PET

PET CT

Faculty Representations: Dr. Ghesani Munir
Hours: 9:00am – until attending dismissal
Attendings: Drs. Ghesani, Nasrin, Lewen
Location: MSW Ballroom, 4th Floor
Objective: Nuclear medicine/PET-CT curriculum (intranet)
  • Your station is first computer on the right when you enter RR
  • PET rotation to be done at MSW
  • Read BC cases and any additional cases as assigned
  • This is a required rotation if you are assigned to PET
  • Protocol cases in RIS-C (see right column for instructions)


MIM 6 INSTRUCTIONS

MIM6 LOGON: 
  • user: mim
  • password hint: state

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
    • Body: 5-6
  • 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)
    • 1 = reset zoom
    • 2 = zoom 2x
    • 3 = zoom 3x
    • 4 = soft tissue window
    • 5 = brain/liver window 
    • 6 = lung window
  • 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

Sending OUTSIDE studies to MIM viewer from PACS: 
  • Right click on study in PACS
  • Send series in DICOM
  • Check off 
    • CT standard, and 
    • PET WB 3D AC 
    • These should have same number of images
  • Send to Destination: MIM_Enterprise

PROTOCOLLING PET CASES

RIS-C filter
Organization: BC
Modality: PT
  1. Click the accession number
  2. Protocol using a drop down menu
  3. For cases without the drop down menu, type "NMS" into the blank "Protocol" box and press the + sign to add comments 
  4. Click "Save" in the upper right hand corner

Examples on how to protocol certain diagnoses:
 
  1. Base of Skull to Mid-Thighs
    • Breast
    • Lymphoma
    • Lung cancer
    • Pelvic cancers
    • Colon cancer
  2. Vertex to Feet 
    • Multiple myeloma
    • Melanoma
    • Merkel cell carcinoma
    • Cutaneous T-cell lymphoma 
    • Any form of skin cancer
  3. Base of Skull to Mid-Thighs + Head and Neck 
    • All head and neck primary ca
  4. Vertex to Mid-Thighs 
    • Thyroid cancer
  5. Ga-68 DOTATATE 
    • Only if written in comments - DOTATATE
    • If not and it is a neuroendocrine tumor please verify with the referring physician (if they want FDG or DOTATATE) 
  6. Fluciclovine (Axumin) 
    • Only if written in comments - Fluciclovine
    • Prostate cancer pts - typically in patient's who have been previously treated, looking for recurrent disease
 
When in doubt of which protocol to select, please ask one of our nuclear medicine residents or the attendings.

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RadRez Administrator,
Sep 14, 2020, 5:22 AM
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RadRez Administrator,
Jun 2, 2020, 6:54 PM