CORE RADIOLOGY (MANDELL) -
NUCLEAR MEDICINE EXAM 2024/2025
SUV ~ (ROI activity x body weight)/administered activity - Precise
Answer ✔✔SUV is proportional to __
Under 200, preferably under 150 - Precise Answer ✔✔Optimal blood
glucose levels for PET
Non-small cell lung cancer - Precise Answer ✔✔Which class of lung
cancers are evaluated by PET?
mediastinoscopy - Precise Answer ✔✔Gold standard for lymph node
staging in lung cancer
8 mm - Precise Answer ✔✔smallest size nodule that can be reliably
evaluated by PET
rising thyroglobulin level with negative whole-body radioiodine scans -
Precise Answer ✔✔When is PET used in thyroid cancer?
G-CSF stimulation, marrow repopulation after chemo, malignant
marrow infiltration - Precise Answer ✔✔Differential for diffuse marrow
uptake in lymphoma
,- acute chest pain
- hemodynamic significance of coronary stenosis
- risk stratification after MI
- preop risk assessment for noncardiac surgery
- viability prior to revascularization therapy
- myocardial revascularization status post CABG - Precise Answer
✔✔clinical indications for myocardial perfusion imaging
EF = (EDC - ESC)/(EDC - BC)
EDC = end diastolic counts
ESC = end systolic counts
BC = background counts - Precise Answer ✔✔Formula to calculate
ejection fraction on gated SPECT
Hypoperfused myocardium that is viable - Precise Answer ✔✔What is
hibernating myocardium
- thallium-201 perfusion imaging
- F-18 FDG PET (gold standard) - Precise Answer ✔✔Radionuclides
used in viability imaging. Which is the gold standard?
Normal or nearly normal wall motion and wall thickening in the area of
the perfusion defect - Precise Answer ✔✔What indicates hibernating
myocardium on SPECT?
, large defect with abnormal wall motion - Precise Answer ✔✔What
indicates nonviable myocardium (scar) on SPECT?
If the region of the perfusion defect takes up FDG. May benefit from
intervention. - Precise Answer ✔✔What is a mismatch myocardial
defect?
Photopenic region corresponding to the perfusion defect. Consistent with
non-viable scar, best treatment is medical therapy only. - Precise Answer
✔✔What is a matched myocardial defect?
- Long half life, low energy photopeaks (low dose administered, easily
attenuated by chest wall)
- ATP Na/K pump
- Undergoes redistribution (leaves target cell)
- Viable: normalization of defect on post-redistribution images
-Scar: persistent defect on post-redistribution images - Precise Answer
✔✔Thallium-201
- No redistribution: remains in myocardium
- Passive diffusion - mitochondrial membrane - Precise Answer
✔✔Technetium-99m sestamibi (Cardiolite)
- perfusion imaging
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