Nucs, MQSA, & Misc Trivia

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Karteikarten am Nucs, MQSA, & Misc Trivia, erstellt von the saggiest am 16/01/2021.
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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
NaF 18 Sharp bones
FDG
Ga 67 Lacrimal glands Fuzzy PET
Tc HDP/MDP Fuzzy bones
I 123 Sharp thyroid Glands, GI, GU, nasopharynx
I 131 Fuzzy thyroid Glands, oral cavity, liver, bowel, bladder
MIBG Myocardium, liver, salivary gland, thyroid Bone = abnormal
Tc Sestamibi Glands, thyroid, heart, liver Critical organ: gallbladder
Octreoscan In 111 Liver, spleen, kidneys
Tc sulfur colloid Liver > spleen Critical organ: liver FNH +; adenoma -; hemangioma -
Tc pertechnetate Glands, thyroid, stomach, breast Critical organ: colon
In 111 WBC Spleen > liver Critical organ: spleen
PSMA F 18 Lacrimal glands, salivary, liver, spleen, kidneys, bowel
DOTA Ga 68 Pituitary, uncinate, liver, spleen, GU
DTPA In 111 Normal
HMPAO Tc 99
FDG
DTPA In 111 Brain death
HMPAO Tc 99 Interictal
DTPA In 111 Cisternogram Normal
DTPA In 111 Cisternogram NPH (in vents)
FDG Normal
Florbetapir F 18 Normal white matter uptake No gray matter uptake to suggest plaque
DAT scan - Ioflupane I 123 Normal comma shaped caudate Absence = Parkinson
Florbetapir F 18 Alzheimer Loss of gray white Abnormal uptake in gray matter
FDG F 18 Alzheimer Posterior cingulate Temporo-parietal Spares motor strip Spares visual cortex
FDG F 18 Pick's Frontotemporal
FDG F 18 Lewy Body Does not spare occipital
Uniformity Intrinsic (collimator off) Extrinsic (collimator on) Co 57 Daily
Spatial resolution & Linearity Weekly
Energy spectrum Daily or automatic with each use
Jaszczak phantom Spatial resolution & Linearity Weekly
Energy resolution & linearity Annually
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
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
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
Tc 99 RBC scan Sensitivity 0.2 mL/min (0.04 in some studies) Critical organ: colon & heart
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? 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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