Nuclear med Flashcards

Question

MUGA

Answer 1

99mTc PYP labeled RBCs 20 mCi IV injection of PYP (pyrophosphate) tags to RBCs IV injection 20 min later of 99mTcO4- tags to PYP Or ultratag kit - 1 bottle with all reagents Septum appears “cold” Anterior “Best septal” or LAO (left anterior oblique)-Used to calculate EF L lateral images Series of 3 different orientation “cine” pictures Additive collection of radioactive particles over and over again to make pictures for movi

Answer 2

“Flatter” graph Decreased EF End Diastole and End Systole pictures Not much change in size This is LAO or best septal view

Answer 3

Echos for structural abnomality chemo ?- functional?

Answer 4

One chance only for Right Ventricle study Left heart will “cover” right heart after “first pass” in circulation RV Normal RVEF=45-55% Should be less than LFEF (10% ish) Utilizes butterfly or other IV access pertechnetate bolus w pt under camera Blood flow imaged

Answer 5

Modified bicycle table or other device-Increase work load (can be done w Echo) Normally see LVEF increase with exercise Wall motion changes (Similar to stress echo) Can be done with pharmaceuticals to mimic “stress”- EG persantine

Answer 6

r/o CAD w SPECT Stress Component Image after exercise protocol completed LV seen Rest Component Either several hours after exercise (using Thallium- a K+ analog) or first with Cardiolite (pertechnetate derivative) May see RV faintly (Tl)

Answer 7

Same views as MUGA Anterior LAO (see donut w/o “bite”) L Lateral

Answer 8

Less common due to US 99mTc Sulfur Colloid 4 mCi Taken up by **macrophage Kuppfer Cells of RES thus, does NOT image hepatocytes!** Homogenous uptake normal

Answer 9

r/o biliary obstruction Aka HIDA or PIPIDA, DISIDA (depends on institution’s pharmaceutical choice) Choletch/mebrofenin Excreted through biliary system 99mTc HIDA 4-8 mCi dose Can be adjusted for abnormal LFTs Should visualize GB by 45 min to hour Should visualize small intestine (by 2 hr) EF of Gallbladder could be calculated after dose of med

Answer 10

Labeled RBCs Figure of bleed distal descending colon

Answer 11

Sulfur colloid scrambled eggs for solid Sulfur colloid in liquid Can follow GI transit time Gastroparesis E.g. Diabetic

Answer 12

**Pertechnetate** **Iodine isotopes Thyroid uptake HOT vs COLD nodules** **Cold may be malignant “could also be a cyst” Ultrasound can help**

Answer 13

Cerebrovascular Disease Ischemia CVA identified earlier than CT Brain death Dementia evaluation PET brain scans “higher tech” Views: Transverse (superior to inferior) Coronal (ant to post) Sagittal (L to R) Again, symmetry is key

Answer 14

DAT (Dementia of Alzheimer’s Type) Epilepsy Schizophrenia

Answer 15

R/o PE (pulmonary embolism) Ventilation phase Xe 133 gas, Tc99m DTPA aerosol Inspiratory phase Equilibrium phase Washout phase

Answer 16

Perfusion phase Tc 99m MAA (microaggregated albumin) Blocks small capillaries Ventilation Perfusion “mismatch” for PE Ventilation normal Perfusion absent area(s) If perfusion normal, vent not performed w perfusion first technique

Answer 17

COPD longer ventilation “washout” phase air trapping Area could be infarcted No vent No perf

Answer 18

Different agents Renal parenchyma Renal tubules

Answer 19

TcO4 saline via bladder Filling phase Voiding phase Measures bladder volume Looks for reflux

Answer 20

US w doppler has largely replaced Acute scrotal pain Chronic scrotal pain Injury Mass Torsion Note: US usually used IV Tc blood flow, pool studies

Answer 21

Thyroid ablation High dose oral radioactive iodine Nuclear Oncology Theranostics- molecular imaging/treatment (aka theragnostic) alpha or beta emitters Palliative or curative therapy goals E.g. mets, but not cure primary site

Answer 22

Bone mets radiotherapy Palliative IV strontium 89 Scintomammography

Answer 23

“Functional” imaging- images not “clear” Hot vs. Cold (increased vs. decreased uptake) Order of imaging done very important! Usually no Allergies/ADRs Radioisotope administration usually IV as many films as necessary from the dose “safe” doses