A Journal from 1978
Please Plan to Attend the
40th
Annual Spring Symposium
for
Technologists, Students, Educators
April 17...
Editor’s Note
P A G E 2V O L U M E 5 I S S U E 1
As we have another issue of the e journal posted many things are going on...
President's Report
P A G E 3V O L U M E 5 I S S U E 1
It has been a long, cold snowy winter and I am sure many of you are ...
The Society of Nuclear Medicine
New England Chapter Technologist Section
40TH
Annual Spring Symposium
April 17 & 18th
, 20...
OFFICERS OF THE NEW ENGLAND CHAPTER
TECHNOLOGIST SECTION
President Martha Burke Wilson, CNMT
President-Elect Kathleen M. K...
GENERAL INFORMATION
Dates
April 17 & 18, 2009
Location
Marriott Hotel
100 Capital Boulevard
Rocky Hill, CT 06067
1-860-257...
ACCOMMODATONS
A block of rooms have been reserved at the Marriott Hotel Rocky Hill, CT
Reservations can be made by calling...
Friday, April 17, 2009
Student Program
Nuclear Medicine Technology Students will present a variety of Scientific
Papers. A...
Friday, April 17, 2009
Technologist Program
11:00 am REGISTRATION OPENS
12:00 pm VENDOR AREA OPENS
General Session
11:50-1...
SATURDAY, April 18, 2009
7:00 am REGISTRATION OPENS
7:-00-8:00 am Continental Breakfast
TECHNOLOGIST PROGRAM
8:00-9:00 am ...
Faculty
Jeanine M, Beratta, JD
Financial Planner /Functional Manager-Training
MetLife
Holyoke, MA
Cathy Coleman, BS, CNMT
...
Faculty
Daniel Murphy, Jr., R.Ph, BCNP
Pharmacy Compliance Manager
Cardinal Health
West Hartford, CT
Leo Nalivaika, MBA, C...
Exhibitors
AnazaoHealth
Astellas
Bracco
Cardinal Health Nuclear Pharmacy
Covidien
GE Health Care
IBA Molecular
ISORX
JRT A...
40th
Annual Spring Symposium
SOCIETY OF NUCLEAR MEDICINE
TECHNOLOGIST REGISTRATION FORM (PLEASE PRINT)
Name ______________...
2008 NECTS Student Program
V O L U M E 5 I S S U E 1
Nuclear Medicine Technology Students presented a variety of
Scientifi...
Evaluating gastrointestinal lesions in patients
diagnosed with blue rubber bleb nevus syndrome
Erin Rickard
Beth Israel De...
NEW ENGLAND CHAPTER TECHNOLOGIST SECTION SOCIETY OF NUCLEAR MEDICINE
The 39th Annual Spring Symposium
Student Presentation...
Case Study of the Utilization of SPECT/CT in Nuclear
Medicine
Christopher Tagliavini
Beth Israel Deaconess Medical Center,...
NEW ENGLAND CHAPTER TECHNOLOGIST SECTION
SOCIETY OF NUCLEAR MEDICINE
The 39th Annual Spring Symposium
Student Presentation...
Whole Body PET/CT for the Evaluation of
Bone Metastases
William T. Sticka Jr.
Beth Israel Deaconess Medical Center, Boston...
NEW ENGLAND CHAPTER TECHNOLOGIST SECTION
SOCIETY OF NUCLEAR MEDICINE
The 39th Annual Spring Symposium
Student Presentation...
NEW ENGLAND CHAPTER TECHNOLOGIST SECTION
SOCIETY OF NUCLEAR MEDICINE
The 39th Annual Spring Symposium
Student Presentation...
NEW ENGLAND CHAPTER TECHNOLOGIST SECTION
SOCIETY OF NUCLEAR MEDICINE
The 39th Annual Spring Symposium
Student Presentation...
NEW ENGLAND CHAPTER TECHNOLOGIST SECTION
SOCIETY OF NUCLEAR MEDICINE
The 39th Annual Spring Symposium
Student Presentation...
A case study of intra-patient 18-F-FDG PET scans
with and without the pre-treatment of a high fat, high
protein and no car...
A Comparison of Ejection Fraction Values in
Exercise versus Dipyridamole
Myocardial Perfusion Stress Imaging
Katelynn Laff...
Title:
Brain Imaging Technologies: Cracking the code on addictions
Author:
Jolene Leger
Objectives:
1. Discuss the differe...
ABSTRACT TITLE:
Tl-201 vs. Tc-99m and Sestamibi vs. Tetrofosmin in myocardial perfusion studies. A
survey of Central Massa...
Title
Strontium 89 versus Samarium 153 for Bone Therapies
Authors/ Affiliations
Author: Michael Zalaski
Affiliation: Briar...
ANIMAL IMAGING AND ITS CONTRIBUTION TO THE RESEARCH AND
DEVELOPMENT OF NUCLEAR MEDICINE
Floyd Davis
Gateway Community Coll...
2
Abstract
This paper will explore the role of animal imaging in the research and development of
nuclear medicine.
Methods...
3
Introduction
Since the dawn of the Renaissance, mankind has greatly benefited from the extraordinary
advances in medicin...
4
including PET/SPECT/CT cameras for small animal imaging. The SPECT-CT cameras use a
pinhole collimator to magnify the im...
5
market takes time and money (2). In the pharmaceutical industry it now takes almost $1 billion
to bring a new drug to ma...
6
$1.3 million grant to the Research Institute at University Hospitals of Cleveland to buy a
magnetic resonance imaging (M...
7
Large animals are also treated for a variety of conditions. Consider the case of a 10 year
old thoroughbred horse with a...
8
Acknowledgements
Professor Kathleen Murphy provided direction in gathering useful information. Doctors
L. Dobrucki and A...
9
References
1. Dobrucki L, Sinusas A. Molecular cardiovascular imaging. Current Cardiology
Reports. 2005; 7:130–135.
2. W...
10
13. The University of Tennessee College of Veterinary Medicine, Equine Bone Scan.
Retrieved April 13, 2008 from http://...
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New England Chapter E-Journal of Nuclear Medicine Technology

  1. 1. A Journal from 1978 Please Plan to Attend the 40th Annual Spring Symposium for Technologists, Students, Educators April 17 & 18, 2009 Marriott Rocky Hill, Connecticut Program details on page 4 New England Chapter E-Journal of Nuclear Medicine Technology S P R I N G 2 0 0 9 President Martha Burke-Wilson, CNMT President-elect Kathleen M Krisak BS, CNMT Past President Mary Cross, BS, CNMT Treasurer Mark Corbin, CNMT Secretary Nancy Cowden, CNMT, RT(N) National Council Delegate Kathleen M Krisak BS, CNMT Editor Leo Nalivaika, MBA, CNMT Newsletter Publisher & Website Admin. Jana Lee Hogan, CNMT The Society of Nuclear Medicine New England Chapter Technologist Section BUSINESS MEETING Saturday April 18, 2009 12:30 PM Rocky Hill Marriott Rocky Hill, Connecticut Physician Officers: President: John Vento, M.D. President-Elect: Rachel Powsner, MD Treasurer: Alan Siegel, M.D. V O L U M E 5 . I S S U E 1 Visit the Chapter Website at www.nects.org For CEU meeting announcements, job postings and reference information on the New England Chapter Technologist Section Send a email to jana.hogan@nects.org to sign up for email announcements
  2. 2. Editor’s Note P A G E 2V O L U M E 5 I S S U E 1 As we have another issue of the e journal posted many things are going on in regards to the happenings of the chapter and the soci- ety. In April the 40th annual Spring Symposium will be held on April 17th and 18th which promises to be not only informative but also an enjoyable time to meet with friends and colleagues. This years meeting will be in Connecticut and as you move through the pages of the ejournal you will find a program as well as registration material. The US Postal service will also be dropping a program with information to all members of the chapter. If you know someone who is not a member please either share the web site or your printed materials with them. Kathy Krisak has done a stellar job in making arrangements and planning this meeting. I hope that everyone that receives a ballot in this years election votes and returns it, participation in the chapter on this level is key. If there are any members who may be interested in running for office contact Martha Wilson who will be formulating a ballot for next years election. Participation in the society is a very rewarding experience. Forty years of spring symposiums do not magically hap- pen unless people do get involved! You will note that abstracts from last year’s student presentations are in this journal, please pardon if an abstract does not appear because of the ability of us to open the file that was sent to the ejournal staff. If someone who was not included sends us a word document we can put it in the next ejournal prior to the fall. This past year we had as student request that his paper be published, if he paper is fit to put in the ejournal we will publish it, this includes non-students also. I had the opportunity to attend the fall meeting in Newport and as always the physicians group as well as tech section from both the New England and New York did a tremendous job. The topics were wide ranging from current to future and these presentations were very informative. Rumor is next falls meeting will be in Rye, New York which is down the road from Stamford CT. The student program this year is planned out very well by Tony Scicigano. This year there will be a board review once more by some of the New England program directors. This year the students of all the programs have been working very hard, if you have a job opening or know of one contact the program directors of nuclear med programs in your area. The economy down turn has either frozen jobs in facilities or have dwindled the 401K so that our mature technologists continue to work in the field, which has of course worsened the scenario. Leo Nalivaika, MBA, CNMT SNM - New England Chapter Physician Section Bylaw Changes Proposed new council members: Don Yoo, M.D., Councilor for Rhode Island John Odershaw, M.D., Trustee Proposed changes to the By-Laws: 1) Article VII, The Council, Item 7 (Page 9): Amend __ The council meetings shall be held al least three (3) times each calendar year to __The council meetings shall be held al least two (2) times each calendar year 2) Article X, Committees Item 1 (Page 11): remove the following items from the list of committees: b. Bylaws, f. Awards, and g. Socio-economics Addition of a new item: Article VII, The Council, Item 9 (Page 9): The President, for the duration of his/her term shall appoint, with the approval of the majority of the council, a Trustee. The Trustee or his/her designee will represent the New England Chapter of the Society of Nuclear Medicine at the House of Delegates meeting at the mid-winter and an- nual Society of Nuclear Medicine meetings. The Trustee will present a summary report of the proceedings of the House of Delegates meetings at the next Council meeting to follow each House of Delegates meeting.
  3. 3. President's Report P A G E 3V O L U M E 5 I S S U E 1 It has been a long, cold snowy winter and I am sure many of you are hoping for an early spring. I attended the SNM Mid-Winter Meeting this month in Clearwater, Florida and many issues were being discussed. Primarily, issues addressed were the job market and the Technetium shortage which plagued us last year and as recent as this week. We also discussed how to get more people to run for office and how to make the SNM more beneficial to join. Some of you may not be aware of the SNM’s Leadership Academy. Every year, Chapters select nuclear medicine technologists to attend a leadership academy for a weekend in the fall. The goal is to help nuclear medicine technologists acquire leadership skills necessary to excel in their field. The Academy is funded so travel and expenses are paid. If interested, the application is on the SNM website and usually has to be submitted by August 1. Also, check the SNM website for scholarships and grants for technologists and students. This includes a scholarship for technolo- gists that want to go back and finish their Bachelor’s degree. Theses benefits are here for you. Please take advantage of them and get involved. Join us for the Spring Meeting that will be held on April 17th and 18th in Connecticut Please check this brochure for the program. Kathy Krisak has put together a great program. Please feel free to email me with any concerns or problems. See you in April! Martha Burke Wilson, CNMT Past President's Report I am looking forward to the spring meeting for many reasons. Kathy has put together another excellent program, we are officially celebrating our 40th meeting and the bar code sign in for VOICE credit should be up and running . The database is built and the computer program seems to be working well. We have purchased barcoded ID cards for everyone who was on the Society of Nu- clear Medicine's master list as of February. (If your dues were not paid in time, you may not have a card with your name on it, but we have a plan for that!) These cards will be reused each year, so they need to be returned when you leave the meeting. There will be five bar code stations in the lecture hall. Right now we are sorting through the technical details. For this meeting, there will be a paper backup in case we run into technical difficulty. Forty years ago, this was not necessary. That's progress!? See you in April. Mary Cross, BS, CNMT President-elect's Report This time of year is very busy for me since I’m very involved with the Holyoke St.Patricks parade and putting together this year’s spring meeting. The spring meeting, our 40th is right around the corner and I hope as with our predecessors this meeting will not dis- appoint you. A great time to get your education credit; check out what our vendors may have, as well as meeting up with old friends and making new ones. A highlight of this years meeting will be the talk on the history of the chapter which includes some very fun photos from the past 40 years. The location for this years meeting is located directly off a major route and is accessible for all of our members. If you have received a brochure please share it with those who may not have received one or refer to the ejournal or our web page www.nects.org which has all the up to date information on the meeting. As the incoming, president I look forward to hearing from the membership in the chapter. See you in Hartford, Kathleen M. Krisak BS, CNMT, FSNMTS
  4. 4. The Society of Nuclear Medicine New England Chapter Technologist Section 40TH Annual Spring Symposium April 17 & 18th , 2009 Marriott Rocky Hill, Connecticut
  5. 5. OFFICERS OF THE NEW ENGLAND CHAPTER TECHNOLOGIST SECTION President Martha Burke Wilson, CNMT President-Elect Kathleen M. Krisak, BS, CNMT, FSNMTS Treasurer Mark Corbin, BS Secretary Nancy Cowden, CNMT Past President Mary Cross, BS, CNMT, RT (N) National Council Delegate Kathleen M. Krisak, BS, CNMT, FSNMTS Historian Emeritus Leo Nalivaika, MBA, CNMT, NCT PROGRAM COMMITTEE Educator's Committee Tony Sicignano, BS, CNMT, RT (N) Vendor Liaison Kathleen M. Krisak, BS, CNMT,FSNMTS Program Coordinator Kathleen M. Krisak, BS, CNMT, FSNMTS Pre Registration Kathleen M. Krisak, BS, CNMT,FSNMTS On Site Registration Dennis Dunn, BS, CNMT VOICE Coordinator Mary Cross, BS, CNMT, RT (N)
  6. 6. GENERAL INFORMATION Dates April 17 & 18, 2009 Location Marriott Hotel 100 Capital Boulevard Rocky Hill, CT 06067 1-860-257-6000 Pre-Registration must be postmarked by April 3, 2009. Technologist registration forms are located at the back of this brochure. On Site Registration Friday, April 17, 2009, 11:00 a.m. Saturday, April 18, 2009, 7:00 a.m. • Hotel registration must be made by April 1, 2009 to secure discounted rate. • After April 1, 2009, the discounted rate will be subject to availability. • Pre-Registration must be postmarked by April 5, 2009. Any registration postmarked after April 5, 2009 will require On-Site Registration fees. *No refunds will be issued after April 8, 2009
  7. 7. ACCOMMODATONS A block of rooms have been reserved at the Marriott Hotel Rocky Hill, CT Reservations can be made by calling 1-800-228-9290 toll free. To receive the discount group rate, attendees must identify themselves with the Society of Nuclear Medicine New England Chapter. The rate for single or double occupancy is $104.00 for Thursday, Friday and Saturday nights. The hotel’s rates are subject to applicable state and local taxes which are currently 12% in effect at the time of check out. Free Parking. Directions: From Boston area: Take the Mass Pike west to exit 9 onto I-84 west. Continue on I-84 to Hartford. Just before Downtown take the exit for I-91 south. Continue on I-91 south to exit 23(West Street-Rocky Hill) At the end of the ramp, make a left. At the second light, turn right. Hotel driveway is on your right. From Springfield: Take I-91 South to exit 23(West Street-Rocky Hill) at the end of the ramp, turn left. At the second light, turn right. Hotel driveway is on your right. From Providence: Take RT 6 West toward Hartford, Ct. Follow RT 6 to RT 384 and continue, as 384 becomes I-84 West. Just before downtown Hartford, take the exit for I-91 south. Continue on I-91 South to exit 23(West Street-Rocky Hill). At end of ramp, make a left. At the second light, turn right. Hotel driveway is on your right. From Glastonbury: Take RT 2 west (towards Hartford). Take the exit 5 onto RT (towards Wethersfield). Continue on RT 3 and take the exit for I-91 South. Continue on I-91 south to exit 23 (West Street-Rocky Hill). At end of ramp, make a left. At the second light, turn right. Hotel driveway is on your right. VOICE Credits CE credit will be given for each scientific session. Attendance during at least 80% of an instructional hour is mandatory. Sign-in sheets will be available at the registration booth. Participants must be signed in each day. Credit cannot be recorded on your VOICE transcript without a VOICE membership number. If you are a member in good standing of the Society of Nuclear Medicine Technologist Section or VOICE tracking program, you must leave your Verification form at the attendance desk for delivery to the SNM for VOICE tracking. Your voice certificate will be mailed to you after the meeting for your records. If you are not a member of the Society of Nuclear Medicine, you must retain your own VOICE credit reporting form for your records.
  8. 8. Friday, April 17, 2009 Student Program Nuclear Medicine Technology Students will present a variety of Scientific Papers. All students participating will receive a small gift as a token of appreciation. 9:00-9:10am President's Welcome- Martha Burke-Wilson 9:10-12:00pm Student Presentations 12:00-1:00pm Lunch (included with registration) Registry Review 1:00-1:45pm Radiopharmacy 2:00-2:45pm Instrumentation 2:45-3:15pm Break 3:15-4:00pm Procedures 4:15-5:00pm Radiation Safety Student Registration for this meeting is being handled by: Tony Sicignano BS, CNMT, RT (N) NECTS-Student Education Coordinator Please Email him for information on the student program TSicignano@srhs.org
  9. 9. Friday, April 17, 2009 Technologist Program 11:00 am REGISTRATION OPENS 12:00 pm VENDOR AREA OPENS General Session 11:50-12:00 pm Welcome Martha Burke Wilson, CNMT President, NECTS 12:00-1:00pm NM Reimbursement 2009: Changes & Issues Including PET & NCOR Denise Merlino, MBA, CNMT, CPC, FSNMTS 1:00-2:00 pm Standards in 2009: Guidelines and Accreditation April Mann, BA, CNMT, NCT, RT (N) FSNMTS 2:00-2:30 pm Coffee Break-Exhibit Hall 2:30-3:30 pm PET and SPECT Imaging of Brain Tumors & Epilepsy Laura L. Horky, MD, PhD 3:30-4:30 pm A Financial Wellness Workshop for Technologists Jeanne Beretta, JD MetLife Larry Mann, Investment Advisor MetLife 4:30-5:30 pm USP Chapter 797 in Nuclear Medicine Dan Murphy, R.Ph, BCNP 5:30-7:00 pm Vendor Reception SATURDAY, April 18, 2009 Past Presidents Breakfast Meeting- Saturday, April 18 from 7am-8am
  10. 10. SATURDAY, April 18, 2009 7:00 am REGISTRATION OPENS 7:-00-8:00 am Continental Breakfast TECHNOLOGIST PROGRAM 8:00-9:00 am Cardiovascular Molecular Imaging: Current and Future Applications Albert J. Sinusas, MD, FACC, FAHA 9:00-10:00 am Clinical Applications of PET Radiopharmaceuticals Serge Lyashchenko, Ph.D, 10:00-10:30 am Coffee Break-Exhibit Hall 10:30-11:30 am Quality Improvements in Imaging Strategies for Success Joe Phillips, MBA, CNMT, RT (N) 11:30-12:30 pm Spring Symposiums Past and Present 40 years Leo Nalivaika, MBA, CNMT, NCT, RT (N) 12:30-1:15 pm Lunch and Vendor Raffle 1:15-2:15 pm Pulmonary Embolis: VQ or CT? David Gilmore, MS, CNMT, NCT, RT(R) (N) 2:15-3:15 pm Observed Patient Motion in Sequential Imaging Karen L Johnson, BS CNMT 3:15-4:15 pm Diagnostic Accuracy of Pet Myocardial Perfusion Imaging: Correlation with Coronary Angiography Lynn E. Sillaman BS, CNMT
  11. 11. Faculty Jeanine M, Beratta, JD Financial Planner /Functional Manager-Training MetLife Holyoke, MA Cathy Coleman, BS, CNMT Program Director Briarwood College School of Nuclear Medicine Technology Southington, CT David Gilmore, MS, CNMT, NCT, RT(R) (N) Program Director Beth Israel Deaconess Medical Center School of Nuclear Medicine Technology Boston, MA Laura L. Horky, MD, PhD Instructor in Radiology Brigham and Women’s Hospital Boston, MA Karen L. Johnson, BS, CNMT Clinical Research Coordinator Department of Radiology, Division of Nuclear Medicine UMASS Medical School Worcester, MA Serge K. Lyashchenko, PhD IBA Molecular Somerset, NJ April Mann, BA, CNMT, NCT, RT (N), FSNMTS Manager, Non-Invasive Cardiology and Clinical Nuclear Medicine Hartford Hospital Hartford, CT Larry Mann Investment Advisor Representative MetLife Denise A. Merlino, MBA, CNMT, CPC, FSNMTS President Merlino Healthcare Consulting Corp. Magnolia, MA
  12. 12. Faculty Daniel Murphy, Jr., R.Ph, BCNP Pharmacy Compliance Manager Cardinal Health West Hartford, CT Leo Nalivaika, MBA, CNMT, NCT Educational Coordinator/Clinical Instructor UMASS Medical Center/Worcester State College Worcester, MA Joseph M. Phillips, MBA, CNMT, RT (N) Director of Imaging Services Southwestern Vermont Healthcare Bennington, VT Stephnie Rhymer, CNMT Clinical Coordinator and Faculty Associate Massachusetts College of Pharmacy and Health Sciences Boston, MA Richard T. Serino, M.Ed., CNMT Chairperson- Medical Imaging Springfield Technical Community College Springfield, MA Tony Sicignano, BS, CNMT, RT (N) Hospital of St.Raphael NECTS-Education Committee Chairperson New Haven, CT Lynn E.Sillaman, BS, CNMT Clinical Applications Specialists Bracco Diagnostics, Inc Albert J. Sinusas, MD, FACC, FAHA Professor of Medicine and Diagnostic Radiology Yale University School of Medicine Nuclear Cardiology New Haven, CT
  13. 13. Exhibitors AnazaoHealth Astellas Bracco Cardinal Health Nuclear Pharmacy Covidien GE Health Care IBA Molecular ISORX JRT Associates Lantheus METLIFE Northeast Electronics PETNET Solutions Philips Medical PINESTAR Technology Siemens Medical Solutions
  14. 14. 40th Annual Spring Symposium SOCIETY OF NUCLEAR MEDICINE TECHNOLOGIST REGISTRATION FORM (PLEASE PRINT) Name _________________ _ (Include Degree/Certification) Mailing Address_____________________________________________ City/ State/Zip__________________________________________________ Daytime Telephone ( ) _____________________________________ Facility Name_______________________________________________ SNM Member Number_________________ Email _________________ Needed for registration Please Check Appropriate Box Pre-Registration Fees by 4/05/09 One Day Two Day Circle One Technologist, SNM Member Fri or Sat $ 40 _____ $ 70 Technologist, Non SNM Member Fri or Sat $150 _____ $200 On Site Registration Fees after 4/05/09 Technologist, SNM Member Fri or Sat $ 70 _____ $100 Technologist, Non SNM Member Fri or Sat $200 _____ $250 All fees include handouts, coffee breaks, continental breakfast and boxed lunch on Saturday. ____If you have a disability, requiring special accommodations, please check here and advise us of your needs at least two weeks in advance of the program. Sorry, but there will be no refunds after April 08, 2009 Cash or Check only Accepted NO CREDIT CARDS Please make checks payable to- New England Chapter, SNM and mail to: Kathleen Krisak 158 Chicopee Street Granby, Mass 01033 Any questions please check our web page at www.nects.org or contact Kathleen Krisak At krisakkk@comcast.net.
  15. 15. 2008 NECTS Student Program V O L U M E 5 I S S U E 1 Nuclear Medicine Technology Students presented a variety of Scientific Papers at the 39th annual Spring Symposium. Please see submitted abstracts on the following pages. This year’s NECTS Student Program will be held on Friday, April 17, 2009 at the Rocky Hill Marriott from 9:00 — 1:00. The program will be followed by a Registry Review from 1:00 — 5:00. Please contact Tony Sicignano BS, CNMT, RT (N), NECTS- Student Education Coordinator for information on the student pro- gram at TSicignano@srhs.org.
  16. 16. Evaluating gastrointestinal lesions in patients diagnosed with blue rubber bleb nevus syndrome Erin Rickard Beth Israel Deaconess Medical Center, Boston, MA School of Nuclear Medicine Technology Blue rubber bleb nevus syndrome is a congenital disorder reported in only about 150 cases worldwide. The disease is characterized by venous malformations that appear both cutaneously and extracutaneously, especially within the gastrointestinal tract. Although cutaneous malformations rarely rupture, malformations within the gastrointestinal tract are prone to chronic bleeding that usually results in severe anemia. The majority of these lesions are not life threatening due to the slow rate and small volume of bleeding. Some lesions, however, pose a fatality risk if rupture results in acute hemorrhage. Traditional methods of localizing and evaluating lesions include endoscopy and imaging with MRI. In addition to these techniques, Nuclear Medicine can also play an important role in imaging lesions using Tc-99m labeled red blood cells. Methods: A 10-year old male patient with known BRBNS was seen in the Nuclear Medicine department at Children’s Hospital Boston to evaluate potential sites of internal bleeding related to the disorder. A blood sample was labeled with Tc- 99m and re-injected with a dose of 0.02mCi/kg. Dynamic images of the abdomen were acquired to visualize possible bleeding within the GI tract. Static and SPECT images of the head were also acquired due to a history of lesions in the skull. Results: While GI bleeding was not visualized in this study, venous lesions in the skull associated with BRBNS were visualized with static images and localized with SPECT images. Conclusion: Imaging with radiolabeled red blood cells is an excellent management option for patients with known cases of BRBNS. This method allows visualization of GI bleeding that could be potentially life threatening. Additional sites of extracutaneous bleeding can also be discovered. The sooner internal bleeding can be localized, the sooner treatment options can be put into place in order to improve the quality of life for BRBNS patients. Submitted by: Erin Rickard
  17. 17. NEW ENGLAND CHAPTER TECHNOLOGIST SECTION SOCIETY OF NUCLEAR MEDICINE The 39th Annual Spring Symposium Student Presentations Friday April 18, 2008 Seacrest Resort and Convention Center in North Falmouth, Mass. Oral & Poster Presentation Abstract Form Identify whether this will be a Poster ____ or an Oral _X_ presentation. Comparison in nuclear cardiology: The pros and cons of PET/CT using 82- Rb and SPECT using 99m-Tc. The arrival of SPECT in the 1970s and PET in the 1980s dramatically changed the clinical utility of radio-tracer techniques for the assessment of myocardial ischemia and viability. This presentation will compare SPECT using 99m-Tc and PET/CT using 82-Rb to determine which would be a more suitable study to perform in the evaluation of coronary artery disease. While the basic principles of PET are similar to those of SPECT, PET systems are generally more sensitive, have better spatial resolution, and provide the possibility for better attenuation correction. Rb-82 has a short half life of 76 seconds which permits rapid clearance by physical decay from the myocardium reducing radiation exposure and allowing repeated studies to be performed. Nicholas J. Eichner Briarwood College
  18. 18. Case Study of the Utilization of SPECT/CT in Nuclear Medicine Christopher Tagliavini Beth Israel Deaconess Medical Center, Boston, MA School of Nuclear Medicine Technology The introduction of SPECT/CT in nuclear medicine has enabled physicians to more accurately locate areas of increased tracer uptake by overlaying detailed anatomical images from a CT scan with traditional SPECT scans. The purpose of this study is to show how SPECT/CT has been utilized at Beth Israel Deaconess Medical Center in the diagnosis if residual metastatic disease. Methods: 80 total patients had a SPECT/CT scan performed. For this study we will be examining two patients who were first examined using traditional nuclear medicine techniques. A SPECT/CT was then performed to locate and identify metastatic tissue. The initial full body scan was done using an ADAC Forte gamma camera, and the SPECT/CT portion was performed on a Phillips Precedence SPECT/CT machine. Results: In the first case study an I-131 ablation patient with papillary thyroid cancer was given a total body scan. There was questionable metastatic disease in the abdomen and a SPECT/CT was performed to rule out contamination and locate the residual tissue. In the second case study a patient with hyperparathyroidism was given a parathyroid scan which showed no increased uptake in the thyroid bed. The patient then received a SPECT/CT of the chest and neck and a substernal soft tissue lesion in the anterior mediastinum was located. Conclusion: The results of these cases show the benefits of using SPECT/CT as a diagnostic tool in differentiating between contamination and metastatic disease, as well as locating residual tissue. Submitted By: Christopher Tagliavini
  19. 19. NEW ENGLAND CHAPTER TECHNOLOGIST SECTION SOCIETY OF NUCLEAR MEDICINE The 39th Annual Spring Symposium Student Presentations Friday April 18, 2008 Seacrest Resort and Convention Center in North Falmouth, Mass. Oral & Poster Presentation Abstract Form Identify whether this will be a Poster __X__ or an Oral ____ presentation. Cholecystokinin is a peptide which regulates gallbladder contraction. It’s secreted as a natural response after the consumption of a meal, with the main stimulants being the fat and protein. Patients with known or suspected gall bladder disease are sent for HIDA scans to assess the gallbladder ejection fraction. The gallbladder ejection fraction is a quantitative calculation of the contraction of the gallbladder and can be characterized as abnormal with an ejection fraction of less than 35%. Possible gallbladder diseases include biliary dyskinesia, cholecystitis and sphincter of oddi dysfunction. The methods used to stimulate the gallbladder during this exam can be controversial and at times produce a false positive result. Currently, there are several stimuli being utilized for gallbladder stimulation. These options include CCK infusion, morphine infusion, and fatty meal. A standardized protocol nationwide should be implemented so the variability of these exams is eliminated, and patients will be accurately diagnosed. Soucy, Lindsay
  20. 20. Whole Body PET/CT for the Evaluation of Bone Metastases William T. Sticka Jr. Beth Israel Deaconess Medical Center, Boston, MA School of Nuclear Medicine Technology Bone scintigraphy with 99m Tc MDP is currently the gold standard for evaluation of bone metastases in patients with many forms of cancer. MDP serves as a phosphate analog which accumulates at sites of increased bone activity, like lesions or sites of metastasis. For this reason, sites of metastases or bone lesions will show increased uptake of the isotope as well, known as a “hot spot”. The PET radiopharmaceutical 18 F-FDG acts as a glucose analog. Because it will concentrate in regions of increased glucose uptake, it also is useful as a radiopharmaceutical for imaging bone lesions as well as metastatic disease. Methods: During a Technetium shortage in December, 2008, a series of 18 F-FDG bone scans were done at Beth Israel Deaconess Medical Center. Two case studies were chosen from this group to show the effectiveness and relevance of 18 F-FDG bone scans in today’s age of Nuclear Medicine. Results: Case study number one had a history of metastatic breast cancer and also had two 99m Tc MDP bone scans done in the previous year. In addition to confirming several areas of increased uptake that were diagnosed as “stable metastatic foci” from the previous bone scans, several areas of increased uptake became apparent from the PET/CT scan alone. These areas in the spine were diagnosed as degenerative changes and not metastatic disease. Case study number two had a history of Non-Small Cell Lung Cancer with a mass in the middle lobe of the right lung, discovered by a chest CT exam done one month prior. Two PET/CT studies were done on this patient, and one showed many areas of increased 18 F-FDG uptake in the spine as well as other osseous structures and both lungs. However, it was determined that not a single one of the “hot spots” found in the bone were due to metastatic disease, but instead were simply degenerative changes in the patient’s body. Conclusion: In comparison to bone scintigraphy, PET/CT has shown better overall resolution, as well as more sensitivity to bone metastases. In addition, PET/CT has shown to be considerably more sensitive to degenerative changes in the patient’s body. For this reason, false positives for could become a problem if close attention is not paid to the study. Submitted by: William T. Sticka Jr.
  21. 21. NEW ENGLAND CHAPTER TECHNOLOGIST SECTION SOCIETY OF NUCLEAR MEDICINE The 39th Annual Spring Symposium Student Presentations Friday April 18, 2008 Seacrest Resort and Convention Center in North Falmouth, Mass. Oral & Poster Presentation Abstract Form Identify whether this will be a Poster ____ or an Oral __X_ presentation. Full implementation determinants of a new diagnostic method in the health care setting: cardiac PET/CT utilizing rubidium-82 Tanya Tupper1 1 Salem State College, Salem Massachusetts Objectives: The objective of this analysis was to identify factors affecting clinical implementation of a diagnostic method which has begun to receive broad acceptance within the medical research community. Implementation of a cardiac PET/CT program utilizing rubidium-82 served as an illustration of how new technologies gain acceptance in the healthcare setting. Methods: Department managers, technologists, physicians, and industry professionals were interviewed concerning their experiences implementing a cardiac PET/CT program. Student experience in a nuclear cardiology stress lab, visits to various hospitals currently utilizing Rb-82 and review of relevant clinical studies contributed to a greater understanding of the determinants of implementation. Results: Several elements were critical to the utilization of a new diagnostic method in a health care setting: training and education of technologists, economic feasibility, cost effectiveness, software availability, technical support, and logistical factors. Dependence on cyclotron-produced radiopharmaceuticals has hindered full utilization of cardiac PET/CT, but the emergence of a commercially available rubidium-82 generator has facilitated wider adoption of this imaging technology. Conclusions: Incorporating innovative diagnostic methods into clinical practice involves the collaboration of many individuals at various levels within a health care institution. Analysis of the overall process provided valuable insight to the challenges institutions face when incorporating new technology into a clinical setting. Development of a PET myocardial perfusion tracer that is generator-produced played an important role in the increasing acceptance of cardiac PET/CT as a viable diagnostic option. TYPE FULL NAME OF AUTHOR Tupper, Tanya J. Tanya Tupper, Salem State College List the name, address, e-mail and telephone of the author who should receive all correspondence.
  22. 22. NEW ENGLAND CHAPTER TECHNOLOGIST SECTION SOCIETY OF NUCLEAR MEDICINE The 39th Annual Spring Symposium Student Presentations Friday April 18, 2008 Seacrest Resort and Convention Center in North Falmouth, Mass. Oral & Poster Presentation Abstract Form Identify whether this will be a Poster ____ or an Oral _X_ presentation. Imaging inflammation for the detection of vulnerable plaque in atherosclerotic arteries using flourine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT). D.H. Menard. Gateway Community College, North Haven, CT. Objectives: The purpose of this study is to review published research to determine the progress made in radionuclide imaging of arteries to identify vulnerable plaques at high risk for rupturing, a clinically silent cause of acute cardiovascular events. Methods: Past imaging methods for atherosclerosis have focused mostly on anatomic obstruction to blood flow. Recent studies suggest that plaque rupture is independent from degree of stenosis. There’s a need for imaging that provides physiological information about plaque composition. Increased vascular uptake of F-18 FDG is representative of glucose metabolic activity of macrophage–rich plaques in active atheromatous lesions. The aorta, carotid, and coronary arteries have also been examined for stenosis via CT calcification scoring to determine the clinical effectiveness of identifying risk for atheroma. Results: The coronary arteries continue to provide a challenge for quantifiable imaging due to their small luminal cross-section, cardiac/respiratory motion, and background tracer uptake of myocardium of which they lie adjacent to. Plaque in larger arteries can be imaged and quantified with better results. Progress is being made through research and clinical use is still a hope for the future. Conclusions: A reliable protocol for imaging vulnerable plaque can play a vital role in early detection and preventative treatment. F-18 FDG PET/CT imaging can play a central role in localizing and assessing the severity of cardiovascular risk. A reliable non-invasive procedure can serve as an alternative to prevent unnecessary invasive procedures like angiography. It can also serve in the clinical management of high risk atherosclerosis by monitoring the therapeutic effect of atheroprotective medications that target vascular inflammation for stabilization of vulnerable plaque to prevent rupture, and therefore reduce the overall occurrence of acute myocardial infarction and stroke. This promises to be a valuable tool in the evolving trend of preventative medicine. TYPE FULL NAME OF AUTHOR David H. Menard III Name _______________________________________________________ Institution ___________________________________________________ Address _____________________________________________________ City __________________________ State _________ Zip Code ________ E-Mail ______________________________________________________ Phone ______________________________________________________ David H. Menard III Gateway Community College – North Haven Campus List the name, address, e-mail and telephone of the author who should receive all correspondence.
  23. 23. NEW ENGLAND CHAPTER TECHNOLOGIST SECTION SOCIETY OF NUCLEAR MEDICINE The 39th Annual Spring Symposium Student Presentations Friday April 18, 2008 Seacrest Resort and Convention Center in North Falmouth, Mass. Oral & Poster Presentation Abstract Form Identify whether this will be a Poster ____ or an Oral _X_ presentation. Animal imaging and its contribution to the research and development of nuclear medicine. F. Davis. Gateway Community College, North Haven, CT. Objective: Since the dawn of the Renaissance, mankind has greatly benefited from the extraordinary advances in medicine to which animals have played a vital role in the discovery and treatment of diseases. Diagnostic imaging is no exception and this paper will explore the role of animal imaging in the research and development of nuclear medicine. Methods: Animal imaging allows for the in vivo characterization and measurement of biological processes at the cellular and molecular level within living organisms. Imaging techniques such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) offer favorable sensitivity and resolution for in vivo tomographic imaging. However, these techniques are limited and do not provide optimal anatomical information. To counter these limitations hybrid systems such as PET/CT and SPECT/CT have been introduced. Results: Nuclear medicine researchers use molecular imaging to study animal models of human disease, assess new drug delivery and gene therapy approaches, and develop new radiotracers for use in diagnostic imaging. One of the key benefits of animal imaging in nuclear medicine has to do particularly with the ability to image at the molecular, cellular, organ and whole body level. Conclusion: It is expected that nuclear animal imaging will continue to play a key role alongside other imaging modalities in understanding the origin and progression of diseases, and in the evaluation and development of therapeutic methods. TYPE FULL NAME OF AUTHOR Floyd M. Davis Name _______________________________________________________ Institution ___________________________________________________ Address _____________________________________________________ City __________________________ State _________ Zip Code ________ E-Mail ______________________________________________________ Phone ______________________________________________________ Floyd Davis Gateway Community College List the name, address, e-mail and telephone of the author who should receive all correspondence.
  24. 24. NEW ENGLAND CHAPTER TECHNOLOGIST SECTION SOCIETY OF NUCLEAR MEDICINE The 39th Annual Spring Symposium Student Presentations Friday April 18, 2008 Seacrest Resort and Convention Center in North Falmouth, Mass. Oral & Poster Presentation Abstract Form Identify whether this will be a Poster __√__ or an Oral ____ presentation Assessment of a standardized, reliable, cost-effective, and practical low fat solid meal for gastric emptying scintigraphy. Ouellette, Patrick R. Briarwood College, Southington, CT. The purpose of this study was to provide evidence of reliable and reproducible results, cost-effectiveness, patient and staff friendliness, and improvement in isotope binding of adoption of a standardized low fat solid meal for gastric emptying. Radionuclide studies of gastric emptying and motility are the most physiologic studies available for evaluating gastric motor function. However, different institutions utilize different test meals with different compositions and methods of preparation. The lack of universal standardization makes it difficult if not impossible to compare studies performed at different institutions and result in the lack of standard normal gastric emptying. Also, the diversity of higher fat meals can be more expensive, time- consuming, and less accepted by patients, physicians and technical staff. Recent studies have found that a low fat solid meal using egg whites provides a better 99mTc-SC bind despite cooking methods compared to a higher fat whole egg solid meal. Previous studies have also shown that low fat solid meals using egg whites provide nearly identical results as high fat meals that are acceptable according to published SNM guidelines and provide improved patient tolerance, compliance, and comfort. Further, the use of a low fat meal for gastric emptying is shown to be more cost-effective and accepted among staff and physicians. The standardization of a low fat solid meal for gastric emptying can provide more comparable results among institutions by establishing a normal standard gastric emptying that improves patient, staff, and physician satisfaction, as well as advancements in prokinetic development.
  25. 25. A case study of intra-patient 18-F-FDG PET scans with and without the pre-treatment of a high fat, high protein and no carbohydrate diet. Lauren D. Bennett Beth Israel Deaconess Medical Center, Boston, MA School of Nuclear Medicine Technology Positron Emission Tomography (PET) imaging has gained great popularity in the treatment of cancer patients, especially in lymphoma and lung cancer patients. While every institution has a protocol to decrease brown fat and myocardial uptake, fasting 4-12 hours prior to scanning is a common protocol. At Beth Israel Deaconess Medical Center, the patients are currently instructed to eat a high fat, high protein and no carbohydrate meal the night before a scan. Patients are also instructed to drink ClearScan, a drink composed mainly of fatty acid, the morning of the PET scan. The latter combination is used to decrease myocardial uptake, which ultimately increases mediastinal and hiliar adenopathy readings. Methods: Several journal articles were reviewed pertaining to PET and variable myocardial uptake. In addition to this, a case study was reviewed of a patient who received several PET scans during treatment for mantle cell lymphoma. Results: The patient received a total of 12 PET scans at Beth Israel Deaconess Medical Center for management and response to chemotherapy. The patient began treatment, and subsequently scanning, prior to the high fat, high protein and no carbohydrate diet and ClearScan protocol. Before the scan, the patient was instructed to fast, which resulted in an SUV maximum of 8.14 in the left ventricle myocardium. In contrast to this, several scans were performed under a high fat, high protein and no carbohydrate and ClearScan protocol. The SUV maximum in the myocardium was 6.07. Although the two maximum SUV values differ in anatomical location, there was markedly diffuse uptake in the fasting state scan as compared to the modified fatty acid diet. Conclusion: As a case study, there was decreased myocardial uptake in the ClearScan and modified diet PET images as compared with the fasting state images. Ultimately, high fat, high protein diets in conjunction with ClearScan could be used to decrease myocardial uptake in routine clinical practice. Submitted by: Lauren D. Bennett
  26. 26. A Comparison of Ejection Fraction Values in Exercise versus Dipyridamole Myocardial Perfusion Stress Imaging Katelynn Laffin Beth Israel Deaconess Medical Center, Boston, MA School of Nuclear Medicine Research has showed that pharmacologic agents can be inefficient at inducing the necessary cardiac response to produce prognostic data in nuclear myocardial perfusion imaging. This study was done in an attempt to find any suggestion that pharmacologic agents are also inefficient at inducing an adequate cardiac response to produce reliable ejection fraction values compared to exercise-induced ejection fraction values. Methods: Fifty randomly selected patients who participated in a dipyridamole nuclear stress test from January 1, 2008 through March 24, 2008 at Beth Israel Deaconess Medical Center were compared to fifty randomized patients who participated in an exercise stress test from the same time period. In the dipyridamole group, the age range was 40-69 years of age, and the exercise group was 45-69 years of age. The average age for the dipyridamole group was 56.8 years of age, and the exercise group was 58.4 years of age. All patients studied were male. Results: Within the dipyridamole group, the average left ventricular ejection fraction value was 52.2%, with a minimum value of 28% and a maximum value of 89%. Within the exercise group, the average left ventricular ejection fraction value was 55.3%, with a minimum value of 29% and a maximum value of 76%. Conclusion: With control measures such as gender, age (the average age being controlled in both groups by +/- 1.6 years), and time period of patient studies, a difference of 3.1% in average ejection fraction values is an indication that pharmacologic agents produce comparable ejection fraction results to their exercise-induced counterparts. Submitted by: Katelynn Laffin
  27. 27. Title: Brain Imaging Technologies: Cracking the code on addictions Author: Jolene Leger Objectives: 1. Discuss the different methods in brain imaging used 2. Identify the brain regions targeted for each addiction 3. Gain an understanding through Positron emission tomography, the brains natural feedback to different examples of stimulus response Summary: Brain imaging techniques have become more useful in researching chemical addictions and abuse. Positron emission tomography (PET) imaging has opened doors to a new understanding on how the brain behaves in response to various stimuli such as drug, alcohol and food addictions. PET imaging uses fluorodeoxyglucose (FDG), when imaging the brain. FDG is a modified glucose molecule that is attached artificially to a radioactive isotope, fluorine. Since glucose is a type of sugar and primary energy source for the brain, it will localize to the brain. PET imaging can show blood flow, oxygen and glucose metabolism, as well as drug concentrations in the brain. When certain areas of the brain uses more energy or are more active, then more glucose is going to be metabolized in that area. During brain imaging, an increase of the radioactive isotope will be observed in the areas of increased activity or increased metabolism. Different chemicals have different ways of acting in the brain to produce their effects. Each substance binds to different receptor types and increases or decreases the activity in that area depending on the substance or receptor affected. By measuring changes in energy metabolism, PET can help identify brain regions that correlate to different addictions and how each one affects each individual region in the brain. PET imaging can also be used to show different changes in the brain after long spans of drug abuse, during drug withdrawals as well as determining the effectiveness of pharmacological therapies being used today. The goal of this presentation is to describe the different brain imaging technologies predominately using PET imaging, and how they detail the brain’s natural feedback and response to different examples of human addictions.
  28. 28. ABSTRACT TITLE: Tl-201 vs. Tc-99m and Sestamibi vs. Tetrofosmin in myocardial perfusion studies. A survey of Central Massachusetts physicians and technologists to determine preferences. AUTHORS/AFFILIATIONS: Author: J. Colonna ABSTRACT BODY: Objectives: A curiosity about the differences between Thallium-201 and Technetium- 99m cardiac imaging agents led to a comparison between the two. In the following pages, each isotope will be discussed pertaining to their reactions within the body, what the physical characteristics of each are, as well as their energies and decay properties. The Tc-99m agents, Sestamibi and Tetrofosmin will also be compared against each other, and what cost to the institution will be by using any of the aforementioned isotopes/radiopharmaceuticals. Methods: A survey was conducted with Nuclear Medicine Technologists and Physicians, in the Central Massachusetts area, to determine whether they preferred Tl-201 or Tc-99m, Sestamibi or Tetrofosmin, and the reasons why. Results: A survey of Nuclear Medicine Technologists and Physicians in the Central Massachusetts area was conducted and the results are as follows: Out of all of the technologists and physicians surveyed, the result was surprising; 45% preferred Tl- 201 and 55% preferred Tc-99m. Surveying technologists only, 40% preferred Tl-201 and 60% preferred Tc-99m. This survey had one response from the physicians; this individual’s preference was Tl-201. The second portion of the survey was to determine which pharmaceutical was preferred; Sestamibi (Cardiolite) or Tetrofosmin (Myoview). The results of the surveyed technologists were similar to the results of preference of Tl- 201 or Tc-99m: 40% preferred Sestamibi and 60% preferred Myoview. The physician surveyed prefers Myoview “due to it having faster hepatic clearance and the cost is less than Sestamibi”. Conclusions: Tl-201 has been called the “Gold Standard” for some time. This is due to the superior ability to detect perfusion abnormalities, low cost, ease of use, and less chance of false positives due to gut uptake. Tc-99m has superior imaging characteristics, shorter half life, allows more flexibility in scanning timing, and is stated to be better for gating. But although both Tl-201 and Tc-99m agents are useful in myocardial perfusion imaging, the preference to use one or the other is not solely determined by image quality. Other factors play a role in which isotope/radiopharmaceutical a facility chooses. The timing of patient flow (scheduling), cost, ability to store for decaying purposes, and contracts are also factors which contribute to determine whether Tl-201 or Tc-99m agents will be used. Some of the facilities surveyed preferred one isotope, but then used the other due to the previously mentioned factors. The preference narrows down to a personal choice by the physicians and/or technologists, of whether Tl-201 or Tc-99m would fit better in running the daily business at their particular facility.
  29. 29. Title Strontium 89 versus Samarium 153 for Bone Therapies Authors/ Affiliations Author: Michael Zalaski Affiliation: Briarwood College Nuclear Medicine Technology Program Learning Objectives 1. Discuss the characteristics of Samarium 153 and Strontium 89 2. Describe how each one works and their effects 3. Draw a conclusion to which treatment is more effective Abstract: Many new students do not get a good amount of experience with the treatment aspect of nuclear medicine, especially bone treatment, so they are not as knowledgeable about it as other areas. However, this presentation will describe in depth, the radiopharmaceuticals, the effects, the benefits, and the side effects. Samarium 153 and Strontium 89 do similar things but are very different in many ways. There are pros and cons to each. After you weigh these pros and cons Samarium 153 is the better drug of choice.
  30. 30. ANIMAL IMAGING AND ITS CONTRIBUTION TO THE RESEARCH AND DEVELOPMENT OF NUCLEAR MEDICINE Floyd Davis Gateway Community College
  31. 31. 2 Abstract This paper will explore the role of animal imaging in the research and development of nuclear medicine. Methods: Animal imaging allows for the in vivo characterization and measurement of biological processes at the cellular and molecular level within living organisms. The imaging techniques used include hybrid systems such as PET/CT, PET/MRI and SPECT/CT. Results: Nuclear medicine researchers use molecular imaging to study animal models of human disease, assess new drug delivery and gene therapy approaches, and develop new radiotracers for use in diagnostic imaging. One of the key benefits of animal imaging in nuclear medicine has to do particularly with the ability to image at the molecular, cellular, organ and whole body level. Conclusion: Nuclear animal imaging will continue to play a key role alongside other imaging modalities particularly due to its ability to image at the molecular level in understanding the origin and progression of diseases, and in the evaluation and development of therapeutic methods.
  32. 32. 3 Introduction Since the dawn of the Renaissance, mankind has greatly benefited from the extraordinary advances in medicine to which animals have played a vital role in the discovery and treatment of diseases. Diagnostic imaging and particularly nuclear imaging is no exception and this paper will explore the role of animal imaging in the research and development of nuclear medicine. In addition to providing biomedical, genetic and pharmacological information, nuclear animal imaging has also provided treatment and relief for countless animals such as canine, feline and equine. This is a perfect example of “give and take” in research. These research methods used, benefit both humans and animals. Materials and Methods Generally speaking, animal imaging involves using specialized equipment designed for imaging animals with a view to gathering useful information with regards to both natural and disease biological processes (1). The animals used in the research process are usually rodents (2). Rabbits, dogs and monkeys are also used. Among the various functional imaging modalities used in both pre-clinical research and human clinical trials, the nuclear imaging modalities single photon emission computed tomography (SPECT) and positron emission tomography (PET) are the most advanced and widely used (3). The equipment used to image small animals is similar in concept to those used to image humans. However, these cameras are modified to meet the challenges of imaging small animals. Manufacturers such as Gamma Medica-Ideas (Northridge, California) have been responsible for retailing dual head SPECT- computed tomography (CT) and multimodality
  33. 33. 4 including PET/SPECT/CT cameras for small animal imaging. The SPECT-CT cameras use a pinhole collimator to magnify the images of the small animals. How is the research conducted? Well, researchers investigating whether fluorine-18 fluorodeoxyglucose (18 F-FDG) PET/CT can be used for in vivo chemosensitivity used 48 male New Zealand rabbits that were 3 to 4 months old. The VX2 tumor model which is a Shope papillomavirus associated the VX2 carcinoma was surgically removed from 6 donor rabbits and implanted into 42 rabbits. The tumor was allowed to grow to approximately 10-20 mm before being imaged. The 42 rabbits with the VX2 tumor were divided into two groups. Ten rabbits served as untreated controls and 32 received chemotherapy with cisplatin a chemotherapy drug used to treat various types of cancer. The treated and untreated rabbits were imaged with 37 MBq/kg of 18 F-FDG on a Discovery LS PET/CT system from GE Healthcare Bio-Science Corporation (Piscataway, New Jersey). The researchers of this experiment concluded that the results suggested that 18 F-FDG may be able to discriminate sensitive from insensitive tumors if the imaging is performed immediately after a test dose of chemotherapy (4). Animal imaging continues to be useful in understanding the process of angiogenesis and biological processes via the use of reporter genes and the effects of radiation on the human body. Cancer researchers have been able to follow the development of cancerous growth, estimate how quickly cancer becomes aggressive and invasive and assess treatment that would slow or stop the transition to an invasive tumor. In the pharmaceutical industry animal imaging is used to study new drugs and their effects on the human body and speed up drug development and delivery to save time and promote efficiency in clinical trials (1). Drug companies have at any one time a number of potential drug compounds in development and this underscores the need to be very efficient. To get a drug from trial to the
  34. 34. 5 market takes time and money (2). In the pharmaceutical industry it now takes almost $1 billion to bring a new drug to market (3). The time can be shortened and the cost decreased if researchers can determine early in the clinical trial whether or not the drug will be effective. For example, if researchers are looking for a drug to treat a brain condition, then it would be important for them to know if the drug will cross the blood-brain-barrier. If it can’t then there would be no need to continue trials on this drug (2). Cancer is the second leading cause of death in the United States and it is expected to become the leading cause within the next decade (5). Armed with this fact researchers have continued to search for new drugs and treatment. At the University of California researchers used mice to study cancers comparable to human disease. They have developed a system that can distinguish different stages of cancer that could lead to more sensitive screening tests for cancer-fighting drugs (6). Scientists at Jefferson Lab and the College of William & Mary found that giving mice a high dose of potassium iodide in the event of a nuclear accident limited the amount of radioactive iodine absorbed by the thyroid (7). Researchers at Yale University have used nuclear animal imaging to study the formation of new capillaries and follow how the heart responds to therapeutic angiogenesis following an ischemic injury (8). Research is very important to our longevity but it comes with a price. Thousands of animals are sacrificed in this process and millions of dollars are spent to provide the type of information that will enable us to live longer. Government agencies and educational organizations with big budgets are often the ones who fund research projects. They cost from a few hundred of thousands to millions of dollars (3). The National Institutes of Health awarded a
  35. 35. 6 $1.3 million grant to the Research Institute at University Hospitals of Cleveland to buy a magnetic resonance imaging (MRI) machine that allows researchers to track exactly where drugs go in mice and in turn how they attack disease (9). Animal imaging in nuclear medicine is not only extended to research and development but also to diagnostic imaging of the animal themselves. Animals such as dog, cats and horses receive therapeutic and diagnostic treatment from nuclear medicine. They undergo a variety of studies such as lung, bone, cardiac, thyroid, renal and liver scans and radioiodine therapy. The following case studies give us an idea of the process of diagnostic imaging of small and large animals. A 2 year old male Labrador Retriever underwent planar renal scintigraphy using 99-m technetium diethylenetriaminepentaacetic acid ( 99m TC DTPA). The right kidney appeared normal but composite images demonstrated a thin rim of functional renal tissue at the periphery of the enlarged left kidney suggesting hydronephrosis (10). A 14 year old male feline underwent successful radioiodine therapy using iodine 131 (I-131) for hyperthyroidism. The feline received a dose of 99-m technetium pertechnetate ( 99m TcO4 - ) that showed a thyroid adenoma. An aggressive treatment showed no sign of thyroid adenoma present after 5 months (11). A 9 year old male Schipperke was imaged with 99-m technetium methylene diphosonate ( 99m Tc MDP). Some of the abnormalities identified included a focal area of uptake in the distal left femoral metaphysis that was consistent with metastatic osteosarcoma; increased radionuclide uptake in the caudal left maxilla, in the area of the left upper premolar suggested dental disease and diffusely increased radionuclide uptake in the left elbow joint was most consistent with osteoarthritis (12).
  36. 36. 7 Large animals are also treated for a variety of conditions. Consider the case of a 10 year old thoroughbred horse with a swelling of the left rear fetlock for 4 weeks. Bone scan images indicated infection of the soft tissues and osteomyelitis of the proximal sesamoid bones. A bone scan was performed on a 5 year old quarter horse with front leg lameness. The scan showed abnormality of the navicular bone. These studies show that the disease and conditions that affect humans affect animals (13). Discussion and Results We have come to expect a great deal from conventional medicine sometimes even miracles. We do this because of the commitment of researchers to understanding the human body and finding new ways to treat diseases. It is no wonder that nuclear medicine’s ability to image at the molecular level has made it a key player in research and development in medicine. In nuclear animal imaging the benefits far exceeds the cost when you consider the billions of dollars spent, hundreds of animals sacrificed and thousands of man hours accumulated in research. Against this background, it is believed that nuclear medicine will continue to play vital role alongside other imaging modalities in understanding the origin and progression of diseases. This means that humans and animals will benefit from the availability of new drug and therapy treatments and lower cost of drug delivery methods. The future looks promising.
  37. 37. 8 Acknowledgements Professor Kathleen Murphy provided direction in gathering useful information. Doctors L. Dobrucki and A. Sinusas explained and provided documentation regarding nuclear animal imaging.
  38. 38. 9 References 1. Dobrucki L, Sinusas A. Molecular cardiovascular imaging. Current Cardiology Reports. 2005; 7:130–135. 2. Ward J. (January 17, 2005). From Mice to Man. Retrieved February 19, 2008 from http://imaging-radiology-oncology- technologist.advanceweb.com/editorial/content/editorial.aspx?cc=72390 3. Buchanan L, Jurek P, Redshaw R. (April 15, 2007). PET and SPECT Help Enhance the Quality of a Product and Prevent Late-stage Failure. Retrieved February 26, 2008 from http://www.ngpharma.com/pastissue/article.asp?art=271761&issue=225 4. Shao-Li Song, Jian-Jun Liu et-al. Changes in 18 F-FDG uptake within minutes after chemotherapy in a rabbit VX2 tumor model. J Nucl Med. 2008; 49:303-309. 5. Stewart S, King J, et-al. (June 4, 2004). Cancer Mortality Surveillance United State 1990 to 2000. Retrieved April 13, 2008 from http://www.cdc.gov/MMWR/preview/mmwrhtml/ss5303a1.htm 6. Abbey C, Borowsky A, Cherry S, Fell A, (August 9, 2004). Small Animal Imaging Gives Cancer Clues. Retrieved April 13, 2008 from http://www.news.ucdavis.edu/search/news_detail.lasso?id=7099 7. Carter K. (April 20, 2005). Nuclear imaging of iodine uptake in mouse tissues. Retrieved April 13, 2008 from http://news.bio-medicine.org/biology-news-3/Nuclear- imaging-of-iodine-uptake-in-mouse-tissues-12105-1/ 8. Dobrucki L, Sinusas A. Imaging angiogenesis. Current Opinion in Biotechnology. 2000; 18:90–96. 9. Robinson R. (October 21, 2002). Grant to help UH buy MRI; Small animal imaging equipment called crucial for biomed research. Retrieved February 26, 2008 from http://find.galegroup.com/itx/infomark.do?&contentSet=IAC- Document&type=retrieve&tabID=T003&prodId=ITOF&dicId=A93418981&source= gale&srcprod=ITOF&userG 10. Advanced Veterinary Medical Imaging, Planar Renal Scintigraphy. Retrieved (February 26, 2008) from http://www.avmi.net/NewFiles/Scintigraphy/Scintigraphy1.html 11. Advanced Veterinary Medical Imaging, Planar Thyroid Scintigraphy. Retrieved (February 26, 2008) from http://www.avmi.net/NewFiles/Scintigraphy/Scintigraphy1.html 12. Advanced Veterinary Medical Imaging, Planar Bone Scintigraphy. Retrieved (February 26, 2008) from http://www.avmi.net/NewFiles/Scintigraphy/Scintigraphy1.html
  39. 39. 10 13. The University of Tennessee College of Veterinary Medicine, Equine Bone Scan. Retrieved April 13, 2008 from http://www.vet.utk.edu/radiology/lacs/scans.shtml

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