Nuclear medicine Flashcards
patient is a smoker, with LBBB and has atypical chest pain
what’s the best test to examine risk of coronary events?
stress test CT calcium dipyridamole MPS exercise MPS contrast echo
dipyridamole MPS is the best choice because:
stress test can’t interpret LBBB
CT calcium score isn’t for intermed risk
exercise MPS is no good with LBBB
contrast echo doesn’t provide any info about future risks
dipyridamole is also better with beta blocker therapy
what is the difference between Hashimoto’s and silent thyroiditis?
these are both autoimmune conditions.
the major difference is that silent is painless goitre, whereas the other is painful
how does Gallium-67 get inside the cell for nuc med scans?
this bad boy is an analogue of ferric iron
therefore, it binds to the serum transferrin! then it is endocytosed
used in malignancy scanning, particularly NHL
what is the role of MIBG imaging?
this is used in neuroendocrine tumours to determine diagnosis and spread
it is an analogue of epinephrine
useful for phaeo, paragangliomas
what is Indium-111 pentetreotide?
what do we use it for?
it is a receptor binding peptide
the binding bit looks a bit like somatostatin.
It can therefore concentrate in neuroendocrine and some non-neuroendocrine tumours that have somatostatin receptors
what would uncontrolled diabetes do to a PET scan?
what about necrosis?
the insulin deficit would mean that the FDG isn’t taken up appropriately into the cell. This would lead to a FALSE NEGATIVE
necrosis is a biologically not-active area. The FDG wouldn’t be taken up. This means that it would be appropriately negative
