Course Description

Required Textbooks

1. Christian, et al Nuclear Medicine And PET/CT Technology and Techniques, 8th edition St. Louis, 2007 Mosby/Elsevier
   1. Skeletal Imaging - Chapter 22 0(p. 576)
   2. Respiratory - Chapter 18 (p. 469)
   3. GI System - Chapter 20 (p. 518)
2. Procedure Standards Binder has selected publications on topics covered in the course. Students are required to read the selected materials as they appear below
   1. Skeletal
      1. SNMMI Procedures Guideline - MDP
      2. SNMMI Procedures Guideline - Na¹⁸F
   2. Pulmonary
      1. SNMMI Procedures Guideline - MAA
      2. ACR-SNMMI Guidelines for Pulmonary Scintigraphy - Adults and Children
   3. GI
      1. SNMMI Procedures Guideline - GI Bleed
      2. SNMMI and EANM Procedures Guideline - Meckel's Diverticulum
      3. SNMMI Procedures Guideline - Gastric Emptying
      4. ACR - SNMMI Procedures Guideline - Liver Spleen Imaging
      5. SNMMI Procedures Guideline Hepatic and Splenic (Focus on Spleen imaging)
      6. SNMMI Procedures Guideline - Hepatobiliary
      7. SNMMI Procedures Guideline - Small-Bowel and Colon Transit
3. Procedures Standards Binder - This is highly recommended and available at the discount rate of $79 to SNMMI members. The above links are found in the procedures binder
4. Use VCU Libraries to find and access library resources, spaces, technology and services that support and enhance all learning opportunities at the university - link https://www.library.vcu.edu/

Attendance Policy
Attendance is mandatory. Failure to take a Kahoot quiz at the beginning of the class will result in a zero.

Course Requirements

1. Regular class attendance.  If absent it is your responsibility to get handouts, notes and any other information presented.
2. Reading assignments
3. Complete all exams
4. Final exam
5. Perform all assigned homework/ projects/ assignments/ articles as assigned

Exams and Assignment Policy

1. As a general rule exams will be given in class and encompass information discussed during lectures, handouts given in class, and homework/reading assignment.  Failure to take an exam on a scheduled exam day will automatically cause a 7% deduction from the total letter grade.  Make-up must be scheduled and completed ASAP, so that the entire class has the opportunity to review the results.  The only exception given to this policy will be if the student has made prior arrangements with the instructor. 
2. There will be Kahoot presentations throughout the semester that will occur at the beginning of class. Kahoot will be completed within the first 5 minutes of class. If you are in attendance and take participate you will receive 100%. Failure to show up means that a zero for the grade. If you get a zero, the first one will be dropped from your course grade.
3. The use of Kahoot will also supplement quizzes and will be administered at the beginning of class. To get credit you just need to be attending class.
4. Final exam - see below.
5. Any assignment or homework given in class must be completed in a time designated by the instructor.  Late assignments will not be accepted.
6. This is a professional courses which means the lowest passing grade is “C”.

Religious Holiday
If you have a religious that requires you to miss call you must tell the instructor, no later than September 3, as per University policy. See Academic Calendar.

ADA Policy
Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 require VCU to provide academic adjustments or accommodations for students with documented disabilities.  Students seeking academic adjustments or accommodations must self-identify with the Coordinator of Services for Students with Disabilities on the appropriate campus.  After meeting with the Coordinator, students are encouraged to meet with instructors to discuss their needs and, if applicable, any laboratory safety concerns related to their disabilities.

Please refer to the VCU ADA policy in the VCU Resource Guide, available at https://equity.vcu.edu/ada/

Policy Regarding Calculators
The Department of Radiation Sciences will only allow use of non-programmable (non-graphing) calculators.  Students will not be allowed to use programmable (graphing) calculators during any type of examination.  In addition, students will not be allowed to share calculators during any examination.

Policy Regarding Final Exam Schedule
The Department Chair establishes policies and schedules for the CLRS final exams. The Department Chair must approve any changes regarding scheduling the course final exam. A penalty may be imposed for missing a scheduled final exam.

Policies Regarding the Academic Calendar and Course Schedule
The Department of Radiation Sciences abides by the VCU academic calendar for the MCV campus (see https://academiccalendars.vcu.edu/)

How to Prepared for Emergencies at VCU

1. Sign up to receive VCU text messaging alerts (http://www.vcu.edu/alert/notify).  Keep your information up-to-date.
2. Know the safe evacuation route from each of your classrooms. Emergency evacuation routes are posted in on-campus classrooms.
3. Listen for and follow instructions from VCU or other designated authorities.
4. Know where to go for additional emergency information (http://www.vcu.edu/alert).
5. Know the emergency phone number for the VCU Police (828-1234).
6. Report suspicious activities and objects.

Students should visit syllabus statement by the Office of the Provost for additional syllabus information: https://provost.vcu.edu/faculty/faculty-resources/syllabus The full university syllabus statement includes information on safety, registration, the VCU Honor Code, student conduct, withdrawal and more.

General Course Objectives

1. Describe
1. The anatomy/physiology and method of radiopharmaceutical localization in the target organ/system.
2. The common pathologic disorders being diagnosed by the various nuclear exams discussed.
3. Normal pathologic distribution of radiopharmaceuticals and image interpretation of such.
4. Common abnormal study findings.
5. Biologic, physical, and effective half-life as it relates to organ dose and image quality.
6. Modifications of the study for use in pediatric patients.
2. Explain
1. Instrumentation parameters and requirements.
2. Acquisition protocol: including views, sequencing, end-point, etc.
3. Common artifacts encountered with each study.
4. Primary photon energies/half-life used with the appropriate imaging agent.
3. Identify
1. Specific radionuclide for each nuclear medicine procedure presented.
2. The rationale for radiopharmaceutical selection.
3. Indications for the study.
4. Optimal organ localization time for appropriate imaging sequence.
5. Patient positioning and landmarks.
6. Study type for the acquisition: SPECT, whole body, dynamic, static.
4. State
1. Patient preparation.
2. Correct dose amount for an adult.
3. Correct route of administration of the appropriate radiopharmaceutical.
4. Computer data acquisition and processing parameters.

1. Anatomy, Physiology, Biodistribution
2. Indications
3. Patient preparation
4. Radiopharmaceutical type/dose amount(s)/route
5. A considerable amount of time will be spent how acquisition and processing parameters which includes (not limited to)
   1. Contrast Enhancement
   2. Black/white/color scales
   3. Distance between patient and detector
   4. Whole body/Spot views/3 phase
   5. Whole body contouring
   6. Imaging counts/detector size/scan speed
   7. Types of collimation
   8. Matrix sizes
   9. Pediatric vs adults
   10. Other technical factors
6. Acquisition Parameters & Computer Processing
7. Normal and abnormal findings

Exam I - Skeletal

Skeletal System Objectives

1. Identify the composition of bone, its formation, and types.
2. Discuss the pathophysiology of the different bone imaging agents.
3. Compare and describe bone imaging techniques and protocols: dynamic, spot, whole body, and SPECT.
4. Explain imaging parameters in bone Scintigraphy.
5. Apply the utilization of three-phase bone imaging to other radiotracer used for to identify bone infection.
6. Compare Na¹⁸F to ^99mTcMDP and associate lytic and blastic lesions.
7. Review and discuss bone scintigraphy is diagnosing cancerous and noncancerous diseases that involve the bone.

Additional information can be found in your Study Guide

Course Outline - Respiratory (Ventilation & Perfusion) [10/03 to 10/31]

1. Anatomy, Physiology, Biodistribution
2. Indications
3. Patient preparation
4. Radiopharmaceutical type/dose amount(s)/ route
5. Imaging options: Planar, SPECT, Dynamic
6. Acquisition Parameters & Computer Processing
7. Normal findings
8. COPD/PE/Ca

Exam II - Respiratory

Respiratory System Objectives

1. Review A and P in the respirator system.
2. Understand lung diseases and its diagnostic characteristics in V/Q lung imaging.
3. Assess different formats used for lung ventilation procedures.
4. Compare imaging results with ventilation and perfusion lung imaging is used to assess disease.
5. Apply reduced particles administration when necessary.
6. Understand PIOPED in the diagnosis of pulmonary emboli (PE).
7. Review other diagnostic procedures (non nuclear) used to diagnose PE.

Course Outline - GI System (Gastrointestinal, Hepatobiliary, Liver/Spleen, other GI track procedures) [11/02 to 12/05]

1. Anatomy, Physiology, Biodistribution
2. Indication
3. Patient preparation
4. Radiopharmaceutical type/dose amount(s)/ route
5. Imaging options: Planar, SPECT, Dynamic
6. Acquisition Parameters & Computer Processing
7. Normal and abnormal findings
8. Other GI track procedures include: GI Bleed, Cavernous Hemangioma, Meckel's Diverticulum, Gastric Esophageal Reflux/transit, and Gastric Emptying

Exam III - GI Track

GI System Objectives

1. Discuss A and P of the: stomach, liver, spleen, esophagus.
2. Understand the compounding of sulfur colloid and the preparation of denatured RBCs.
3. Outline imaging protocols for: liver, spleen, hepatobiliary, gastric emptying, esophageal transit, gastric reflux, Meckel's, cavernous hemangioma, GI bleeding.
4. Assess diseases of the hepatobiliary system with the appropriate pharmaceutical augmentation.
5. Compare the application of sulfur colloid and labeled RBCs in the detection of cavernous hemangioma and GI bleeding.
6. Calculate gastric emptying times.
7. Identify the mechanism of uptake of pertechnetate in a Meckel's Diverticulum procedure.
8. Understand the application of applying ROIs in an esophageal transit and gastric reflux procedures.

Addi tonal information can be found in your Study Guide

Final Exam Review - 12/07

Final Exam schedule is arranged by the Department Chair and will be sent to all student at least several weeks before the of the semester.

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