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Nuclear Medicine Technique II
Course Number RAD 311
Credit hours 3
Prerequisite RAD 206, RAD 305
Co-requisite -
Course introduction:
Nuclear medicine is rapidly progressing branch in medical imaging. The introduction of many isotopes in medicine made the application of nuclear medicine in many investigation one of the essential methods for assessment of functions and morphology of many organs in the body.
Putting this course; students will learn imaging technique employed in nuclear medicine such as thyroid scan, bone scan & renal scan. Also, there will be brief discussion about the use of isotopes in treatment of some benign & malignant diseases.
Objectives:
By the end of the course, the student should know how to:
1. Take relevant history from the patient.
2. Give instructions for preparation of the patient at time of giving appointment.
3. Prepare the required radionuclide and the suitable kite.
4. Adjust the dose required for the examination and report it.
5. Explain the procedure to the patient at the time of arrival and take consent signed by the patient.
6. Identify the proper requirement and ac program needed for the patient.
7. Select the proper requirements in the given course that is needed for the prepared examinations.
8. Exhibit commitment to professionalize and special patient care considerations in the nuclear medicine.
9. Provide post-procedure instructions to the patient.
10. To develop problem Solving Skills
11. To develop term skills.
Topical outlier:
1- THYROID AND PARATHYRIOD
Radiopharmaceuticals
Iodine 131
Iodine 123
Iodine 125
Technetium 99m
Dosimetry
Iodine Uptake Test
Principle and technique
Procedure
Factors Affecting Uptake
Clinical Considerations
Elecated 131I Uptake ● Reduced 131I Uptake
Imaging
Technical Considerations
Normal Thyroid Images
Abnormal Images
Histologically Normal Ectopic Thyroid Tissue ● Thyriod Nodule ● Multinodular Glands ● Diffuse Toxic Goiter ● Thyroiditis ● Thyroid Carcinoma
131I Therapy in Thyroid Disease
Principle
Hyperthyroidism
Patient Preparation
131I in Treatment of Thyroid Carcinoma
Functioning Metastases
Parathyroid Imaging
2 - BONE SCANNING
Anatomy and Physiology
Radiopharmaceuticals
Technique
The Normal Scan
Indications for Bone Scanning
Metastatic Disease
Malignant Bone Tumors
Benign Osseous Neoplasm
Soft Tissue Uptake
Trauma
Osteomyelitis versus Cellulitis
Benign Non-neoplastic Disease
3- GENITOURINARY SYSTEM
Physiology
Radiopharmaceuticals
Renal Imaging Techniques
Imaging Techniques for the Ureters and Bladder
Genitourinary Imaging in Disease
Anatomic Variants
Intrarenal Mass Lesions
Vascular Abnormalities
Diffuse Renal Disease
Obstructive Uropathy
Evaluation of Renal Transplants
Scrotal Imaging
Adrenal Imaging
4 - RESPIRATORY SYSTEM
Anatomy and Physiology
Radiopharmaceuticals
Perfusion Agents
Ventilation agents
Technique
Perfusion Imaging
Ventilation Imaging
Normal Lung Scan
Perfusion Scan
Ventilation Scan
Pulmonary Imaging in Disease
Pulmonary Embolism
Ventilation-Perfusion (V/Q) Scan Findings
Inflammatory Disease
Approaches to Scan Interpretation ● Lung Scan versus Pulmonary Angiography ● Follow-Up ● Alternative Imaging Methods
Emphysema
5 - CARDIOVASCULAR SYSTEM
Anatomy and Physiology
Infarct avid Imaging (Pyrophosphate Scanning)
Pathophysiology
Radiopharmaceuticals
Imaging Technique
Scan Interpretation
Diffuse Uptake ● Focal Uptake ● Persistent
Uptake ● Sensitivity and Specificity
Diagnosis of Acute Myocardial Infarction
Myocardial perfusion Scintigraphy with thallium
Physical Characteristics
Biokinetics
Technique
Scan Interpretation
The abnormal Scan
Reversible Abnormalities ● Nonreversible
Abnormalities ● Rapid Washout or Reverse
Redistribution
Clinical Applications of Thallium Exercise Imaging
Coronary Artery Disease ● Valvular
Lesions ● Resting Thallium Scintigraphy
Tests of cardiac Function
Computer Methods
Qualitative Data Display ● Quantitative Data display ● Functional Images
First-Transit Studies
Principle ● Radiopharmaceutical ● technique ● Interpretation
Equilibrium or Blood Pool Radionuclide Ventriculography
Principle ●Radiopharmaceutical ● Technique ● Interpretation ● Clinical Applications
6- TUMOR AND ABSCESS IMAGING
Gallium
Biologic Behavior
Gallium Imaging Technique
Computer Subtraction Imaging
Normal Gallium Scan
Neoplastic Imaging
Inflammatory Disease
Pyogenic Abscess
Indium 111 Labeled Leukocytes
Labeling and Biologic Behavior
Imaging Techniques
Normal Scan
Abnormal Scan
Labeled Antibodies
7 - GASTROINTESTINAL TRACT
Liver-Spleen Imagin
Radiopharmaceutical
Technique
The Liver
Normal Liver Scan
Abnormal Liver Scan
Specific Disease Entities
Alcoholic Lever Disease ● Diffuse and Infiltrative Disorders ● Metastatic Disease ● Primary Liver Neoplasm ● Miscellaneous
The Spleen
Normal Spleen Imaging
Abnormal Spleen Imaging
Focal Lesions ● Splenomegaly ● Trauma ● Nonvisulaization of the Spleen
Gastrointestinal Bleeding
Lower Gastrointestinal Hemorrhage
Technique
Interpretation
Meckel’s Deverticulum
Hepatobiliary Imaging
Radiopharmaceuticals
Technique
The Normal Scan
Clinical Manifestations
Acute Cholecystitis
● Chronic Cholecystitis ● Biliary Obstruction ●Posttraumatic and Postsurgical ● Biliary Atresia ● Evaluation of Defects on Sulfur Colloid Scans
Gastroesophageal Function
Esophageal Transit
Radiopharmaceuticals
Technique
Normal and Abnormal Esophageal Transit
Gastroesophageal Reflux Studies
Radiopharmaceuticals
Technique
Normal and Abnormal Studies
Gastric Emptying
Radiopharmaceuticals
Technique
Normal and Abnormal Studies
8 - CEREBROVASCULAR SYSTEM
Conventional Brain Scanning
Physiology
Radiopharmaceuticals
Technique of Imaging
Preparation of the Patient ● Radionuclide
Angiogram ● Static Images ● Delayed Static Images
The Normal Brain Scan
Radionuclide Angiogram ● Static Images
The Abnormal Brain Scan
Metastatic Neoplasm ● Primary Brain Tumors ● Cerebrovascular Occlusive Disease ● Cerebral Death ● Intracranial Inflammatory Disease ● Trauma
Specialized Brain Imaging
Radioiodinated Amines
Positron-Emitting Agents
Cerebrospinal Fluid Imaging
Radiopharmaceuticals
Technique
Normal Examination
Pathologic States
Communicating Hydrocephalus ● Noncommunicating
Hydrocephalus ● CSF Leaks ● Shunt Patency
9- PET SCAN &PET C.T
Teaching methods/ strategies:
- Lectures
- Demonstrations.
- BPL
- Training on Gama Camera.
Evaluation methods:
- Mid semester Quiz 20 marks
(MCQ 10 Mark & Clinical 10 Mark)
- Reporting 20 marks
- Final exam. 40 marks
- Practical exam. 20 marks
- Recommended Text Books:
1. Essentials of nuclear medicine imaging. Fred A. Mettler & Milton J. Guiberteau., ed. Grune & Stratton, Inc. Orlando, FL., USA.
2. Textbook of Nuclear Medicine. Michael A. Wilson., ed. Lippincott-Raven, Inc. FL., USA
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