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Nuclear Imaging > Radiotracers and Protocols > Flashcards

Radiotracers and Protocols Flashcards

1
Q

What tracers are currently used for myocardial perfusion imaging?

A

Thallium 201 (Tl-201) and two technetium 99m agents (Tc-99 sestamibi and TC-99 tetrofosmin)

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2
Q

Which tracer is an analog of potassium?

A

Thallium (Tl-201)

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3
Q

Has a physical half-life of 73.1 hours

A

Thallium (Tl-201)

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4
Q

What does Thallium (Tl-201) decay to?

A

Mercury (Hg-201) – decays by electron capture

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5
Q

Has a principal emission of 68-80 keV

A

Thallium (Tl-201)

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6
Q

Has the higher first pass metabolism of the tracers used (85%)

A

Thallium (Tl-201) has higher first pass than TC-99m

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7
Q

Which tracer is excreted by the kidneys (so the kidneys light up on imaging)?

A

Thallium (Tl-201)

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8
Q

What is the whole body effective dose of radiation per mCi of Thallium (Tl-201) injected?

A

6.3 mSv per mCi of Thallium (Tl-201) injected

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9
Q

Describe the imaging protocol for Thallium (Tl-201) stress test.

A

A single dose of 2.5-4.0 mCi of Tl-201 is injected prior to peak exercise stress or at peak pharmacologic vasodilatation, and SPECT imaging starts 10-15 minutes later. Redistribution (rest) imaging is done 2.5-4.0 hours later.

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10
Q

In Thallium (Tl-201) cases where standard stress-redistribution imaging shows a fixed or minimally reversible perfusion abnormality, describe how viability can be assessed.

A

Myocardial viability can be assessed with a rest image at 18-24 hours or following reinjection of an additional 1-2 mCi dose of Tl-201.

An alternative method for viability assessment is injection of 3-4 mCi of Tl-201 at rest followed by 3- to 4-hour redistribution imaging.

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11
Q

Which tracer is lipid soluble?

A

Sestamibi and Tetrofosmin (Tc-99m)

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12
Q

Which tracer is transported into the myocyte by active membrane transport?

A

Thallium (Tl-201)

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13
Q

Which tracer has myocyte washout (redistribution) that begins within 10-15 minutes after injection?

A

Thallium (Tl-201)

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14
Q

Which agent is excreted via the hepatobiliary system and excreted into the GI tract?

A

Sestamibi and Tetrofosmin (Tc-99m)

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15
Q

What is the whole body effective dose of radiation per mCi of Sestamibi and Tetrofosmin (Tc-99m) injected?

A

0.3 mSv per mCi of Sestamibi and Tetrofosmin (Tc-99m) injected

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16
Q

What are the minimum imaging delays for Sestamibi (Tc-99m) with exercise? rest? pharmacologic stress?

A

15-20 min for exercise.
45-60 min for rest.
60 min for pharmacologic.

17
Q

What are the minimum imaging delays for Tetrofosmin (Tc-99m) with exercise? rest? pharmacologic stress?

A

10-15 min for exercise.
30-45 min for rest.
45 min for pharmacologic.

Nuclear Imaging (2 decks)

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