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Flashcards in Nucs Deck (41):
1

Whole body scan with bones and liver hotter then spleen. What are possible tracers?

More photons -> Tc99m Sulfur colloid
Less photons -> gallium

2

Whole body scan showing bones and spleen hotter than liver what is the tracer?

Indium 111-wbc

3

Whole body scan, no bones, no liver, no spleen. What are you options?

I-123 or I-131

4

Whole body scan, no bones, liver and spleen are lighting up. What is the tracer if the liver > spleen? What is the tracer if spleen > liver and renal uptake?

Liver > spleen I-131 MIBG
Spleen > liver + kidney I-131 MIBG

5

If there are bones and lacrimal gland uptake what are your options?

Free Tc if the bones are faint
Gallium but only if there is no spleen uptake

6

Hot spleen what should you think of?

Octreotide and WBC (sullfur colloid will have liver = spleen)

7

What does MIBG often look for?

Neuroblastoma

8

No bones + no liver + dark kidneys and spleen = ?

Octreotide. Higer count study the images should be cleaner

9

When do you image for Tc wbc scan?

4 adn 24 hours

10

How long can you see lung uptake in a Tc WBC scan?

4 hours

11

in WBC or Tc WBC which has no renal or GI take?

Indinum

12

What organ gets the highest dose of radiation with MDP? With F-18?

Bone for MDP
Bladder for F-18

13

What is normal distribution for Tc-MDP?

Bone
Kidney (If not seen or faint = super scan)
bladder
breasts (in young females)
soft tissues - low levels
epiphyses in kids

14

If there is more then faint uptake in the skull what should you think of? ( Tc-MDP)

Renal osteodystrophy

15

If the renal cortex is hotter then lumbar spine ( Tc-MDP)

Hemochromatosis

16

If there is diffuse renal uptake ( Tc-MDP)

Seen in chemotherapy and urinary obstruction

17

What could abnormal liver uptake indicate? ( Tc-MDP)

Too much Al+3 contamination
Cancer mets or hepatoma
Amyloidosis
Liver Necrosis

18

Lung uptake in ( Tc-MDP) can be from what?

Heteroptic calcification (dystrophic or mets)
Osteosarcoma
Fibrothroax
primary lung tumors
radiation changes
sarcoid
berylliosis
alveolar microlithiasis
wegeners (etc)

19

What is flair phenomenon for ( Tc-MDP)?

Increase in activity 2 weeks to 3 months post treatment. X-rays should show lesions getting more sclerotic

20

Prostate ca mets are uncommon with a PSA below?

10

21

Prostate mets where?

Bone!

22

Lung cancer bone mets tend to be where?

appendicular skeleton

23

What bone related condition is assoicated with lung cancer?

Hypertrophic osteoarthropathy

24

Solitary sternal lesion on bone scan is concering for what?

Breast CA

25

Where does neuroblastoma frequently met?

Metaphysis of long bones

26

I-123 and 131 MIBG are superior for detection of bone mets in what condition?

neuroblastoma

27

How does osteopoikilosis look on bone scan?

Cold

28

What is hypertrophic osteoarthopathy assoicated with?

Chronic hypoxia (CF< Cyanotic heart disease, mesothelioma, pneumoconiosis) and LUNG CANCER!

29

Tram tracking on bone scan?

HPOA

30

What does AVN look like on bone scan?

Early and Late is cold, middle is hot from repair

31

What are HOT benign bone lesions on bone scan?

Fibrous dysplasia
Giant cell tumor
ABC
Osteoblastoma
OO

32

What is a benign COLD lesion on bone scan?

Bone cyst without fracture

33

What is variable on bone scan but benign?

Hemangioma
Multiple hereditary exostosis

34

How can RSD look on bone scan?

Hot on flow and pool with periarticular uptake on delayed phase

35

When do you use Tc HMPAO WBC over In-WBC?

Kids - Tc99 will have lower absorbed dose and shorter imaging times
Small parts - Tc99m does better in hands and feet

36

What cells are labeled by In-WBC?

Neutrophils

37

Normally what is the critical organ for In-WBC?

Spleen

38

In In-Wbc what happens to the distribution if the cells get fragmented?

Indium binds with transferrin and increased liver and bone marrow uptake

39

What is the dose used for ablating a thyroid remenent

30-75

40

What dose is used for treatment of recurrent diseasein the thyroid bed?

150

41

What dose is used for bone or distant thyroid mets?

200-250