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

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

3. Sample Techniques for Nuclear Imaging

4. 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.

5. 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

6. 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

7. 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.

8. 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.

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

10. 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.

11. 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.

12. 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).

13. Thank you