NMTCB PET CERTIFICATION REVIEW FINAL
PAPER 2026 COMPLETE QUESTIONS AND
ANSWERS
◉ Imaging procedure with F18-Sodium Fluoride. Answer: inject
well-hydrated pt with 10 mCi F-18 sodium fluoride. incubate 1 to 2
hours and total body images. Can also do dynamic flow images with
blood pool.
◉ advantages of F18-Sodium Fluoride bone images over medronate
MNP. Answer: Na18F has greater lesion detection, greater uptake,
May miss some lesions with MDP (Tc99m agents)
◉ F18-Fluorothymidine method of localization. Answer: F18-
Fluorothymidine (F18-FLT) affinity to cytoplasmic thymidine kinase
1 (TK1) as marker of cellular proliferation. For examine cellular
proliferation in oncology (wide variety of CA).
◉ F18-Fluorothymidine production. Answer: F18-FLT produced by
nucleophilip substitution with precursor. F18-FLT is extracted by
high-performance liquid chromatography (HPLC) system added to
the synthesis module of F18 FDG production
,◉ Imaging procedure with F18-Fluorothymidine. Answer: Injection
of 7 to 10 mCi F18-FLT with dynamic imaging or whole body
imaging after 1-hour incubation
◉ F18-Fluoromisonidazole method of localization. Answer: F18-
Fluoromisonidazole (F18-FMISO) used to quanitify tumor hypoxia in
head and neck CA, lung CA and solid tumors of brain. F18-FMISO
binds to intracellular marcomolecules where oxygen deficit
◉ F18-Fluoromisonidazole production. Answer: F18-FMISO
perpared by nucleophilic substitution like F18-FLT with proudct
extracted and purified from HPLC labeled materials or cartridge
purification
◉ Imaging procuedure with. Answer: inject 10 mCi of F18-FMISO
and incubate 2 hours. Alternatively, dynamic images can be taken in
aresa of known tumor.
◉ Non-cancer use of F18-Fluoromisonidazole. Answer: F18-FMISO
can also be used to evaluate cellular hypoxia in mycoardium
◉ N13-Ammonia method of localization. Answer: myocardial cells
have a high extraction fraction of ammonia and is partially trapped
in myocardial tissue. Glutamic acid/glutamine reaction fixes
ammonia into myocardial tissue
,◉ N13-Ammonia production. Answer: N13-Ammonia is produced by
irradiating high-purity water typically containing 5% ethanol and
subsequently formulated for patient use
◉ imaging procedure using N13-Ammonia. Answer: Pt fasts for
pharmacologic myocardial stress imaging. Pt placed on scanner bed
and injected with 15 mCi v and imaged after 2 to 3 minute delay.
Myocardial rest imaging, Stress study followed 25 to 30 minutes
later.
◉ Oxygen-15 Gas method of localization. Answer: 15O2 ) evaluated
blood flow, blood volume, and oxygen metabolism and primarily
used in neurologic PET
◉ Oxygen-15 Gas Production. Answer: cyclotron production of 15O2
performed by irradiation of 14N-gas.
◉ Procedure for imaging with Oxygen-15 Gas. Answer: imaging with
Oxygen-15 Gas by rapid dynamic acquisition over one-bed position
area to evaluate regional cerebral blood flow, usually with
quantitation of regional cerebral blood flow (CMRO2 - cerebral
metabolic rate) - slices through the brain for specific areas
, ◉ O15-water method of localization. Answer: O15-water a "nearly"
perfect blood flow agent
◉ O15-water method of production. Answer: O15-water produced
by traget irradiation of 14N-gas. Radioactive O-15 gas and hydrogen
gas are heated on a palladium or platinum catalyst wire to control
production of H2O-15
◉ Imaging procedure with O15-water. Answer: evaluate blood flow
in oncology, cardiology or neurology applications. Dynamic images
after IV injection of O15-water. 2.03 min half-life. Injections 30 mCi
or more.
◉ Rb-82 Chloride method of localization. Answer: Rubidium is a
potassium analog and extracted by myocardiyum tissue via the
Na+/K+ adenosine triphosphatase pump. Rb-82 Chloride is used as
a myocaridal perfusion agent
◉ Imaging procedure with Rb-82 Chloride. Answer: Pt on scanner
with generator next to bed. Elute generator directly into patient with
dose of 30 to 60 mCi Rb-82 chloride. 90 second incubation to clear
vasculature and resting heart imagines taken. Follow up with
pharmacologic stress study. Test takes 30 minutes.
PAPER 2026 COMPLETE QUESTIONS AND
ANSWERS
◉ Imaging procedure with F18-Sodium Fluoride. Answer: inject
well-hydrated pt with 10 mCi F-18 sodium fluoride. incubate 1 to 2
hours and total body images. Can also do dynamic flow images with
blood pool.
◉ advantages of F18-Sodium Fluoride bone images over medronate
MNP. Answer: Na18F has greater lesion detection, greater uptake,
May miss some lesions with MDP (Tc99m agents)
◉ F18-Fluorothymidine method of localization. Answer: F18-
Fluorothymidine (F18-FLT) affinity to cytoplasmic thymidine kinase
1 (TK1) as marker of cellular proliferation. For examine cellular
proliferation in oncology (wide variety of CA).
◉ F18-Fluorothymidine production. Answer: F18-FLT produced by
nucleophilip substitution with precursor. F18-FLT is extracted by
high-performance liquid chromatography (HPLC) system added to
the synthesis module of F18 FDG production
,◉ Imaging procedure with F18-Fluorothymidine. Answer: Injection
of 7 to 10 mCi F18-FLT with dynamic imaging or whole body
imaging after 1-hour incubation
◉ F18-Fluoromisonidazole method of localization. Answer: F18-
Fluoromisonidazole (F18-FMISO) used to quanitify tumor hypoxia in
head and neck CA, lung CA and solid tumors of brain. F18-FMISO
binds to intracellular marcomolecules where oxygen deficit
◉ F18-Fluoromisonidazole production. Answer: F18-FMISO
perpared by nucleophilic substitution like F18-FLT with proudct
extracted and purified from HPLC labeled materials or cartridge
purification
◉ Imaging procuedure with. Answer: inject 10 mCi of F18-FMISO
and incubate 2 hours. Alternatively, dynamic images can be taken in
aresa of known tumor.
◉ Non-cancer use of F18-Fluoromisonidazole. Answer: F18-FMISO
can also be used to evaluate cellular hypoxia in mycoardium
◉ N13-Ammonia method of localization. Answer: myocardial cells
have a high extraction fraction of ammonia and is partially trapped
in myocardial tissue. Glutamic acid/glutamine reaction fixes
ammonia into myocardial tissue
,◉ N13-Ammonia production. Answer: N13-Ammonia is produced by
irradiating high-purity water typically containing 5% ethanol and
subsequently formulated for patient use
◉ imaging procedure using N13-Ammonia. Answer: Pt fasts for
pharmacologic myocardial stress imaging. Pt placed on scanner bed
and injected with 15 mCi v and imaged after 2 to 3 minute delay.
Myocardial rest imaging, Stress study followed 25 to 30 minutes
later.
◉ Oxygen-15 Gas method of localization. Answer: 15O2 ) evaluated
blood flow, blood volume, and oxygen metabolism and primarily
used in neurologic PET
◉ Oxygen-15 Gas Production. Answer: cyclotron production of 15O2
performed by irradiation of 14N-gas.
◉ Procedure for imaging with Oxygen-15 Gas. Answer: imaging with
Oxygen-15 Gas by rapid dynamic acquisition over one-bed position
area to evaluate regional cerebral blood flow, usually with
quantitation of regional cerebral blood flow (CMRO2 - cerebral
metabolic rate) - slices through the brain for specific areas
, ◉ O15-water method of localization. Answer: O15-water a "nearly"
perfect blood flow agent
◉ O15-water method of production. Answer: O15-water produced
by traget irradiation of 14N-gas. Radioactive O-15 gas and hydrogen
gas are heated on a palladium or platinum catalyst wire to control
production of H2O-15
◉ Imaging procedure with O15-water. Answer: evaluate blood flow
in oncology, cardiology or neurology applications. Dynamic images
after IV injection of O15-water. 2.03 min half-life. Injections 30 mCi
or more.
◉ Rb-82 Chloride method of localization. Answer: Rubidium is a
potassium analog and extracted by myocardiyum tissue via the
Na+/K+ adenosine triphosphatase pump. Rb-82 Chloride is used as
a myocaridal perfusion agent
◉ Imaging procedure with Rb-82 Chloride. Answer: Pt on scanner
with generator next to bed. Elute generator directly into patient with
dose of 30 to 60 mCi Rb-82 chloride. 90 second incubation to clear
vasculature and resting heart imagines taken. Follow up with
pharmacologic stress study. Test takes 30 minutes.
