ABR Nuclear Radiology study guide
ABR Nuclear Radiology · Work through your exam, one topic at a time.
The ABR Nuclear Radiology subspecialty certificate is a credential from the American Board of Radiology, a not-for-profit organization and member of the American Board of Medical Specialties. Its stated mission is to certify that diplomates demonstrate the requisite knowledge, skill, and understanding of their disciplines to benefit patients. The ABR Nuclear Radiology study guide has 8 sections and about 2,549 words.
01Physics, Instrumentation, and Radiation Detection
Nuclear imaging physics reduces to three interaction modes. Photoelectric absorption dominates at diagnostic gamma energies in high-Z detector material and produces the full-energy photopeak; its probability scales roughly with Z³/E³.
341 words, about 2 min02Radiopharmacy and Radiopharmaceutical Chemistry
A Tc-99m generator is an alumina column loaded with Mo-99; saline elutes pertechnetate, and because Mo-99 (66 h) is the parent, the system reaches transient equilibrium in about 24 h, when Mo activity slightly exceeds Tc activity at elution. Aluminium breakthrough from the column is measured colorimetrically and degrades labeling; molybdenum breakthrough is assayed separately and is limited to 0.15 kBq Mo-99 per MBq Tc-99m.
355 words, about 2 min03Radiation Safety, Dosimetry, and Regulations
ALARA governs practice: minimize time, maximize distance, and shield according to photon energy. Dose rate follows the inverse-square law for a point source, so doubling distance quarters the rate; for an extended source such as a patient the approximation overestimates the benefit at short distances.
346 words, about 2 min04Oncologic Imaging with PET/CT and SPECT/CT
F-18 FDG enters cells via GLUT transporters, is phosphorylated by hexokinase to FDG-6-phosphate, and is trapped because the phosphate cannot be further metabolized and dephosphorylation is slow. Uptake therefore reflects transporter density and hexokinase activity, not simply glucose consumption.
304 words, about 2 min05Cardiovascular Nuclear Imaging
Myocardial perfusion tracers distribute in proportion to regional blood flow at the moment of injection. Tc-99m sestamibi and tetrofosmin are lipophilic cations retained by mitochondrial membrane potential with minimal redistribution, so rest and stress require separate injections; Tl-201 enters via the Na/K-ATPase and redistributes, permitting stress-redistribution-reinjection protocols.
293 words, about 1 min06Endocrine, Gastrointestinal, Genitourinary, and Pulmonary Nuclear Medicine
Thyroid: Tc-99m pertechnetate images trapping while I-123 images trapping and organification; Graves disease shows diffusely increased uptake, subacute thyroiditis shows low uptake, and a hot nodule suppressing the remainder suggests autonomy. Parathyroid localization uses early and delayed sestamibi (or I-123 subtraction), exploiting washout from thyroid but not from adenoma.
318 words, about 2 min07Skeletal, Infection, and Inflammation Imaging
Tc-99m MDP adsorbs to the hydroxyapatite crystal surface, so uptake reflects osteoblastic activity and regional blood flow rather than tumor type. Three-phase imaging (flow, blood pool, delayed) separates hyperemia from bone turnover: cellulitis produces increased flow and blood pool without focal delayed uptake, whereas osteomyelitis adds focal delayed uptake.
293 words, about 1 min08Neuroimaging and Radiopharmaceutical Therapy
Brain death scintigraphy uses a perfusion tracer; absent cerebral perfusion with preserved facial and scalp activity is consistent with brain death. I-123 ioflupane (DaTscan) images presynaptic dopamine transporters and is abnormal in Parkinson disease but normal in essential tremor and drug-induced parkinsonism.
299 words, about 1 min