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Nuclear Medicine in Gastrointestinal Function

  • Majid Assadi
  • Hojjat Ahmadzadehfar
  • Hans-Jürgen Biersack
Chapter

Abstract

  1. 1.
    Early stages of sialadenitis on scintigraphy are characterized by:
    1. (a)

      Prolonged T max, shortened E5%

       
    2. (b)

      Shortened T max, prolonged E5%

       
    3. (c)

      Shortened T max, normal E5%

       
    4. (d)

      Prolonged T max, normal E5%

       
     
  2. 2.
    Which of the following statements about sialoscintigraphy is NOT correct?
    1. (a)

      It can exclude space-occupying lesions.

       
    2. (b)

      It is the most reliable index of the recovery of salivary glands after antibiotic therapy.

       
    3. (c)

      It can support a correct clinical diagnosis.

       
    4. (d)

      It is the most sensitive index of the recovery of salivary glands after anti-inflammatory therapy.

       
     
  3. 3.
    Salivary gland dysfunction is NOT seen in:
    1. (a)

      Chronic pancreatitis

       
    2. (b)

      Amyotrophic lateral sclerosis

       
    3. (c)

      Autoimmune thyroiditis

       
    4. (d)

      Hepatitis

       
     
  4. 4.
    Which salivary gland tumor is NOT cold on scintigraphy?
    1. (a)

      Warthin’s tumor

       
    2. (b)

      Papillary cystadenoma

       
    3. (c)

      Oncocytoma

       
    4. (d)

      All of the above

       
     
  5. 5.
    Which technique is preferred for the primary diagnosis of salivary gland tumors?
    1. (a)

      PET

       
    2. (b)

      MRI

       
    3. (c)

      Dual-isotope SPECT

       
    4. (d)

      67Ga

       
     
  6. 6.
    Which of the following lesions appear as a cold spot in the salivary gland scan with 99mTc-pertechnetate?
    1. (a)

      Papillary cystadenoma

       
    2. (b)

      Oncocytoma

       
    3. (c)

      Oxyphilic adenoma

       
    4. (d)

      Pleomorphic adenoma

       
     
  7. 7.
    Which one is recommended for the follow-up of Sjogren’s syndrome?
    1. (a)

      Sialoscintigraphy with Tc

       
    2. (b)

      Biopsy of lips

       
    3. (c)

      Dacryoscintigraphy

       
    4. (d)

      67Ga scan

       
     
  8. 8.
    In sialoscintigraphy:
    1. (a)

      Parenchymal involvement occurs in the initial stage of chronic inflammation.

       
    2. (b)

      Excretion is compromised in the early stage of Sjogren’s syndrome.

       
    3. (c)

      Parenchymal absorption is disturbed in a short time after radioiodine therapy.

       
    4. (d)

      Papillary cystadenoma has a minor radiotracer uptake.

       
     
  9. 9.
    Sialoscintigraphy is performed on a patient with edema of the salivary glands. A symmetric bilateral uptake is observed in the parotid glands with reduced T max and normal E5%. The scan of the submandibular glands is also normal. What is the most probable diagnosis?
    1. (a)

      Acute viral sialadenitis

       
    2. (b)

      Sjogren’s syndrome

       
    3. (c)

      Bilateral parotid sialolithiasis

       
    4. (d)

      Bilateral facial nerve paralysis

       
     
  10. 10.
    Sialoscintigraphy in Sjogren’s syndrome:
    1. (a)

      Sialoscintigraphy alone canNOT differentiate a simple chronic inflammation from Sjogren’s syndrome.

       
    2. (b)

      In Sjogren’s syndrome, the submandibular glands show a higher uptake and a lower secretory response to stimulation than the parotid glands.

       
    3. (c)

      The level of oral radioactivity is NOT correlated with the severity of disease.

       
    4. (d)

      67Ga scintigraphy is NOT helpful for the detection of recurrence.

       
     
  11. 11.
    Sialoscintigraphy with technetium is performed on a 44-year-old woman. The salivary glands and oral cavity appear at the 15th and 30th min after tracer injection, respectively. The activity of the parotid glands is homogenous and lower than that of the thyroid. What is the most probable diagnosis?
    1. (a)

      Papillary cystadenoma

       
    2. (b)

      Sjogren’s syndrome

       
    3. (c)

      Cystic hygroma

       
    4. (d)

      Sialolithiasis

       
     
  12. 12.
    Sialoscintigraphy with technetium is performed on 5-year-old child. A lesion in the right parotid gland is observed in the 5th min of imaging, which shows a small retention after lemon stimulation. What is the most probable diagnosis?
    1. (a)

      Papillary cystadenoma

       
    2. (b)

      Sjogren’s syndrome

       
    3. (c)

      Cystic hygroma

       
    4. (d)

      Sialolithiasis

       
     
  13. 13.
    Sialoscintigraphy of a 55-year-old man shows an increased regional uptake in the right parathyroid gland, which is intensified after lemon administration. What is the most probable diagnosis?
    1. (a)

      Sialadenitis

       
    2. (b)

      Papillary cystadenoma

       
    3. (c)

      Abscess

       
    4. (d)

      Acute parotitis

       
     
  14. 14.
    Scintigraphy of Sjogren’s syndrome:
    1. (a)

      Sialoscintigraphy is valuable for the diagnosis of the early stage of the disease.

       
    2. (b)

      67Ga scan is indicated for the diagnosis.

       
    3. (c)

      A rapid and diffuse uptake is the common scan pattern.

       
    4. (d)

      It has NO value in follow-up after treatment.

       
     
  15. 15.
    In sialoscintigraphy:
    1. (a)

      Radiotherapy increases the diffuse uptake in the salivary glands.

       
    2. (b)

      Uptake in the salivary glands decreases in acute parotiditis.

       
    3. (c)

      Warthin’s tumor is detected as a photopenic lesion.

       
    4. (d)

      Uptake in the salivary gland is normally equal or higher than that of the thyroid.

       
     
  16. 16.
    Sialoscintigraphy is indicated for the evaluation of:
    1. (a)

      Reiter’s syndrome and steal disease

       
    2. (b)

      Ankylosing spondylitis and brucellosis

       
    3. (c)

      Lupus and rheumatoid arthritis

       
    4. (d)

      Behcet’s syndrome and Felty’s syndrome

       
     
  17. 17.
    Sialoscintigraphy is performed on a 59-year-old man. An increased activity of the rim sign around the sensitive parotid is observed in the angiography phase, but no uptake is demonstrated in images at the 40th min. What is the most probable diagnosis?
    1. (a)

      Acute inflammation

       
    2. (b)

      Abscess

       
    3. (c)

      Adenoma cystitis

       
    4. (d)

      Mixed cell tumor

       
     
  18. 18.
    A 57-year-old woman with a history of nasopharynx cancer is referred with a dry mouth after completion of the treatment. She also reports a history of radiotherapy. The patient is subjected to sialoscintigraphy with 99mTc-pertechnetate and gallium scan. What is the expected scan pattern for the salivary glands?
    1. (a)

      Sialoscintigraphy, reduced uptake; gallium scan, reduced uptake

       
    2. (b)

      Sialoscintigraphy, increased uptake; gallium scan, increased uptake

       
    3. (c)

      Sialoscintigraphy, reduced uptake; gallium scan, increased uptake

       
    4. (d)

      Sialoscintigraphy. increased uptake; gallium scan, reduced uptake

       
     
  19. 19.
    The parotid glands appear at the 5th min of sialoscintigraphy with technetium, and oral accumulation of activity is observed at the 25th min. What is the grade of the disease based on the intensity of involvement of the salivary glands?
    1. (a)

      Grade 1

       
    2. (b)

      Grade 2

       
    3. (c)

      Grade 3

       
    4. (d)

      Grade 4

       
     
  20. 20.
    Which of the following findings is common in the sialoscintigraphy of a patient with Warthin’s tumor?
    1. (a)

      Increased parotid uptake, which decreases after lemon stimulation

       
    2. (b)

      Decreased parotid uptake, which increases after lemon stimulation

       
    3. (c)

      Increased parotid uptake, which enhances after lemon stimulation

       
    4. (d)

      Lack of radiotracer uptake before and after lemon stimulation

       
     
  21. 21.
    A focal increase in uptake is observed in sialoscintigraphy. What is the most probable diagnosis?
    1. (a)

      Sjogren’s syndrome

       
    2. (b)

      Abscess

       
    3. (c)

      Warthin’s tumor

       
    4. (d)

      Cyst

       
     
  22. 22.
    Sialoscintigraphy with technetium:
    1. (a)

      This scan is NOT indicated for the evaluation of graft versus host disease.

       
    2. (b)

      Papillary cystadenoma shows an increased uptake.

       
    3. (c)

      This scan is NOT indicated for Bell’s palsy.

       
    4. (d)

      Scan pattern does NOT depend on the stage of sialadenitis.

       
     
  23. 23.
    Which of the following diseases demonstrates a diffusely decreased activity on scintigraphy with technetium?
    1. (a)

      Sterile acute parotitis

       
    2. (b)

      Sialolithiasis

       
    3. (c)

      Abscess

       
    4. (d)

      Warthin’s tumor

       
     
  24. 24.
    A diffusely decreased technetium uptake and an increased gallium uptake are reported on sialoscintigraphy. What is the most probable diagnosis?
    1. (a)

      Sterile acute parotitis

       
    2. (b)

      Warthin’s tumor

       
    3. (c)

      Radiotherapy

       
    4. (d)

      Recurrence of chronic parotitis

       
     
  25. 25.
    Which of the following statements about Sjogren’s syndrome is NOT correct?
    1. (a)

      Sialoscintigraphy alone canNOT discriminate a simple inflammatory process from Sjogren’s syndrome.

       
    2. (b)

      An increased salivary and a decreased lacrimal uptake in gallium scan are pathognomonic for this syndrome.

       
    3. (c)

      A higher technetium uptake in the submandibular glands and lower a secretory response to stimulation in comparison with the parotid glands indicates Sjogren’s syndrome.

       
    4. (d)

      Gallium is indicated for therapeutic monitoring.

       
     
  26. 26.
    Which of the following statements regarding the study of salivary gland function is NOT correct?
    1. (a)

      It is performed with 4 mCi of technetium pertechnetate.

       
    2. (b)

      Dynamic images are obtained for 40 min.

       
    3. (c)

      E5% is the count of salivary gland 5 min after radiotracer injection.

       
    4. (d)

      Submandibular and parotid gland function can be examined through this method.

       
     
  27. 27.
    What is the most common salivary gland tumor?
    1. (a)

      Pleomorphic adenoma

       
    2. (b)

      Warthin’s tumor

       
    3. (c)

      Cystadenocarcinoma

       
    4. (d)

      Oncocytoma

       
     
  28. 28.
    Which tumor of the salivary glands is malignant?
    1. (a)

      Godwin’s tumor

       
    2. (b)

      Acinic cell tumor

       
    3. (c)

      Pleomorphic adenoma

       
    4. (d)

      Oncocytoma

       
     

Suggested Readings

  1. 1.
    Ahmadzadehfar H, Biersack HJ, Freeman LM, Zuckier L. Clinical nuclear medicine, 2, Springer Heidelberg;2018Google Scholar
  2. 2.
    Ell PJ, Gambhir SS. Nuclear medicine in clinical diagnosis and treatment. 3rd ed. Edinburgh: Churchill Livingstone; 2004.Google Scholar
  3. 3.
    Sandler MP, Coleman RE, Patton JA, Th Wackers FJ, Gottschalk A. Diagnostic nuclear medicine. 4th ed. Philadelphia: Lippincott & Williams Wilkins; 2003.Google Scholar
  4. 4.
    Henkin RE. Nuclear medicine. 2nd ed. Philadelphia: Mosby Elsevier; 2006.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Majid Assadi
    • 1
  • Hojjat Ahmadzadehfar
    • 2
  • Hans-Jürgen Biersack
    • 3
  1. 1.Department of Nuclear MedicineBushehr University of Medical SciencesBushehrIran
  2. 2.Department of Nuclear MedicineUniversity Hospital BonnBonnGermany
  3. 3.Department of Nuclear MedicineUniverity Hospital BonnBonnGermany

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