Imaging of Neuroendocrine Tumors with
I-123 mIBG and In-111 Octreoscan

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Test: Imaging of Neuroendocrine Tumors with I-123 mIBG and In-111 Octreoscan

1.  Epidemiology of neuroendocrine tumors tend to be...:

        Familial

        Male only

        Not related to hypertension

        Never occurs in children

2.  Neuroblastomas ...:

        Are the 2nd largest cause of cancer death in children

        Are the most curable of all neuroendocrine tumors

        Only occur in females

        Are treated with testosterone

3.  123I-mIBG:

        Is NDA approved

        Is Available in the United States as of December, 2008

        Both are true

        Neither is true

 4.    Properties of 131I -mIBG are...:

        tphys of 131I = 3 days; Eg = 330.5 keV

        tphys of 131I = 3 hr; Eg = 159 keV       

        tphys of 131I = 3 hr; Eg = 364.5 keV

        tphys of 131I = 8.08 days; Eg = 364.5 keV

5.     Properties of 123I -mIBG are...:

        tphys of 123I = 3.3 hr; Eg = 140 keV

        tphys of 123I = 13.3 hr; Eg = 159 keV

        tphys of 123I = 13.3 hr; Eg = 160 keV

        tphys of 123I = 8.08 days; Eg = 364.5 keV

6.   When injecting *I-mIBG...:

        Inject slowly over a 2 minute period of time

        Watch the patient for 20 minutes to check for adverse reactions

        Release the patient if no adverse reaction occurs

        All of the above

7.   The results of *I-mIBG imaging show :

        Image quality of 131I mIBG is superior to that obtained using 123I mIBG

        Image quality of 123I mIBG is superior to that obtained using 131I mIBG

        Image time significantly reduced with 131I

        Sensitivity and specificity are both <90%

8.   Which one of the following statements is true?:

        Pentetreotide is a long acting analog of the hormone testosterone

        Pentetreotide is a long acting analog of the hormone somatostatin

        Pentetreotide is a long acting analog of the hormone estrogen

        Pentetreotide is a long acting analog of the hormone progesterone

9.    111In-Octreoscan changed patient management in...: 

        3.1 % of patients

         31 % of patients

         .031 % of patients

        13% of patients

10.    Contraindications of 111In-Octreoscan are...:

        Anemia

        Hydration

        Sensitivity to somatostatin and its analogues

         Migraine headaches

11.    Which one of the following is NOT an indication for performing an mIBG scan?:

        Pheochromocytoma

        Neuroblastoma

        Paraganglioma

        Malignant Melanoma

        Carcinoid Tumors

12.    The fraction of all hypertensive patients who have a pheochromocytoma is approximately...:

        30%

        3%

        .03%

         Pheochromocytomas have no relationship to hypertension

13.    The 10% rules for pheochromocytomas include all of the following except...:

        10% of pheochromocytomas are familial

        10% of pheochromocytomas occur bilaterally

        10% of all patients develop leukemia or lymphoma

        10% of pheochromocytomas are malignant

14.    Which of the following is an appropriate thyroid-blocking protocol for use of I-123 mIBG?

        Administer ten drops of SSKI Solution ~1 hr prior to injection of mIBG and ten drops once a day for three days thereafter

        Administer three drops of SSKI Solution ~1 hr prior to injection of mIBG and ten drops once a day for three days thereafter

        Administer three drops of SSKI Solution ~1 hr prior to injection of mIBG and three drops once a day for three days thereafter

         Thyroid blockage is not required

15.    What is the critical organ (highest radiation dose) resulting from an injection of I-123 mIBG?:

        Gastric mucosa

        Parotids

        Adrenals

        Kidneys

16.    Adrenal imaging with I-123 mIBG is contraindicated if the following drug(s) have been taken by the patient...:

        Cocaine

        Tricyclic antidepressants

        Both of the above

        Neither of the above

17.    Which of the following is an appropriate thyroid-blocking protocol for use of In-111 Octreoscan?:

        Administer ten drops of SSKI Solution ~1 hr prior to injection of Octreoscan and three drops once a day for three days thereafter

        Administer three drops of SSKI Solution ~1 hr prior to injection of Octreoscan and ten drops once a day for three days thereafter

        Administer ten drops of SSKI Solution ~1 hr prior to injection of Octreoscan and ten drops once a day for three days thereafter

        Administer three drops of SSKI Solution ~1 hr prior to injection of Octreoscan and three drops once a day for three days thereafter

         Thyroid blockage is not required

18.    The typical injected dose of Octreoscan for SPECT Imaging is...:

        1-2 mCi

        5-6 mCi

        10 mCi

        20 mCi

19.    Which two organs absorb the highest radiation dose following an injection of In-111 Octreoscan?...:

        Gastric mucosa and parotids

        Liver and spleen

        Kidneys and spleen

        Urinary bladder and gall bladder

20.    Normal distribution of In-111 Octreoscan includes all of the following except...:

        Normal Pituitary Gland

        Liver

        Spleen

        Kidneys

        Gall Bladder

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