Nuclear Medicine Flashcards

Flashcards covering key concepts and procedures in nuclear medicine, based on lecture notes from RDT 126.

What is Gated radionuclide angiography (RNA) used for?

To measure left ventricular ejection fraction and evaluate left ventricular regional wall motion.

What is the adult dose of 99mTc-labeled red blood cells used in Exercise Radionuclide Angiography?

25 to 40 mCi (1110 MBq), based on the patient's height and weight.

What are the imaging positions for the heart in Exercise Radionuclide Angiography?

Anterior, left lateral, and left anterior oblique positions.

What is the sensitivity and specificity of the stress thallium-201 study for coronary artery disease?

High sensitivity (about 90%) and specificity (about 75%).

What is the adult dose for a stress study using 201TI thallous chloride?

3 mCi (111 MBq) administered intravenously at peak stress.

When is 99mTc sestamibi preferred over 201TI and why?

Whenever possible in obese patients, so that a higher dose may be administered for clearer imaging results

How is 99mTc sestamibi used in myocardial perfusion imaging?

To assess myocardial salvage resulting from therapeutic intervention in acute infarction; to determine the myocardial blood flow during periods of spontaneous chest pain; and to diagnose coronary artery disease in obese patients.

When is SPECT imaging done after injecting the dose of 99mTc sestamibi?

Normally 30 to 60 minutes after injection of the dose, for both stress and rest studies, with more delayed images obtainable for up to 4 to 6 hours after injection.

What radiotracers are used in cardiac PET imaging?

82Rubidium, Nitrogen-13 Ammonia, and 18F-Fluorodeoxyglucose (FDG).

What are the clinical applications of salivary glands scans?

Recurrent salivary gland swelling, Sialolithiasis, Recurrent parotitis and Dry mouth

What radiopharmaceutical is used in salivary gland scans and how is it taken up?

99mTechnetium pertechnetate (99mTcO4) is taken up by salivary glands and secreted by the ductal epithelium.

What is the role of a sialagogue in a salivary gland scan?

Causes prompt salivation and drainage of the glands when the salivary ducts are patent.

What radiopharmaceutical is used in esophageal transit studies?

99mTc-Sulfur Colloid in water (esophageal transit) or 99mTc-SC (in 200 ml acidified orange juice pH 6 (Gastrointestinal transit and reflux)

Name three indications for esophageal scintigraphy.

Esophageal dysfunction, Reflux esophagitis and Oropharyngeal dysfunction

What is the purpose of radionuclide gastric emptying and motility studies?

For studying gastric motor function.

List three clinical applications for gastric emptying studies.

Suspected gastroparesis, unexplained Nausea/vomiting and Gastro-esophageal reflux

What radiopharmaceuticals are used in gastric emptying studies?

Liquid phase: Non absorbable liquid labelled with 111In-DTPA /99mTc-sulphur colloid (99mTc-SC) in water and Solid phase: Non absorbable solid labelled with 99mTc

Why are anterior and posterior views obtained in gastric emptying studies?

To allow calculation of a geometric mean.

What is bile reflux frequently found as?

As a complication of previous gastric surgery.

Why is bone scintigraphy commonly used?

As a screening test for suspected bone metastases because of its high sensitivity, availability, low cost, and ability to scan the entire skeleton.

What is the most widely used radiopharmaceutical for bone scintigraphy?

99mTc-methylene diphosphonate (MDP)

What is renal scanning used to assess?

Renal perfusion and function, particularly in renal failure and renovascular hypertension and after renal transplantation.

How is DMSA taken up by the kidneys?

DMSA is taken up by the proximal tubules and fixed there.

How is renal function assessed using 99mTc-DTPA?

At 2 minutes after injection.