Learning objectives
To know the methods of image acquisition and post-processing for conventional Nuclear Medicine and PET.
To know major clinical applications.
To know the basic concept of treatment with radiolabelled molecules.
The concept of theranostic.
To know methods of radiopharmaceuticals preparation, administrated activities and the quality assurance system.
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, EPRPs
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.
The Quality Assurance System (QAS): enviroment, biohazard hoods and hot cells, radiopharmaceutical preparations, equipment and dose calibrator, operators.
Radionuclide therapy with radioisotopes (I-131, Ra-223, Y-90, Lu-177).
Major clinical applications.
Cross-fire effect.
The teranostic concept:
Bibliography
• Duccio Volterrani, Paola Erba, Giuliano Mariani. Fondamenti di medicina nucleare: Tecniche e applicazioni. Editore Springer
• EANM Guidelines.www.eanm.org
• Gillings, N., Hjelstuen, O., Ballinger, J. et al. Guideline on current good radiopharmacy practice (cGRPP) for the small-scale preparation of radiopharmaceuticals. EJNMMI radiopharm. Chem. 6, 8 (2021)
• Mario Marengo. La fisica in medicina nucleare. Patron Editore.
Teaching methods
Theoretical lessons, videos, practical training, guided visits in the Dept. Lectures will be held on-site in compliance with safety standards, provided that further instructions on the ongoing health emergency are not implemented. Supporting material will be available on the specific, student-reserved platform (Elly) and will include slide presentations, audio-video aids or video-recording of the lectures.
Other information
Power Point versions of the lessons, guidelines, scientific papers, procedures and protocols as PDF documents
