NMTCB PET Certification Review
1. What quality control tests for F18-FDG cannot be performed before patientuse: Sterility
2. The initial precursor molecule for producing FDG is: mannose triflate
3. Due to high radioactivity, the production of PET Rx's must be done inlead-shield hot cells
with automated systems called: synthesis modules
4. 1 mCi = X MBq: 37
5. Webster Ped dose: Dose(adult) x (Age+1)/(Age+7)
6. Clark Ped Dose: Dose(Adult) x (child weight/150 pds)
7. Alternate Ped Dose: Snmmi dose/weight range at 3 min
8. max dose for best quality 3D images: 15 mCi FDG due to dead time andrandoms events
9. Standard delay equation: A(o)e(-ht) where h=0.693(T1/2)
10. T1/2 for F18 FDG: 109.7 min
11. Method of localization of 11C-Sodium Acetate: acetate last to bind in the Kreb's cycle.
Represents myocardial oxygen utilization; in oncology, 11C-acetatereflects tissue fatty acid
metabolism in acetyl-coenzyme pathway
12. Production of C11-Acetate: reaction of Grignard reagent, methyl magnesiumbromide and
11CO(2) gas
13. duration of fasting for C11-Acetate imaging: 6 hours
14. approximate dose for C11-acetate: 20 mCi
15. Scan time for C11-acetate: immediate - single bed or whole body with 5 minuptake
16. C11-acetate uptake advantage over F18 FDG: No brain and no renal uptake
17. common imaging using C11-acetate: Prostrate CA and myocardial perfusionwith O15
18. C-11 Choline method of localization: Water-soluble transported into cell for biosynthesis
of phospholipids which is used in fatty acid metabolism of cell mem-brane production
19. Production of C-11 Choline: Produced 11CO2 in cyclotron and to create C11-methyl
iodine which is reacted with dimethylaminoethanol and purified
20. C-11 Choline used to image: Ca - brain, colon, prostrate
21. Procedure for imaging with C-11 Choline: 6 hr NPO, place patient on scanner and inject 20
mCi, delay images 5 to 10 minutes
22. C-11 Palmitate method of localization: Palmitate is a fatty acid that is in blood. It is rapidly
extracted by normal myocardial cells. Rapid 2 phase clearance 1) rapid vascular transit and 2)
incorporated into triglycerides
23. Production of C-11 Palmitate: Produce 11CO2 in cyclotron. React with pen-
,tadecylmagnesium bromide to form 11C-Palmitate and purified.
24. Procedure for imaging with C-11 Palmitate: NPO 6 hrs. Place patient onscanner and
injected and 5 min uptake then scan.
25. F-18 FDG method of localization: Glucose analog transported across cell membrane.
Cells metabolized FDG my phosphorylation by hexokinase to make FDG-6-phosphate and
stays in cells.
26. Normal biodistribution of FDG: Brain, myocardium, moderate in nasopharyn- geal
region,mild in muscle, liver, spleen and testes (suv appox 2). FDG is glomerulus filtered so in
bladder, ureter and kidneys
27. FDG critical organs: Bladder and kidneys
28. Altered distribution of FDG: Inflammation, strenuous exercise 24 hrs before, movement,
chewing gum and talking during incubation period.
29. Production of FDG: Produced by nucleophilic substitution with precursor ofmannose
triflate. Cyclotron produced
30. Rb-82 Genertaor Alert Level: 14L of eleute volume reached, or Sr-82 level0.002uCi/mCi
of Rb-82, or Sr-85 level 0.02uCi/mCi of Rb-82
31. Actions for Rb82 Generator Alert Level: Test after every 750 mL has passedthrough
generator
32. Stop using Rb-82 generator if: 17L of eleute volume reached, or 42 days post calibration
date, or Sr82 levenis 0.01uCi/mCi of Rb82, or Sr85 level reaches0.1uCi/mCi of Rb82
33. Cyclotron produced isotopes and half-life: C11, 20.3 min; N13 9.97 min; O15
2.03 min; F18, 109.7 min
34. Advantages of negative ion cyclotrons: 1) less nuclear activation of cyl potioncavity and
surroundings, 2) can self-focus beam of particles, 3) can irradiate 2 targets at once
35. Isotopes produces by negative ion cyclotrons: C, N, O = metabolites
36. Reaction for chemical labeling of F18-FDG: Nucleophilic substitution
37. Chemical reaction of FDG: Electron rich group of atoms change place onmolecule with
a positively charged leaving group
38. Precursor molecule for FDG: Mannose triflate
39. Chem formula of FDG: 2-deoxy-2-[18F]fluoro-D-glucose. (FludeoxyglucoseF-18)
40. Intermediate step in FDG synthesis: Alkaline hydrolysis of 4 acetyl groups byreplacing
with OH
41. Size filter used after purification: 0.22 um
42. FDA ref for PET pharma production: General chapter 823
, 43. FDG QA appearance: Colorless liquid
44. FDG QA radiochemical identity: Thin-layer chromatography Rf value to refer-ence
standard
45. FDG QARadionuclide identity: Half-life 105 and 115 minutes
46. FDG QA bacterial endotoxins test: LAL (Limulus amebocyte lysate) <175 USPendotoxins
units per max volume injection; endotoxins< 17.5 EU
47. FDG QC pH: Between 4.5 to 7.5
48. FDG QA Radiochemical purity: Thin-layered chromatography radioactive Rfshould be
not less than 90% of total radioactivity of chromatography plate
49. FDG QC Radionuclideic purity: should be >99.5% of radionuclidie specified.tested using
multi-channel analyzer with peaks at 0.511 and 1.022 MeV
50. FDG QC chemical purity: testing depends upon synthesis method used tocreate FDG
51. Kryptofix 222: FDG QC chemical purity test - thin-layer paper chromatographyspot test.
50 ug/mL and FDG solution must demonstrate a less intense response than standard
52. 2-Chloro-2-deoxy-D-glucose: FDG QC chemical purity test used if hydrolysis step was
performed with hydrochloric acid. Use high-performance liquid chromatog- raphy using an
electrochemical detector. Mus not have more than 1 mg CLDG:
2-deoxy-2-D-glucose
53. FDG QC Residual solvents: solvents can be in FDG from cleaning or synthesis solutions.
solutions may contain acetonitrle, ether anddehydrated alcohol. no more 0.04% acetonitrle,
and less than 0.5% of ether or ethanol
54. FDG QC Sterility: not performed before dosing due to need of 14 days to perform.
Regulations require final produce to be placed in soy broth mixture witha thioglycollate
growth media for 30 hrs. look for observable bacteria
55. FDG QC Filter membrane integerity: final sterility filter used at end of manu- facturing
process. Filter must remain intact as pressure increased to 50 psi (bubblepoint test)
56. FDG synthesis room requirements: room: cGMP, ISO class 5 clean room airhood, 21 CFR
212 for manufacturing of IV drugs
57. which radiouclides are possible radioactive contaminates in eluent ofRb82 generators:
Sr82 and Dr85
58. negative ion PET cyclotrons accelerate which partiles: negatively chargedhydrogen atoms
59. chemical method used to label F18 to glucose: nucleophilic substitution
60. The least amount of energy needed by bombarding particles used fornuclear reactions
occurring within a cycltron: 8 Mev
1. What quality control tests for F18-FDG cannot be performed before patientuse: Sterility
2. The initial precursor molecule for producing FDG is: mannose triflate
3. Due to high radioactivity, the production of PET Rx's must be done inlead-shield hot cells
with automated systems called: synthesis modules
4. 1 mCi = X MBq: 37
5. Webster Ped dose: Dose(adult) x (Age+1)/(Age+7)
6. Clark Ped Dose: Dose(Adult) x (child weight/150 pds)
7. Alternate Ped Dose: Snmmi dose/weight range at 3 min
8. max dose for best quality 3D images: 15 mCi FDG due to dead time andrandoms events
9. Standard delay equation: A(o)e(-ht) where h=0.693(T1/2)
10. T1/2 for F18 FDG: 109.7 min
11. Method of localization of 11C-Sodium Acetate: acetate last to bind in the Kreb's cycle.
Represents myocardial oxygen utilization; in oncology, 11C-acetatereflects tissue fatty acid
metabolism in acetyl-coenzyme pathway
12. Production of C11-Acetate: reaction of Grignard reagent, methyl magnesiumbromide and
11CO(2) gas
13. duration of fasting for C11-Acetate imaging: 6 hours
14. approximate dose for C11-acetate: 20 mCi
15. Scan time for C11-acetate: immediate - single bed or whole body with 5 minuptake
16. C11-acetate uptake advantage over F18 FDG: No brain and no renal uptake
17. common imaging using C11-acetate: Prostrate CA and myocardial perfusionwith O15
18. C-11 Choline method of localization: Water-soluble transported into cell for biosynthesis
of phospholipids which is used in fatty acid metabolism of cell mem-brane production
19. Production of C-11 Choline: Produced 11CO2 in cyclotron and to create C11-methyl
iodine which is reacted with dimethylaminoethanol and purified
20. C-11 Choline used to image: Ca - brain, colon, prostrate
21. Procedure for imaging with C-11 Choline: 6 hr NPO, place patient on scanner and inject 20
mCi, delay images 5 to 10 minutes
22. C-11 Palmitate method of localization: Palmitate is a fatty acid that is in blood. It is rapidly
extracted by normal myocardial cells. Rapid 2 phase clearance 1) rapid vascular transit and 2)
incorporated into triglycerides
23. Production of C-11 Palmitate: Produce 11CO2 in cyclotron. React with pen-
,tadecylmagnesium bromide to form 11C-Palmitate and purified.
24. Procedure for imaging with C-11 Palmitate: NPO 6 hrs. Place patient onscanner and
injected and 5 min uptake then scan.
25. F-18 FDG method of localization: Glucose analog transported across cell membrane.
Cells metabolized FDG my phosphorylation by hexokinase to make FDG-6-phosphate and
stays in cells.
26. Normal biodistribution of FDG: Brain, myocardium, moderate in nasopharyn- geal
region,mild in muscle, liver, spleen and testes (suv appox 2). FDG is glomerulus filtered so in
bladder, ureter and kidneys
27. FDG critical organs: Bladder and kidneys
28. Altered distribution of FDG: Inflammation, strenuous exercise 24 hrs before, movement,
chewing gum and talking during incubation period.
29. Production of FDG: Produced by nucleophilic substitution with precursor ofmannose
triflate. Cyclotron produced
30. Rb-82 Genertaor Alert Level: 14L of eleute volume reached, or Sr-82 level0.002uCi/mCi
of Rb-82, or Sr-85 level 0.02uCi/mCi of Rb-82
31. Actions for Rb82 Generator Alert Level: Test after every 750 mL has passedthrough
generator
32. Stop using Rb-82 generator if: 17L of eleute volume reached, or 42 days post calibration
date, or Sr82 levenis 0.01uCi/mCi of Rb82, or Sr85 level reaches0.1uCi/mCi of Rb82
33. Cyclotron produced isotopes and half-life: C11, 20.3 min; N13 9.97 min; O15
2.03 min; F18, 109.7 min
34. Advantages of negative ion cyclotrons: 1) less nuclear activation of cyl potioncavity and
surroundings, 2) can self-focus beam of particles, 3) can irradiate 2 targets at once
35. Isotopes produces by negative ion cyclotrons: C, N, O = metabolites
36. Reaction for chemical labeling of F18-FDG: Nucleophilic substitution
37. Chemical reaction of FDG: Electron rich group of atoms change place onmolecule with
a positively charged leaving group
38. Precursor molecule for FDG: Mannose triflate
39. Chem formula of FDG: 2-deoxy-2-[18F]fluoro-D-glucose. (FludeoxyglucoseF-18)
40. Intermediate step in FDG synthesis: Alkaline hydrolysis of 4 acetyl groups byreplacing
with OH
41. Size filter used after purification: 0.22 um
42. FDA ref for PET pharma production: General chapter 823
, 43. FDG QA appearance: Colorless liquid
44. FDG QA radiochemical identity: Thin-layer chromatography Rf value to refer-ence
standard
45. FDG QARadionuclide identity: Half-life 105 and 115 minutes
46. FDG QA bacterial endotoxins test: LAL (Limulus amebocyte lysate) <175 USPendotoxins
units per max volume injection; endotoxins< 17.5 EU
47. FDG QC pH: Between 4.5 to 7.5
48. FDG QA Radiochemical purity: Thin-layered chromatography radioactive Rfshould be
not less than 90% of total radioactivity of chromatography plate
49. FDG QC Radionuclideic purity: should be >99.5% of radionuclidie specified.tested using
multi-channel analyzer with peaks at 0.511 and 1.022 MeV
50. FDG QC chemical purity: testing depends upon synthesis method used tocreate FDG
51. Kryptofix 222: FDG QC chemical purity test - thin-layer paper chromatographyspot test.
50 ug/mL and FDG solution must demonstrate a less intense response than standard
52. 2-Chloro-2-deoxy-D-glucose: FDG QC chemical purity test used if hydrolysis step was
performed with hydrochloric acid. Use high-performance liquid chromatog- raphy using an
electrochemical detector. Mus not have more than 1 mg CLDG:
2-deoxy-2-D-glucose
53. FDG QC Residual solvents: solvents can be in FDG from cleaning or synthesis solutions.
solutions may contain acetonitrle, ether anddehydrated alcohol. no more 0.04% acetonitrle,
and less than 0.5% of ether or ethanol
54. FDG QC Sterility: not performed before dosing due to need of 14 days to perform.
Regulations require final produce to be placed in soy broth mixture witha thioglycollate
growth media for 30 hrs. look for observable bacteria
55. FDG QC Filter membrane integerity: final sterility filter used at end of manu- facturing
process. Filter must remain intact as pressure increased to 50 psi (bubblepoint test)
56. FDG synthesis room requirements: room: cGMP, ISO class 5 clean room airhood, 21 CFR
212 for manufacturing of IV drugs
57. which radiouclides are possible radioactive contaminates in eluent ofRb82 generators:
Sr82 and Dr85
58. negative ion PET cyclotrons accelerate which partiles: negatively chargedhydrogen atoms
59. chemical method used to label F18 to glucose: nucleophilic substitution
60. The least amount of energy needed by bombarding particles used fornuclear reactions
occurring within a cycltron: 8 Mev
