Nuclear Medicine Board Review UPDATED ACTUAL Questions and CORRECT
Answers
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
Gas Ventilation
xenon gas until decayed to background
single breath: during inhalation
wash in / equilibrium : collected while the xenon distrib-
utes through aerated portions of the lung
wash out : while radioactivity is cleared from lungs
Strontium Chloride, Metastron
1.46 MeV max, .58 Mev mean
half life = 50.5 days
40-60 uci/kg IV
Sr 89 Chloride
for skeletal mets, depresses bone marrow
shouldn't be used if leukocyte count below 2400/ul or
platelet below 60,o00/ul
excretion : urinary
Bexxar
half life = 8.04 days
606.3 KeV max energy
treatment of patients with NHL
before treatment, patient must receive 650 mg aceta-
I 131 Tositumomab
minophen 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
,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
ethylenediaminetetra methylene phosphonic
Quadramet
half life = 46.7 hours
0.81 MeV maximum
concentrates in bone marrow
Sm 153 EDTMP
for patients with more metabolically activate metastases
from prostate or breast cancer, as well as those from os-
teogenic sarcoma
1.0mci/kg
urinary excretion
60,000-100,000/ul platelet
Bone therapy blood requirements 2400-3000/ul leukocyte
2000/ul granuolyte
metaiodobenzylguanidine
half life = 8.06 days
localization/treatment of primary or metastatic pheochro-
I 131 MIBG
mocytomas/ neuroblastoma
8.04 days
kidney/ urinary excretion
I 131 Sodium Iodide
, 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
Tc99m Pertechnetate
-least desirable (accumulated in choroid plexus)
-15-30mCi
-premed with KCLO4- preferred
Tc99m Pentetate (DTPA)
-planar
-cleared by kidneys
Blood Brain Barrier Imaging
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
Tc99m exametazime/HMPAO/ceretec
Tc99m Biscisate (ECD, neurolite)
Lipid soluble, crosses BBB
SPECT
Brain Perfusion dimly lit room for injection
10-20mCi
approx. 45 min post inject imaging with ECD, and 90 min
for HMPAO
looking for photogenic defects (no tracer)
1-3 post injection Tc99m HMPAO/Ceretec
Planar Imaging for Cerebral Brain Death
Total abscense of tracer = brain death
Cisternography / CSF Leak / Shunt Patency
Answers
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
Gas Ventilation
xenon gas until decayed to background
single breath: during inhalation
wash in / equilibrium : collected while the xenon distrib-
utes through aerated portions of the lung
wash out : while radioactivity is cleared from lungs
Strontium Chloride, Metastron
1.46 MeV max, .58 Mev mean
half life = 50.5 days
40-60 uci/kg IV
Sr 89 Chloride
for skeletal mets, depresses bone marrow
shouldn't be used if leukocyte count below 2400/ul or
platelet below 60,o00/ul
excretion : urinary
Bexxar
half life = 8.04 days
606.3 KeV max energy
treatment of patients with NHL
before treatment, patient must receive 650 mg aceta-
I 131 Tositumomab
minophen 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
,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
ethylenediaminetetra methylene phosphonic
Quadramet
half life = 46.7 hours
0.81 MeV maximum
concentrates in bone marrow
Sm 153 EDTMP
for patients with more metabolically activate metastases
from prostate or breast cancer, as well as those from os-
teogenic sarcoma
1.0mci/kg
urinary excretion
60,000-100,000/ul platelet
Bone therapy blood requirements 2400-3000/ul leukocyte
2000/ul granuolyte
metaiodobenzylguanidine
half life = 8.06 days
localization/treatment of primary or metastatic pheochro-
I 131 MIBG
mocytomas/ neuroblastoma
8.04 days
kidney/ urinary excretion
I 131 Sodium Iodide
, 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
Tc99m Pertechnetate
-least desirable (accumulated in choroid plexus)
-15-30mCi
-premed with KCLO4- preferred
Tc99m Pentetate (DTPA)
-planar
-cleared by kidneys
Blood Brain Barrier Imaging
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
Tc99m exametazime/HMPAO/ceretec
Tc99m Biscisate (ECD, neurolite)
Lipid soluble, crosses BBB
SPECT
Brain Perfusion dimly lit room for injection
10-20mCi
approx. 45 min post inject imaging with ECD, and 90 min
for HMPAO
looking for photogenic defects (no tracer)
1-3 post injection Tc99m HMPAO/Ceretec
Planar Imaging for Cerebral Brain Death
Total abscense of tracer = brain death
Cisternography / CSF Leak / Shunt Patency
