Official Course
Description: MCCCD Approval: 12-13-05 |
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ICE277
2006 Spring – 2009 Summer
II |
LEC |
1.50 Credit(s) |
1.50 Period(s) |
Nuclear
Medicine Cardiac Imaging I |
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Cardiovascular
anatomy, physiology and pathology as it relates to cardiac system imaging.
Cardiac stress and rest testing, myocardial perfusion and viability,
equilibrium radionuclide angiograph (ERNA or MUGA or RVG). First pass
angiography, infarct imaging, major vessels flow studies and detection of
deep vein thrombosis. Prerequisites: Admission to Nuclear Medicine Technology
program or certified nuclear medicine technologist or permission of Nuclear
Medicine Technology program director. |
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Cross-References:
DMI277 |
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Go to Competencies Go to Outline
MCCCD
Official Course Competencies: |
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ICE277 2006
Spring – 2009 Summer II |
Nuclear Medicine Cardiac Imaging I |
1.
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Describe the gross anatomy and physiology of the
cardiovascular system as it relates to nuclear medicine including heart
chambers, heart valves, great vessels, cardiac circulation,
electrophysiology, and pathology. (I) |
2.
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Describe characteristics and causes of common cardiac
pathologies as they relate to nuclear medicine studies. (II) |
3.
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Discuss the relationship between abnormal cardiac output
and respiratory function. (II) |
4.
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State whether a cardiac cycle is normal or abnormal given
an electrocardiogram (ECG) tracing obtained with a 3-lead ECG technique.
(III) |
5.
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List the indications, contraindications, and possible
adverse reactions associated with exercise stress testing, myocardial
perfusion/viability imaging, equilibrium radionuclide angiograph (ERNA)
imaging, first pass angiography imaging, infarct imaging, major vessel flow
studies and deep vein thrombosis (DVT) detection studies. (III-VIII) |
6.
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Discuss the patient preparation necessary for exercise
stress testing, myocardial perfusion/viability imaging, ERNA imaging, first
pass angiography imaging and infarct imaging. (III-VIII) |
7.
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Discuss the equipment and basic procedures and processing utilized
in exercise stress testing, myocardial perfusion/viability imaging, ERNA,
first pass angiography, infarct imaging, major vessel flow studies and DVT
detection studies. (III-VIII) |
8.
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Compare and contrast the various exercise stress testing protocols
including the advantages and disadvantages of each. (III) |
9.
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Discuss the skin preparation and electrode placement for a
12 lead electrocardiogram (ECG). (III) |
10.
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Discuss each of the pharmacological interventions used in
cardiac stress testing methods including mechanisms of action, indications,
contraindications, adverse effects, administration protocols, patient
preparation, antidotes, and the operation of an infusion pump. (III) |
11.
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Discuss the action of low level exercise to a
pharmacologic intervention study including indications, contraindications,
adverse effects, positive effects, administration protocols, types of
low-level exercise and patient preparation. (III) |
12.
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Identify normal and abnormal ECG's including arrythmias on a 3-lead ECG tracing. (III) |
13.
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Compare and contrast the dose and route of administration,
biorouting, and dosimetry
of each radiopharmaceutical used for myocardial perfusion/viability imaging,
ERNA imaging, first pass angiography imaging, infarct imaging, major vessel
flow studies and DVT detection studies. (IV-VIII) |
14.
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Discuss normal variants, abnormal finding, artifacts, and
the diagnostic and prognostic value of cardiovascular studies including
myocardial perfusion/viability imaging, ERNA imaging, first pass angiography
imaging, infarct imaging, major vessel flow studies and DVT detection
studies. (IV- VIII) |
15.
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Identify normal scans and/or procedure results including
myocardial perfusion/viability scan, ERNA scan, first pass angiography
procedure, infarct scan, major vessel flow study, and DVTscan.
(IV-VIII) |
16.
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Describe the interventions and additional procedures that
may be added to the basic ERNA study. (V) |
Go to Description Go to top of
Competencies
MCCCD
Official Course Outline: |
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ICE277 2006
Spring – 2009 Summer II |
Nuclear Medicine Cardiac Imaging I |
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I. Review of Cardiac
Anatomy and Physiology A. Heart chambers B. Cardiac
electrophysiology 1. Conduction pathways 2. Normal electrocardiogram
C. Coronary artery
distribution D. Heart valves and great
vessels E. Physiologic responses to
stress II. Cardiac Pathologies -
Characteristics/Causes/Population/Treatment A. Heart and great vessels 1. Coronary artery disease a. ischemia b. infarction c. hibernating or stunned
myocardium d. zones of ischemia,
injury, and infarction e. coronary artery spasm 2. Congenital abnormalities
a. transposition of the
great vessels b. dextracardia
c. septal
defects 3. Valve disease a. mitral valve prolapse/stenosis/regurgitation
b. tricuspid stenosis/regurgitation 4. Infectious disease 5. Pericardial effusion 6. Cardiomyopathy
7. Chemotherapeutic
toxicity 8. Congestive heart failure
9. Arrhythmias 10. Transplant rejection 11. Thyroid related hear disease 12. Cardiac 13. Coarctation
of aorta B. Systemic vasculature 1. Arteriosclerosis 2. Aneurysms 3. Phlebitis 4. Deep vein thrombosis 5. Hypertension III. Cardiac Stress Testing
A. Indications B. Contraindications and
adverse reactions 1. Physical or pathologic
conditions 2. Interfering drugs 3. Precautions 4. Adverse reactions C. Patient preparation
(including consent if applicable) D. Equipment 1. Treadmill 2. Supine cycle 3. Upright cycle 4. Hand ergometer
5. ECG monitor 6. Blood pressure monitor E. Basic procedure 1. Protocols 2. ECG a. skin preparation b. electrode placement 3. Endpoints F. Interventions and
procedures 1. Pharmacologic
intervention a. pharmaceuticals and
mechanisms of action (1). dipyridamole
(2). adenosine (3). dobutamine
(4). arbutamine
b.
indications/contraindications and adverse effects c. antidotes for the
reversal of the adverse effects d. administration protocols
e. patient preparation f. infusion pump 2. Pharmacologic
intervention with low-level physical exercise a.
indications/contraindications and adverse effects b. positive effects of
introducing low-level physical exercise c. administration protocols
d. patient preparation G. Interpretation 1. Normal rhythm 2. Arrythmias
3. Other ECG abnormalities IV. Myocardial
perfusion/Viability Imaging A. Indications B. Radiopharmaceuticals 1. Tracers a. thallium-201 (T1-201) b. technetium-99m sestamibi c. technetium-99m tetrofosmin d. dual nuclide: T1-201 and
a Tc-99m agent 2. Dose range and route of
administration 3. Biorouting
a. uptake b. distribution c. excretion 4. Dosimetry
C. Contraindications and
adverse reactions 1. Physical and pathologic
conditions 2. Interfering studies 3. Interfering drugs 4. Precautions 5. Adverse reactions D. Patient preparation E. Equipment 1. Camera 2. Collimators 3. Computer 4. Cardiac monitor for
gating, if applicable 5. Arm boards, Velcro
straps, etc. F. Basis procedure and
processing 1. Protocols 2. Dose range and
administration technique 3. Acquisition parameters 4. Positioning and views,
including adaptations 5. Data processing a. normalization b. circumferential profiles
c. polar maps d. cines of gated studies
(wall motion/wall thickening) e. ejection fraction
calculation f. attenuation and motion
correction software g. filtering and
reconstruction techniques h. 3-D displays i.
heart-lung ratio 6. Dosimetry
7. Pitfalls G. Interpretation of images
and data 1. Normal 2. Normal variants 3. Abnormal 4. Artifacts 5. Diagnostic/Prognostic
Value of the Study a. outcomes b. treatment decisions c. prognostic risk factors
based on diagnosis V. Equilibrium Radionuclide
Angiography (ERNA or MUGA or RVG) A. Indications B. Radiopharmaceuticals 1. Tc-99m tagged red blood
cell (RBC) 2. Physical and chemical
characteristics 3. Kit and
radiopharmaceutical preparation a. in vivo b. in vitro c. modified in vivo/in
vitro 4. Dose range and
administration 5. Biorouting
a. uptake b. distribution c. excretion 6. Dosimetry
C. Contraindications and
adverse reactions 1. Physical or pathologic
conditions 2. Interfering studies 3. Interfering drugs 4. Precautions 5. Adverse reactions D. Patient preparation E. Equipment 1. Camera 2. Collimators 3. Computer 4. Cardiac monitor for
gating 5. Supine bicycle for
exercise if applicable 6. Infusion pump if
applicable F. Basic procedure and
processing 1. Protocols 2. Dose range and
administration technique 3. Acquisition parameters 4. Positioning and views,
including adaptations 5. Data processing a. ejection fraction
calculations b. cine display c. other measurements 6. Image formatting 7. Pitfalls G. Interpretation of images
and data 1. Supine bicycle exercise 2. Dobutamine
H. Interpretation of images
and data 1. Normal 2. Normal variants 3. Abnormal 4. Artifacts 5. Diagnostic/Prognostic
Value of the Study a. outcomes b. treatment decisions c. prognostic risk factors
based on diagnosis VI. First Pass Angiography A. Indications B. Radiopharmaceuticals 1. Tracers a. Tc-99m DTPA (pentetate) b. Tc-99m pertechnetate c. any Tc-99m labeled
radiopharmaceutical of at least 15 mCi 2. Dose range and route of
administration 3. Biorouting
a. uptake b. distribution c. excretion 4. Dosimetry
C. Contraindications and
adverse reactions 1. Physical or pathologic
conditions 2. Interfering studies 3. Interfering drugs 4. Precautions 5. Adverse reactions D. Patient preparation E. Equipment 1. Cameras a. multicrystal
b. single crystal 2. Collimators 3. Computer 4. Upright bicycle or
treadmill if applicable F. Basic procedure and
processing 1. Protocols 2. Dose range and
administration technique 3. Acquisition parameters 4. Positioning and views,
including adaptations 5. Data processing a. ejection fraction calculations
b. functional images c. cine display d. left-to-right shunt quantitation e. other measurements 6. Image formatting 7. Pitfalls G. Interpretation of images
and data 1. Normal 2. Normal variant 3. Abnormal 4. Artifacts 5. Diagnostic/Prognostic
Value of the Study a. outcomes b. treatment decisions c. prognostic risk factors
based on diagnosis VII. Infarct Imaging A. Indications B. Radiopharmaceuticals 1. Tracers a. Tc-99m pyrophosphate b. In-111 antimyosin 2. Dose range and route of
administration 3. Biorouting
a. uptake b. distribution c. excretion 4. Dosimetry
C. Contraindications 1. Physical conditions 2. Interfering studies 3. Precautions 4. Adverse reactions D. Patient preparation E. Equipment 1. Camera 2. Collimator 3. Computer F. Basic procedure and
processing 1. Protocols 2. Dose range and
administration technique 3. Acquisition parameters 4. Positioning and views,
including adaptations 5. Data processing 6. Image formatting 7. Pitfalls G. Interpretation of images
1. Normal 2. Normal variants 3. Abnormal 4. Artifacts 5. Diagnostic/Prognostic
Value of the Study a. outcomes b. treatment decisions c. prognostic risk factors
based on diagnosis VIII. Deep Vein Thrombosis
Detection A. Indications B. Radiopharmaceuticals 1. Tracers a. Tc-99m MAA (macroaggregated albumin) b. Tc-99m apcitide 2. Dose range and route of
administration 3. Biorouting
a. uptake b. distribution c. excretion 4. Dosimetry
C. Contraindications and
adverse reactions 1. Physical conditions 2. Interfering studies 3. Precautions 4. Adverse reactions D. Patient preparation E. Equipment 1. Camera 2. Collimators 3. Computer F. Basic procedure and
processing 1. Protocols 2. Dose range and
administration technique 3. Acquisition parameters 4. Positioning and views,
including adaptations 5. Image formatting 6. Pitfalls G. Interpretation of images
1. Normal 2. Normal variants 3. Abnormal 4. Artifacts 5. Diagnostic/Prognostic
Value of the Study a. outcomes b. treatment decisions c. prognostic risk factors
based on diagnosis |
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