-
List the steps in preparing a unit
dose of radiopharmaceutical
- •1) Choosing the correct RP
- •2) Determining the activity to be
- administered
- •3) Calculating the unit dose volume
- •4) Withdrawing the unit dose into a
- syringe
- •5) Assaying the unit dose
-
-
-
-
-
-
Define assay (calibration)
-
-
Convert units of radioactivity between the CGS and MKS(SI) systems.
-
If appropriate, calculate the RP
activity to be administered based on the patient’s body weight
-
calculate pediatric RP doses
-
Define aseptic technique as it
relates to unit dose preparation and identify common breaks in aseptic
technique
- Wear disposable plastic gloves
- Wipe
- vial rubber closures with fresh 70% isopropyl alcohol
- Puncture
- rubber closures properly to prevent coring
- Do not force air into vials and
- create positive pressure
- Enter vials only with a new syringe
- & needle
- Use
- fresh needles on syringes before injecting patients
- Keep all openings in sterile
- set-ups protected before use
- Inspect all materials, devices, and
- solutions carefully – be observant at all times
- No
- eating, drinking, smoking, or pipetting by mouth is allowed
-
Identify specific radiation
protection techniques to be used during RP dose preparation
- work behind L block
- plan ahead
- use inverse square law
-
Explain the appropriate choice of
needle and syringe when preparing individual patient doses from multidose vials
-
Define a medical event according to the NRC, and intrepret the NRC regulations regarding
medical events and reports.
- A
- dose that differs from the prescribed dose or dose that would have resulted
- from the prescribed dosage by more than 0.05
Sv (5 rem) effective dose equivalent,- 0.5
Sv (50 rem) to an organ or tissue, or 0.5 Sv (50 rem) shallow dose equivalent- to the skin;
AND - The
- total dose delivered differs from the prescribed dose by 20 percent or more
-
The
most accurate estimate of required imaging dose for pediatric patients
Area rule (m1)^2/3 / (m2)^2/3 *adult dose
-
Agrees
with Area Rule until age 11 or 12
websters rule age +1 / Age +7 * adult dose
-
does not do a great job of accounting for variability in body weight at a
given age.
- Webster’s Rule and Young’s Rule
- youngs = age / age +12 * adult
-
•Differentiate the terms “diluted
to” and “added to”.
-
–Define
working standard and stock standard
-
Dilution:
- –The
- ratio of the quantity of a desired solute (serum, urine, chemical solution,
- etc.) contained in a solvent (diluents such as water or saline).
-
Added To
- Refers
- to the volume of the solute added to a specified volume of solvent
-
•Diluted To:
- –The
- same as “dilution”. If 1ml is diluted to 10 ml, enough diluent is added to the
- original volume to yield a final, total volume of 10 ml.
-
•Serial Dilution:
- Refers
- to multiple dilutions. An initial dilution is made and then this dilution is
- used to make a second dilution, and so on
-
•Stock Standard:
- A concentrated standard, usually made up in large volume; used for the
- preparation of a working standard
-
•Working Standard:
–A dilute standard solution made from a stock standard.
-
Compare
I-123 and I-131 based on decay characteristics,
- I-123 has 13.2hr t1/2 159keV
- I-131 8day t1/2 364keV
-
Compare
I-123 and I-131 based on mode
of production
- I-123 is cyclotron produced
- I-131 is reactor produced
-
Compare
I-123 and I-131 based on radionuclidic impurities
- I-123: 124, 125, 126, 130 ,131
- I-131: I-127
-
Compare
I-123 and I-131 based on absorbed
dose
I-131 about 100x higher ... to thyroid.
-
•safety procedures to be followed
when working with iodine liquid radionuclides.
use fume hood, refrigerate
-
•, identify mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose:Ga-67 citrate
- Cyclotron
- t1/2=78hrs
- 93 kev (38%), 185 keV (24%)
- critical organ= GI-tract
-
•, identify their mode ofproduction, decay characteristics, photon energy(ies), and organs receiving thegreatest absorbed radiation dose: In-111 oxine (wbc)
- t1/2 =2.8days
- cyclotron
- 171keV, 245 keV
- crit organ= spleen
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: P-32 chromic phosphate
- t1/2= 14.3 days
- reactor produced ( NEUTRON activation)
- intracavitary use only
- Critical organ = pleural surface
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: P-32 sodium phosphate
- t1/2 14.3days
- pure beta 1710keV
- Reactor (neutron activation)
- critical organ = bone marrow
- clear, colorless, iv use only.
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Tl-201 thallous chloride
- t1/2 73 hrs
- xrays 68-80kev (95%)
- gamma mainly 135 keV
- cyclotron
- critical organ=kidney
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Xe-133 xenon gas
- t1/2 5.3 days
- 81keV
- critical organ = lung
- absorbs readily onto plasic
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: I-131 MIBG
- t1/2 8 days
- y = 364 keV
- b= 192 keV
- pheochromocytomas and neuroblastomas
- reactor
- critical= liver and bladder wall
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: I-123 MIBG
- t1/2 =13.3hrs
- cyclotron
- y=159keV
- critical organ = bladder
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Cr-51 sodium chromate RBCs
- t1/2= 27.7days
- reactor
- 320keV
- critical organ= 2.64
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Sr-89 chloride
- t1/2 = 50.5days
- reactor
- critical organ -= bone surface
- 100% beta emitter 1492keV
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Sm-153 lexidronam
- t1/2 = 46.3hrs
- reactor
- critical organ = bone surface 25 rad/mci
- y=103kev
- b= 710, 640, 810
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Re-186
- t1/2 = 9hrs
- reactor
- critical organ = bone marrow
- b= 1.071 Mev, 835 kev
- y = 137
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Y-90 microspheres
- t1/2 = 64.2hrs
- reactor
- critical dose= liver
- pure beta 937
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose:Dy-165
- treatment of Rheumatoid arthritis
- radio-synovectomy
- t1/2 2.33hr
- reactor
- beta 1.29Mev
- y=95
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Ho-166
- Radio-synovectomy
- t1/2= 26.4hrs
- reactor
- b=1.85Mev
- y= 184
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: 1-123MIBG
- t1/2 13.3hrs
- cyclotron
- bladder
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: C-14 urea
- t1/2 = 5730 yrs
- reactor
- critical = bladder wall
-
•, identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Y-90 ibritumomab tiuxetan
- t1/2 64.2
- reactor
- critical= liver
- 100% beta 937kev
-
•Differentiate P-32 chromic
phosphate and P-32 sodium phosphate
- chromic is used intracavitary only, blue-gree collodial suspension, treats cancer
- sodium is clear , colorless solution iv use only (bone marrow) bone pain palliation.
-
Describe
when to use appropriate interventional drugs associated with different Nuclear
Medicine studies
-
recommended diluent for iodine radioisotopes
purified water containing .2% sodium thiosulfate
-
to reduce volatility if iodine radioisotopes
refrigerate
-
•List the order reagents should be
mixed for optimum Tc-99m radiolabeling.
- reconstitute kit with concentrated Tc04-
- then dilute after incubation
-
•Identify 3 methods used to minimize
oxidation and to prolong stability in RP kits and/or preparations.
- use only preservative free saline
- N2 purged vials
- cold storage
- seal integrity
-
Identify
3 problems associated with radionuclidic contamination
- increased dose to patient
- errors in dose calibration
- image degradation
-
List
4 methods used to decrease volatility
- use buffers
- add chelating agent
- maintain at room temp
- encapsulation
-
•Discuss 3 factors to be considered
when using heat during RP preparation.
- temperature
- duration: too short=poor labeling efficiency, too long= increased particle size.
- volume: smaller=more uniform heating
-
What happens with AL+3 breakthrough with
sulfur colloid, Diphosphonates (bone), TcO4-
- Sulfur colliod- lung localization b/c of larger particle size
- Diphosphonates= forms radiocolloid , liver/spleen activity
- pertechnetate= soft tissue uptake
-
particle size is affected by
- Al concentration
- extended heating times
- aggregation over time
-
•Explain the effects encapsulation
of labeled tracers may have on quantitative test results.
may alter biodistribution if capsule does not dissolve rapidly, or does not dissolve in stomach fluids
-
for Tc-SC kit prep order
- Tc-O4, acid and thiosulfate must be combined before heating,
- gelatin, helps maintain particle size
- EDTA , removes AL
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