phases? what does each phase demonstrate?

A

1) flow phase: demonstrates perfusion
2) blood pool: demonstrates blood pool (balance bw plasma & interstitium)
3) delayed: degree of uptake depends on blood flow and rate of new bone formation

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21
Q

heterotopic ossification –> mature –> bone scan findings

A
  • normal flow
  • normal blood pool
  • normal uptake on delayed
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22
Q

thallium-201 –> used for what study?

A

myocardial perfusion imaging

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23
Q

what is the critical organ for myocardial perfusion imaging using Tl-201 chloride?

A

kidneys

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24
Q

what is I-131 used for?

A

thyroid ablation s/p post-thyroidectomy for thyroid cancer

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25
Q

what is Tc-99m sestamibi used for?

A
  • parathyroid scan

- myocardial perfusion scintigraphy

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26
Q

breastfeeding patient –> Tc-99m - sestamibi –> how long should stop breastfeed?

A

not need to stop breastfeeding

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27
Q

breastfeeding patient –> radiopharmaceutical –> child dose limit?

A

1mSv

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28
Q

breastfeeding patient –> 18F FDG –> how long should stop breastfeed?

A

12hr

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29
Q

breastfeeding patient –> Tc-99m MDP –> how long should stop breastfeed?

A

not need to stop breastfeeding

30
Q

breastfeeding patient –> I-131 –> how long should stop breastfeed?

A

complete cessation recommended

31
Q

bone scan –> what is the mechanism of uptake of MDP?

A

chemiabsorption

32
Q

Indium-111 –> used in what kind of study?

A

In-111 leukocyte scinitigraphy –> localize infection/inflamm

33
Q

In-111 –> half life?

A

67 hr

34
Q

Gallium-67 –> half life?

A

78 hr

35
Q

Iodine-123 –> half life?

A

13 hr

36
Q

Iodine-131 –> half life?

A

8 days

37
Q

Technetium-99m –> half life?

A

6 hr

38
Q

Thallium-201 –> half life?

A

73 hr

39
Q

Xenon-133 –> half life?

A

5 days

40
Q

Gallium-67 –> used for what kind of study?

A

Gallium-67 scinitgraphy –> sites of inflamm –> esp spinal infection, esp discitis

41
Q

V/Q scan –> perfusion scintigraphy –> focal areas of increased tracer uptake –> what does it mean?

A

focal areas of aggregated MAA particles d/t:

  • blood in syringe during injection
  • particles not properly suspended
42
Q

gastric emptying pattern:

  • liquid?
  • solid?
A

liquid: exponential
solid: linear

43
Q

I-123 MIBG –> what medication should be d/c prior to scan? why?

A

TCA –> interfere with I-123 MIBG uptake

44
Q

suspect spinal osteomyelitis –> best scan?

A

combined Tc-99m MDP & gallium-67 citrate scans

45
Q

yttrium-90 ibritumomab –> used to treat what malignancy?

A

non-Hodgkins lymphoma

46
Q

HIDA scan –> rim sign:

  • what is rim sign?
  • dx?
A
  • nonvisualization of gallbladder
  • increased pericholecystic hepatic uptake

==> gangrenous cholecystitis

47
Q

gastric emptying study –> what radiopharmaceutical?

A

Tc-99m sulfur colloid

48
Q

gastric emptying study –> liquid –> used for which situtations? (2)

A
  • feeding tube

- peds –> feeding difficulty/failure to thrive

49
Q

QC –> which parameters are checked…

  • daily?
  • wkly?
  • qtrly?
A
  • uniformity –> daily
  • linearity –> wkly
  • center of rotation –> qtrly
50
Q

QC for the following are checked how often?

  • Geometry
  • Constancy
  • Linearity
  • Accuracy
A
  • Geometry –> once
  • Constancy –> daily
  • Linearity –> qtrly
  • Accuracy –> yrly
51
Q

According to the Nuclear Regulatory Commission (NRC) Agreement State Program, regulatory
authority over radioactive source material and by-products is transferred to a state via an
agreement signed by the NRC Chairman and who else?

A

governor of state

52
Q

what is the annual whole-body total effective dose equivalent limit?

A

5 rem (50 mSv)

53
Q

dementia with Lewy bodies –> hallmark finding of hypometabolism in what struct?

A

occipital lobe –> visual cortex

54
Q

What is the MOST commonly cited threshold for the diagnosis of malignancy using standardized uptake value (SUV) on PET imaging for a solitary pulmonary nodule

A

2.5

55
Q

which med is the MOST appropriate pharmacologic stress agent for patients undergoing myocardial perfusion imaging who have severe bronchospasm?

A

dobutamine

56
Q

empiric treatment of Plummer disease (autonomously functioning thyroid nodule) or multinodular goiter –> I-131 dose?

A

30 mCi

57
Q

bone scan –> focal decreased uptake –> bone mets of what primary cancer? (4)

A

“cold” mets:

  • lung
  • breast
  • renal
  • thyroid
58
Q

thyroid cancer –> regional neck metastasis –> I-131 dose?

A

100 - 150 mCi

59
Q

thyroid cancer –> lung and bone metastasis –> I-131 dose?

A

175-200 mCi

60
Q

What is the mechanism of localization of F18 - FDG

A

Uptake via surface transport receptors

61
Q

what is purpose of 60 minute sincalide (CCK analog) infusion during hepatobiliary imaging?

A

Decrease gallbladder ejection fraction variability

62
Q

cardiac study –> what is maximum acceptable percent of aberrant beats permitting accurate assessment of regional wall motion and left ventricular ejection fraction?

A

10%

63
Q

A Tc-99m sulfur colloid scan performed in a 25-year-old woman reveals an incidental round, hyperintense area of activity within the liver. What is the MOST likely etiology for this finding?

A

focal nodular hyperplasia

64
Q

What finding on an In-111 Zevalin® scan would constitute a CONTRAINDICATION to radioimmunotherapy with Y-90 Zevalin

A

Lung activity greater than liver activity

65
Q

stress myocardial perfusion imaging in patients with left bundle branch block –> Exercise treadmill testing –> false positive rate –> dec/same/inc?

A

inc

66
Q

C-14 urea breath test for the detection of Helicobacter pylori (H. pylori) infection –> abx will affect the results –> T/F?

A

T

67
Q

C-14 urea breath test for the detection of Helicobacter pylori (H. pylori) infection –> bismuth will affect the results –> T/F?

A

T

68
Q

C-14 urea breath test for the detection of Helicobacter pylori (H. pylori) infection –> PPI will affect the results –> T/F?

A

T

69
Q

C-14 urea breath test for the detection of Helicobacter pylori (H. pylori) infection –> antacid will affect the results –> T/F?

A

F

70
Q

center of rotation offset error in SPECT imaging –> produce what artifact?

A

ring artifact

71
Q

In nuclear medicine, what is the primary benefit for the use of a narrow energy window?

A

Reduces scatter radiation in image

R1 (15 decks)

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