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Nuclear Medicine

Offered by the Mallinckrodt Institute of Radiology in conjunction with
The Office of Continuing Medical Education
Washington University School of Medicine

Program Description
This course is intended to offer the practicing radiologist or nuclear medicine physician an opportunity to observe and discuss procedures in PET/CT.  Staff members in Nuclear Medicine are committed to devoting time to the visiting Fellow for his or her instruction. 

Our PET/CT course provides the Visiting Fellow with the opportunity to become familiar with the technical and clinical aspects of clinical PET/CT.  Although the course is very flexible and can be tailored to meet the needs of each participant, our experience suggests that those who have benefited most have had a good foundation in the basic principles of PET (such as might be obtained by prior attendance at a didactic course or by reading one of several available textbooks).

The Clinical PET Facility of the Mallinckrodt Institute of Radiology (MIR) has a busy clinical schedule (averaging 18-24 cases per day). Most studies are performed on either a Siemens Biograph mCT time-of-flight PET/CT scanner or a Siemens Biograph LSO-40 PET/CT scanner located on the second floor of the Center for Advanced Medicine (Barnes-Jewish Hospital North Campus). Mallinckrodt Institute of Radiology also has another Siemens Biograph LSO-40 PET/CT scanner, a Siemens/CTI ECAT HR+ scanner, and a Siemens mMR PET/MR scanner, which are used for clinical research studies. The vast majority of clinical studies involve oncologic imaging performed with F-18 fluorodeoxyglucose (FDG); a smaller number are performed with F-18 sodium fluoride and F-18 florbetapir. However, many radiopharmaceuticals other than FDG (such as F-18 fluorothymidine Cu-64 ATSM) also are used for oncologic research studies. Approximately 5% of studies are FDG studies of the brain. Myocardial perfusion imaging with N-13 ammonia and PET/MR is expected to begin during 2014. Various other radiopharmaceuticals are used in the research setting. The Clinical PET facility is staffed each day by one attending nuclear medicine physician, a nuclear medicine resident and 1-2 radiology residents, as well as several technologists with dedicated PET expertise, so there is ample opportunity for the Visiting Fellow to have his or her questions answered.

This fellowship involves the following activities:

  • Attend the daily PET image interpretation sessions (usually beginning mid morning and continuing throughout the afternoon).
  • Review didactic lectures on PET, available on CD or as PowerPoint files with audio tracks, on computers close to the PET reading room.  A large number of these lectures, covering all aspects of PET, are available for use by the Visiting Fellow.
  • Review PET teaching file cases either in digital format (at http://gamma.wustl.edu) or as hard copy films.
  • Observe PET technologists performing patient preparation, positioning, scanning, and reconstruction of the PET images.
  • Review the Division’s PET Procedure Manual and various forms used to schedule patients and to address appropriateness and billing issues.
  • A tour of the Cyclotron Facility can be arranged for those visiting fellows who so desire.
  • If desired, attend daily 8:30–9:30 a.m. Nuclear Medicine Division teaching conferences (held on the ninth floor of the Barnes-Jewish Hospital West Pavilion) and 12:00–1:00 p.m. Radiology Department teaching conferences (held in Scarpellino Auditorium on the first floor of the MIR building).  A schedule of these conferences to be held during the visit will be provided at the beginning of each fellowship.

The following books are recommended for review, either before or during the Visiting Fellowship.  These books can be borrowed from the Division of Nuclear Medicine library.  Copies of these and other books are available at the PET facility or in the main Division office on the ninth floor of the Barnes-Jewish Hospital West Pavilion.

  1. Blodgett TM, Ryan A, Almusa O, Papachristou M, Padisetty S. Specialty Imaging: PET/CT. Amirys; 2009.
  2. Delbeke D, Israel O, eds. Hybrid ET/CT and SPECT/CT Imaging. A teaching File. Springer; 2010.
  3. von Schultess GK.  Molecular Anatomic Imaging, 2nd ed. Lippincott, Williams & Wilkins; 2007.
  4. Wahl, RL, ed. Principles and Practice of PET/CT, 2nd ed. Lippincott, Williams & Wilkins; 2009.

Cost
The participation fee is $350.00 per day or $1,500.00 per five days extending Monday through Friday.  In general, only one Visiting Fellow per week can be accommodated in each course.  These courses are intended to add to prior knowledge and not meant to create an “expert” in a short time.  Legal insurance restrictions prevent us from allowing direct participation of Visiting Fellows in procedures.

Accreditation
Washington University is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians.

Washington University designates this educational activity for a maximum of 8 hours per day of Category 1 credit toward the AMA Physicians’ Recognition Award.  Physicians should claim only those hours of credit that they actually spent in the educational activity.

Disclosure Policy
It is the policy of Washington University School of Medicine, Office of Continuing Medical Education, to ensure balance, independence, objectivity and scientific rigor in all its educational programs.  All faculty participating in these programs are expected to disclose to the program audiences any real or apparent conflicts of interest related to the content of their presentations.

HIPAA Compliance
Because the Visiting Fellow will have access to confidential information, including protected health information of our patients, Washington University School of Medicine requires completion of a Confidentiality Agreement at the beginning of the Fellowship program.  This document will be provided to the Visiting Fellow for signature upon arrival. 

In the rare event of program participation for 2 weeks or more in duration, the Visiting Fellow will be required to complete the Washington University on-line HIPAA training.  This is necessary in order to comply with the federal Health Insurance Portability and Accountability Act of 1996.   A unique ID# and password from the University Compliance Office will be provided that will allow the Visiting Fellow to access the Washington University web-based training.  The education modules can then be completed on the web prior to arriving for the Fellowship program. 

Housing
Overnight accommodations arrangements must be made by the participant. A list of nearby hotels is included with the application form.

Application Information

Should you care to participate, please contact Barb Knipshild to obtain an application.

Division of Nuclear Medicine
Mallinckrodt Institute of Radiology
510 S. Kingshighway Blvd.
St. Louis, MO  63110
TEL:  314-362-2809
FAX:  314-362-2806