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NUCLEAR MEDICINE

Nuclear Medicine

Faculty representative:  Dr. Onseng/Goldfarb

Hours: 8:00am – until attending dismissal

Location:  Morningside Nuclear Medicine Reading Room, 5th Floor

Attendings: Dr. Goldfarb (W/F), Dr. Ongseng (M/T/Th)

Nuclear at M issues:
For any nuclear issues at Morningside (M) such as morphine, lasix, CCK administration, lymphoscintigraphy (rare), etc, residents on other rotations will be contacted as follows:

1. Nucs
2. Neuro M
3. VIR M

NYRA nuclear medicine

Faculty representative: Dr. Richard Goldfarb

Hours: 8:00 am – until attending dismissal (approximately 5:00 pm)

Location: NYRA office (55 E 34th St, New York, New York 10016, 3rd floor)

Attendings: Dr. Goldfarb (W/F), Dr. Ongseng (M/T/Th)

Expectations:

  • Nuclear studies from BI, KH, and NYHC
  • DEXA studies from PACC (DUS), Cancer Center, KH, and NYHC
  • Obtain consent and administer PO I-131 treatment. Record in log (ACGMErequirement)
  • IM thyrogen injections
  • Breast sentinel node injections
  • Add CCK to IV bag and inject IV morphine for HIDA scans (pick up from IR/pharmacy)
  • YOU MUST LOG I-131 ADMINISTRATIONS WITH DOSE!
  • Please don't forget to lock the door at the end of the day

ED & IP BI NUCLEAR MEDICINE STUDIES

Any MSBI ED or IP NM exam that MUST be performed will be done at West, either via a one-way transfer or round-trip if feasible. 
  • Gather clinical information from requesting physician
  • Review case with NM Attending & discuss NM study indication
  • Once approved by NM Attending, contact Raj Head NM Tech at West (ext. 23-6366) during business hours or West NM Tech on-call & give patient information and requested NM study
  • Coordinate roundtrip or inpatient transfer between Beth Israel & West. 
  • Refer to MSBI-to-MSW Nuclear Medicine PDF for step-by-step instructions
During COVID Era, ventilation is temporarily not being performed in V/Q scans. It is important to check the most recent Chest X-Ray for any abnormalities. If there are chest abnormalities, perfusion study will provide limited information. Be sure to notify NM attending of any chest abnormalities on the most recent Chest X-Ray when discussing the case.

On call Procedure

Nuclear Medicine On-Call procedure for MSBI, MSB, MSWEST AND MSM

  1. A resident On-Call determines that the requested procedure is indicated.
  2. A resident On-Call, or a secretary/On-Call tech manager if available, calls Nuclear Medicine technologist On-Call to come in for the study.
    • For MSBI, MSB and MSM call Agency Technologist.
    • For MS WEST call RH technologists, Igor or Emilia, first. If they are not available then call Agency technologist.
  3. After the study is done the NM technologist sends the images to PACS/remote PACS.
  4. NM technologist notifies the resident On-Call by phone. The NM Technologist stands by while the resident consulting with an attending On-Call.
  5. The On-Call resident calls an attending On-Call to discuss the case.
  6. The resident On-Call calls the NM technologist informing her/him that the study is done or additional images are necessary.
  7. The NM technologist completes the study in IDX.
  8. The On-Call resident dictates the case.

NRC Authorized User

  • Credentialing process administered by the Nuclear Regulatory Commission (NRC) that states that you can oversee the safe and effective medical use of radionuclides in nuclear medicine.  
  • This is very helpful when you are looking for a job, even if you are not reading nuclear medicine studies yourself, as an authorized user needs to be present whenever radionuclides are used at your institution or practice.
  • ABR authorized user forms are signed by PD and Dr. Heiba after completing the required hours of training classes and experience in addition to RAI treatment. The RAI treatment experience include a minimum of 3 cases of <33 mCi and 3 cases of > 33 mCi. Residents also have to actively participate in the consultations of hyperthyroid cases (3 cases) and thyroid CA cases (3 cases) in order to get the basic experience in RAI treatment.


Resources

Required Readings

Recommended Articles
  • G:\Dept\RH1\Radiolog\Ghesani\Articles for PET/CT rotation
  • University of Virginia PET website
  • DePuey, Ernest Gordon. "Advances in cardiac processing software." Seminars in nuclear medicine. Vol. 44. No. 4. Elsevier, 2014.
  • DePuey, E. Gordon. "Image artifacts." Nuclear cardiac imaging: principles and applications. Oxford, New York, 2008. 137-138.
  • Hecht, Harvey S. "Coronary artery calcium scanning: past, present, and future." JACC: Cardiovascular Imaging 8.5 (2015): 579-596.

Recommended Book
Case in Point
  • Thyroid: [1], [2], [3], [4]

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