Nuclear Medicine 1

Question 1

Target organ: liver

Answer 1

In-prostascint
I-131
IV sulfur colloid

Question 2

Target organ: distal colon

Answer 2

Gallium

Question 3

Target organ: bladder

Answer 3

MAG 3
MDP
i-123 MIBG

Question 4

Target organ: renal cortex

Answer 4

DMSA
thallium

Question 5

Target organ: spleen

Answer 5

In-wbc
Damages rbcs
Octreotide

Question 6

Target organ: proximal colon

Answer 6

Sestamibi
Oral sulfur colloid

Question 7

Target organ: gallbladder wall

Answer 7

HIDA

Question 8

Radionuclide purity

• acceptable
• test

Answer 8

• 0.15 microCi of Mo-99 per 1 milliCi of Tc-99
• dose calibrator with lead shields: Mo-99 is assayed first

Question 9

Radiochemical purity

Answer 9

Amount of free Tc
95% purity for pertechnetate
92% for sulfur colloid
91% for everything else

-thin layer chromatography

Question 10

Chemical purity

Answer 10

Amount of aluminum

• 10 micrograms per 1mL
• pH paper
• aluminum contamination shows up as lung activity in a sulfur colloid scan and as liver activity in a Tv scan

Question 11

Xenon-133

• half life?
• energy?

Answer 11

5.3 days (physical)
80 keV

Question 12

Gallium-67

• production?
• decay?
• half life?
• energies?
• critical organ?

Answer 12

• cyclotron: bombardment of Zn-68
• half life: 78 hours
• electron capture; emits gamma rays
• Energies: 93 keV, 184 keV, 300 keV, 393 keV
• critical organ: distal colon

Question 13

I-131

• half life?
• energy?

Answer 13

• 8 days
• 364 keV

Question 14

thyroid formation in fetus

Answer 14

8-12 week

Question 15

Breast feeding

• Tc 99m ?
• I -123
• I-131

Answer 15

Tc 99: resume breast feeding in 12-24 hrs
I-123: resume breast feeding in 2-3 days
I-131: stop breastfeeding

Question 16

when does patient have to be admitted after radioiodine therapy?

Answer 16

• 7mR/h measured at 1 meter from patient’s chest
• 33 mCi of residual activity

Question 17

Thallium-201

• half life
• production
• decay
• energies

Answer 17

• 73 hours
• cyclotron
• decays by electron caputre
• major emissions are characteristic X rays of daughter product Mercury 201: 69 and 81

Question 18

dose of morphine for HIDA

Answer 18

0.02-0.04 mg/kg over 30- 60 minutes

Question 19

dose of CCK for HIDA

Answer 19

0.02 micrograms/kg over 60 minutes

Question 20

phenobarbital dosing

Answer 20

2.5 mg BID for 5 days (5 mg for 5 days)

Question 21

cyclotron produced; decay by electron capture

Answer 21

Th-201, Ga-67, In-111, I-123
emission are gamma rays

Question 22

cyclotron produced, decay by beta plus

Answer 22

C-11, N-13, O-15, F-18

Question 23

what interval do you perform FDG PET after therapy?

Answer 23

chemo: 2-3 weeks
radiation: 8-12 weeks

Question 24

SUV calculation

Answer 24

FDG concentration / (dose/body weight)

Question 25

tumors that are PET cold

Answer 25

- renal cell - BAC - anything mucinous - carcinoid - bowel implants/peritoneal implants - prostate

Question 26

benign things that are PET HOT

Answer 26

- infection/inflamation - ovaries in follicular phase - muscles - brown fat - thymus - oncocytomas

Question 27

Indium-111 -half life - production - decay photopeak

Answer 27

- half life = 67 hours - cyclotron - electron capture - 173 keV, 247 keV

Question 28

agents used to treat bone pain due to breast or prostate mets

Answer 28

- Sr-89 chloride - Sm153 EDTMP - Ra-223 dichloride

Question 29

absolute contraindications for Sr-89 and Sm-153 treatment

Answer 29

- pregnancy - breast feeding - renal failure (GFR \<30)

Question 30

Sm-89 chloride

Answer 30

- Metastron - worst and oldest agent used to treat cancer related bone pain - pure beta emitter - high myelotoxicity - binds to hydroxyapatite where bone turnover is the highest - renal excretion

Question 31

Sr-153

Answer 31

- Quadramet - 2nd best agent for bone pain - binds to hydroxyapatite where bone turnover is the highest - beta decay, with 28% of decay gamma rays (103 keV) - transient bone marrow suppression that recovers faster than Sr (6-8 weeks vs. 8-12 weeks) - renal excretion

Question 32

Ra-223

Answer 32

-Xofigo - emits 4 alpha particles - ds DNA breaks - absorbed into bone matrix at sites of active mineralization - side effects are diarrhea, nausea, vomiting, fatigue long half life (11.4 days)

Question 33

Y-90

Answer 33

- pure beta emitter - 175 keV and 185 kEV emissions can be used to image - half life = 2.67 days

Question 34

produced in generator

Answer 34

Tc-99 Rb-82