Advanced Clinical Practice in Nuclear Medicine Sayed abbas NMT 474 L 8

Evaluate, demonstrate and prepare the patient prior to commencing a procedure

Sample Techniques for Nuclear Imaging

BRAIN DEATH OR CEREBRALBLOOD FLOW SCAN Procedure imaging time 20 to 30 minutes Radiopharmaceutical Technetium-99m (99mTc), diethylenetriamine pentaacetic acid (DTPA), or glucoheptonate. Brain-specific agents such as 99mTc hexamethylpropyleneamine oxime (HMPAO), single-photon emission computed tomography (SPECT) scan, and 99mTc ethyl cysteinate dimer (ECD), also called Tc-Bicisate, can be used. They do obviate the need for a very good bolus injection.

Method of administration - Bolus IV injection Normal adult administered activity - 15 to 30 mCi (555 MBq to 1.11 GBq) Injection-to-imaging time - Immediate Conflicting examinations and medications - None Bolus : قرص دواء

Patient preparation None necessary, although some institutions put a rubber band or tourniquet around the head just above ears to help diminish scalp blood flow. This should not be done in patients with a history of head trauma. Patient should be normally ventilated. Ventilated : التهوية

Technique Collimator * High-resolution or ultra-high-resolution; field of view (FOV) should include from the level of the common carotids to the skull vertex. Dynamic flow imaging time * Blood flow images: 1 to 3 seconds/frame for at least 60 seconds. * Flow images should start before the arrival of the bolus in the neck.

Routine views Immediate blood pool anterior and anterior image at 5 minutes each. Many institutions also obtain posterior and both lateral views. Note: If brain-specific images are obtained, initial images as described previously are obtained as well as planar and SPECT images obtained after 20 minutes.

Patient positioning Sitting or supine Photopeak selection 140-keV (15% to 20% window)

SPECT BRAIN IMAGING Procedure imaging time * 30 to 60 minutes Instrumentation * SPECT camera Radiopharmaceutical * 99mTc-HMPAO For unstabilized 99mTc-HMPAO, inject no sooner than 10 minutes after preparation and not more than 30 minutes after preparation.

Method of administration Place patient in a quiet, dimly lit room and instruct him or her to keep eyes and ears open. The patient should be seated or reclining comfortably. IV access should be placed at least 10 minutes before injection. The patient should not speak or read, and there should be little or no interaction before, during, or up to 5 minutes after injection.

Normal administered activity 15 to 30 mCi (555 MBq to 1.11 GBq), children 0.2 to 0.3 mCi/kg (7.4 to 11.1 MBq/kg). Minimum dose, 3 to 5 mCi (111 to 185 MBq).

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