Uptake Report
Printed on: 1/26/2013 10:36:49 AM
Patient Information
Name
Date of Birth
Identification #
Referring Physician
:
:
:
:
BOURNE, JASON
98756832
05/26/1969
2,520,906
Phillpsq Bulb
50
1/25/2013 10:28:34 AM
:
:
:
:
Performed By
Lab Background CPM
Standard Count CPM
Standard Count Time
Isotope
Dose Activity
Count Time (sec)
Admin Date / Time
:
:
:
:
I-123
30
1/25/2013 10:28:34 AM
225.00 uCi
121:Detector S/N
Radionuclide Administration Dose / Standard Results
Count
Time
(sec)
Thyroid
CPM
Patient Bkg
CPM
Corrected Dose
CPM
Time Stamp Hours
Uptake
Percent
Staff
Data
Set
Thyroid Uptake Data
30 15,006
2,343 2,035,362 1/25/2013 2:33 PM 4.07
0.62 %
Phillpsq Bulb
1
30 212,358
2,860 712,652 1/26/2013 10:32 AM 24.06
29.40 %
Phillpsq Bulb
2
Normal Ranges
4 hours 6% to 12%
24 hours 10% to 20%
JOHNSON MEMORIAL CLINIC
NUCLEAR MED DEPT.
123 HOSPITAL ROAD,
PORT JEFFERSON, NY 11778
+1(631)-924-4455
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