Learning objectives
To know the methods of image acquisition and post-processing for conventional Nuclear Medicine and PET
To know methods of radiopharmaceuticals preparation, quality control and administrated activities.
To be oriented in a diagnostic Dept with high technological and organizational complexity with multidisciplinary activity.
Course unit content
Conventional Nuclear Medicine and Positron Emission Tomography (PET): physics and clinical applications, tomograph and detectors, sections of a Nuclear Medicine Department and PET Center, workflow and organization of activities.
Radiopharmacy Laboratory: workflow and organization of activities; equipment and facilities.
National and international regulations (NBP, GMP, cGRPP, Italian and Eur.Pharmacopoeia).
Manipulation, preparation and quality controls of radiopharmaceuticals: kit-based preparations (from licensed and unlicensed kits) and extemporaneously prepared radiopharmaceuticals, EPRs
Utilization of a Nuclear Medicine management software for full traceability from ordering stock to radiopharmaceutical preparation and injection.
Production of radioisotopes: cyclotrons and generators.
Basic operating principle of cyclotron working, uses, targets for radionuclide production, production workflow, cyclotron team, quality controls.
Generators 99Mo/99mTc, 68Ge/68Ga: availability, production workflow, team, quality controls.
Dose fractioning systems
Radioactive waste management.
Images acquisition methods (static, dynamic, whole body, 3D SPECT and PET, respiratory and cardiac gating, brain) and post-processing; normal and pathological pattern of radiopharmaceutical biodistribution.
Hybrid imaging: SPECT/CT, PET/CT, PET/MR.
Tools for quantitative assessment of imaging biomarkers (BasalGanglia, SPM5, SPM8, CortexID Suite, DatQuant, SUV metrix, TLG, MTV) and imaging software (Dicom RT, Cardioplanet, ecc).
PET/CT for radiotherapy planning: positioning technique, immobilization options, staff skills, laser light, 4D imaging.
Major clinical applications of SPECT and PET imaging: neurodegenerative diseases, oncology, endocrinology, pediatrics, bone and genitourinary diseases, cardiovascular and respiratory diseases, infections and inflammation.
Radionuclide therapy with radioisotopes: I-131, Ra-223, Y-90, Lu-177.
Bibliography
Duccio Volterrani, Paola Erba, Giuliano Mariani. Fondamenti di medicina nucleare: Tecniche e applicazioni. Editore Springer
EANM Guidelines. www.eanm.org
Elsinga P, Todde S and the radiopharmacy Commettee of the EANM. Guidance on current good radiopharmacy practice (cGRPP) or the small scale preparation of radiopharmaceuticals. Eur J Nucl Med Mol Imaging (2010) 37:1049-1062
Mario Marengo. La fisica in medicina nucleare. Patron Editore.
Teaching methods
Theoretical lessons, videos, practical training, guided visits in the Dept.
Other information
Power Point versions of the lessons, guidelines, scientific papers, procedures and protocols as PDF documents
