Dave’s: Nuclear Medicine Board Review 15 – Flashcards

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Indium 111 WBC scan
Indium 111 WBC scan
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Dose: 500 uCi Indium-111
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Indium 111 WBC scan
Indium 111 WBC scan
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T1/2: 2.8 (3) days
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Indium 111 WBC scan
Indium 111 WBC scan
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Photopeaks: 173 and 247 keV (20% windows)
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Indium 111 WBC scan
Indium 111 WBC scan
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Imaging: planar +/- spect at ?4, 24, ?48 hr
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Indium 111 WBC scan
Indium 111 WBC scan
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Critical organ: spleen 20 rads/500 uCi
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I-123
I-123
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Surveillance of thyroid CA - thyroid hormone withdrawl vs Thyrogen
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I-123
I-123
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Dose: 2-4 mCi Orally
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I-123
I-123
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Energy: 159 keV. T1/2 = 13 hrs.
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I-123
I-123
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Image: 24 hr +/- 48 hr planar WB + Hi-count neck/chest. ? Cobalt transmission
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I-123
I-123
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Critical Organ: bladder
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I-131
I-131
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Treatment & surveillance of thyroid CA
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I-131
I-131
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D/c thyroid hormone vs thyrogen
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I-131
I-131
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Dose: 4 mCi I-131 PO.
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I-131
I-131
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T1/2 = 8 days.
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I-131
I-131
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Energy: multiple, but image 364 keV
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I-131
I-131
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Imaging: 48 hr planar WB + Hi-count neck/chest. ? Delayed images.
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In-111 Octreoscan (pentetreotide)
In-111 Octreoscan (pentetreotide)
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Indications: Carcinoid, insulinoma, gastrinoma, glucagonoma, pheochromocytoma, paraganglionoma, medullary thyroid cancer, VIPoma, pituitary adenoma
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In-111 Octreoscan (pentetreotide)
In-111 Octreoscan (pentetreotide)
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Dose: 5 mCi Indium-111 pentetreotide IV
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In-111 Octreoscan (pentetreotide)
In-111 Octreoscan (pentetreotide)
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Energy: 173 & 247 keV, 20% photopeaks
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In-111 Octreoscan (pentetreotide)
In-111 Octreoscan (pentetreotide)
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T ½ = 2.8 (3) days
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In-111 Octreoscan (pentetreotide)
In-111 Octreoscan (pentetreotide)
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Patient Prep: good hydration and bowel prep. D/c octreotide 1 wk prior. (Octreotide immediate-release injection is also used to control diarrhea and flushing caused by carcinoid tumors (slow-growing tumors that release natural substances that can cause symptoms) and vasoactive intestinal peptide secreting adenomas (VIP-omas; tumors that form in the pancreas and release natural substances that can cause symptoms).
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In-111 Octreoscan (pentetreotide)
In-111 Octreoscan (pentetreotide)
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Imaging: 24 +/- 48 hrs WB planar +/- spect with fusion.
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In-111 Octreoscan (pentetreotide)
In-111 Octreoscan (pentetreotide)
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Critical Organ: kidney 1.8 rads/mCi, bladder 1.0 rads/mCi.
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I-123 MIBG - Adrenomedullary Imaging
I-123 MIBG - Adrenomedullary Imaging
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Indications: pheochromocytoma, paraganglionoma, neuroblastoma.
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I-123 MIBG - Adrenomedullary Imaging
I-123 MIBG - Adrenomedullary Imaging
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I-123: 159 keV
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I-123 MIBG - Adrenomedullary Imaging
I-123 MIBG - Adrenomedullary Imaging
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13 hr T ½
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I-123 MIBG - Adrenomedullary Imaging
I-123 MIBG - Adrenomedullary Imaging
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Dose: 10 mCi I-123 MIBG IV
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I-123 MIBG - Adrenomedullary Imaging
I-123 MIBG - Adrenomedullary Imaging
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Imaging: Whole body planar +/- hi-count planar vs spect with fusion at 24 hrs, =/- 48 hrs.
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I-123 MIBG - Adrenomedullary Imaging
I-123 MIBG - Adrenomedullary Imaging
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Protect the "critical organ" - the thyroid. Pretreat with Lugol's soln (6.3 mg I/drop). 1 gtt 2x/d for 1 day prior and 7 days post.
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F-18 FDG
F-18 FDG
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Energy: 511 keV, coincident photons
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F-18 FDG
F-18 FDG
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T 1/2: 109 min
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F-18 FDG
F-18 FDG
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Dose: 10-20 mCi
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F-18 FDG
F-18 FDG
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Imaging - PET/CT at 60 min post-injection, +/- delays in H;N, others.
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GALLIUM-67
GALLIUM-67
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Indications: Tumor imaging, infection and inflammation imaging.
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GALLIUM-67
GALLIUM-67
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Energy: 93, 185, 288, 394 keV (Think 100, 200, 300, 400 keV.)
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GALLIUM-67
GALLIUM-67
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T ½ 78 hrs.
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GALLIUM-67
GALLIUM-67
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Dose: 10 mCi.
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GALLIUM-67
GALLIUM-67
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Critical Organ: Bone Marrow 0.6 rads/mCi
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Quality Control of Radiopharmaceuticals
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Chemical purity Radiochemical purity Radionuclide purity
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Causes of diffuse liver uptake on bone scan
Causes of diffuse liver uptake on bone scan
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Aluminum contamination (chemical purity) Colloid formation (radiochemical purity)
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Chemical purity
Chemical purity
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Mostly refers to amount of aluminum contamination
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Chemical purity
Chemical purity
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Legal limit of aluminum is 10 micrograms/ml
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Radiochemical purity
Radiochemical purity
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Refers to the Tc based compounds other than the desired pharmaceutical ;TcO4 TcSC Other Tc Tc DMSA Tc HMPAO
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Radiochemical purity
Radiochemical purity
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Tested with thin layer chromatography: free Tc04 migrates in saline and methanol Tc99m compounds migrate in saline only
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Radionuclide purity
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Refers to molybdenum breakthrough
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Radionuclide purity
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Test is based on greater energy of Moly HVL in lead is 6mm vs. 0.2 mm for Tc
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Radionuclide purity
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Legal limit is 0.15 uCi Mo/mCi Tc
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Radionuclide purity
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If there is too much moly then the dose to the patient especially the liver is increased Mo has a long t 1/2 and is a Beta emitter
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Bone Scan Tc-99m MDP
Bone Scan Tc-99m MDP
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Energy: 140 keV
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Bone Scan Tc-99m MDP
Bone Scan Tc-99m MDP
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T1/2: 6 hrs
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Bone Scan Tc-99m MDP
Bone Scan Tc-99m MDP
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Dose: 25 mCi
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Bone Scan Tc-99m MDP
Bone Scan Tc-99m MDP
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Normal biodistribution: bone, kidney, bladder
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Bone Scan Tc-99m MDP
Bone Scan Tc-99m MDP
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Critical organ=bladder (2-8 rads)
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Bone Scan Tc-99m MDP
Bone Scan Tc-99m MDP
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Timing: 2 hrs
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