NUCLEAR/PET

ROTATIONS‎ > ‎

Faculty representative: Rosna Mircheva

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

Location: RH Reading Room in Nuclear Medicine corner

Conference:

Expectations:

Faculty Representative: Dr. Ernest Depuey

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

Location: SL Nuclear Reading Room, Clark 5

Expectations:

Faculty representative: Dr. Richard Goldfarb

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

Location: BI NM Reading Room

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

Expectations:

Nuclear studies from BI and KH
DEXA studies from PACC (DUS), Cancer Center
Obtain consent and administer PO I-131 treatment. Record in log (ACGME requirement)
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

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.
The full list of requirements will be given to you in a separate folder by the nuclear medicine department.
You have your whole residency to complete this.

LOGON:

To open study:

Patient Data Source window in upper left corner of screen, choose MIMpacs (MIM Server)
Type patient last name, first in the Name field
Click SEARCH button on right
Ctrl-Click choose the CT and PET (AC) series for the current study plus up to three comparisons (do not select the uncorrected images = NAC)
In the Workflow window on the right, make sure the "workflow" tab is selected, then choose the workflow staging protocol from the options to display your studies, then Open
If your station does not have workflows populated, you can install it directly. Look for the nuclear folder on the shared G drive on intranet. Look for mim folder and copy/paste to your desktop. From mim, click "organize" in bottom right and then select the browser link at top to navigate to the mim folder. Choose the options under workflow to add to your mim folder individually. You may need to close and re-open mim to see changes.

MIM viewer functions

To adjust PET scale, left click on the scale and choose the color range, left click and drag to change the SUV range, right click and drag to adjust gamma

To zoom in, right click on image, hit magnifying glass and drag
OR use "1" "2" "3" keys to zoom.
To measuring SUVs - "S" is keyboard shortcut, right click to enlarge/shrink ROI
To measure, "T"is for tape measure (but you should really measure on the standard PACs CT images)
Keyboard shortcuts (top numbers)

To switch Coronal/Sagittal, use "V"
To see if there is enough RAM to open study, you can use Help>> About MIM>> Refresh free MIM; to open 3 studies (current+2 comps, need >~ 1000)
To Close Study, Session "X" patient, confirm

Required Readings

Recommended Articles

H:\Dept\RH1\Radiolog\Ghesani\Articles for PETCT 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