Nuclear Medicine Board Review Exam Study Guide With Verified Solutions.

Nuclear Medicine Board Review Exam Study Guide With Verified Solutions. Gas Ventilation - answerXe 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 - answerStrontium 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 - answerBexxar 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 - answerZevalin 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 - answerethylenediaminetetra 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 - answer60,000-100,000/ul platelet /ul leukocyte 2000/ul granuolyte I 131 MIBG - answermetaiodobenzylguanidine half life = 8.06 days localization/treatment of primary or metastatic pheochromocytomas/ neuroblastoma 8.04 days kidney/ urinary excretion I 131 Sodium Iodide - answerhalf 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 - answerTc99m 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 - answerTc99m exametazime/HMPAO/ceretec Tc99m Biscisate (ECD, neurolite) Lipid soluble, crosses BBB SPECT 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) Planar Imaging for Cerebral Brain Death - answer1-3 post injection Tc99m HMPAO/Ceretec Total abscense of tracer = brain death Cisternography / CSF Leak / Shunt Patency - answerIn 111 DTPA intrathecially for cisternography