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tumor and inflammation > review > Flashcards

review Flashcards

1
Q

cold pharmaceutical may be given before F18 to reduce the uptake of brown fat?

A

lorazepam or diazepam

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2
Q

what drug and dose can be given for sedation in claustrophobia?

A

1mg xanax

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3
Q

in what age group do most malignant neuroblastoma tumors occur?

A

infants and children less than 10

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4
Q

what is the reward of using In111-WBC procedure vs Ga-67

A

In111-WBC greater specificity of 97%. Ga67 - 64%

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5
Q

characteristic of cancer cells?

A

uncontrolled growth
invasion
mets

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6
Q

when is imaging possible after the patient has been injected with 67Ga-Citrate

A

anytime from 6hr to 1 week from injection

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7
Q

which type of collimator does the textbook recommend be used when imaging with 67Ga?Why?

A

high energy collimator because of the physical characteristics of the emissions of the photon. Ga67 has 3 different photopeak

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8
Q

when using 111In-WBC. what does early imaging demonstrate?

A

same retention of the labeled WBC within the lungs this will clear after several hours

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9
Q

what is drawback of using 111In-WBC for inflammatory imaging?

A

it is necessary to obtain a large volume of blood (50ml) from patient and 2 to 3 hours for the labeling procedure

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10
Q

what other two radiopharmaceuticals may be used for inflammatory imaging?

A

99mTc-Exametazine (Certec) and 99mTc-fanolesomab (Neutrospec)

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11
Q

what is an antibody?

A

immunoglobulins created by B lymphocytes or plasma cells in response to an antigen foreign substance

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12
Q

which gender typically gets primary hyperparathyroidism? At what age?

A

female over the age 60

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13
Q

how is a positive parathyroid adenoma defined?

A

a focal area of increased uptake of the radioisotope in the thyroid bed and surrounding areas that represents a progressive intensity over time or fixed uptake that persists as the normal thyroid activity decreases

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14
Q

where are somatostatin receptor found in the body?

A

inside the endocrine cells throughout the body and in numerous endocrin tumors

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15
Q

what is the normal radiopharmaceutical distribution of 111In-Octreoscan?

A

pituitary, thyroid, liver, spleen, kidneys, bowel, gallbladder, ureters, bladder and stimulated adrenal glands

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16
Q

what is the patient prep for 111in-Octreoscan?

A

proper hydration before injection and for 24 hours post injection and mild laxative is recommended the night before injection and the evening post injection. insulinoma patients will need to be given a solution with glucose intravenously before and during administration of the radioisotope

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17
Q

what is the primary clinical symptom for pheochromocytoma? are the lesions benign or malignant? where are they typically located?

A

hypertension. benign found anywhere from the skull base to the pelvic flood

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18
Q

are neuroblastomas malignant or benign? where are they typically located?

A

malignant. most would start in the adrenal glands or sympathetic nervous system ganglia of the abdomen. some can be found in the chest,neck,pelvis or spinal cord

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19
Q

what are the contraindication for MIBG imaging?

A

cocaine, calcium channel blockers, adrenergic blockers, some foods, slected cold preparations and decongestants, antipsychotics, catecholamine agonist and reserpine

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20
Q

which Rp is used for breast imaging? how is the Rp administered?

A

99mTc-sestamibi injected in the contralateral arm following with 10ml of saline flush. it it is a bilateral disease the injection would be done into a foot vein

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21
Q

what is the normal radiopharmaceutical distribution of the breast imaging agent?

A

salivary gland and thyroid glands, myocardium, gallbladder, liver, intestines, muscle, kidneys, and bladder.

22
Q

what is a sentinel node?

A

sentinel node first node to receive regional lymphatic flow from the tumor site and is good indicator of the presence or absence of metastatic tumor in a lymph node group

23
Q

why is it better for an antigen to remain on the surface of a tumor for antibody labeling?

A

if antigen released from the surface of the tumor into the blood there is higher background and it makes the tumor more difficult to image. is better if tumor antigen stay on the surface for antibody labeling

24
Q

what happens to the remaining dose?

A

15-25% of the injected dose is exerted via the kidneys. approximately 10% of administrated dose is exerted in stool during first week

25
Q

what type of lesions should not be imaged after 3hrs if you are using 201Tl-Cl for tumor viability imaging?

A

benign lesions should not be imaged after 3hrs

26
Q

when is the best time for imaging breast and lung carcinomas when using 201Tl-Cl?

A

when imaging breast and lungs carcinomas you should image after 3hrs. improve target to non-target ratio

27
Q

Explain how HAMA is created?

A

mouse antibody seen by the body as a foreign antigen and human antibodies are made in response. second injection of mouse antibody, the human immune response is triggered and various amounts of human antimouse antibody (HAMA) are created

28
Q

neutrophils ingest bacteria with packets of enzymes calles?

A

lysosome

29
Q

which type of antibody is used for tumor imaging?

A

tumor imaging with polyclonal IgG

30
Q

what is the indication for perfroming a lymphoscintigraphy study? what type of malignancies are mostly imaged?

A

indication of lymphoscintigraphy are to study regional lymph node drainage pathways from malignant neoplasms. breast and skin malignancies

31
Q

what is pyogenic abscess?

A

is a localized collection of dead white cells and bacteria

32
Q

what is the plasma clearance time of an IgG molecule? what is the plasma clearance time for the two identical fragment F(ab)

A

IgG molecules are large and clears from plasma very slowly T1/2 =40hrs papain removed Fe region and divides the molecules into 2 identical fragments F(ab)-t1.2 = about 1hr

33
Q

explain why the center of the cancer becomes necrotic?

A

center of a CA can die because central blood flow insufficient

34
Q

How long should breast imaging scintigraphy be delayed following a fine needle aspiration?

A

2 weeks

35
Q

when imaging breasts, what does a negative scan with a palpable lesion suggest?

A

negative scan with a palpable lesion also suggest the lesion is not cancerous

36
Q

for infection localization what serum proteins bind to 67Ga?

A

tumor cell transferrin receptor facilitates Ga uptake in certain tumors, endocytosis of protein bound Ga by tumor cells.

37
Q

what are the symptoms of septicemia?

A

fever, chills

38
Q

what are the two circumstances that allow cancer to become lethal

A

spreads (mets) or is in a critical organ

39
Q

describe the purpose of B lymphocytes and T lymphocytes

A

B lymphocytes become plasma cells and produce antibodies
T lymphocytes control many diverse activities of the immune system

40
Q

when imaging with 67Ga what is the imaging time for infection and for tumor?

A
  • infection 24 hours after injection then additional delayed images at 48 and 72 hours
  • tumor 48 hours then additional delayed images at 72 hours or longer
41
Q

what amount of 67Ga should be administered when a patient has known cancers?

A

10 mCi

42
Q

what technique is used to differentiate between normal colonic activity and lesions in the abdomen?

A

image 24 hours after injection to differentiate infection from physiological bowel clearance. bowel is not normally seen at 24 hours

43
Q

what Rp used when imaging inflammatory bowel disease? what is the dose?

A

99mTc-HMPAO WBC
10-25 mCi

44
Q

at what time should imaging be initiated when using 111In-WBC? what is the static acquisition time?

A

24 hours post injection and occasionally at 6 hours
static images 5min each

45
Q

what pharmaceutical is given to reduce hepatobiliary excretion when imaging inflammatory bowel disease

A

pethidine

46
Q

what are the contraindications for the B-cell lymphoma imaging zevalin?

A
  • greater than 25% involvement of bone marrow
  • impaired bone marrow reserve
  • history of type 1 reaction of anaphylactic reaction to murine antibody
  • patient who have previously received murine antibodies should be screened for HAMA
47
Q

why are these tumor referred to as neuroendocrine tumor?

A

many of them secrete hormones

48
Q

how long should octreotide therapy be stop prior to imaging? what special prep is needed for patients suspected of having an insulinoma?

A

discontinue octreotide therapy 3-7 days before injection.
inpatients suspected of having an insulinoma administer an IV drip of glucose solution D5W just prior to and during injection of the Rp

49
Q

which type of tumors may be detected and localized using the tumor viability study?

A

Tl201 localized in living tumor cells
tumor that aren’t necrotic or non viable
malignant tumor will have an accumulation of sestamibi

50
Q

what are the Rp and doses used for tumor viability imaging?

A

Tl201 thallous chloride 3 mCi
99mTc-Sestamibi 25-30 mCi

51
Q

in what age group do most malignant neuroblastoma tumors occur?

A

infants and children less than 10

52
Q

what drug and dose can be given for sedation in claustrophobia?

A

1mg xanax

tumor and inflammation (3 decks)

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