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CORE > Nucs > Flashcards

Nucs Flashcards

1
Q

Whole body scan with bones and liver hotter then spleen. What are possible tracers?

A

More photons -> Tc99m Sulfur colloid

Less photons -> gallium

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2
Q

Whole body scan showing bones and spleen hotter than liver what is the tracer?

A

Indium 111-wbc

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3
Q

Whole body scan, no bones, no liver, no spleen. What are you options?

A

I-123 or I-131

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4
Q

Whole body scan, no bones, liver and spleen are lighting up. What is the tracer if the liver > spleen? What is the tracer if spleen > liver and renal uptake?

A

Liver > spleen I-131 MIBG

Spleen > liver + kidney I-131 MIBG

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5
Q

If there are bones and lacrimal gland uptake what are your options?

A

Free Tc if the bones are faint

Gallium but only if there is no spleen uptake

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6
Q

Hot spleen what should you think of?

A

Octreotide and WBC (sullfur colloid will have liver = spleen)

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7
Q

What does MIBG often look for?

A

Neuroblastoma

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8
Q

No bones + no liver + dark kidneys and spleen = ?

A

Octreotide. Higer count study the images should be cleaner

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9
Q

When do you image for Tc wbc scan?

A

4 adn 24 hours

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10
Q

How long can you see lung uptake in a Tc WBC scan?

A

4 hours

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11
Q

in WBC or Tc WBC which has no renal or GI take?

A

Indinum

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12
Q

What organ gets the highest dose of radiation with MDP? With F-18?

A

Bone for MDP

Bladder for F-18

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13
Q

What is normal distribution for Tc-MDP?

A 
Bone
Kidney (If not seen or faint = super scan)
bladder
breasts (in young females)
soft tissues - low levels
epiphyses in kids
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14
Q

If there is more then faint uptake in the skull what should you think of? ( Tc-MDP)

A

Renal osteodystrophy

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15
Q

If the renal cortex is hotter then lumbar spine ( Tc-MDP)

A

Hemochromatosis

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16
Q

If there is diffuse renal uptake ( Tc-MDP)

A

Seen in chemotherapy and urinary obstruction

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17
Q

What could abnormal liver uptake indicate? ( Tc-MDP)

A

Too much Al+3 contamination
Cancer mets or hepatoma
Amyloidosis
Liver Necrosis

18
Q

Lung uptake in ( Tc-MDP) can be from what?

A 
Heteroptic calcification (dystrophic or mets)
Osteosarcoma
Fibrothroax
primary lung tumors
radiation changes
sarcoid
berylliosis
alveolar microlithiasis
wegeners (etc)
19
Q

What is flair phenomenon for ( Tc-MDP)?

A

Increase in activity 2 weeks to 3 months post treatment. X-rays should show lesions getting more sclerotic

20
Q

Prostate ca mets are uncommon with a PSA below?

A

10

21
Q

Prostate mets where?

A

Bone!

22
Q

Lung cancer bone mets tend to be where?

A

appendicular skeleton

23
Q

What bone related condition is assoicated with lung cancer?

A

Hypertrophic osteoarthropathy

24
Q

Solitary sternal lesion on bone scan is concering for what?

A

Breast CA

25
Q

Where does neuroblastoma frequently met?

A

Metaphysis of long bones

26
Q

I-123 and 131 MIBG are superior for detection of bone mets in what condition?

A

neuroblastoma

27
Q

How does osteopoikilosis look on bone scan?

A

Cold

28
Q

What is hypertrophic osteoarthopathy assoicated with?

A

Chronic hypoxia (CF< Cyanotic heart disease, mesothelioma, pneumoconiosis) and LUNG CANCER!

29
Q

Tram tracking on bone scan?

A

HPOA

30
Q

What does AVN look like on bone scan?

A

Early and Late is cold, middle is hot from repair

31
Q

What are HOT benign bone lesions on bone scan?

A 
Fibrous dysplasia
Giant cell tumor
ABC
Osteoblastoma
OO
32
Q

What is a benign COLD lesion on bone scan?

A

Bone cyst without fracture

33
Q

What is variable on bone scan but benign?

A

Hemangioma

Multiple hereditary exostosis

34
Q

How can RSD look on bone scan?

A

Hot on flow and pool with periarticular uptake on delayed phase

35
Q

When do you use Tc HMPAO WBC over In-WBC?

A

Kids - Tc99 will have lower absorbed dose and shorter imaging times
Small parts - Tc99m does better in hands and feet

36
Q

What cells are labeled by In-WBC?

A

Neutrophils

37
Q

Normally what is the critical organ for In-WBC?

A

Spleen

38
Q

In In-Wbc what happens to the distribution if the cells get fragmented?

A

Indium binds with transferrin and increased liver and bone marrow uptake

39
Q

What is the dose used for ablating a thyroid remenent

A

30-75

40
Q

What dose is used for treatment of recurrent diseasein the thyroid bed?

A

150

41
Q

What dose is used for bone or distant thyroid mets?

A

200-250

CORE (14 decks)

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