Tumor, Inflammatory and GU Imaging

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Tumor, Inflammatoryand GU Imaging
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Inflammation Radiopharmaceuticals

• 67 Gallium citrate (67Ga)
• IV injection
• GI and renal excretion
• 111Indium oxine white blood cells
• IV injection / renal excretion
• 99mTcHMPAO white blood cells
• IV injection / renal excretion

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Normal Areas of Uptake

• 67Ga citrate
• liver, spleen, marrow, kidneys and bowel
• 111In oxine 99mTc HMPAO white blood cells
• liver and spleen

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111In Oxine WBCs

• 67 hour physical half life
• Imaging window of 4 - 24 hours
• Good for acute infections
• Labeling process takes several hours
• Whole body, SPECT and statics

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99mTc HMPAO WBCs

• 6 hour physical half life
• Imaging window of 2 - 12 hours
• Good for acute infection
• Labeling process takes several hours
• Whole body, SPECT and statics

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Tumor Imaging

• Monoclonal antibody agents
• Ag / Ab reactions
• 111In Prostascint, 99mTc CEA-Scan
• Peptide chemical receptor agent
• 111In Octreoscan
• neuroendocrine tumors

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GU Procedures

• Renal glomerular filtration
• Renal tubular secretion
• Renal anatomy/morphology
• Cystogram
• Testicular blood flow study

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Glomerular Filtration Study

• 99mTc DTPA, IV injection
• May use lasix intervention
• 30 - 45 minute dynamic study
• Posterior images unless renal transplant patient
• Normal total GFR 125 ml/min

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Tubular Secretion Study

• 99mTc MAG3 or 131I hippuran, IV
• May use lasix intervention
• 30 to 45 min dynamic study
• Posterior images unless renal transplant
• Function quantified

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Functional Renal Processing

• Must draw renal and renal background AOIs
• Function quantified numerically and with graphs

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Renal Anatomy Imaging

• Not the imaging method of choice
• 99mTc DMSA or 99mTc glucoheptonate, IV injection
• 2 to 3 hour delay images
• SPECT and magnified static views

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Cystogram

• Detects vesicoureteral reflux
• Catheterize bladder to fill with saline and
  99mTc04-
• Dynamic acquisition as bladder fills
• Stop with bilateral reflux, predicted volume
  reached or extreme discomfort

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Testicular Torsion Study

• Emergency procedure
• Differentiates torsion from epididymitis
• 99mTc04- , given IV
• Anterior dynamic flow
• Increased vs decreased uptake