Nuclear Medicine Critique Final Exam The following WB bone image represents a an anterior posterior WB bone scan b a patient with epiphyseal growth plate activity c a positive image display capability d all of the above verified answer d all of the above The inclusion of SPECT CT imaging during a bone scan a Allows for shorter imaging times during a bone scan b Provides structural and functional data combined c Provides 3 D anatomical data only d Is necessary in all bone scan studies verified answer b provides structural and functional data combined Osteomyelitis is usually evaluated on a bone scan by a Routine delayed imaging only b By perfusion and blood pool imaging alone c 24 hour delayed imaging d 3 Phase study techniques verified answer d 3 phase study techniques The following characteristics best describe a patient with Paget s disease EXCEPT a Usually over 55 years old b Usually female c Usually considered a superscan d alkaline phosphotase in blood verified answer b usually female d Poor image quality verified answer c infiltration of the radiopharmaceutical dose 1 The main technical issue with this WB bone scan is a Improper positioning b Insufficient data collection c Infiltration of the radiopharmaceutical dose Diffuse bone metastases is usually identified by a Normal bony uptake of the Tc 99m MDP agent b 3 Phase imaging techniques c Multiple hot spots seen over the bony anatomy d The use of a medium energy collimator during the imaging process verified answer c multiple hot spots seen over the bony anatomy 1 The use of pinhole collimation while performing a bone scan a Is best implemented for evaluation of avascular necrosis of the hip femoral joint b Is a routine imaging choice for most clinical indications c Provides detail of soft tissue anatomy d Allows the technologist to complete the clinical study quickly verified answer a is best implemented for evaluation of avascular necrosis of the hip femoral joint A tri athelete comes to the Nuclear Medicine clinic for a bone scan What would be the most typical clinical findings of this scan considering the chief complaint is leg pain a Diffuse metastatic disease b Paget s Disease c Osteomyelitis d Stress Fractures verified answer d stress fractures Getting the patient to void prior to delayed bone scan imaging a Allows better identification of bony structures in the pelvis area b Provides better opportunity to complete the scan without patient interuption c Removes excessive bladder uptake from the images d All of the above verified answer d all of the above Evaluation of patients with joint replacement is fairly routine as a part of bone scintigraphy in Nuclear Medicine The following are concerns in this patient EXCEPT a Prosthesis loosening b Prosthesis bony infection c Technically sufficient static views of that appendage area for evaluation d Hyper extension of the neck area during the WB images verified answer d hyper extension of the neck area during the WB images 1 A typical Tc 99m MDP adult bone scan dose is likely to be a 10 15 mCi b 5 mCi c 25 mCi a Bone scan b Renal scan d 55 mCi verified answer 25 mCi 1 The following scan is most likely a c Cerebral Perfusion scan d A CSF scan verified answer d a CSF scan 1 Typical cerebral perfusion agents are all of the following EXCEPT a I 123 HMPAO b Tc 99m Ceretec c Tc 99m ECD d Tc 99m Neurolite verified answer a I 123 HMPAO 1 A ventriculo venous shunt is evaluated on a 5 year old boy post surgical repair for hydrocephalus If Tc 99m MAA was injected in the shunt reservoir proper shunt function is observed a When radiotracer is observed in the abdomen within a few minutes b When radioactivity is seen in the liver c When the radiopharmaceutical is observed in the lung fields d When the radiopharmaceuticals stays at the shunt site only verified answer c when the radiopharmaceutical is observed in the lung fields if In 111 DTPA is injected intrathecally into a patient you are likely to be performing a A Cerebral perfusion scan b A Parathyroid scan c A Bone Desity study d A Cisternogram study verified answer d a Cisternogram study 1 A cerebral perfusion study performed in conjunction with and without the pharmaceutical Diamox is considered a n a Brain perfusion stress test b Ictal seizure evaluation c Evaluation for communicating hydrocephalus d Indication for Brain Death verified answer a brain perfusion stress test 1 Incomplete cerebral circulation of artrial capillary and venous pathways during a brain flow study indicates 1 The endocrine feedback system for the thyroid include the following EXCEPT a Communicating hydrocephalus b Brain tumor c Meningitis Brain Death verified answer d brain death a Hypothalamus b Pituitary c T3 and T4 blood levels d PTH verified answer d PTH 1 The following image is an example of a A non functioning thyroid gland b Sublingual thyroid tissue c An ectopic parathyroid adenoma 1 A typical dose of I 123 sodium iodide for routine thyroid scan and uptake study would be a 1 2 mCi b 50 mCi c 100 400mCi d A Medullary thyroid cancer site verified answer c an ectopic parathyroid adenoma d 25 mCi verified answer c 100 400 uCi 1 The best imaging time periods for parathyroid imaging with Tc 99m MIBI is d 15 minutes 2 3 hours verified answer d 15 minutes 2 3 hours a 6 24 hours b 4 8 hours c 30 minutes post injection 1 Thyromegally implies a An underactive thyroid b Ectopically placed thyroid tissue c An enlarged thyroid d Bulging eyes exothalmy verified answer c an enlarged thyroid 1 A patient with a 24 hour uptake of I 123 sodium iodide of 55 would likely be considered a Euthyroid Normal Function b Hyperthyroid c Hypothyroid verified answer b hyperthyroid 1 A 62 year old female who was treated for papillary thyroid cancer five years ago has an I 131 sodium iodide WB scan today After reviewing the following image state the findings a The patient has been treated effectively b The patient should have a follow up parathyroid scan c The patient has widespread thyroid metastatic disesae d The patient has a neuroblastoma verified answer c the patient has widespread thyroid metastatic disease 1 Most routine thyroid scans with I 123 sodium iodide are acquired as a 3 phase acquisition b Static images about the thyroid c A SPECT acquisition d A WB acquisition verified answer b static images about the thyroid 1 A patient being imaged with I 123 MIBG would likely have the following characteristics a Be a child or pediatric b Be assessed for a neuroendocrine tumor