Study Guide - Exam I

Here's a study guide for your next exam. If you understand the material below then you be able to Ace your test. Good luck~! :=)

1. (Lecture1) Discuss the different radiopharmaceuticals used in Myocardial Perfusion Imaging (MPI)
   1. ⁸²Rb
   2. ¹⁸FDG
   3. Isonitriles
   4. BATO
   5. Disphosphines
   6. ²⁰¹Tl
   7. (Lecture3) Kinetics of the perfusion agents
      1. ²⁰¹Tl distribution
         1. Oxidative phosphorylation
         2. Glycolytic pathways
         3. Redistribution
      2. Myocardial kinetics and defect (patterns)
2. (Lecture 4) Evaluate ^99mTc-radiopharmaceuticals
   1. ^99mTcMIBI
   2. ^99mTc-tetrofosmin
   3. Compare the agents
3. (Lecture 2) Define CAD and how it develops over time
   1. Identify the symptoms of coronary insufficiency
   2. Discuss how this leads up to having an acute MI
   3. Define the hemodynamics of normal myocardial blood flow, ischemic, and occlusion
   4. Identify other coronary related disease
      1. Inflammatory
      2. Valvular
      3. Hypertension
      4. CHF
      5. Edema
4. (Lecture 5) Understand the imaging procedures (stress)for SPECT/planar cardiac perfusion (²⁰¹Tl and ^99mTc agents), and MI scanning
   1. Modified/Bruce protocol
   2. Pharmacological
      1. Dipyridamole
      2. Adenosine
      3. Regadenoson
      4. Infarct Imaging
5. (Lecture 6) Evaluate the different methods of MPI acquisition
   1. Instrumentation
   2. ²⁰¹Tl acquisition
   3. ^99mTc-radiopharmaceutical acquisition
      1. One day
      2. Two day
      3. Dual isotope
   4. (Lecture 8) Assess the different components in gating a SPECT
      1. Compare to MUGA
      2. Review the concerns of gating ²⁰¹Tl
      3. Outline the process
      4. Compare methods of gating: fixed, variable, and list modes
      5. Identify the process of setting up a beat rejection window
      6. Review of image quantification and data rendering
   5. Review the types of cameras
   6. Apply QC procedures
   7. Understand Planar and SPECT acquisition
   8. Myocardial viability
6. (Lecture 7) Discuss processing and quantification of an MPI procedure
   1. Review planar processing
      1. Background subtraction
      2. Image smoothing
      3. Circumferential profile and activity curves
   2. Follow the steps required to process a SPECT procedure
      1. Apply filtering
      2. Assess image reconstruction
      3. Evaluate disease in the processed data
7. Review the anatomy of the myocardium
   1. (Lecture 9)Evolute Planar and SPECT
      1. (Planar) RAO, ANT, 45 to 70 degrees, and L-LAT
      2. (SPECT) Short, vertical long, and horizontal long axises
   2. (Lecture 11) Assess Bullseye/Polar Maps
      1. Label the map
      2. Process the polar map
      3. Compare the walls of the myocardium to the coronary arteries that supply blood to associated wall
      4. Understand the 17 segment polar map
8. (Lecture 10) Gated SPECT
   1. Compare ²⁰¹Tl to ^99mTc-pharmaceuticals
   2. Identify the methods used to get the heart
      1. Fixed
      2. Variable
      3. List
   3. Discuss the application of the rejection window
   4. Define temporal blurring: its cause and prevention
   5. Quantify the EF and assess wall motion
      1. Apply the formula
      2. Based on wall motion explain: RWM, SWT, partial volume effect
9. (Lecture 12) Review and understand QPS, QGS, and Emory Tool Box
   1. Polar maps
      1. Developing a polar map
      2. Sum scores and difference
   2. Wall motion
   3. Ejection fraction
   4. Phase amplitude analysis
10. Consider the many types and different ways an MPI procedure can be acquired
    1. Type of radiopharmaceutical
    2. Treadmill Stress test
    3. Pharmacological stress test
    4. Viability
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