Nuclear Medicine Board Exam Review
with Accurate Solutions
Gas Ventilation - ANS-Xe 133, 81 KeV, 5.3 half life; reactor produced
dose: 10-20 mCi
imaging: posterior position
negative pressure room required
uses activated charcoal trap to accumulate the exhaled xenon gas until decayed to
background
single breath: during inhalation
wash in / equilibrium : collected while the xenon distributes through aerated portions of
the lung
wash out : while radioactivity is cleared from lungs
Sr 89 Chloride - ANS-Strontium Chloride, Metastron
1.46 MeV max, .58 Mev mean
half life = 50.5 days
40-60 uci/kg IV
for skeletal mets, depresses bone marrow
shouldn't be used if leukocyte count below 2400/ul or platelet below 60,o00/ul
excretion : urinary
I 131 Tositumomab - ANS-Bexxar
half life = 8.04 days
606.3 KeV max energy
treatment of patients with NHL
before treatment, patient must receive 650 mg acetaminophen and 50mg diphydramine
orally
thyroid uptake should be minimized with SSKI
activity initially seen in blood pool, liver and spleen
later times, activity in liver, spleen, thyroid, bladder, and tumor sites
Y 90 ibritumomab tiuxtetan - ANS-Zevalin
half life = 2.67 days
2.281 MeV
treatment of patients with NHL (disseminated follicular B-Cell)
monoclonal antibody against lymphoma antigens
before treatment, patient must receive 650 mg (imaging) acetaminophen and 50mg
diphydramine orally
max dose = 32 mci
platelets must be at least 100,000/mm3
, Sm 153 EDTMP - ANS-ethylenediaminetetra methylene phosphonic
Quadramet
half life = 46.7 hours
0.81 MeV maximum
concentrates in bone marrow
for patients with more metabolically activate metastases from prostate or breast cancer,
as well as those from osteogenic sarcoma
1.0mci/kg
urinary excretion
Bone therapy blood requirements - ANS-60,000-100,000/ul platelet
2400-3000/ul leukocyte
2000/ul granuolyte
I 131 MIBG - ANS-metaiodobenzylguanidine
half life = 8.06 days
localization/treatment of primary or metastatic pheochromocytomas/ neuroblastoma
8.04 days
kidney/ urinary excretion
I 131 Sodium Iodide - ANS-half life = 8.06 days
used to treat hyperthyroidism, thyroid carcinoma
10-15 mCi for graves
20-30 mCi for nodular goiters
*special release precautions
Blood Brain Barrier Imaging - ANS-Tc99m Pertechnetate
-least desirable (accumulated in choroid plexus)
-15-30mCi
-premed with KCLO4- preferred
Tc99m Pentetate (DTPA)
-planar
-cleared by kidneys
Dynamic imaging: cerebral blood flow
static blood pool
delayed statics: 3-30 min after
6 sec after tracer: rt and lt carotid and anterior cerebral
abnormal: increased localization of RP
brain death: tracer distribution in carotids, abscense of perfusion
Brain Perfusion - ANS-Tc99m exametazime/HMPAO/ceretec
Tc99m Biscisate (ECD, neurolite)
Lipid soluble, crosses BBB
SPECT
dimly lit room for injection
with Accurate Solutions
Gas Ventilation - ANS-Xe 133, 81 KeV, 5.3 half life; reactor produced
dose: 10-20 mCi
imaging: posterior position
negative pressure room required
uses activated charcoal trap to accumulate the exhaled xenon gas until decayed to
background
single breath: during inhalation
wash in / equilibrium : collected while the xenon distributes through aerated portions of
the lung
wash out : while radioactivity is cleared from lungs
Sr 89 Chloride - ANS-Strontium Chloride, Metastron
1.46 MeV max, .58 Mev mean
half life = 50.5 days
40-60 uci/kg IV
for skeletal mets, depresses bone marrow
shouldn't be used if leukocyte count below 2400/ul or platelet below 60,o00/ul
excretion : urinary
I 131 Tositumomab - ANS-Bexxar
half life = 8.04 days
606.3 KeV max energy
treatment of patients with NHL
before treatment, patient must receive 650 mg acetaminophen and 50mg diphydramine
orally
thyroid uptake should be minimized with SSKI
activity initially seen in blood pool, liver and spleen
later times, activity in liver, spleen, thyroid, bladder, and tumor sites
Y 90 ibritumomab tiuxtetan - ANS-Zevalin
half life = 2.67 days
2.281 MeV
treatment of patients with NHL (disseminated follicular B-Cell)
monoclonal antibody against lymphoma antigens
before treatment, patient must receive 650 mg (imaging) acetaminophen and 50mg
diphydramine orally
max dose = 32 mci
platelets must be at least 100,000/mm3
, Sm 153 EDTMP - ANS-ethylenediaminetetra methylene phosphonic
Quadramet
half life = 46.7 hours
0.81 MeV maximum
concentrates in bone marrow
for patients with more metabolically activate metastases from prostate or breast cancer,
as well as those from osteogenic sarcoma
1.0mci/kg
urinary excretion
Bone therapy blood requirements - ANS-60,000-100,000/ul platelet
2400-3000/ul leukocyte
2000/ul granuolyte
I 131 MIBG - ANS-metaiodobenzylguanidine
half life = 8.06 days
localization/treatment of primary or metastatic pheochromocytomas/ neuroblastoma
8.04 days
kidney/ urinary excretion
I 131 Sodium Iodide - ANS-half life = 8.06 days
used to treat hyperthyroidism, thyroid carcinoma
10-15 mCi for graves
20-30 mCi for nodular goiters
*special release precautions
Blood Brain Barrier Imaging - ANS-Tc99m Pertechnetate
-least desirable (accumulated in choroid plexus)
-15-30mCi
-premed with KCLO4- preferred
Tc99m Pentetate (DTPA)
-planar
-cleared by kidneys
Dynamic imaging: cerebral blood flow
static blood pool
delayed statics: 3-30 min after
6 sec after tracer: rt and lt carotid and anterior cerebral
abnormal: increased localization of RP
brain death: tracer distribution in carotids, abscense of perfusion
Brain Perfusion - ANS-Tc99m exametazime/HMPAO/ceretec
Tc99m Biscisate (ECD, neurolite)
Lipid soluble, crosses BBB
SPECT
dimly lit room for injection
