| Question 1: What theranostic pair was the first to be used clinically? |
| Reference: | Choudhury PS, Gupta M. Differentiated thyroid cancer theranostics: radioiodine and beyond. Br J Radiol. 2018 Nov;91(1091):20180136. |
| Choice A: | Octreoscan - Lu-177 DOTATATE |
| Choice B: | Ga-68 PSMA11 - Lu-177 PSMA617 |
| Choice C: | Radioiodine - I-131 |
| Choice D: | Ga-68 PSMA11 - Ac-225 PSMA |
| Question 2: What is the main goal for dosimetry in theranostics? |
| Reference: | Eberlein U, Cremonesi M, Lassmann M. Individualized Dosimetry for Theranostics: Necessary, Nice to Have, or Counterproductive? J Nucl Med. 2017 Sep;58(Suppl 2):97S-103S |
| Choice A: | Maximizing radiation dose to tumor |
| Choice B: | Optimizing dose to normal organs |
| Choice C: | Minimizing cost of the procedure |
| Choice D: | Minimizing dose to normal organs |
| Question 3: Dosimetry is likely to be the most accurate for which theranostic isotope pair? |
| Reference: | Chappell LL, Dadachova E, Milenic DE, Garmestani K, Wu C, Brechbiel MW. Synthesis, characterization, and evaluation of a novel bifunctional chelating agent for the lead isotopes 203Pb and 212Pb. Nucl Med Biol. 2000;27:93–100 |
| Choice A: | Ga-68 and Lu-177 |
| Choice B: | Ga-68 and Ac-225 |
| Choice C: | I-131 and At-211 |
| Choice D: | Pb-203 and Pb-212 |
| Question 4: Dosimetry based on reference phantoms is most appropriate for which circumstance? |
| Reference: | MIRD Pamphlet 21 |
| Choice A: | Comparing the risk of radiation detriment of one imaging agent against another |
| Choice B: | Determining the risk of a particular patient for later cancer induction |
| Choice C: | Assessing the toxicity and anti-tumor efficacy of a therapeutic agent |
| Choice D: | Calculating the dose that will best treat a given patient’s tumor |
| Question 5: Which of these methods is not a part of radiopharmaceutical therapy? |
| Reference: | Sgouros G. Radiopharmaceutical Therapy Health Phys; 2019, 116 (2), 175-178 |
| Choice A: | radiolabeled carriers |
| Choice B: | alpha-particle emitting radionuclides |
| Choice C: | radiodine seeds |
| Choice D: | beta-particle emitting radionuclides |
| Question 6: 3Ga-68-DOTATATE is likely to be inaccurate for Lu-177- DOTATATE dosimetry because: |
| Reference: | MIRD Pamphlet 16 |
| Choice A: | Ga-68 is a positron emitter while Lu-177 is a beta-particle emitter |
| Choice B: | They emit different photon energies |
| Choice C: | Ga-68 half-life is 68 minutes |
| Choice D: | Ga-68-DOTATATE does not have the same pharmacokinetics as Lu-177-DOTATATE |
| Question 7: What would be a qualification factor prior to treating with Lu-177 Dotatate? |
| Reference: | LUTATHERA® [prescribing information]. Millburn, NJ: Advanced Accelerator Applications USA, Inc.; July 2018 |
| Choice A: | Tracer avid disease on a Ga-68 PET/CT |
| Choice B: | Tracer avid disease on F-18 FDG PET/CT |
| Choice C: | Tracer avid disease on an In-111 Octreoscan |
| Choice D: | More than one of the above |
| Choice E: | None of the above |
| Question 8: Name a side effect from treatment with Lu-177 PSMA |
| Reference: | Ahmadzadehfar H, Eppard E, Kürpig S, et al. Therapeutic response and side effects of repeated radioligand therapy with 177Lu-PSMA-DKFZ-617 of castrate-resistant metastatic prostate cancer. Oncotarget. 2016;7(11):12477–12488. doi:10.18632/oncotarget.7245 |
| Choice A: | Dry Mouth |
| Choice B: | Thyroiditis |
| Choice C: | Pulmonary Fibrosis |
| Choice D: | Carcinoid Crisis |
| Question 9: What is the normal biodistribution for Ga-68 Dotatate |
| Reference: | Kuyumcu S1, Özkan ZG, Sanli Y, Yilmaz E, Mudun A, Adalet I, Unal S. Physiological and tumoral uptake of (68)Ga-DOTATATE: standardized uptake values and challenges in interpretation. Ann Nucl Med. 2013 Jul;27(6):538-45. doi: 10.1007/s12149-013-0718-4. |
| Choice A: | Brain, bladder, kidneys, liver, spleen, heart |
| Choice B: | Salivary glands, thyroid, adrenal glands, spleen, liver, pituitary gland, kidneys, uncinated process of pancreas |
| Choice C: | Pancreas, liver, spleen, musculature |
| Choice D: | Bones, vasculature, heart |
| Question 10: What is the purpose of pre-dosing the patient with intravenous amino acids prior to Lu-177 Dotatate therapy? |
| Reference: | Rolleman, Edgar & Melis, Marleen & Valkema, Roelf & Boerman, Otto & Krenning, Eric & de Jong, Marion. (2009). Kidney protection during peptide receptor radionuclide therapy with somatostatin analogues. European journal of nuclear medicine and molecular imaging. 37. 1018-31. 10.1007/s00259-009-1282-y. |
| Choice A: | Prevention of nausea |
| Choice B: | Renal protection |
| Choice C: | Enhancement of radiation effects to tumor cells |
| Choice D: | Mitigation of radiation contact precautions |
