Question 1
Question
Which are the main goals of nuclear oncology
Answer
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Imaging of the functional activity and the degree of proliferation of the tumor
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The degree of malignant tumor spread: lymphogenic and haematogenic
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Imaging and quantitative assessment of the effect from chemo- and hormone-therapy
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All answers are correct
Question 2
Question
The scanning systems used in nuclear medicine are based on the principle of
Answer
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Emission of Gamma-rays from the scanning system
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Transition of Roentgen-rays through the patient's body
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Detection of Gamma-rays or positron emission (pairs of annihilation Gamma-rays) emitted from the studied object
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All answers are correct
Question 3
Question
Which methods of nuclear medicine are used for diagnosis of malignant tumours
Question 4
Question
Nuclear medicine diagnosis provides
Question 5
Question
Nuclear medicine applies
Answer
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Unsealed radioactive sources for medical diagnosis
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Unsealed radioactive sources for radiotherapy
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Sealed radioactive sources for medical diagnosis and therapy
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Correct answers- a) and b)
Question 6
Question
PET/CT is a multimodality system combining
Answer
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PET scanner with low-dose CT for improvement of the quality and precise localization of the functional image
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PET scanner with possibility for additional targeted diagnostic contrast CT
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Acquisition and fusion of functional and structural-anatomic images
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All answers are correct
Question 7
Question
CT and PET scans demonstrate different aspects of disease indicating regions with
Answer
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Altered metabolism (PET) and areas of structural change (CT)
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Altered metabolism (CT) and areas of structural change (PET)
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Altered metabolism (PET) and areas of structural change (PET)
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Altered metabolism (CT) and areas of structural change (CT)
Question 8
Question
Which of the following diagnostic methods belong to modern Nuclear medicine
Answer
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PET/CT
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SPECT/CT
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PET/MRI
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All answers are correct
Question 9
Question
Which radionuclides are used for metabolic brachytherapy
Answer
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High-energy γ (Gamma) emitters
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β- (Beta)-emitters
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β- (Beta) and γ (Gamma)-emitters
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Correct answers — b) and c)
Question 10
Question
Nuclear medicine methods are used for
Answer
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Diagnosis of benign and malignant diseases
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Treatment of benign diseases
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Treatment of malignant diseases
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All answers are correct
Question 11
Question
PET /CT imaging has demonstrated significant application in the following clinical areas EXCEPT
Answer
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Oncology
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Cardiology
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Pulmonology
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Neurology
Question 12
Question
Which radiopharmaceuticals are used for tumor-specific imaging
Answer
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131 I- NaI
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III In-Octreoscan
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99m Tc-Tetrofosmin
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All answers are correct
Question 13
Question
Malignant tumors present on scintigraphy with tumor-specific radiopharmaceuticals as
Answer
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Zones of increased uptake of the radiopharmaceuticals
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Zones of decreased uptake of the radiopharmaceuticals
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Zones of absent uptake of the radiopharmaceuticals
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Zones of normal uptake of the radiopharmaceuticals
Question 14
Question
The most frequently used radiopharmaceutical for PET/CT imaging is
Answer
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18F-FDG
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99mTc-Pertechnetate
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131-Iodine — Nal
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No correct answer
Question 15
Question
The PET scanner is detector of
Question 16
Question
Bone scintigraphy is
Answer
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Highly specific diagnostic method
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Highly sensitive diagnostic method
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Highly sensitive and highly specific diagnostic method
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Non-sensitive and non-specific diagnostic method
Question 17
Question
The main indication for bone scintigraphy is
Answer
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Inflammatory bore disorders
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Early detection of bone metastases
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Benign bone tumors
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Degenerative joint disorders
Question 18
Question
Metabolic brachytherapy with Metastron (89 Stroncium) is applied in patients with
Answer
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Bone metastases
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Pulmonary metastases
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Brain metastases
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Liver metastases
Question 19
Question
Contraindication for metabolic brachytherapy in patients with metastatic bone disease is
Question 20
Question
Differentiated Thyroid cancer after total thyroidectomy and manifested distant haematogenic metastases is treated successfully with
Question 21
Question
Which of the following statements describing 18-F FDG PET imaging in thyroid carcinoma is FALSE
Answer
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18-F FDG PET can be negative in well differentiated types
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18-F FDG PET negative lesions are more likely to be resistant to 1-131 treatment
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18-F FDG uptake is proportional to Iodine uptake
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18-F FDG PET may not be accurate in patient with Tg levels below 2 ng/ dL
Question 22
Question
The most specific method for follow-up after treatment of Differentiated thyroid cancer is
Question 23
Question
A Thyroid cancer presents on the conventional scintigram with 99mTc as
Answer
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Hot nodule
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Warm nodule
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Cold nodule
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All answers are correct
Question 24
Question
Which histologic types of Thyroid cancer COULD NOT be treated with 131-Iodine metabolic brachytherapy
Question 25
Question
An oncology patient referred for PET/CT should fast prior to the appointment for at least
Question 26
Question
The recommended time interval for PET/CT. imaging after biopsy is
Answer
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1 week
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2-4 weeks
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2-6 months
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more than 6 months
Question 27
Question
In order to avoid false-positive results, FDG PET/ CT scans should be performed
Answer
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1-2 weeks after the last cycle of chemotherapy
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2-4 weeks after the last cycle of chemotherapy
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4-6 weeks after the last cycle of chemotherapy
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6-8 weeks after the last cycle of chemotherapy
Question 28
Question
False-negative PET/CT scans in lung cancer imaging occur predominantly because of
Answer
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Lesions are too big to be evaluated by PET
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Lesions are too superficial to be evaluated by PET
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Lesions are too small to be evaluated by PET
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Lesions are too deep to be evaluated by PET
Question 29
Question
F-18 FDG PET/CT is considered as a superior modality, compared with CT for evaluating post-treatment response in lymphoma patients because of
Question 30
Question
A breast-feeding patient referred for PET/CT imaging should
Answer
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Discontinue breast-feeding 12 h before injection of radiotracer
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Discontinue breast-feeding 6 h before injection of radiotracer
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Discontinue breast-feeding for at least 6 h after injection of radiotracer
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Discontinue breast-feeding for at least 12 h after injection of radiotracer
Question 31
Question
A PET quantifier, calculated as the tracer activity concentration within a volume of interest divided by the injected dose per unit body weight is
Question 32
Question
The Standardized Uptake Value (SUV) is
Answer
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The measured activity divided by the body mass
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The amount of tracer needed for a particular body weight
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The measured activity normalized for body weight and inject dose
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The measured activity within a particular organ divided by the sampled volume
Question 33
Question
For optimal patient care and interpretation of FDG PET/CT images, the following information from the patient should be obtained
Answer
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Breast-feeding info
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Recent surgery info
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Use of medication info
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All answers are correct
Question 34
Question
FDG PET/CT provides beneficial information in all of the following areas of lymphoma evaluation EXCEPT
Answer
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Diagnosis
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Response to therapy
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Recurrence detection
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Staging
Question 35
Question
Which of the following statements correctly explains the influence of FDG PET/CT imaging on staging in patients with Hodgkin's lymphoma
Answer
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Upstaging of approximately 15-25 % of patients
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Down-staging in a small minority of patients
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Upstaging in a small minority of patients
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Down-staging of approximately 15-25 % of patients
Question 36
Question
All of the following are well-established indications for FDG PET/CT imaging in patients with recurrent colorectal carcinoma EXCEPT
Answer
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Falling CEA levels in the absence of a known source
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Staging recurrent colorectal carcinoma
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Preoperative staging
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Equivocal lesion on conventional imaging
Question 37
Question
When monitoring response to treatment with FDG PET/CT Imaging is essential to obtain
Question 38
Question
FDG uptake by cancer cells tends to decline as
Answer
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Blood glucose and insulin levels decrease
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Blood glucose level decrease and insulin levels increase
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Blood glucose and insulin levels increase
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Blood glucose level increase and insulin levels decrease
Question 39
Question
All of the following statements describe the usefulness of FDG PET/CT imaging in malignant pleural mesothelioma (MPM) EXCEPT
Answer
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FDG PET/CT reduces the number of futile surgical procedures
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FDG PET/CT imaging is useful for guiding needle biopsy
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FDG PET/CT increases the accuracy of overall MPM staging
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High levels of FDG uptake are associated with a favourable prognosis
Question 40
Question
The intensity of FDG uptake in the majority of mesotheliomas
Answer
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Ranges from absent to low
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Ranges from low to moderate
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Ranges from moderate to high
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Is always high
Question 41
Question
Selected tumours with low FDG uptake include all of the following EXCEPT
Question 42
Question
All of the following statements correctly describe the postsurgical 18-F FDG uptake at the intervention site EXCEPT
Answer
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Postsurgical 18-F FDG uptake is mainly diffuse
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Postsurgical 18-F FDG uptake corresponds to the site of surgery
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Postsurgical 18-F FDG uptake increases in intensity with time
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Postsurgical 18-F FDG uptake in size with time
Question 43
Question
18-F FDG PET/CT should be performed on patients previously treated for differentiated thyroid cancer when the finding of 131-I whole body scintigraphy are negative and
Answer
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The thyroglobuline (Tg) levels are more than 10 ng/ mL
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The thyroglobuline (Tg) levels are less than 10 ng/ mL
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The TSH levels are more than 30 mIU/L
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The TSH levels are less than 30 mIU/ L
Question 44
Question
FDG PET/CT findings in anaplastic thyroid cancer can be described by all of the following EXCEPT
Answer
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FDG PET/CT defines the local extent of disease and the presence of metastases
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A positive PET/CT scan after therapy is linked with longer survival
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FDG PET/CT have an impact on patients' management
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Intense FDG uptake and volume are prognostic for a bad outcome
Question 45
Question
FDG PET/CT used in patients with suspected and residual/ recurrent gliomas is limited by
Answer
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The low 18-F FDG uptake in normal brain tissue
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The high 18-F FDG uptake in normal brain tissue
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The low 18-F FDG uptake in tumour tissue
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The high 18-F FDG uptake in tumour tissue
Question 46
Question
18-F FDG PET imaging is NOT indicated for initial staging of
Answer
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Breast cancer
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Hodgkin's lymphoma
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Prostate cancer
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Lung cancer
Question 47
Question
Which of the following statements describing 18-F FDG PET in the diagnostic work-up of patients with melanoma is FALSE
Answer
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FDG PET is a standard modality in evaluation of recurrent melanoma
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Melanin content influences lesion detectability by FDG PET
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FDG PET is most valuable in stage III disease
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FDG PET is more accurate for systemic staging than regional staging
Question 48
Question
Ovarian uptake of 18-F FDG in a postmenopausal patient indicates
Answer
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A normal finding
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Malignancy
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Pregnancy
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Benign ovarian cyst
Question 49
Question
F-18 FDG focal uptake seen 6 months after completion of radiation therapy should be considered as
Answer
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Tumour recurrence
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Normal finding
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Radiation necrosis
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Radiation pneumonitis
Question 50
Question
According to the PERCIST (PET Response Criteria in Solid Tumours) criteria for treatment response evaluation, the changes in SUVs should be assessed as
Answer
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Percentage change in the same lesion
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Percentage change in the “hottest” lesion
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Value change in the same lesion
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Value change in the “hottest” lesion