Michigan Nuclear Medicine Practice
Questions 2026 Study Guide
1. differentiate whole body Key points:
scans (see flip side) Gallium has light spleen uptake
Octreotide has intense kidney uptake
MIBG has no kidneys (remember we use it to look at adrenals)
2. Indium vs. Tc99m WBC scan Tc WBC
appearance -renal and GI activity
-lung uptake if imaged at 4 hours
In WBC
-no renal or GI activity
3. mechanism of MDP bone chemisorption
scans -phosphate binds to bone
-distribution based on flow and osteoblastic activity
4. how is MDP tagged to Tc99m add free pertechnetate to stannous ion (to reduce it)
it will then bind to MDP
5. what causes free Tc when air in the syringe (oxidation)
preparing MDP scans
OR
not enough stannous ion
, Michigan Nuclear Medicine Practice
Questions 2026 Study Guide
6. highest dose organ with MDP MDP: bones
and F-18 bone scans
F-18: bladder
7. marked bone scan uptake hyperPTH
along cranial sutures
8. focal breast uptake on bone breast cancer
scan
9. marked renal cortex uptake hemochromatosis
on MDP bone scan
10. liver uptake on bone scan cancer, amyloid, liver necrosis
11. spleen uptake on bone scan infarcted spleen (sickle cell)
12. sacral insufficiency fracture Honda sign
on bone scan
13. muscle uptake on bone scan rhabdomyolysis
14. preferred test for bones mets MIBG with I-123/131
from neuroblastoma
15. hypertrophic osteoarthropa- "tram line uptake" along periosteum
thy on bone scan
next step? chest CT for lung cancer
next step?
, Michigan Nuclear Medicine Practice
Questions 2026 Study Guide
16. Pagets on bone scan enlarged hot long bone or hemipelvis
"mickey mouse" vertebrae (body and post elements)
17. early and late AVN on bone Early and late are cold
scan
middle may be hot (from repair)
18. osteoid osteoma on bone double density
scan
19. BENIGN BONE LESIONS ON all hot except bone cyst without fracture
BONE SCAN
HOT or COLD?
fibrous dysplasia
bone cyst without fracture
Questions 2026 Study Guide
1. differentiate whole body Key points:
scans (see flip side) Gallium has light spleen uptake
Octreotide has intense kidney uptake
MIBG has no kidneys (remember we use it to look at adrenals)
2. Indium vs. Tc99m WBC scan Tc WBC
appearance -renal and GI activity
-lung uptake if imaged at 4 hours
In WBC
-no renal or GI activity
3. mechanism of MDP bone chemisorption
scans -phosphate binds to bone
-distribution based on flow and osteoblastic activity
4. how is MDP tagged to Tc99m add free pertechnetate to stannous ion (to reduce it)
it will then bind to MDP
5. what causes free Tc when air in the syringe (oxidation)
preparing MDP scans
OR
not enough stannous ion
, Michigan Nuclear Medicine Practice
Questions 2026 Study Guide
6. highest dose organ with MDP MDP: bones
and F-18 bone scans
F-18: bladder
7. marked bone scan uptake hyperPTH
along cranial sutures
8. focal breast uptake on bone breast cancer
scan
9. marked renal cortex uptake hemochromatosis
on MDP bone scan
10. liver uptake on bone scan cancer, amyloid, liver necrosis
11. spleen uptake on bone scan infarcted spleen (sickle cell)
12. sacral insufficiency fracture Honda sign
on bone scan
13. muscle uptake on bone scan rhabdomyolysis
14. preferred test for bones mets MIBG with I-123/131
from neuroblastoma
15. hypertrophic osteoarthropa- "tram line uptake" along periosteum
thy on bone scan
next step? chest CT for lung cancer
next step?
, Michigan Nuclear Medicine Practice
Questions 2026 Study Guide
16. Pagets on bone scan enlarged hot long bone or hemipelvis
"mickey mouse" vertebrae (body and post elements)
17. early and late AVN on bone Early and late are cold
scan
middle may be hot (from repair)
18. osteoid osteoma on bone double density
scan
19. BENIGN BONE LESIONS ON all hot except bone cyst without fracture
BONE SCAN
HOT or COLD?
fibrous dysplasia
bone cyst without fracture
