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Flashcards in nuclear Deck (153)
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1

Cardiac uptake on a scan - not PET

MIBG, sestamibi, thallium

2

MIBG vs. Octreotide

MIBG and octreotide can both localize to neuroendocrine tumors (pheochromocytoma, paraganglioma, **neuroblastoma, and carcinoid). In almost all cases, MIBG is the way to go. The exceptions are **carcinoids and extraadrenal pheochromocytomas, gastrinoma (according to Gainesville)

3

what nuclear scan to look for PCP pneumonia

Gallium 67

4

What is thyrogen and when is it used in nuc med?

a highly purified recombinant form of human thyroid stimulating hormone (TSH), given by injection prior to I-131 study as an alternative to going off thyroid hormone

5

normal distribution of octreoscan?

Liver, spleen, kidneys, thyroid, GB, bladder, Normal pituitary gland

6

What is MIBG structurally similar to?

Norepinephrine - thus scanning for Pheos, **neuroblastoma, and paragangliomas

7

half life of Tc-99m

6 hours

8

In-111 half life

2.8 (3) days

9

In-111 WBC scan normal distribution

liver, spleen, bone marrow (NO urinary or GI tract activity!)

10

I-123 half life

13h

11

Iodine scan normal distribution

thyroid gland (target organ)
nasopharynx
salivary glands
stomach (target organ)
colon
bladder (target organ)
lactating breasts

12

I-131 half life

8 days

13

What's the prep before I-131 scanning?

D/c thyroid hormone or us thyrogen

14

octreoscan - what radiopharmaceutical?

In-111

15

Octreoscan - what's it used for?

Neuroendocrine tumors: carcinoid tumour, paraganglioma(s), glomus jugulare/tympanicum/vagale,
carotid body tumour, pheochromocytoma, small cell lung cancer, pituitary adenoma, neuroblastoma, medullary thyroid carcinoma, islet cell tumour of pancreas

16

octreotide is an analogue of what?

somatostatin (thus useful for neuroendocrine tumors)

17

MIBG - what radiopharmaceutical?

I-123

18

MIBG - used for what?

*phaeochromocytoma.
*neuroblastoma
esthesioneuroblastoma
carcinoid tumour
paraganglioma
phaeochromocytoma
medullary thyroid carcinoma
ganglioneuroma
ganglioneuroblastoma

19

MIBG normal distribution

liver
spleen
heart(!)
salivary glands
urinary bladder
gastrointestinal tract (faint)
lungs
brown fat

20

FDG - half life

109 minutes

21

Gallium-67 - half life

78 hours (think 67, 78)

22

Ga-67 normal distribution

lacrimal glands!
liver (site of highest uptake)
bone marrow
spleen
GI tract
salivary glands
nasopharynx
kidneys and bladder in the first 24 hours (only!)- faint uptake can still be normal for up to 72 hours
breast uptake (especially in pregnant and lactating women)
mild diffuse lung uptake at 24 hours or less

23

What's a superscan in a bone scan? What are causes?

intense symmetric activity in the bones with diminished renal and soft tissue activity
diffuse metastatic disease (prostatic, breast cancer, TCC, lymphoma
metabolic bone diseases (renal osteodystrophy, hyperparathyroidism -often secondary hyperparathyroidism-, osteomalacia (will involve distal skeleton smoother uptake)
myelofibrosis / myelosclerosis
mastocytosis
widespread Paget's disease

24

sestamibi - normal distribution

thyroid, parathyroid, heart

25

sestamibi radiopharmaceutical

Tc 99m

26

sestamibi - used for?

parathyroid adenoma detection
cardiac imaging (MIBI)

27

sulpher colloid - what radiopharmaceutical?

Tc 99m

28

sulpher colloid normal distribution

spleen, Kupffer cells in the liver and a small proportion by bone marrow

29

Tc-99m pertechnetate - used for?

Meckel's scan (also thyroid in pediatrics, parathyroid, testicle)

30

what's a bone scan's pharmaceutical?

Tc 99m MDP