Nuclear Medicine

• Brain Death – Technetium 99m HMPAO
  • T1/2 – 6 hrs
  • Photopeak – 140 keV
  • Dose: 15-30 mCi IV
  • Image at 5 min for flow, 30-90 min for static images
• Brain Death – Technetium 99m ECD
  • T1/2 – 6 hrs
  • Photopeak – 140 keV
  • Dose: 15-30 mCi IV
  • Image 45 min after injection
• SPECT/CT Perfusion – Technetium 99m HMPAO
  • T1/2 – 6 hrs
  • Photopeak – 140 keV
  • Dose: 20-30 mCi IV
  • Imaging may be performed within 15 minutes after injection
• SPECT/CT Perfusion – Technetium 99m ECD
  • T1/2 – 6 hrs
  • Photopeak – 140 keV
  • Dose: 20-30 mCi IV
  • Imaging may be performed within 15 minutes after injection
• DaT Scan – Iodine 123 Ioflupane
  • T1/2 – 13 hours
  • Photopeak – 156 kev
  • Image 3-6 hours after injection

• Technetium 99m Pertechnetate
  • T1/2 – 6 hrs
  • Photopeak – 140 keV
  • Dose: 2-10 mCi PO
  • Image 5-30 minutes after administration
• Iodine 123 Na Iodide- Uptake scan
  • T1/2 – 13 hours
  • Photopeak – 159 keV Gamma
  • Dose: 0.1 – .04 mCi PO
  • Image at 24 hours post administration
• Iodine 123 Na Iodide- SPECT or Pinhole Scan
  • T1/2 – 13 hours
  • Photopeak – 159 keV Gamma
  • Dose: 1-4 mCi PO
  • Image at 24 hours post administration
• Iodine 131 Na Iodide- SPECT or Whole Body Scan
  • T1/2 – 8 days
  • Photopeak – 364 keV Gama
  • Dose: 2-4 mCi PO
  • Uptake at 24 hours, image at 48 hours post administration
• Iodine 131 Na Iodide- Therapy
  • T1/2 – 8 days
  • Photopeak – 364 keV Gamma
  • Grave’s Dose: based on weight, up to 15 mCi
  • Toxic multinodular goiter dose: 25 mCi
  • Low Dose Ablation: 30 mCi
  • High Dose Ablation: 100-200 mCi

• Technetium 99m Sestamibi
  • T1/2: 6 hrs
  • Photopeak 140 kev
  • Dose: 20 – 30 mCi
  • Image at 15 min and 2 hours post injection

SPECT

• Technetium 99m Sestamibi
  • T1/2 – 6 hrs
  • Photopeak 140 kev
  • Rest Dose: 8-10 mCi IV
  • Stress Dose: 20-30 mCi IV
  • Image at 15-60 min post injection
• Thallium 201
  • T1/2 – 73 hrs
  • Photopeaks 69-81 kev
  • Dose: 4 mCi IV at max stress
  • May image at 4-24 hr for redistribution

PET

• Rubidium 82
  • T1/2 – 76 sec
  • Photopeak – 511 keV
  • Dose: 10-20 mCi IV bolus before rest and at max stress
  • Image immediately
• Nitrogen 13 Ammonia
  • T1/2 – 10 min
  • Photopeak – 511 keV
  • Dose: 10-20 mCi IV bolus before rest and at max stress
  • Image immediately
• F18 FDG
  • T1/2 – 110 min
  • Photopeak – 511 keV
  • Dose: 5-10 mCi IV
  • Image with PET/CT 60 min after injection
• Dipyridamole
  • Vasodilator will work unless vessel critically stenosed
  • Dose: 0.56 mg/kg IV over 4 minutes, up to 60 mg
• Regadenoson
  • Used for pharmacologic stress
  • Dose: 0.4 mg/5 mL IV
  • Administer 10-20 sec prior to radiopharmaceutical
• Dobutamine
  • Beta1 agonist can be used in COPD and after caffeine use
  • Dose: Start with 10 ug/kg/min, increase by 10 ug/kg/min
    every 3 minutes to maximum of 40-50 ug/kg/min

Perfusion

• Technetium 99m MAA
  • T1/2 – 6 hrs
  • Photopeak 140 kev
  • Dose: 1-4 mCi IV
  • Image with no delay

Ventilation

• Technetium 99m DTPA
  • T1/2 – 6 hrs
  • Photopeak 140 kev
  • Dose: 25-35 mCi in nebulizer for inhalation
  • Inhaled, lasts 20-60 min
  • Image with no delay
• Xenon 133
  • T1/2 –  125 hours
  • Photopeak – 81 keV Gamma
  • Dose: 10-20 mCi inhaled
  • Image with no delay

• Technetium 99m Sulfur-Colloid
  • Tc 99m T1/2 – 6 hrs
  • Sulfur-Colloid T1/2 – 2-3 min
  • Photopeak 140 kev
  • Dose: 3-10 mCi IV
  • Image 10-20 min after injection
• Yttrium 90
  • T1/2 – 64 hours
  • Photopeaks – 175 and 185 keV

• Technetium 99m IDA (Disofenin or Mebrofenin)
  • T1/2 – 6 hrs
  • Photopeak 140 kev
  • Dose: 1.5 – 5 mCi IV
  • Dynamic image for at least 60 min
• Cholecystokinin – use if <24 hr NPO to empty gallbladder
  • Dose: 10 ng/kg IV over 3 minutes
  • Alternate Dose: 0.02 ug/kg IV over 30-60 min
• Morphine – Administer if small bowel activity and no gallbladder after 1 hr
  • Dose: 0.04 mg/kg IV over 2-3 min

• GI Bleed Scan – Technetium 99m RBCs
  • T1/2 – 6 hrs
  • Photopeak 140 kev
  • Dose: 15-30 mCi IV
  • Dynamic imaging immediately with delays as needed
• Meckel’s Scan – Technetium 99m Pertechnetate
  • T1/2 – 6 hrs
  • Photopeak – 140 keV
  • Dose: 10 mCi IV
  • Dynamic imaging immediately after injection

• Iodine 123 MIBG
  • T1/2 – 13 hours
  • Photopeak – 159 keV
  • Dose: 5-10 mCi IV
  • Imaging at 24 +/- 48 hours post injection
• Iodine 131 MIBG – Therapy
  • T1/2 – 8 days
  • Photopeak – 364 keV Gamma

• Technetium 99m DTPA
  • T1/2 – 6 hrs
  • Photopeak – 140 keV
  • Dose: 5-10 mCi
  • Dynamic imaging immediately for 30-90 min
  • Measures GFR/perfusion
• Technetium 99m MAG3
  • T1/2 – 6 hrs
  • Photopeak – 140 keV
  • Dose: 3-5 mCi
  • Dynamic imaging immediately for 30-90 min
  • Measures renal plasma flow/perfusion
• Technetium 99m DMSA
  • T1/2 – 6 hrs
  • Photopeak – 140 keV
  • Dose: 2-6 mCi
  • Dynamic imaging immediately with optional 2-3 hour delay
  • Evaluates renal parenchyma (scar)
• Furosemide – Used to assess for obstructive hydronephrosis
  • 20-40 mg IV after 20-30 min of imaging (DTPA scan)

• Technetium 99m MDP (Bone Scan)
  • T1/2 – 6 hrs
  • Photopeak – 140 keV
  • Dose: 20-30 mCi IV
  • Image 2-4 hours after injection
  • Flow and blood pool early are optional
  • Normal Distribution – Bone, Kidney, Bladder

• F18-FDG (PET)
  • T1/2 – 110 min
  • Photopeaks – 511 keV
  • Dose: 5-10 mCi
  • Image at 60-90 minutes post injection
• Gallium 67 Citrate
  • T1/2 – 78 hours
  • Photopeaks – 93, 185, 288, 394 keV
  • Dose: 4-6 mCi
  • Image at 24 +/- 48 hours post injection
• Indium 111 Pentetreotide (Octreotide)
  • T1/2 – 67 hours
  • Photopeaks – 173 and 247 keV
  • Dose: 5 mCi IV
  • Imaging at 24 +/- 48 hours post injection
• Indium 111 WBC
  • T1/2 – 67 hours
  • Photopeaks – 173 and 247 keV
  • Dose: 500 uCi
  • Imaging at 4, 24, 48 hrs post injection
  • Normal Distribution – Liver, Spleen, Marrow