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PET practice test Flashcards

1
Q

If the physician suspects overdose of calcium channel blockers in a patient, which of the following medications may be prescribed?

A

Glucagon

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2
Q

__________ has a rapid onset of 1 to 2 minutes, stimulates alpha-1 receptors, constricts blood vessels, and raises blood pressure.

A

Epinephrine

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3
Q

NPH is what type of insulin?

A

Intermediate acting

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4
Q

__________ is an example of an antiarrhythmic.

A

Adenosine

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5
Q

Which of the following aids in the prevention of hypoglycemia?

A

Glucagon

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6
Q

Antiemetics are used to treat/manage which of the following symptoms? Select the best answer.

A

Nausea and vomiting

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7
Q

Immediate phosphorylation of glucose by __________ prevents diffusion out of the cell.

A

hexokinase

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8
Q

Why should dextrose 5% in water be included in the crash cart?

A

IV hydration

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9
Q

Which of the following is an important polypeptide non-steroid hormone produced by the alpha cells in the islets of Langerhans in the pancreas?

A

Glucagon

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10
Q

__________ is considered the temperature control center of the body.

A

Hypothalamus

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11
Q

__________ protects the privacy and identifiable patient health information.

A

HIPPA

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12
Q

__________ can cause hyperglycemia which alters the biodistribution of 18F-FDG.

A

Dexamethasone

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13
Q

__________ is a loop diuretic that prevents the body from absorbing too much salt, allowing the salt to instead be passed in your urine.

A

Furosemide

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14
Q

Which of the following is a normal male hemoglobin level?

A

17.5 g/dL

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15
Q

__________ is an insulin resistance with an insulin secretory deficit. It is more prevalent and includes adult-onset diabetes.

A

Type II diabetes mellitus

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16
Q

Which of the following medications is used to treat hypertension?

A

ACE inhibitor

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17
Q

Which of the following factors influence pulse rate?

3

A

meds
pain
gender

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18
Q

Sarcomas should be scanned from the skull base to the upper thigh.

A

false

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19
Q

__________ is a cancer composed of cells derived from transformed cells that produce cartilage.

A

Chondrosarcoma

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20
Q

An increasing CA-125 is indicative of which type of cancer?

A

Ovarian cancer

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21
Q

Squamous Cell Carcinoma is the most common type of kidney cancer.

A

false

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22
Q

What is a typical dose of 18-FDG in oncologic PET imaging?

A

10 mCi

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23
Q

What is an important consideration when performing PET on a patient with melanoma?

A

Imaging should be performed from the top of the head to the bottom of the feet

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24
Q

Gastrointestinal stromal tumors most often occur in the esophagus or large intestine.

A

false

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25
Q

What is generally used to make an initial diagnosis of Colon Cancer?

A

Colonoscopy

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26
Q

The ____________ is a common place for colorectal cancer to metastasize and will progress via the lymphatic system.

A

liver

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27
Q

__________ are malignant tumors formed from glandular structures in epithelial tissues.

A

Adenocarcinomas

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28
Q

Prostate cancers tend to metastasize to the __________.

A

bones

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29
Q

_______ originates in the blood cells.

A

Leukemia

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30
Q

__________ is an enlarged prostate.

A

BPH

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31
Q

Which of the following criteria is considered the gold standard for cancer staging?

A

TNM

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32
Q

Which of the following indications should be imaged from the top of the head to the bottom of the feet?

A

cutaneous lymphoma

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33
Q

Other than skin cancer, which of the following is the most common cancer in women?

A

breast

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34
Q

Sarcomas grow in connective tissue.

A

true

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35
Q

Cancers can begin in any tissue or organ in the body

A

true

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36
Q

__________ cancer almost always manifests from HPV.

A

cervical

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37
Q

Which of the the following is considered to be an abnormal Gleason score for prostate cancer?

A

10

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38
Q

The kidneys produce a hormone called __________.

A

Erythropoietin

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39
Q

Which of the following is(are) advantages of 18F-sodium fluoride PET/CT over 99mTc-MDP bone scintigraphy?
(3)

A
  • Anatomical correlation
  • Better penetration of tissues after administration to the patient
  • Increase spatial resolution and sensitivity
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40
Q

Which of the following is TRUE concerning Lymphoma or the lymphatic system?

A

true

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41
Q

__________ is the development of new blood vessels from preexisting blood vessels.

A

Angiogenesis

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42
Q

In hepatocellular carcinoma, differentiating disease from background is important

A

true

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43
Q

Hodgkin’s Lymphoma

Non-Hodgkin’s Lymphoma

A
  • spread is systemic but it mostly occurs above diaphragm

- more common and most often manifests as B-cell related disease

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44
Q

In myeloma, presentation occurs when too many plasma cells develop and the bone begins to dissolve

A

true

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45
Q

Which of the following is a typical dose for a patient undergoing a F-18 sodium fluoride bone scan for breast cancer?

A

5-10mci

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46
Q

Most head and neck cancers are squamous cell carcinomas.

A

true

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47
Q

When scanning a chest CT, it is important to include which organ(s)?

A

Adrenal glands

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48
Q

GTV
CTV
PTV

A
  • area of malignancy
  • encompasses the tumor and microscopic surrounding areas
  • portion of the body that will be treated using radiation therapy
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49
Q

What is the critical organ for 18-FDG?

A

bladder

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50
Q

Epithelial cells, lymphocytes, neuroendocrine cells, and Kulchitsy cells are the main types of cells in the thymus

A

true

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51
Q

Which cells are known as the pacemaker of the GI tract?

A

Cajal

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52
Q

Respiratory gating procedures can be used to minimize breathing artifacts during a PET scan

A

true

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53
Q

The breast is divided into __________ anatomical sections.

A

20

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54
Q

Mucosa
Submucosa
Muscle layer
Outer layer

A
  • inner lining
  • contains glands that make mucus
  • push food down
  • covers organ
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55
Q

In general, what is the minimum SUV threshold for malignancy?

A

2.0

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56
Q

Acute lymphocytic leukemia occurs in both adults and children

A

true

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57
Q

The pancreas produces ____________ along with several other hormones.

A

Insulin

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58
Q

__________ is a glycoprotein constituent of mucus.

A

Mucin

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59
Q

Which of the following is an indication for a PET/CT F-18 sodium fluoride scan?

A

AVN

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60
Q

__________ tumors are most common in the pediatric population.

A

Wilm’s

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61
Q

Fundus
Corpus
Cervix

A
  • top
  • middle
  • bottom
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62
Q

__________ is a protein that is present on the surface of most, but not all, ovarian cancer cells.

A

CA-125

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63
Q

What is the advantage of PET/CT for patients?

A

Ability to determine the extent of tumor burden or spread

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64
Q

It is quite easy to differentiate malignancy vs. normal tissue in 18-FDG Brain PET studies.

A

false

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65
Q

__________ is a protein produced by normal, as well as malignant, cells of the prostate gland.

A

psa

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66
Q

PET is not the best modality for the initial work up of __________ cancer.

A

prostate

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67
Q

__________ is(are) the tissue that envelops the organs of the abdomen and lines the walls.

A

Peritoneum

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68
Q

Patients should be instructed to avoid physical exertion for _________ prior to their PET scan as this type of activity can result in uptake of FDG by skeletal muscle.

A

1 - 2 days

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69
Q

PET imaging is useful in patients with known Alzheimer’s disease as it can predict the course of treatment that will cure the disease.

A

false

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70
Q

Which of the following is considered a vascular disease?

A

Multi-infarct dementia

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71
Q

Which of the following patterns of FDG uptake in the brain is most typical of Pick’s Disease?

A

Symmetric frontal lobe hypometabolism

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72
Q

frontal
parietal
temporal
occipital

A
  • cognition, motor, personality
  • memory, language, sensation
  • memory & speech
  • vision
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73
Q

A(n) __________ seizure is when a patient becomes vacant and unresponsive for a short time and may not be aware afterwards that the event took place.

A

absence

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74
Q

Which disease process can be considered a spectrum disorder of FTD?

A

Pick’s disease

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75
Q

The lobe of the brain that is LEAST likely to be affected by Alzheimer’s disease is the __________ lobe.

A

occipital

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76
Q

Plaques and tangles associated with Alzheimer’s disease are present in patients with Pick’s disease.

A

False

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77
Q

Which of the following statements is TRUE concerning AD and FTD? Select the best answer.

A

FTD is primarily a temporal lobe disease

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78
Q

There are numerous reports in the literature documenting that at least some psychoactive drugs cause alteration in the pattern and degree of FDG uptake in the brain. If a patient is taking psychoactive drugs, what is the BEST option?

A

Include a medication history in the patient assessment

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79
Q

Clinically approved non-FDG imaging of patients with AD targets which of the following in the brain?

A

β-amyloid

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80
Q

Which of the following contains the neuron’s nucleus?

A

Neuronal cell bodies

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81
Q

Which of the following consists mostly of myelinated axons?

A

White matter

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82
Q

The cerebellum consists of two rounded hemispheres divided from the cerebrum by a plate of fibrous tissue called the __________.

A

tentorium

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83
Q

Sensitivity of FDG PET for AD and FTD is generally found to be higher than specificity.

A

True

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84
Q

Which AD stage requires high levels of assistance with daily activities and personal care?

A

Late-stage

85
Q

The __________ controls “higher functions” such as thinking, language, memory, motor and sensory function, and vision.

A

Cerebrum

86
Q

The frontal lobe and the temporal lobes are separated by what structure?

A

Central sulcus

87
Q

Which of the following is TRUE concerning the rationale for EEG monitoring during PET imaging of seizure disorder?

A

If seizures occur in close temporal proximity to the injection of FDG, seizure activity will be seen as a “cold spot” in the brain

88
Q

Gray matter is typically intensely __________ on FDG PET.

A

hypermetabolic

89
Q

Changes in AD may be asymmetric, particularly early in the course of the disease

A

true

90
Q

It has been shown that there is a correlation between the intensity of uptake in primary brain tumors and the grade of the tumor.

A

true

91
Q

Partial seizures from a localized effect on the brain

A

true

92
Q

Underlying cerebral metastases may be inconspicuous due to its similarity in intensity to the cortex, there is often associated vasogenic edema. Areas of vasogenic edema appear __________ on a PET scan.

A

photopenic

93
Q

Which of the following is the standard imaging modality for epilepsy?

A

MRI

94
Q

Functional imaging exploits the fact that between seizures, the epileptic focus has higher perfusion and high metabolic activity than normal brain.

A

false

95
Q

During a PET brain scan, why is it important for the patient to remain quiet, still, and avoid undue sensory stimulation during the uptake and scan portion of the exam? Select the best answer.

A

Can result in cortical activation and alteration of cerebral tracer uptake

96
Q

For cardiac PET images with Rb-82, areas of diminished radiotracer activity on both rest and stress images are presumed to represent sites of prior myocardial infarction and nonviable myocardium.

A

true

97
Q

Which of the following coronary arteries supplies blood to the right atrium, right ventricle, bottom portion of the left ventricle, and back of the septum?

A

RCA

98
Q

Does demonstrate functional significance on underlying disease

A

true

99
Q

What is the infusion criteria for dipyridamole?

A

4 minutes at a rate of 0.14 mg/kg/min

100
Q

Which of the following is produced in a cyclotron by bombardment of Oxygen-16 with protons?

A

13N-Ammonia

101
Q

Pressures in systemic circulation are much higher than in pulmonary circulation

A

true

102
Q

Which set of arteries supply blood to the myocardium? Select the best answer.

A

Coronary arteries

103
Q

Which of the following is TRUE concerning adenosine infusion?

A

AV block can occur

104
Q

82Rb can decay by multiple pathways. Which decay method accounts for approximately 95% of the decay events?

A

Beta plus

105
Q

What imaging method is the gold standard for determining the presence, absence, or degree of coronary artery disease?

A

Coronary angiography

106
Q

PET images using high-energy positron-emitting isotopes are therefore of higher spatial resolution than those isotopes with low-positron energies.

A

False

107
Q

What should be the fasting time for PET imaging of the heart?

A

6 hours

108
Q

Why should patients avoid smoking before PET imaging of the heart? Select the best answer.

A

Can affect coronary flow reserve

109
Q

Which radiopharmaceutical is widely used for PET nuclear cardiac scanning? Select the best answer.

A

82Rb-chloride

110
Q

Which term is used to describe areas of the heart muscle that are viable but under-perfused? Select the best answer.

A

Hibernating myocardium

111
Q

Resulting positron is ejected from the nucleus with a certain amount of kinetic energy

A

true

1022

112
Q

When using 13N, how long should you wait before beginning the stress portion of the test?

A

45 minutes

113
Q

What is the term used to describe the resting metabolic state of the body early in the morning after fasting for a minimum of 12 hours? Select the best answer.

A

Basal state

114
Q

What is the plasma half-life of dipyridamole?

A

30 to 40 minutes

115
Q

At what time, during the infusion of adenosine, is the radiopharmaceutical injected?

A

3 minutes

116
Q

Which valve is located between the left atrium and left ventricle?

A

Mitral

117
Q

What are the infusion instructions for Regadenoson?

A

0.4 mg over approximately 10 seconds

118
Q

Attenuation artifacts can occur in the inferior wall, making it appear as if there has been infarction in the vascular distribution of the left coronary artery

A

true

119
Q

Which of the following coronary arteries supplies blood to the left atrium and the back side of the left ventricle?

A

LCX

120
Q

Gated PET can provide valuable information about cardiac wall motion and ejection fraction in the post-stress state

A

true

121
Q

During a PET viability study, supplemental insulin is usually required to raise serum glucose levels in diabetic patients.

A

false

122
Q

What is the half-life of 82Rb?

A

75 seconds

123
Q

Regions of the heart that demonstrate absent perfusion but the presence of metabolism are deemed viable

A

true

124
Q

To test for hibernating myocardium, the perfusion portion of the scan is not necessary.

A

False

125
Q

When should 18F-FDG be injected during a PET viability study?

A

Once serum glucose levels decrease to less than 150 mg/dL

126
Q

Which of the following are matching algorithms used in image fusion? (Select all that apply.)

A
  • Mutual Information
  • Shape Differential
  • Count Differential
127
Q

Which of the following becomes worse when we use the PET image as the target image in image fusion?

A

Resolution

128
Q

When viewing a PET image, the “rim sign” is a clue the image has not been __________.

A

attenuation corrected

129
Q

How many interations does the mutual information algorithm perform before stopping?

A

There is not a set number of iterations

130
Q

Breathing artifacts are evidenced on fused PET/CT images in the form of a __________.

A

curvilinear cold artifact

131
Q

What is the best way to establish whether a patient has a tumor that is accumulating FDG vs. photon absorption in a patient that received oral contrast prior to the PET/CT?

A

Compare the non-attenuation corrected images to the attentuation corrected images

132
Q

Which of the following leads to streak artifacts and may obscure lesions adjacent to areas of high activity?

A

Filtered back projection

133
Q

The best way to minimize the risk that the breathing artifact will alter image interpretation is to __________.

A

view the non-attenuation corrected images as well as the attenuation corrected images

134
Q

Select all the DISADVANTAGES of software fusion of PET and CT images. (Select all that apply.)

A
  • Different scanner bed profiles

- Image retrieval from different archives

135
Q

A fused PET/CT image can only be considered diagnostic if the target registration error is less than 1 mm.

A

false

136
Q

What kind of artifact might one expect to see on PET/CT images if the patient has a metallic implant?

A
  • Cold artifact due to absorption of the photons
  • Hot artifact due to attenuation correction
  • Streaked artifacts due to reconstruction
137
Q

Brown fat is __________.

A

a vestigial organ of thermogenesis

138
Q

Dental fillings, hip prosthetics, or chemotherapy ports are examples of PET/CT imaging artifacts described as __________.

A

metallic implant artifacts

139
Q

Normal distribution of 18FDG includes __________. (Select all that apply.)

A
  • low uptake into white matter and cerebrospinal fluid
  • variable uptake into stomach, small intestine, colon, and rectum
  • age related testicular uptake
140
Q

Which of the following reduces the incidence of brown fat? (Select all that apply.)

A
  • Warm blanket

- Benzodiazepines

141
Q

What is the main reason for truncation artifacts?

A

The CT field of view is smaller than the PET field of view

142
Q

Which is true about a sinogram?

A

It displays all angles of one slice

143
Q

What is it called when only coincidences from detectors within the same ring are allowed?

A

Direct Plane

144
Q

Which process allows the reconstruction of 3D PET using 2D reconstruction methods such as OSEM?

A

Rebinning

145
Q

Why is OSEM the most commonly used 2D reconstruction method in PET?

A

It is quicker and requires less computer power since only a portion of the data is sampled

146
Q

Which phenomenon is the result of Partial Volume Effect?

A

Small lesions appear colder

147
Q

Which is the typical matrix size used in viewing PET images?

A

128x128

148
Q

Which information is stored in list mode acquisition in PET imaging?

A
  • time
  • energy
  • position
149
Q

Displacement on a sinogram equals __________.

A

the distance of the LOR from the centerpoint of the FOV

150
Q

Which of the following is used to describe axial sampling?

A

Span

151
Q

__________ plots those detectors on one side of the gantry that are allowed to be in coincidence with detectors on the other side of gantry.

A

Michelogram

152
Q

To reduce the number of angular samples by a factor of two, one would add every other row in the sinogram to the previous row and assume the resultant data were acquired half-way between the two samples. This manner of reducing the angular sampling is referred to as ______.

A

sinogram mashing

153
Q

Which is true regarding Single Slice Rebinning?

A

It readjusts LORs from cross plane to direct plane

154
Q

It is more desirable for a PET crystal to have a long decay time.

A

false

155
Q

Advantage:
BGO
GSO
LSO

A
  • very good stopping power
  • very good energy resolution
  • good stopping power with short decay time
156
Q

DISADVANTAGE:
LSO
GSO
BGO

A
  • poor energy resolution
  • poor light output
  • very long decay time
157
Q 
Scatters
Randoms
Singles
Trues
Multiples
A
  • incorrect LOR (change paths)
  • originate from different
  • one striking
  • two striking
  • more than two striking
158
Q

What is the approximate maximum percentage of single events that are converted into a true annihilation event?

A

10%

159
Q

The difference between 2-D and 3-D PET is the presence of septa between the detector rings in 2-D mode.

A

True

160
Q

Which method of attenuation correction works best in PET imaging?

A

CT-based

161
Q

What type of detector is a PET camera?

A

Scintillation

162
Q

As count rate increases, ____________ rate increases exponentially.

A

randoms

163
Q

Which area of the field of view is most susceptible to unevenly spaced LORs, thus requiring arc correction?

A

Edges of FOV

164
Q

What occurs to the Trues count rate upon reaching the maximum Noise Equivalent Count Rate (NECR)?

A

?

165
Q

The delayed timing window is used to correct for which of the following?

A

Randoms

166
Q

Normalization is similar to which Gamma Camera QC procedure?

A

Non-uniformity analysis

167
Q

The axial FOV is along the direction of the table (length of hole) while the transaxial FOV is across the gantry (hole diameter).

A

True

168
Q

What type of error is created when a photon interaction takes place within the crystal rather than at the surface?

A

?

169
Q

As compared to SPECT imaging, which characteristic of the crystal becomes less important?

A

?

170
Q

Which term describes the line connecting two detectors processing a true event?

A

LOR

171
Q

Adding dectector rings to a PET camera could significantly reduce imaging time. Why don’t all PET cameras have detectors that could scan the whole patient at once?

A

Cost

172
Q

Events detected in the delayed window are considered randoms and subtracted from the event detected in the PMT tube.

A

False

173
Q

Scatter is not count rate dependent

A

true

174
Q

All scatter correction methods have disadvantages. Which of the following are disadvantages of model-based calculations? Select all that apply.

A
  • Data has scatter Incorporated

- Takes a lot of computer power and memory

175
Q

How are energy windows manipulated to correct for scatter?

A

Collect 1-2 energy windows below the primary window to subtract from final image

176
Q

Separate Transmission
Simultaneous Transmission/Emission
Singles Transmission
CT Method

A
  • source rotates around patient
  • counted in LOR
  • singles mode
  • higher resolution and more accurate
177
Q

The __________ determines the labeling and packaging requirements.

A

DOT

178
Q

At what distance is the exposure rate (in mR/hr), indicated by a package transport index, measured?

A

1 meter from the surface

179
Q

According to the NRC - 10 Code of Federal Regulations Part 20 Section 1201, a maximum permissible dose to extremities for radiation workers should not exceed __________.

A

50 rem/year

180
Q

Radioactive materials should be held for __________ half-lives before being disposed of in the regular trash.

A

10

181
Q

With radiation effects, __________ means there is a probability of occurrence that has no threshold, increases with increasing doses to the individual, and does not increase with severity as a function of the dose.

A

stochastic effects

182
Q

Title 10 CFR part 19 relates to __________.

A

reports on workers and inspection

183
Q

PET radiopharmaceuticals are usually shipped in a package with which label?

A

Yellow-II

184
Q

According to 10 CFR 35.67, leak tests on sealed sources must be performed __________.

A

semi-annually

185
Q

Records for personnel monitoring must be kept for __________.

A

the duration of the license

186
Q

According to the NRC, an unrestricted area is one in which a person would receive a radiation dose of less than __________.

A

2 mrem/hr

187
Q

A licensee must ensure the dose equivalent to an embryo/fetus during a 9-month pregnancy of a declared pregnant worker does not exceed __________.

A

0.5 rem

188
Q

What is the most practical material used for shielding in PET?

A

Lead

189
Q

Absorbed dose
Equivalent dose
effective dose

A
  • energy deposited per unit mass of an absorbing material
  • weight summed of the equivalent doses
  • absorbed dose weighted
190
Q

Which of the following accounts for most of the radiation dose to organs and tissues in PET imaging?

A

Positrons

191
Q

Which of the following are potential causes of external exposure from PET radionuclides?

A
  • A deep dose from Bremsstrahlung generated in lead or other shielding material of high atomic number
  • An immersion and inhalation dose from a release of radioactive gas into the room air
  • A skin dose from surface contamination
192
Q

__________ is the federal governing body that has the primary mission of protecting public health and safety and the environment from the effects of radiation from nuclear reactors, materials, and waste facilities.

A

NRC

193
Q

Dosimeters should be issued to personnel who could receive in excess of ___________ of the occupational limit.

A

500 mrem/year

194
Q

__________ has a maximum radiation level at any point on the external surface of greater than 0.5 mrem/hr but less than or equal to 50 mrem/hr.

A

Yellow-II

195
Q

Standards for radiation protection are covered in __________.

A

10 CFR 20

196
Q

How often should inventories of sealed sources be performed?

A

Semi-annually

197
Q

Which of the following signs should be posted if a person could receive more than 5 mrem in an hour?

A

?

198
Q

What is “rest mass”?

A

Particle has no kinetic energy

199
Q

What is the minimum energy for Pair Production to occur?

A

1.022 MeV

200
Q

Positron range is affected by ______.

A
  • matter density
  • particle energy
  • particle mass
201
Q

Which isotope has the poorest image resolution?

A

Rb-82

202
Q

Which of the following has the greatest rest energy?

A

Neutron

203
Q

Who discovered and named the positron?

A

Carl Anderson

204
Q

In the Positron decay reaction, the neutrino helps to satisfy which of the following?

A

Conservation of energy

205
Q

What is formed when an emitted positron joins an electron?

A

Positronium

206
Q

If a nuclide is proton-rich but lacks 1.022 MeV, what type of reaction takes place? (Select the best answer.)

A

Electron Capture

207
Q

What is the HVL for 511 keV annihilation photons in lead?

A

4.10 mm

208
Q

Why does a nuclide decay by positron emission?

A

It has too many protons

209
Q

Why is the result of annihilation two 180-degree photons?

A

Conservation of Momentum

z Nuc Med z (14 decks)

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