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