PRACTICAL APPLICATIONS Chapter 20 HW Done

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Downey Adult School *

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2020

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Medicine

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Apr 3, 2024

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RADIOLOGY.AND NUCLEAR MEDICINE 869 Wyinr {arnia PRACTICAL APPLICATIONS CASE STUDY: MELANOMA FOLLOW-UP Rill Q P ) ¢ o o - % Bill Smith, a 51-year-old sales representative, was initially diagnosed with stage II1 melanoma 4 years ago 3-month follow-up CT 1 lswers to the questions are found on page 876 | | | E | { b He underwent surgery and received interferon treatment at that time. At his 3 1% k tieluation last year, Mr. Smith received bad news. The CT scan indicated a small 1-cm nodule that could 1 be 2 melanoma metastasis. To confirm the diagnosis, Mr. Smith underwent a PET scan. He was admitted to the nuclear medicine unit of the hospital on the morning of the scan He had been istructed to fast (no food or beverage 12 hours before the scan). The nuclear medicine physician had told him especially not to eat any type of sugar, which would compete with the radiopharmaceutical 18F-FDG j [radiolabeled fluorodeoxyglucose, "*F-FDG), a radioactive glucose molecule that travels to every cell in the P body B The PET scan began with an injection of a trace amount of 18F-FDG by the physician. Bill was asked 1} I lie still for about an hour in a dark, quiet room and to avoid talking to prevent the compound from i gncentrating in the tongue and vocal cords. The waiting time allowed the 18F-FDG to be ahsorbed and 1 wleased from normal tissue. After emptying his bladder, Bill reclined on a bed that moved slowly and i | quietly through a PET scanner, a large tube similar to a CT scanner. The radioactive glucose emits charged particles called positrons, which interact with electrons, producing gamma rays that are in turn detected by the scanner. Color-coded images indicate the intensity of metabolic activity throughout the body. Cancerous cells absorb more radioactive glucose than noncancerous cells. The malignant cells show up b brighter on the PET scan. € Bill's PET scan proved the CT wrong: His melanoma had not metastasized. He returned home quite P rilieved. Questions about the Case Study: Melanoma Follow-up I. In CT scanning: 2. A radioactive tracer is used b, Magnetic images reveal images in all three planes of the body ¢. A nuclear physician performs the ultrasound procedure d X-rays and a computer produce images in the axial plane P 2 In PET scanning: a, A radioactive tracer is used b. X-ray images reveal images in all three planes of the body ¢ A nuclear physician performs the ultrasound procedure d. Doppler ultrasound is used 3, Bill's case showed that: a CT scanning and PET scanning are equally effective in diagnosis of metastases b, PET scanning is useful in cancer diagnosis and staging ¢ Melanoma never progresses to stage IV d A diet high in glucose helps concentrate the radioactive 18F-FDG before the PET scan
- 870 RADIOLOGY AND NUCLEAR MEDICINE GENERAL HOSPITAL: NUCLEAR MEDICINE DEPARTMENT Available Radionuclides Radionuclide Radiopharmaceutical Xe-133 xenon gas Tc-99m albumin microspheres Sr-87m (strontium) solution Te-99m diphosphonate Tc-99m pertechnetate Tc-99m sulfur colloid Te-99m HIDA Tc-99m DTPA Tc-99m DMSA 1-123 sodium iodide 1-131 sodium iodide TI-201 (thallium) thallium chloride Te-99m sestamibi Ga-67 (gallium) gallium citrate DMSA, dimercaptosuccinic acid; DTPA, diethylenetriaminepentaacetic acid, HIDA, NH2,6-dimethyllimir PO, oral (Latin per os, by mouth) Questions about the General Hospital: Nuclear Medicine Department Administration Route inhaled v 1. Which radionuclide is used with sestamibi in an ETT of heart function? a. Thallium-201 b. Todine-131 ¢. Gallium-67 d. Technetium-99m 2. Which radionuclide would be used to diagnose disease in an endocrine gland? a. Ga-67 b. 1-123 c. Xe-123 d. Sr-87m Target Organ lungs lungs bone bone brain liver/spleen gallbladder kidney kidney thyroid thyroid heart heart tumors and abscesses acetic acd
RADIOLOGY AND NUCLEAR MEDICINE 871 Remember to check your answers carefully with the Answers to Exercises, page 875. o Complete the medical terms based on the definitions and word parts given. Wy e — S—— 1. Obstructing the passage of x-rays: radio _{ 2. Permitting the passage of x-rays: radio _\Jlgw\¥= e 3. Aids physicians in performing ultrasound procedures: ___ Sonv grapher 4. Transformation of stable substances into charged particles: __ _lon _ization 5. Radioactive drug administered for diagnostic purposes: radio \L\ 22> 6. Radioactive chemical that gives off energy in the form of radiation: radio nwe. S o 7. A physician who specializes in diagnostic radiology: radi 0\oiy S 8. Study of the uses of radioactive substances in the diagnosis of disease: ___’ uy medicine o Match the special diagnostic techniques below with their definitions. computed tomography _ magnetic resonance imaging contrast studies- ultrasonography . interventional radiology 1. Radiopaque substances are given and conventional x-rays taken Condans Gx BN 2. Use of echoes of high-frequency sound waves to diagnose disease __\ XU (A . 3. A magnetic field and radio waves are used to form images of the body _\M\¢ DXL (SN, . 4. X-ray pictures are taken circularly around an area of the body, and a computer synthesizes the information into composite images _()Wpux ¢t Ay laahy . —mmw%, ¢ Therapeutic procedures are performed by a radiologist under the guidance of CT, MRI, or 3] ultrasonography _ \\NXUAMAOG (LY NN o Match the diagnostic x-ray test in Column | with the part of the body that is imaged in Column Il COLUMN | COLUMN 1l 1. myelography i A. spinal cord 2. retrograde pyelography _%_ 2 ::(t:t;s\.ifijc;;llInpmn . 3. angiography _(,‘ )) esophagus, stomach, and small intestine L saceriiyeies ):)_ -; :::\I\:Ir&d;rtj:-'tlnlmmul tract S 6. bile vessels (ducts) . 5. cholangiography 6. barium enema X 7. hysterosalpingography ) K OO\ o
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