NUC MED

SUMMARIES

PET- POSITRON EMISSION TOMOGRAPHY

CT- COMPUTED TOMOGRAPHY
PET/CT- COMBINED MODALITIES
SPECT/CT-COMBINED MODALITIES
MRI-MAGNETIC RESONANCE IMAGING
SPECT- SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY

CHAPTER 1:CARDIAC

RADIOPHARMACEUTICALS- F-18 FDG PET CT

FLUORODIOXY GLUCOSE- FLOURINE-18 (RED IMAGES)

-MANY USES BUT CLINICALLY NOT RECOMMENDED USED TO PATIENT WITH HIGH SUGAR
- BAD FOR KIDNEYS
TL-201

FOR: MYOCARDIAL VIABILITY

TC -99M RBC-RED BLOOD CELLS(MUGA SCAN)

MUGA SCAN- MULTI- GATED CARDIAC BLOOD POOL ACQUISITION
- MYOCARDIAL PERFUSION SCINTIGRAPHY

- USED FOR LEFT VENTRICULAR FUNCTION

LEFT VENTRICULOGRAPHY

TC- 99M MAA

-PULMONARY PERFUSION STUDY/SCAN
-USED FOR RIGHT TO LEFT CARDIAC SHUNT
- TC 99 M CAN BE DISSOCIATE FROM MAA RESULTING TO TC 99M PERCTECHNETATE

ARTIFACTS FOR CARDIAC

MOTION-SCATTER-RECONSTRUCTION-ATTENUATION

TC- 99M SESTAMIBI /TC- 9M TETROFOSMIN/THALLIUM-201

USED FOR RECOGNIZING MYOCARDIAL IMFARCTION/ISCHEMI

CHAPTER 2:CNS-CENTRAL NERVOUS SYSTEM

CSF- CEREBROSPINAL FLUID

CISTERNOGRAPHY CSF IMAGING

RADIOPHARMACEUTICALS
-IN-111 OR TC99M DIETHYLENETRIAMINE PENTAACETIC ACID(DTPA)
GAMMA CAMERA IMAGING
USED FOR MICROSPIC TEARS IN DURA
BASILAR SKULL FRACTURE PARANASAL SINUS FRACTURE
LEAKAGE IN CSF
SHUNTS OF CSF
HYDROCEPHALUS

INTRATHECAL

ALZHEIMERS DISEASE(AD)- PROGRESSIVE NEURODEGENERATIVE DISEASE

- RELATED TO AMYLOID-BETA SYNAPTIC DYSFUNCTION
- NEURONAL/GLIAL CELL DEATH

IMAGING

AMYLOID PET -INCREASE AMYLOID GRAY MATTER

F-18 FDG PET- GLUCOSE HYPERMETABOLISM MORE PROGRESSIVE IF MORE INTAKE OF F-18 FDG
(MEANS MORE RED IMAGE).
- ALSO USED IN FRONTOTEMPORAL DEMENTIA FOR CAUSES OF DEMENTIA(BEST)
-LEWY BODY DIESEASE
-PARKINSONS DISEASE

- BRAIN ABSCESS AND ENCEPHALITIS

TC - 99M HMPAO -SPECT ---USED BUT LESS SENSITIVE THAN F-18 FDG PET

SPECT-2ND LINE OF MODALITIES OR ALZHEIMERS

LEWY BODY DISEASE-A VARIANT OF DEMENTIA

-CHARACTERIZED BY PARKINSONS -
VISUAL HALLUCINATIONS /ALERTNES ETC.
-IMAGING

(DAT)SCAN-DOPAMINE TRANSPORTER-SPECT W/ I- 123FP-CIT (IOFLUPANE)- USED FOR LOSS OF

NEURONS/PARKINSONS

PARKINSON DISEASE- CHRONIC PROGRESSIVE BRAIN DISORDER/ LOSS OF DOPAMIMERGIC NEURONS

BRAIN DEATH - IRREVERSIBLE CESSATION OF CIRCULATORY, RESPIRATORY AND FUNCTIONS OF ENTIRE

BRAIN ENCLUDING BRAINSTEM

IMAGING FOR BRAIN DEATH

BRAIN PARENCHYMA SCINTIGRAPHY-

TC 99M EXA METAZIME(HMPAO),- FOR CEREBRAL UPTAKES (NORMALS AND ABNORMALITIES)
BRAIN PARECHYMA ABESENCE OF BLOOD FLOW
TC 99M ETHYL CYSTEINATE DIMER (ECD) -ALSO USED FOR CEREBROVASCULAR ISCHEMIA
CHAPTER 3-GASTRO INTESTINAL

IMAGING-

-TC- 99M, IDA HEPATOBILIARY SCINTIGRAPHY

USED FOR ACUTE CHOLECYSTITIS AND OBSTRUCTION BILE FLOW ABNORMALITIES/LEAKAGES
-LIVER BENIGN SOLID LESIONS
- TO AVOID LIVER BIOPSY

TC - 99M - SULFUR COLLOID(SC)SCINTIGRAPHY and TC 99M RBC SCAN

-USED FOR LIVER BENIGN LESIONS /FUNCTIONS OF KUFFER CELLS/
hyperplasia/

TC - 99M - SULFUR COLLOID-FOR LIVER PARENCHYMA

TC 99 M RBC SCINTIGRAPHY/ - BLOOD FLOW OF LIVER - GASTRO INTESTINAL BLEEDINGS

TC 99 M PERTECHNETATE- RADIOTRACER

GASTRIC EMPTYING- SOLID GASTRIC EMPTYING DUE TO PERISTATIC PUMP

IMAGING- GASTRIC EMPTYING SCINTIGRAPHY (GES)

RADIOTRACERS- TC- 99M SULFUR COLLOID IN EGG SANDWICH OR STEW

-CAN BE IN LIQUID (GES) IN -111 DTPA MILK AND WATER

ABDOMINAL INFECTION AND INFLAMMATION

F-18 FDG PET-FAST AND LEAST EXPEPENSIVE(RED IMAGES)

TC 99 M HMPAO WBC(TC-99M TRACER)- SPECT CT- OFTEN USED IN CHILDREN AND EXTREMITIES

IN-111 WBC W/TC 99M MDP-BONE SCAN FOR WHOLE BODY (TRADITIONAL)

GA-67- FOR INFLAMMATION

SPLEEN LOCALIZATION

TC -99M PERTECHNETATE DENATURED RBC SCAN

FOR RBC DAMAGE/BLOOD POOL ACTIVITY

- CAN BE HELP WITH SPECT- SPECT/CT (FUNCTIONAL MODALITIES)

TC -99M SULFUR COLLOID LIVER/SPLEEN SCAN

- LIVER AND SPLEEN ARE IN THE SAME PLACE CONNECTED THROUGH BILE

.
CHAPTER 4 LYMPHATIC AND VASCULAR

VASCULAR IMAGING:

LARGE VESSEL VASCULITIS- INFLAMATION OF THE LARGE VESSEL

-F-18 FDG PET CT- USE FOR DISEASE ACTIVITY -FLOW(OCCLUSION,RUPTURE,HEMORRRHAGE)

IN-111 WBCS,TC 99M HMPAO WBC- CAN BE BE USED VASCULAR GRAFT INFECTION AFTER F-18 FDG

LYMPHEDEMA-PATHOLOGIC

2 TYPES
PRIMARY-(CONGENITAL -PATHO)
SECONDARY-(TYPICAL A WORLD EPEDEMIC)
NON LYPHATIC-CHRONIC VENOUS EFFICIENCY

TC 99M SULFUR COLLOID LYMPHOSCINTIGRAPHY

- STANDARD STUDY (TO GUIDE AND DIFFERENTIATE DIAGNOSIS OF EXTREMITY EDEMA)

SENTINEL LYMPH NODE MAPPING (FOR BIG LYMPH NODE MAPPING)

-TC 99M SULFUR COLLOID SLN MAPPING

LARGE VESSEL VASCULITIS -INFLAMATION OF AORTA DUE TO T- CELL RESPONSE

- F-18 FDG PET/CT (SUGAR SCAN)- A VERSATILE SCAN FOR EVERY SOFT TISSUE ABNORMALITIES/BENIGN
LESIONS
CHAPTER 5: BONE SCAN

PROTOCOLS :WHOLE BODY

==LIMITED BONE SCAN
--3= PHASE BONE SCAN
--- SPECT- SPECT /CT(FUNCTIONAL)

FOR TUMOURS (BENIGN)-- F-18 FDG PET/CT- LOCALIZATION OF BENIGN LESIONS

TC 99M -MDP BONE SCAN - IDENTIFICATION OF LESIONS\(BONE)

WHOLE BODY SCAN- STAGING/ DIAGNOSIS OF SKELETAL METASTASES

RADIOPHARMACEUTICALS- TC- 99M METHYLENE DIPHOSPHONATE(MDP)

TC- 99M HYDROXYMETHYLENE DIPHOSPHONATE(HDP)

ADDITIONAL-NOT NECESSARY

F- 18 NAF PET/CT AND F-18 FDG PET CT(OBVIOUS FOR CANCER BENIGN LESIONS)

GA-67 SCINTIGRAPHY-INCREASED ACTIVITY IN FD(FIBROUS DYSPLASIA)

-SPINALDICITIS/ OSTEOMYELITIS

FIBROUS DYSPLASIA/PAGET DISEASE- BENIGN DEVELOPMENTAL DISORDER ON FIBRO OSSEOUS

TISSUE IN MEDULLARY SPACE OF ONE OR MORE BONE.

OSTEOPENIA- BONE DENSITY NOT NORMAL BUT NOT AS LOW AS OSTEOPOROSIS

OSTEPOROSIS- SYSTEMIC SKELETAL DISEASE CHARACTERIZE BY LOW BONE MASS

DETERIORATION OF BONE TISSUE/FRAGILE
DUAL X-RAY ABSORPTIOMETRY(DXA) -CONSIDERED A STANDARD FOR OSTEOPOROSIS
DIAGNOSIS AND FRACTURE RISK AND PREDICTIONS.
ARTHROPLASTY COMPLICATION-CEMENTING THE BONE WITH COBALT OR OTHER COMPOUNDS

BEST IMAGING TOOL

3 PHASE SCAN--MOST COMMON FOR SCREENING/ARTHRITIS

TC- 99M SULFUR COLLOID - FOR LEUKOCYTE RESULTS

TC 99M -MDP BONE SCAN AND WHOLE BONE SCAN - FOR BLOOD POOL DELAYED BONE SCAN

WBC ,TC 99M SULFUR COLLOID SCANS - FOR MATURED BONE RED MARROW

AVASCULAR NECROSIS(AVN): SCHEMIC DEATH OF TRABECULAR BONE AND MARROW

-BONE SCAN WITH SPECT

-TC 99M SULFUR COLLOID SCANS(BONE MARROW)

AVASCULAR NECROSIS

BONE TUMOR - METASTASIS IN LUNG , BREAST /PROSTATE

BURSITIS - INFLAMMATION OF BURSA

OSTEOARTHRITIS- INREASED UPTAKE WEIGHT BEARING LOCATION(OLD POPULATION)

TC - 99M MDP- BONE SCAN

SICKLE CELL DISEASE- GENETIC DISORDER OF HEMOGLOBIN

CHAPTER 6: THYROID AND PARATHYROID

THYROID SCAN
I- 123- THYROID NODULES

TC 99M PERTECHNETATE OR I- 123 THYROID SCANS

- ETIOLOGY OF HYPERTHYROIDISM

SPECT/ CT- COMMON AND MUCH BETTER RESOLUTIONS./ LOCALIZATION

TC 99M- SESTAMIBI PARATHYROID SCANS

- FOR NO ADENOMA OF PARATHYROID

PARATHYROID ADENOMA- ENLARGED PARATHYROID GLAND

CHAPTER 7 :LUNGS

ATYPICAL INFECITIOUS DISEASES= PNEUMONIA AND INFECTIONS AFFECTING PATIENTS

WITH HIV, CANCER IMMUNOSUPPRESSIVE THERAPY

GA 67 SCINTIGRAPHY AND F- 18 FDG PET/ CT - FOR ACTIVE CELLULAR INFILTRATIONS

COMMON DISEASES
_TUBERCULOSIS- NON-TUBERCULOSIS - CYTOMEGALOVIRUS PNEUMONIA-FUNGAL PNEUMONIA
-KAPOSI SARCOMA-LYPHOID INTERSTITIAL PNEUMONIA- ESOPHAGEAL CANDIDIASIS-

F- 18 FDG PET/CT USED FOR MANY DISEASES(RED SCAN)

GRANULOMATOUS DISEASE- FORMATION OF GRANULOMAS (INFECTIOUS OR NON-INFECTIOUS)

PULMONARY EMBOLISM(PE)- SEGMENTAL LUNG PERFUSION.

TC 99M MAA- USED FOR VASCULAR REGIONS OF LUNG PERFUSIONS

CHAPTER 8: URINARY TRACT

RADIOPHARMACEUTICALS-RENAL SCINTIGRAPHY

TC 99M -DIMERCAPTOSUCCINIC ACID(DMSA)-CORTICAL

USED FOR RENAL CORTEX SCAN
-RENAL PARENCHYMA AND INJURIES

TC 99M - GLUCOHEPTONATE- CORTICAL

TC 99M - MECAPTOACETYLTRIGLYCINE(MAG3)-SECRETED BY TUBULES

COMMONLY USED FOR RENAL TRANSPLANT
-RENOVASCULAR HYPERTENSION

TC 99M- DIETHYLENE TRIAMINE PENTAACETIC ACID(DTPA) , I - 131 - FILTERED

-VESICOURETERAL REFLUX -TO KNOW THE CAUSE OF UTI-RENAL PARANCYMAL INJURIES

ACUTE TUBULAR NECROSIS(ATN)- DEGENERATION OF TUBULES

ANGIOTENSIN-CONVERITING ENZYME INHIBITOR(ACEI) - EXCELLENT WAY TO DETECT

RENAL ARTERY STENOSIS(RAS)

GLOMERULAR FILTRATION RATE

DISEASES
HYDRONEPHROSIS- DILATATION OF COLLECTING SYSTEMS DUE TO OBSTRUCTION OF URINE OUTFLOW