Infection, Tumor imaging, and Therapy Review Test (2/3)

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Joshua Liberty

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Infection, Tumor imaging, and Therapy Review Test (2/3)Online version Multiple choice questions by Joshua Liberty 1 A patient is having therapy with Y-90 labeled glass microspheres; following the placement of the hepatic catheter; _____ is administered into the hepatic artery to determine the ______? a 2 mCi to 4 mCi of Tc99m MAA; correct placement of hepatic catheter b 5 mCi to 8 mCi of Tc99m MAA; extent of A-V shunting to the lungs and confirm the absence of gastric and duodenal flow c 2 mCi to 4 mCi of Tc99m MAA; extent of A-V shunting to the lungs and confirm the absence of gastric and duodenal flow d 2 mCi to 4 mCi of Y-90 labeled glass microspheres; extent of A-V shunting to the lungs and confirm the absence of gastric and duodenal flow 2 Ga-68 Dotatate is indicated for use with? a Gamma camera imaging of somatostatin receptor positive neuroendocrine tumors (NETs) in adult and pediatric patients b PET infection imaging c Localization of brain tumors d PET localization of somatostatin receptor positive neuroendocrine tumors (NETs) in adult and pediatric patients 3 Ga-68 recommended dose is? a 0.034 mCi/kg up to 4.4 mCi b 0.054 mCi/kg up to 5.4 mCi c 0.074 mCi/kg up to 7.4 mCi d 0.094 mCi/kg up to 7.4 mCi 4 The MOL for sestamibi breast imaging is? a Compartmental b Receptor binding c Unknown, thought to be increased blood flow and metabolic rate in abnormal cells d AT 5 Regarding Y-90 therapy which of the following are true? a Y90 resin microspheres are used for unresectable liver mets from colorectal cancer b Y-90 labeled glass microspheres are used for unresectable liver mets from colorectal cancer c The hepatic vein is used for infusion d None of these 6 The MOL of Yttrium(90Y)-Ibritumomab tiuxetan is ? a Targets the CD20 antigen on surface of normal/malignant B lymphocytes b AT c Compartmental d Passive diffusion through cell membrane of normal/malignant B lymphocytes 7 A patient is having a Y-90 Ibritumomab tiuxetan therapy; his platelet count is > 150,00; his dose should be ? a 0.5 mCi/kg b 32 mCi c 0.4 mCi/kg d 0.3 mCi/kg 8 A patient is having a Y-90 Ibritumomab tiuxetan therapy; his platelet count is 100,00-149,000; his dose should be ? a 0.5 mCi/kg b 32 mCi c 0.4 mCi/kg d 0.3 mCi/kg 9 Yttrium (Y-90)-Ibritumomab tiuxetan is used for ? a Non-Hodgkin's Lymphoma b Leukemia c Pheochromocytoma d Bone pain 10 _____ radiation can be used to from a crude picture of Y-90 liver distribution by SPECT. a Electron Capture b Bremsstrahlung c B- d Internal conversion 11 The hypothetical first lymph node or group of nodes reached by metastasizing cancer cell from a tumor called ? a Axillary lymph node b Inguinal lymph node c Sentinel lymph node d Lymphedema 12 A patient has bilateral breast disease; where should the sestamibi be injected? a Rt arm b Lt arm c Rt wrist d Lt wrist e Foot 13 Which normal and noncancerous conditions also show FDG uptake? a Infection b Inflammation c Healing tissue d Atelectasis e All listed 14 Increased lung uptake of FDG can occur with? a TB b Fungal infections c Pneumonia d None of these e All of these 15 FDG may accumulate in? a Recent surgical sites b Ostomy sites c Arthritic joints d Pleural effusions e All of these 16 Which body structures show normal FDG uptake? a Brain b Liver c Kidneys d Thymus e All of these 17 An SUV value over ___ should raise the possibility of malignancy. a 2.5 b 1.5 c 1 d 0.5 18 FDG uptake is obtained in a single ROI at carious time intervals post injection to 5 hours later; if the SUV's rise, cancer is more likely; this is called? a Temporal imaging b Standardized uptake value c Time of flight d Dual time point imaging 19 SUV results would be affected by? a How much activity injected b How much activity remaining in syringe c Patient physical activity d Patient obesity e All of these 20 A lymphoma patient is taking prednisone for therapy; this could be a problem because in PET FDG imaging? a This medication can elevate blood sugar b This medication can lower blood sugar c Hormone therapy decreases PET resolution d This medication can cause lymph nodes to have uptake of FDG 21 The most important prognostic factor in long term survival of patients with breast cancer is ? a How long patient has had disease b Number and extent of axillary and lymph node mets c Amount and frequency of chemotherapy given d Presence of brain mets 22 Normal distribution of Ga-68 Dotatate is seen in the? a Choroid plexus of the brain b Pituitary gland c Glandular tissues of the neck d Liver and Pancreas e All of these 23 Y-90 Resin microspheres are contraindicated in patients who have? a Had previous external beam radiation therapy to the liver b Ascites or are in clinical liver failure c 20% lung shunting of the hepatic artery blood flow, or >30Gy RAD to the lungs, as estimated by MAA scan d Abnormal LFTs e All of these 24 Radium 223 Dichloride is used for? a Bone pain b Treatment of patients with breast cancer, symptomatic bone metastases c Treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases d Osteosarcoma primary tumors 25 The dose regimen of Radium 223 dichloride is ___ per ____ of body weight given at 4 weeks intervals for ___ injections. a 1.35 mCi; kg; 6 b 1.49 uCi; kg; 6 c 1.49 uCi; kg; 4 d 1-2 mCi; kg; 4 e 1.49 mCi; kg; 6 f 1.49 uCi; lb; 6 26 With Radium 223 dichloride, the high LET of alpha emitters leads to a high frequency of ______, resulting in anti-tumor effect on bone metastases. a Double-strand DNA breaks in adjacent cells b Single-strand DNA breaks in adjacent cells c Damage to soft tissue d Hypercalcemia 27 Sr-89 chloride should be used with caution in patients with platelet counts < _____ and WBC counts < _____. a 60,000; 2,400 b 100,000; 2,400 c 60,000; 1,200 d 60,000; 800 28 _______ is indicated for PET in men suspected prostate cancer recurrence based on elevated blood prostate specific antigen (PSA) levels following prior treatment? a Iobengaune I-131 b Y-90 resin microspheres c Fluciclovine F-18 d Ga-68 dotatate e F-18 Flutemetamol 29 _____ is indicated for the treatment of adult/pediatric patients 12 years and older with iobengaune scan positive, unresectable, locally advanced or metastatic pheochromocytoma or paraganglioma who require systemic anticancer therapy. a Iobengaune I-131 b Y-90 resin microspheres c Fluciclovine F-18 d Ga-68 dotatate e F-18 Flutemetamol 30 ______ is a radiolabeled somatostatin analog indicated for the treatment of somatostatin receptor-positive gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs), including foregut, midgut, and hindgut neuroendocrine tumors in adults. a Iobengaune I-131 b Y-90 resin microspheres c Fluciclovine F-18 d Ga-68 dotatate e Lutetium Lu-177 dotatate

Infection, Tumor imaging, and Therapy Review Test (2/3)Online version

Multiple choice questions

by Joshua Liberty

A patient is having therapy with Y-90 labeled glass microspheres; following the placement of the hepatic catheter; _ is administered into the hepatic artery to determine the __?

2 mCi to 4 mCi of Tc99m MAA; correct placement of hepatic catheter

5 mCi to 8 mCi of Tc99m MAA; extent of A-V shunting to the lungs and confirm the absence of gastric and duodenal flow

2 mCi to 4 mCi of Tc99m MAA; extent of A-V shunting to the lungs and confirm the absence of gastric and duodenal flow

2 mCi to 4 mCi of Y-90 labeled glass microspheres; extent of A-V shunting to the lungs and confirm the absence of gastric and duodenal flow

Ga-68 Dotatate is indicated for use with?

Gamma camera imaging of somatostatin receptor positive neuroendocrine tumors (NETs) in adult and pediatric patients

PET infection imaging

Localization of brain tumors

PET localization of somatostatin receptor positive neuroendocrine tumors (NETs) in adult and pediatric patients

Ga-68 recommended dose is?

0.034 mCi/kg up to 4.4 mCi

0.054 mCi/kg up to 5.4 mCi

0.074 mCi/kg up to 7.4 mCi

0.094 mCi/kg up to 7.4 mCi

The MOL for sestamibi breast imaging is?

Compartmental

Receptor binding

Unknown, thought to be increased blood flow and metabolic rate in abnormal cells

Regarding Y-90 therapy which of the following are true?

Y90 resin microspheres are used for unresectable liver mets from colorectal cancer

Y-90 labeled glass microspheres are used for unresectable liver mets from colorectal cancer

The hepatic vein is used for infusion

None of these

The MOL of Yttrium(90Y)-Ibritumomab tiuxetan is ?

Targets the CD20 antigen on surface of normal/malignant B lymphocytes

Compartmental

Passive diffusion through cell membrane of normal/malignant B lymphocytes

A patient is having a Y-90 Ibritumomab tiuxetan therapy; his platelet count is > 150,00; his dose should be ?

0.5 mCi/kg

32 mCi

0.4 mCi/kg

0.3 mCi/kg

A patient is having a Y-90 Ibritumomab tiuxetan therapy; his platelet count is 100,00-149,000; his dose should be ?

0.5 mCi/kg

32 mCi

0.4 mCi/kg

0.3 mCi/kg

Yttrium (Y-90)-Ibritumomab tiuxetan is used for ?

Non-Hodgkin's Lymphoma

Leukemia

Pheochromocytoma

Bone pain

_____ radiation can be used to from a crude picture of Y-90 liver distribution by SPECT.

Electron Capture

Bremsstrahlung

B-

Internal conversion

The hypothetical first lymph node or group of nodes reached by metastasizing cancer cell from a tumor called ?

Axillary lymph node

Inguinal lymph node

Sentinel lymph node

Lymphedema

A patient has bilateral breast disease; where should the sestamibi be injected?

Rt arm

Lt arm

Rt wrist

Lt wrist

Foot

Which normal and noncancerous conditions also show FDG uptake?

Infection

Inflammation

Healing tissue

Atelectasis

All listed

Increased lung uptake of FDG can occur with?

Fungal infections

Pneumonia

None of these

All of these

FDG may accumulate in?

Recent surgical sites

Ostomy sites

Arthritic joints

Pleural effusions

All of these

Which body structures show normal FDG uptake?

Brain

Liver

Kidneys

Thymus

All of these

An SUV value over ___ should raise the possibility of malignancy.

2.5

1.5

0.5

FDG uptake is obtained in a single ROI at carious time intervals post injection to 5 hours later; if the SUV's rise, cancer is more likely; this is called?

Temporal imaging

Standardized uptake value

Time of flight

Dual time point imaging

SUV results would be affected by?

How much activity injected

How much activity remaining in syringe

Patient physical activity

Patient obesity

All of these

A lymphoma patient is taking prednisone for therapy; this could be a problem because in PET FDG imaging?

This medication can elevate blood sugar

This medication can lower blood sugar

Hormone therapy decreases PET resolution

This medication can cause lymph nodes to have uptake of FDG

The most important prognostic factor in long term survival of patients with breast cancer is ?

How long patient has had disease

Number and extent of axillary and lymph node mets

Amount and frequency of chemotherapy given

Presence of brain mets

Normal distribution of Ga-68 Dotatate is seen in the?

Choroid plexus of the brain

Pituitary gland

Glandular tissues of the neck

Liver and Pancreas

All of these

Y-90 Resin microspheres are contraindicated in patients who have?

Had previous external beam radiation therapy to the liver

Ascites or are in clinical liver failure

20% lung shunting of the hepatic artery blood flow, or >30Gy RAD to the lungs, as estimated by MAA scan

Abnormal LFTs

All of these

Radium 223 Dichloride is used for?

Bone pain

Treatment of patients with breast cancer, symptomatic bone metastases

Treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases

Osteosarcoma primary tumors

The dose regimen of Radium 223 dichloride is _ per of body weight given at 4 weeks intervals for _ injections.

1.35 mCi; kg; 6

1.49 uCi; kg; 6

1.49 uCi; kg; 4

1-2 mCi; kg; 4

1.49 mCi; kg; 6

1.49 uCi; lb; 6

With Radium 223 dichloride, the high LET of alpha emitters leads to a high frequency of ______, resulting in anti-tumor effect on bone metastases.

Double-strand DNA breaks in adjacent cells

Single-strand DNA breaks in adjacent cells

Damage to soft tissue

Hypercalcemia

Sr-89 chloride should be used with caution in patients with platelet counts < _ and WBC counts < _.

60,000; 2,400

100,000; 2,400

60,000; 1,200

60,000; 800

_______ is indicated for PET in men suspected prostate cancer recurrence based on elevated blood prostate specific antigen (PSA) levels following prior treatment?

Iobengaune I-131

Y-90 resin microspheres

Fluciclovine F-18

Ga-68 dotatate

F-18 Flutemetamol

_____ is indicated for the treatment of adult/pediatric patients 12 years and older with iobengaune scan positive, unresectable, locally advanced or metastatic pheochromocytoma or paraganglioma who require systemic anticancer therapy.

Iobengaune I-131

Y-90 resin microspheres

Fluciclovine F-18

Ga-68 dotatate

F-18 Flutemetamol

______ is a radiolabeled somatostatin analog indicated for the treatment of somatostatin receptor-positive gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs), including foregut, midgut, and hindgut neuroendocrine tumors in adults.

Iobengaune I-131

Y-90 resin microspheres

Fluciclovine F-18

Ga-68 dotatate

Lutetium Lu-177 dotatate

Infection, Tumor imaging, and Therapy Review Test (2/3)

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