Nucs, MQSA, & Misc Trivia

Question	Answer
Tc 99	Synthesis: Generator Decay: Internal conversion Emit: Gamma photon Half life: 6 hr Energy: 140
I 123	Synthesis: Cyclotron Decay: Electron capture Emit: Photon Half life: 13 hr Energy: 159
I 131	Synthesis: Fission Decay: Beta minus Emit: Beta (some gamma) Half life: 8 days Energy: 364
Ga 67	Synthesis: Cyclotron Decay: Electron capture Emit: Photon Half life: 78 hr Energy: 90, 190, 290, 390
In 111	Synthesis: Cyclotron Decay: Electron capture Emit: Photon Half life: 67 hr Energy: 173, 247
Tl 201	Synthesis: Cyclotron Decay: Electron capture Emit: Photon Half life: 73 hr Energy: 69, 81 Critical organ: kidneys
Xe 133	Synthesis: Fission Decay: Beta minus Emit: Gamma (some beta) Half life: 5.3 d Energy: 81 Critical organ: trachea
C 11	Synthesis: Cyclotron Decay: Annihilation Emit: Positron Half life: 20 min Energy: 512
N 13	Synthesis: Cyclotron Decay: Annihilation Emit: Positron Half life: 10 min Energy: 512
O 15	Synthesis: Cyclotron Decay: Annihilation Emit: Positron Half life: 2 min Energy: 512
F 18	Synthesis: Cyclotron Decay: Annihilation. Election capture. Emit: Positron Half life: 110 min Energy: 512
Ru 82	Synthesis: Generator Decay: Annihilation Emit: Positron Half life: 1 min Energy: 512
Radionuclide Purity	0.15 uCi Mo per 1 mCi Tc Dose calibrator
Radiochemical Purity	< 5% free Tc (some say < 10%) Thin layer chromatography
Chemical Purity	< 10 ug Al per 1 mL Tc Paper colorimetry (pH paper)
Nuclear Spills Major if > x	1 mCi - I 131 10 mCi - Ga 67, In 111, I 123 100 mCi Tc 99, Tl 201
MEN 1	Pituitary adenoma Pancreatic islet cell Parathyroid adenoma/carcinoma
Men IIa	Pheochromocytoma Medullary thyroid cancer Parathyroid hyperplasia
Men IIb	Pheochromocytoma Medullary thyroid cancer Marfanoid habitus Ganglioneuromas (mucosal)
VHL	Renal cell carcinoma Angiomyolipoma Pheochromocytoma Pancreatic cysts and cystic tumors Liver cysts Hemangioblastoma
Tuberous Sclerosis	Cortical tubers Subependymal nodules Subependymal giant cell astrocytomas Angiomyolipoma Renal cell carcinoma Lymphangioleiomyomatosis Cardiac rhabdomyomas
NF 1	Plexiform neurofibroma Optic nerve glioma Sphenoid wing dysplasia
Image: F18 (binary/octet-stream)	NaF 18 Sharp bones
Image: Fdg (binary/octet-stream)	FDG
Image: Ga67 (binary/octet-stream)	Ga 67 Lacrimal glands Fuzzy PET
Image: Hdp (binary/octet-stream)	Tc HDP/MDP Fuzzy bones
Image: I23 (binary/octet-stream)	I 123 Sharp thyroid Glands, GI, GU, nasopharynx
Image: I31 (binary/octet-stream)	I 131 Fuzzy thyroid Glands, oral cavity, liver, bowel, bladder
Image: Mibg (binary/octet-stream)	MIBG Myocardium, liver, salivary gland, thyroid Bone = abnormal
Image: Mibi (binary/octet-stream)	Tc Sestamibi Glands, thyroid, heart, liver Critical organ: gallbladder
Image: Oct (binary/octet-stream)	Octreoscan In 111 Liver, spleen, kidneys
Image: Sco (binary/octet-stream)	Tc sulfur colloid Liver > spleen Critical organ: liver FNH +; adenoma -; hemangioma -
Image: Tc (binary/octet-stream)	Tc pertechnetate Glands, thyroid, stomach, breast Critical organ: colon
Image: Wbc (binary/octet-stream)	In 111 WBC Spleen > liver Critical organ: spleen
Image: Psma (binary/octet-stream)	PSMA F 18 Lacrimal glands, salivary, liver, spleen, kidneys, bowel
Image: Dota (binary/octet-stream)	DOTA Ga 68 Pituitary, uncinate, liver, spleen, GU
Image: Dtpa (binary/octet-stream)	DTPA In 111 Normal
Image: Hmpao (binary/octet-stream)	HMPAO Tc 99
Image: Fdg+Brain (binary/octet-stream)	FDG
Image: Dtpa+Brain+Death (binary/octet-stream)	DTPA In 111 Brain death
Image: Hmpao+Interictal (binary/octet-stream)	HMPAO Tc 99 Interictal
Image: In+111+Dtpa+Cisternogram (binary/octet-stream)	DTPA In 111 Cisternogram Normal
Image: In+111+Dtpa+Cisternogram+Nph (binary/octet-stream)	DTPA In 111 Cisternogram NPH (in vents)
Image: Fdg+Brain+Normal (binary/octet-stream)	FDG Normal
Image: F18+Florbetapir (binary/octet-stream)	Florbetapir F 18 Normal white matter uptake No gray matter uptake to suggest plaque
Image: Dat+Scan (binary/octet-stream)	DAT scan - Ioflupane I 123 Normal comma shaped caudate Absence = Parkinson
Image: F18+Florbetapir+Abnormal (binary/octet-stream)	Florbetapir F 18 Alzheimer Loss of gray white Abnormal uptake in gray matter
Image: Fdg+Alzheimer (binary/octet-stream)	FDG F 18 Alzheimer Posterior cingulate Temporo-parietal Spares motor strip Spares visual cortex
Image: Fdg+Picks (binary/octet-stream)	FDG F 18 Pick's Frontotemporal
Image: F18+Lewy+Body (binary/octet-stream)	FDG F 18 Lewy Body Does not spare occipital
Image: Flood+Uniformity (binary/octet-stream)	Uniformity Intrinsic (collimator off) Extrinsic (collimator on) Co 57 Daily
Image: Bar+Phantom (binary/octet-stream)	Spatial resolution & Linearity Weekly
Image: Energy+Spectrum (binary/octet-stream)	Energy spectrum Daily or automatic with each use
Image: Jaszczak+Phantom (binary/octet-stream)	Jaszczak phantom Spatial resolution & Linearity Weekly
Image: Energy+Resolution (binary/octet-stream)	Energy resolution & linearity Annually
Image: Center+Of+Rotation (binary/octet-stream)	Center of rotation test Monthly
MQSA: - Education hours - CME - CME for new modality - Case volume as trainee - Case volume in practice	Education - 60 hours CME - 15 credits in 3 years New modality - 8 credits Cases - 240 w/in 6 months, 2 yr prior to graduating Continue in practice - 960 in 2 yrs
MQSA Audit Frequency	12 month
MQSA QC: Processor	Daily
MQSA: Darkroom cleanliness	Daily
MQSA QC: Phantom evaluation	Weekly
MQSA QC: Viewbox conditions	Weekly
MQSA QC: Repeat analysis	Quarterly
MQSA QC: Screen film contact	Semi-annually
MQSA QC: Darkroom fog	Semi-annually
MQSA QC: Compression test	Semi-annually
Image: Density+Difference (binary/octet-stream)	Breast QC Density difference & background density Background must be < 0.2 OD of baseline Density diff must be < 0.05 OD of baseline
MQSA phantom, how many: - Fibers - Speck groups - Masses	2018 MQSA says: >= 2 fibers >= 3 speck groups >= 2 masses Image: Phantom+2 (binary/octet-stream)
Image: Bar+Test (binary/octet-stream)	Spatial resolution test (breast) > 11 or 13 line pairs per mm
MQSA Audit: Cancers detected (per 1,000)	> 2.5
MQSA Audit: Recall rate	5-12%
MQSA Audit. Define: - PPV1 - PPV2 - PPV3	- PPV1: #cancer/#recall - PPV2: #cancer/#biopsies recommended - PPV3: #cancer/#biopsies performed
MQSA Audit: PPV1	3-8% PPV1 = # cancer / # recalls
MQSA Audit: PPV2	Screening: 15-40% Palpable lump: 25-50% PPV2 = #cancer / #biopsies recommended
MQSA Audit: PPV3	Screening: 20-45% Palpable lump: 30-55% PPV3 = #cancer / #biopsies performed
MQSA: Notify pts of results in ___ days. If suspicious, then ___ days.	30 days. 5 days.
MQSA: Mammograms must be retained for how long?	5 years (default) OR 10 years if no priors
Occupational Max Radiation Dose: Whole body	50 mSv = 5,000 mrem
Occupational Max Radiation Dose: Eye lens	150 mSv = 15,000 mrem
Occupational Max Radiation Dose: Extremity	500 mSv = 50,000 mrem
Occupational Max Radiation Dose: Pregnant	5 mSv from declaration date
Max Radiation Dose: Member of public	1 mSv = 100 mrem per year
Radiation Deterministic Effect: Transient erythema	3-6 Gy
Radiation Deterministic Effect: Epilation (hair loss)	4 Gy
Radiation Deterministic Effect: Cataract	0.5 Gy (new number) 5 Gy (old literature)
Radiation Deterministic Effect: Sterility	3.5 Gy (male), 2.5 Gy (female)
Radiation Deterministic Effect: Bone marrow suppression	0.5 Gy
Radiation Deterministic Effect: Cognitive effects	1-2 Gy (adult), 0.1-0.2 Gy (infant)
Radiation Deterministic Effect: Lethal dose	5 Gy
Radiation Stochastic Effect: Excess relative risk of cancer (% per Sv)	4-5% per Sv in adults 5.5-6.0% per Sv all comers
Radiation Stochastic Effect: 1) Fetus threshold 2) Effect by weeks	1) > 100 m Gy 2) - weeks 0-2 = death - weeks 3-8 = organogenesis problems - weeks 8 - 15= cognitive problems
I 123 Thyroid 24 hr Uptake: - Normal range - Graves range	Normal 10-30% Graves 40-70%
I 131 Dose: Graves Multinodular goiter Post-surgical thyroid remnant Metastasis	Graves 10 - 15 mCi Goiter 20 - 30 mCi Thyroid remnant 75 - 150 mCi Metastasis 200 mCi
After I 131, send patient home when:	- If dose < 33 mCi - Pt < 7 mrem/hr at 1 meter - Dose to family < 500 mrem
VQ perfusion scan - Number beads - Size beads - Decrease dose for these populations	Normal: 200,000-600,000 beads 100,000-200,000 if infant, R->L shunt, pregnant, or pulm HTN Size 30 - 50 um
Image: Rbc+Scan (binary/octet-stream)	Tc 99 RBC scan Sensitivity 0.2 mL/min (0.04 in some studies) Critical organ: colon & heart
Image: Meckel (binary/octet-stream)	Meckel Scan Tc pertechnetate Critical organ: thyroid
HIDA (DISIDA) CCK (sincalide) dose	0.02 mcg/kg over 15 - 60 min
HIDA (DISIDA) morphine dose	0.04 mg/kg (over 3 min)
HIDA (DISIDA) phenobarbital dose	5 mg/kg/day for 5 days
Gallbladder EF < ___ = chronic cholecystitis / biliary dyskinesia	35%
Gastric emptying: Delayed if ___ residual at 1 hr or ____ at 4 hr	90%, 10%
Diuretic renography. Lasix dose?	40 mg
Renograph for obstruction. Normal half time? Abnormal half time?	< 10 min = normal 10 - 20 min = indeterminate > 20 min = obstruction (somewhat related, normal time to peak is 3-5 min)
Radiation dose limit for unrestricted area	2 mrem/hr = 0.02 mSv/hr
Surface dose limit? 1 meter? Image: Surface+Dose (binary/octet-stream)	I - surface 0.5 mrem/hr (5 uSv) II - surface 50 mrem/hr (0.5 mSv) - 1 meter 10 mrem/hr (0.1 mSv) III - surface 200 mrem/hr (2 mSv) - 1 meter 10 mrem/hr (0.1 mSv)
Fission produced radioisotopes	I 131, Xe 133, (Mo 99)
Cyclotron produced radioisotopes	I 123, F 18, Ga 67, In 111, Tl 201, Mo 99
Nuclear gastroesophageal reflux study threshold	> 4% is abnormal Tc sulfur colloid study
Mammogram anode/target k-edge: - Molybdenum - Rhodium - Tungsten (Iodine, silver, and barium for fun)	Molybdenum 20 keV Rhodium 23 Tungsten 70 (Iodine 33, Silver 25, Barium 37)
Fluoro: leakage from x-ray tube housing must be less than...	1 mGy/h at 1 m
Sentinel event = _____ unintended cumulative dose (according to Joint Commission)	15 Gy = root cause analysis & Joint Commission inspector visit
Fluoro: max entrance air kerma (according to FDA)	100 mGy/min
Gamma camera QC tests and timing	- Extrinsic uniformity (daily) - Photopeaking (daily) - Intrinsic uniformity (weekly) - Bar phantom (weekly) - Center of rotation (monthly) - Jascszak phantom (quarterly)
Dose calibrator tests and timing	CLAG - Constancy (daily) - Linearity (quarterly) - Accuracy (annually) - Geometry (at installation/repair)
K space (contrast vs sharpness): - Central = - Peripheral =	Central = contrast Peripheral = sharpness
Radiation deterministic effects: - Erythema - Epilation - Desquamation - Atrophy/necrosis	- Erythema 2-5 Gy - Epilation 5-10 Gy - Desquamation 10-15 Gy - Atrophy/necrosis >15 Gy

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Nucs, MQSA, & Misc Trivia

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	Created by the saggiest almost 4 years ago