Name that scan!

Question 1

Answer 1

I-131 scan more metastatic thyroid cancer, beta minus decay

uptake in the thyroid shows star artifact along with multiple metastatic sites

Question 2

Answer 2

F18- NaF

Question 3

Answer 3

Tc-99m MDP scan,

MOA: adsorption to crystals in bone matrix

Question 4

Answer 4

In-111 tagged WBC scan

hot spleen!!

two varieties of WBC scans: Tc-99m and In-111

Tc-99m WBC scan is preferred in kids because shorter half life (lower dose in kids) AND higher quality imaging (better spatial resolution for smaller parts)

In-111 has a longer half life –> more delayed imaging

In-111 –> less bowel uptake so preferred to evaluate for IBD

Question 5

Answer 5

In-111 WBC in Crohns diseae with abscess

Question 6

Answer 6

I-123 whole body pre-treatment

medium energy detector (not as crappy picture as I-131)

Question 7

post thyroid ablation

what uptakes differs between pre and post treatment iodine scans?

Answer 7

post treatment: liver uptake (physiologic) is present in post treatment scan which is never present pre-treatment

can also see breast and colon uptake as in this case

Question 8

Answer 8

Question 9

Answer 9

normal distribution of Ga67

Question 10

Answer 10

I-123 MIBG

Question 11

I-123 MIBG scan. Normal or abnormal?

Answer 11

super abnormal. you shouldn’t see the bones at ALL. if you see bones on MIBG scan –> bone mets

Question 12

Answer 12

tc99m O4 (pertechnetate)

Question 13

Answer 13

Question 14

Answer 14

Tc-99m MDP

Question 15

Answer 15

Tc-99m sulfur colloid

Question 16

Tc-99m sulfur colloid scan, posterior image (spleen on screen left)

Answer 16

colloid shift = portal HTN

typically on SC scan the liver = spleen –> portal HTN the blood is shunted to the spleen –>

spleen > liver

Question 17

Answer 17

tagged RBC scan to look for bleed

Flow images of red blood cell labeled 99m-Tc gastrointestinal bleed scan: Chronological first site of bleed localized to distal ileum (arrow head) and proximal jejunum as primary site of bleed (arrow)

https://www.wjnm.org/viewimage.asp?img=WorldJNuclMed_2013_12_3_111_136735_f1.jpg

Question 18

Answer 18

free tech in a meckel scan

Question 19

Answer 19

altered biodistribution of MDP due to radiochemical impurity (free tech)

Question 20

Answer 20

f-18 fdg pet

Question 21

Answer 21

tc99m sestamibi

Question 22

Answer 22

whole body sestamibi

Question 23

Answer 23

F-18 fluciclovine PET (axumin)

taken up via the human l-type amino acid transporter and alanine-serine-cysteine transporter systems

uptake
in tissues that produce proteins or process amino
acids. l-type amino acid transporter and alanineserine-cysteine transporter systems

The most intense physiologic tracer uptake is seen in the pancreas (Fig 2). However, this uptake decreases within 15 minutes after injection of the radiopharmaceutical –> becomes more intense in the liver

moderate salivary gland and pituitary gland uptake and variable mild to moderate bowel activity

Liver is the critical organ

Question 24

Answer 24

F-18 fluciclovine PET (axumin)

you have to image fluciclovine very soon after injection and scan from the pelvis up - start the scan before concentration in the urinary system

Question 25

Answer 25

xe133 ventilation

Question 26

Answer 26

dtpa Tc99m ventilation scan

Question 27

Answer 27

in111 DTPA CSF scan. Radiotracer injected intrathecally looking for delayed clearance (NPH) or shunt malfunction

Question 28

How big are the particles?

Answer 28

Tc99m-MAA (microaggregated albumin) 10-100 micrometers

Question 29

Tc-99m MAA

Answer 29

Shunting through AVMs --\> systemic circulation should only see MAA uptake in the lungs, if see it systemically it means there is a R --\> L shunt

Question 30

What does the red arrow point to?

Answer 30

hepatic steatosis Xe-133 uptake in the liver

Question 31

Answer 31

Gastric emptying study Tc99m Sulfur colloid standarized meal of eggs (radiotracer mixed in eggs) and toast

Question 32

Answer 32

Tc99m-MAG3 you can see the various phases as it enters, transits, and excretion Look for time activity curve

Question 33

Answer 33

[Tc-99m DMSA](https://radiopaedia.org/articles/tc-99m-dmsa?lang=us)

Question 34

Answer 34

Question 35

Answer 35

Question 36

Answer 36

In-111 octreotide

Question 37

Answer 37

In-111 octreotide

Question 39

Answer 39

MIBG

Question 40

Answer 40

Question 41

Answer 41

MIBG

Question 42

Answer 42

In-111 octreotide case of metastatic carcinoid. Liver mets. carcinoid tumor in RLQ at TI

Question 43

Answer 43

In-111 WBC scan if this were a Tc-99m scan would see bladder, kidneys, and gut

Question 44

Answer 44

Tc-99m DMSA

Question 45

Answer 45

Tc-99m HMPAO WBC scan if see gut uptake \< 24 hrs (in the 4hr range), it is suggestive of IBD or colitis/enteritis

Question 46

Answer 46

sestamibi

Question 47

Answer 47

variable appearance of Ga-67 lacrimal gland and bowel uptake is variable

Question 48

Answer 48

sestamibi with delays bowel uptake decreases over time with sestamibi, so if using for the heart you have to delay so hepatobiliary uptake doesn't get in the way

Question 49

Answer 49

Tc-99m hmpao WBC scan gut and bladder activity mean Tc-99m HMPAO

Question 50

Answer 50

In-111 octreotide

Question 51

Answer 51

Ga67 shitty bone scan plus liver

Question 52

Answer 52

In-111 WBC no gut or bladder uptake

Question 53

Answer 53

octreotide

Question 54

Answer 54

In-111 octreotide absent spleen