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nuclear cardiology > review game > Flashcards

review game Flashcards

1
Q

What is the preferred technique for labeling RBC’s? - (it has the highest labeling efficiency)

A

in vitro

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2
Q

What imaging artifact could potentially occur if a patient with a LBBB or a pacemaker undergoes a nuclear exercise stress test?

A

false positive septal wall defect

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3
Q

Name the cellular receptor activated by Regadenoson

A

a2a adenosine receptor

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4
Q

Name the part of the cardiac cycle that involves relaxation of the cardiac muscle (when ventricles are full)

A

diastole (end diastole)

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5
Q

Name two items that we can use to help assess for patient motion on a MPI study?

A

sineogram, cine

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6
Q

Can the cine be used to asses for motion if the scan was done on the CZT530?

A

no

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7
Q

What is this the equation for?

SV/EDV x100%

A

ejection fraction

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8
Q

What does delayed (4hr/24hr) Tl-201 imaging represent?

A

redistribution (viable myocardium)

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9
Q

An ischemic event will cause the heart to switch to which type of substrate for its energy needs?

A

glucose

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10
Q

MPI SPECT imaging on conventional gamma cameras covers _____ degrees and goes from

_______ to _________

A

180 degrees and 45 RAO and 45 LPO

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11
Q

What is the dose (mg) for all patients receiving Lexiscan?

A

0.4 mg/5 mL

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12
Q

Which of the following drugs would prevent a patient from undergoing a LST?

Theophylline, Aspirin, Persantine, Caffeine, Heparin

A

theophylline, caffeine, persantine

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13
Q

What does Myovation Evolution enable us to decrease while still maintaining image quality?

A

dose or acquisition time or combo of both

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14
Q

Tc99m-Myoview and Tc99m-Sestamibi bind to what in the myocyte?

A

mitochondrial membrane

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15
Q

Which one (QGS or QPS) enables us to evaluate wall motion?

A

QGS (g cuz g goes like the wall goes in motion)

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16
Q

Polar maps and SSS would be considered what kind of analysis?

(Qualitative, quantitative, technical,               retrospective)
A

quanitative

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17
Q

What is being quantified by calculating the LVEF on an ERNA study?

A

percentage of blood ejected from left ventricle per beat

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18
Q

What is being quantified by calculating the LVEF on an ERNA study?

A

Tc99MAA

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19
Q

What % of Tc99m-MAA would need to be deposited outside of the lungs for a RtLt shunt to be present?

A

> 10%

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20
Q

Name the reconstruction method that divides the projection images into subsets.

A

OSEM

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21
Q

Is noise in an image considered low or high frequency?

A

high

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22
Q

To eliminate noise should a low-pass or high-pass filter be used?

A

low pass so only low pass get through

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23
Q

Which reconstruction method is associated with the star artifact?

A

filtered back projection

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24
Q

What is the term that describes the condition when blood supply to the heart does not meet demand?

A

ischemia

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25
Q

If an area of the myocardium is completely deprived of blood supply and the tissue dies, an __________ has occurred.

A

infarction

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26
Q

The uptake method for Tl-201 is primarily __________ and for Tc99m-Myoview it is primarily ___________.

A

active; passive

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27
Q

What is the chelating agent used in the Ultratag Kit for RBC labeling?

A

tin (stannous ion)

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28
Q

What is the main purpose of syringe I and II in the Ultratag kit?

A

sequester any residual extracellular tin

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29
Q

Name the two cardiac conditions that we can use Tc99m-PYP to evaluate in Nuclear Cardiac imaging?

A

Myocardial Infarct

Cardiac Amyloidosis

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30
Q

I-123 MIBG is an analogue of _____________

A

norepinephrine

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31
Q

In women undergoing MPI, what artifact is most commonly seen?

A

anterior wall perfusion defect

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32
Q

In men undergoing MPI, diagnosing CAD in which artery might be compromised due to diaphragmatic attenuation?

A

RCA

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33
Q

Which of the positron emitters have the lowest spatial resolution?

A

Rb-82 because its MeV travels further = less res

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34
Q
A
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35
Q

How does prone imaging improve the diagnostic accuracy of SPECT MPI?

A

shifting the location of any attenuation

36
Q

I-123 MIBG can be used in the detection of _________________

A

heart failure

37
Q

One reason for early termination of a treadmill stress test is if the systolic BP drops by greater than _____ mm Hg

A

10

38
Q

The main goal of filtering in nuclear medicine is to reduce ____________ while preserving _________________

A

noise; resolution

39
Q

Perfusion on an MPI study can be graded semi-quantitatively using models with either ___ or ____ segments

A

17 or 20

40
Q

Perfusion on the 17 or 20 segment models can then be graded on a 5 point scale from 0-4. Which number represents normal perfusion?

A

0=normal tracer uptake

1=mild reduction of uptake

2=moderate reduction of uptake

3=severe reduction of uptake

4=no uptake of tracer

41
Q

In a fasting state the heart primarily uses _________ to meet its energy needs

A

fatty acid

42
Q

In a fed-state the heart primarily uses _________ to meet its energy needs

A

glucose

43
Q

Sarcoidosis is an inflammatory disease in which ______________ gets deposited in tissue.

A

WBCs (specifically non-caseating granulomas)

44
Q

How long is the fasting period according to Froedtert’s protocol for F-18 FDG Sarcoid?

What dietary recommendations does the standard protocol give?

A

NPO after 5 PM

Avoid carbs ( eat high fat/high protein) day before test

45
Q

Name the method of action for Adenosine and Regadenoson

A

direct vasodilation

46
Q

Name the method of action for Persantine

A

indirect vasodilation

47
Q

Dobutamine is a positive __________and _____________

A

inotrope and chronotrope

48
Q

To determine peak filling and emptying rates on a MUGA (highly quantitative measurements) you need more _________ than the standard 16. This would also require a ___________ acquisition time to achieve adequate count density.

A

bins (frames), longer

49
Q

Name two methods of attenuation correction for PET scan

A

CT Cs-137 rods or Ge-68 rods

50
Q

What main camera component does our NAI cameras have that the CZT 530 does not?

A

PMT

51
Q

We do prone imaging on the CZT 530 to try and eliminate what type of artifact?

A

diaphragmatic (affects inferior wall of heart)

52
Q

Name two possible benefits of having a patient do low-level exercise during a pharmacologic stress test

A

less gi uptake, reduced symptoms

53
Q

Tl-201 has gamma emissions at two different energy levels. It also has abundant low energy x-rays. What is the energy range of these three emissions?

A

69-80keV x-rays (90%)

135keV gamma ray (8%)

167keV gamma ray (2%)

54
Q

What % drop in LVEF would be considered statistically significant on a resting ERNA study?

A

> 5-7%

55
Q

The advantage of Tc99m-PYP in the diagnosis of cardiac Amyloidosis is help differentiate which two types of Amyloid?

A

ATTR and AL

56
Q

Tc99m-PYP 3hr images are graded on a scale of 0-3. Which number represents uptake equal to that of the ribs?

A

2

57
Q

Name a common artifact seen when using filtered back projection (FBP) as a reconstruction method? What filter is used in FBP?

A

star artifcat; ramp

58
Q

Could you image a rest MPI scan on the 670 and the stress portion on the CZT530 and compare the two image sets? Why or why not?

A

no bc CZT 4mm slices vs. 670 6.8mm slices

59
Q

F-18 FDG viability vs. F-18 FDG Sarcoid

Which exam requires glucose loading and which doesn’t. Why?

A

viability

60
Q

Name the three views used to acquire an ERNA study.

A

45° LAO

ANT

70° LAO

61
Q

Name the two tracers available to evaluate myocardial viability

A

F-18 FDG

Tl-201

62
Q

If the technologist places a portion of the myocardium from the NM emission data in the lung field on CTAC, what is the potential outcome?

A

false positive

63
Q

If a patient is unable to reach their target HR on a nuclear exercise stress test, what number of METS should be achieved so the test could still be considered to be diagnostic?

A

greater than or equal to 10 mets

64
Q

In general does a high or low Duke treadmill score indicate a low risk for the patient?

A

higher duke score= lower the ris

65
Q

In general, if you were performing a 2-Day protocol for a stress test, would you do the rest or stress portion first?

A

stress

66
Q

What is the infusion rate for Adenosine?

A

140ug/kg/min

67
Q

T1/2 Adenosine?

A

approx 10 sec

68
Q

The CZT 530 directly converts photons into what?

A

electrical signal

69
Q

Is Lexiscan a high or low-affinity A2A adenosine receptor agonist?

A

low affinity bc not long term affect

70
Q

How many half-lives does Lexiscan have?

A

3
2-4 minutes (initial phase)

30 minutes (intermediate phase)

2 hours (terminal phase

71
Q

Describe the timing of Lexiscan administration (including tracer)

A

Lexiscan over 10-20sec

Immediate 5cc saline flush

Inject tracer 10-20sec after flush

72
Q

What NM study could be used to evaluate for the presence of a LtRt shunt?

A

First Pass Angiography

Region drawn around lungs

73
Q

Other than shunt assessment, what other use does First Pass angiography have?

A

left or right ventricular function

74
Q

How long after symptoms/MI is the optimal time to inject a patient with Tc99m-PYP to evaluate for infarction?

A

48-72 hrs

75
Q

A TID ratio greater than the normal value could indicate what?

A

extensive CAD (triple vessel disease)

76
Q

One of the problems with Adenosine is that it is an agonist for A2B and A3 receptors. Activation of these receptors can lead to what undesired side effect?

A

bronchoconstriction

77
Q

What are the two key pieces of information derived from I-123 mIBG imaging for heart failure?

A

HMR (<1.6 = abnormal)

WR (higher washout rate = poorer prognosis)

78
Q

What is referred to as the “ischemic memory tracer” ?

A

I-123 BMIPP

79
Q

What are the three types of coincidence events detected in PET imaging?

A

true, random, scatter

80
Q

What are two important quantitative measurements that can be obtained in PET myocardial imaging (that SPECT imaging can’t provide?)

A

MBF, MFR

81
Q

Absolute Myocardial Blood Flow (MBF)

A

MBF uses dynamic acquisition from time of injection (binning data with time)

blood flow in mL/min/g tissue

Normal MBF 0.99 +/- 0.23 mL/min/g

SPECT MPI only relative differences in blood flow

82
Q

Myocardial Flow Reserve (MFR)

A

Ratio of hyperemic flow : resting flow

Dynamic acquisition

ROIs around LV myocardium and LV blood pool

time activity curves generated

MFR >2.3 = favorable prognosis

MFR <1.5= significantly diminished , associated with elevated cardiac risk

83
Q

Which of the PET radiopharmaceuticals we discussed is produced by a generator?

A

Rb-82

84
Q

Which PET radiopharmaceutical for cardiology has the best spatial resolution?

A

F-18 FDG

85
Q

Which PET tracer is showing promise in evaluating sarcoidosis?

A

DOTA peptides

nuclear cardiology (1 decks)

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