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Official Course
Description: MCCCD Approval: 12-11-2012 |
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NUC170 2013
Spring - 9999 |
LEC 3.0 Credit(s) 3.0 Period(s) 3.0 Load Occ |
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Nuclear Medicine Cardiac Imaging |
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Review of cardiovascular anatomy, physiology and pathology as it relates to cardiac imaging including cardiac blood flow, electrophysiology, and function. Cardiac indications, contraindications, and radiopharmaceuticals used for cardiac imaging. Preparation for pharmacologic and non pharmacologic stress testing methods used in conjunction with imaging. Patient care during stress tests and imaging and the interventional drugs used for emergency care. Cardiac imaging instrumentation, acquisition and processing procedures, artifacts, and interpretation of data and images. Cardiac imaging procedures. Prerequisites: Admission to Nuclear Medicine Technology program. |
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Go to Competencies Go to Outline
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MCCCD Official Course Competencies: |
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NUC170 2013 Spring - 9999 |
Nuclear Medicine
Cardiac Imaging |
1. Describe
the gross anatomy and physiology of the cardiovascular system as it relates to
nuclear medicine including heart chambers, tissue layers, cellular physiology,
blood flow, conduction systems and pathways, cardiac cycle, and functional
parameters. (I)
2. Describe
the pathology and pathophysiology associated with the cardiovascular system and
the indications for cardiac imaging including coronary artery disease, heart
pathology, and systemic vessel pathology. (II)
3. Describe
and apply the appropriate protocols for cardiac stress testing. Includes patient preparation, adverse reactions, antidotes,
equipment, and protocols for pharmacologic and non
pharmacologic stress tests. (III)
4. Identify
whether a cardiac cycle represents normal or abnormal rhythm when given an
electrocardiogram (ECG) tracing obtained with a 12 or 3-lead ECG technique.
(III)
5. List
the indications and contraindications for cardiac imaging to include:
myocardial perfusion and viability, equilibrium radionuclide angiocardiography
also known as multigated blood pool acquisition,
gated blood pool or radionuclide ventriculopathy,
first pass radionuclide angiography, infarct imaging, major vessel flow studies
and detection of deep vein thrombosis. (IV-IX)
6. Describe
and apply the appropriate radiopharmaceuticals (includes normal and abnormal biodistribution), patient preparation, acquisition and
processing protocols used for the cardiac studies listed in 5. (IV-IX)
7. Describe
the imaging and ancillary equipment required for cardiac system imaging listed
in 5. (IV-IX)
8. Evaluate
cardiac system images and quantitative data for technical quality, including
artifacts and normal variants for the studies listed in 5. (IV-IX)
9. Discuss the diagnostic/prognostic value of cardiac system imaging and correlative tests that are used in comparison. (IV-IX)
Go to Description Go to top of Competencies
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MCCCD Official Course Outline: |
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NUC170 2013 Spring - 9999 |
Nuclear Medicine
Cardiac Imaging |
I Review of Anatomy and Physiology
A Gross anatomy and function
1 Heart chambers
2 Tissue layers
a Endocardium
b Myocardium
3 Epicardium
4 Pericardium
B Cellular physiology
C Blood flow
1 Coronary
2 Systemic
D Conduction system and pathways
E Cardiac cycle
F Functional parameters
1 Ejection fraction
2 Stroke volume
3 Cardiac output
4 Other
II Pathology: characteristics, causes, population, and treatment
A Spectrum of coronary artery disease
B The heart and great vessels
1 Coronary artery disease
a Ischemia
b Infarction
c Hibernating or stunned myocardium
d Zones if ischemia, injury, and infarction
e Coronary artery spasm
f Angina
g Congestive heart failure
2 Congenital abnormalities
a Transposition of the great vessels
b Dextrocardia
c Situs inversus
d 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 Arrhythmias
9 Transplant rejection
10 Thyroid-related heart disease
11 Cardiac tumors
12 Coarctation of aorta
C Systemic vasculature
1 Arteriosclerosis
2 Aneurysms
3 Phlebitis
4 Deep vein thrombosis
5 Hypertension
III Cardiac Stress Testing Methods
A Indications
B Contraindications and adverse reactions
1 Physical or pathologic conditions
2 Possible interfering drugs
3 Precautions
4 Adverse reactions
C Patient preparation (consent if applicable)
D Equipment
1 Treadmill
2 Supine cycle
3 Upright cycle
4 Hand ergometer
5 Electrocardiogram (ECG) monitor
6 Blood pressure monitor
7 Infusion pump
E Basic procedure
1 Protocols
2 ECG
a Skin preparation
b Electrode placement
3 End points
F Interventional procedures
1 Pharmacologic intervention
a Pharmaceuticals and mechanisms of action
(1) Regadenoson (Lexiscan)
(2) Adenosine
(3) Dobutamine/arbutamine/atropine
(4) Dipyridamole
b Indications/contraindications and adverse effects
c Antidotes for the reversal of the adverse effects
d Administration protocols
e Patient preparation
f Infusion pump
g Pharmacologic intervention with low-level physical exercise
(1) Indications/contraindications and adverse effects
(2) Positive effects of introducing low-level physical exercise
h Administration protocols
G Cardiac electrophysiology
1 Leads
a 3-lead
b modified 12-lead
2 ECG interpretations
a ECG strip measurements
b Patterns
(1) Normal rhythm
(2) Segment changes
(3) Basic arrhythmias
(4) Other ECG abnormalities
IV Myocardial Perfusion/Viability
A Indications
B Radiopharmaceuticals
1 Tracers
a Thallium-201
b Technetium-99m sestamibi
c Technetium-99m tetrofosmin
d Dual nuclide: Thallium-201 and a Techetium-99m (Tc-99m) agent
2 Route of administration
3 Biodistribution
a Uptake
b Distribution
c Excretion
d Extraction fraction
4 Dosimetry
C Contraindications and adverse reactions
1 Physical and pathologic conditions
2 Interfering studies
3 Possible interfering drugs
4 Precautions
5 Adverse reactions
D Patient preparation
E Equipment
1 Imaging equipment
2 Ancillary equipment
a Immobilization devices
b Comfort devices
c Gating devices
F Protocol
1 Dose range and administration technique
2 Acquisition parameters
3 Positioning and views
4 Data processing
a Cineangiograms
b Ejection fraction determination
c Functional images
d Heart-lung ratios
e Image manipulation techniques
f Image filtering
g Polar plot analysis
h Wall motion analysis
(1) Attenuation correction
j Time-activity curves
k Summed stress score, summed rest score, summed difference score
l Quantitative software techniques
5 Image display/format
a Short axis
b Vertical long axis
c Horizontal long axis
G Artifacts
1 Radiopharmaceutical distribution and attenuation factors
2 Acquisition parameters
a Uniformity
b Energy window
c Gating
d Motion
e Center of rotation
f Attenuation
3 Processing parameters
H Interpretation of images and data
1 Normal
2 Normal variants
3 Abnormal
4 Artifacts
5 Diagnostic/prognostic value of the study
6 Evaluation of technical quality
7 Correlative tests
a Imaging
b Nonimaging
V Equilibrium Radionuclide Angiocardiography, Also Known as Multigated Blood Pool Acquisition, Gated Blood Pool Scan, or Radionuclide Ventriculography
A Indications
B Radiopharmaceuticals
1 Tc-99m tagged red blood cells
a In vivo
b In vitro
c Modified in vivo/in vitro
2 Route of administration
3 Biodistribution
a Uptake
b Distribution
c Excretion
4 Dosimetry
C Contraindications and adverse reactions
1 Physical or pathologic conditions
2 Interfering studies
3 Possible interfering drugs
4 Precautions
5 Adverse reactions
D Patient preparation
E Equipment
1 Imaging equipment
2 Ancillary equipment
a Cardiac monitor for gating
b Supine bicycle for exercise if applicable
c Infusion pump if applicable
d Blood pressure monitor
e ECG monitor
F Protocol
1 Dose range and administration technique
2 Acquisition parameters
3 Positioning and views
4 Data processing
a Ejection fraction calculations
b Cine display
c Other measurements
5 Image display/format
6 Sources of error
G Interventional procedures
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
6 Evaluation of technical quality
7 Correlative tests
a Imaging
b Nonimaging
VI First-Pass Radionuclide Angiography
A Indications
B Radiopharmaceuticals
1 Tracers
a Tc-99m Diethylenetriaminepentaacetic acid
b Tc-99m pertechnetate
c Any Tc-99m labeled radiopharmaceutical of at least 15 millicurie (except macroaggregated albumin [MAA])
2 Route of administration
3 Biodistribution
a Uptake
b Distribution
c Excretion
4 Dosimetry
C Contraindications and adverse reactions
1 Physical or pathologic conditions
2 Interfering studies
3 Possible interfering drugs
4 Precautions
5 Adverse reactions
D Patient preparation
E Equipment
1 Imaging
2 Upright bicycle or treadmill if applicable
3 Gating devices
F Protocol
1 Dose range and administration technique
2 Acquisition parameters
3 Positioning and views
4 Data processing
a Ejection fraction calculations
b Functional images
c Cine display
d Left-to-right shunt quantification
e Other measurements
5 Image display/format
6 Sources of error
G Interpretation of images and data
1 Normal
2 Normal variants
3 Abnormal
4 Artifacts
5 Diagnostic/prognostic value of the study
6 Evaluation of technical quality
7 Correlative tests
a Imaging
b Nonimaging
VII Infarct Imaging
A Indications
B Radiopharmaceuticals
1 Tracers
a Technetium-99m pyrophosphate
b Indium-111 antimyosin
2 Route of administration
3 Biodistribution
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 Imaging equipment
F Protocol
1 Dose range and administration technique
2 Acquisition parameters
3 Positioning and views
4 Data processing
5 Image display/format
6 Sources of error
G Interpretation of images
1 Normal
2 Normal variants
3 Abnormal
4 Artifacts
5 Diagnostic/prognostic value of the study
6 Evaluation of technical quality
7 Correlative tests
a Imaging
b Nonimaging
VIII Superior Vena Cava Obstruction Study
A Indications
B Radiopharmaceuticals
1 Tracers
a Technetium-99m diethylenetriaminepentaacetic acid
b Technetium-99m pertechnetate
2 Route of administration
3 Biodistribution
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 Imaging equipment
F Protocol
1 Dose range and administration technique
2 Acquisition parameters
3 Positioning and views
4 Image display/format
5 Sources of error
G Interpretation of images
1 Normal
2 Normal variants
3 Abnormal
4 Artifacts
5 Diagnostic/prognostic value of the study
6 Evaluation of technical quality
7 Correlative tests
a Imaging
b Nonimaging
IX Venogram/Thrombus Localization
A Indications
B Radiopharmaceuticals
1 Tracers
a Technetium-99m macroaggregated albumin
b Other
2 Route of administration
3 Biodistribution
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 Imaging equipment
F Protocol
1 Dose range and administration technique
2 Acquisition parameters
3 Positioning and views
4 Image display/format
5 Sources of error
G Interpretation of images
1 Normal
2 Normal variants
3 Abnormal
4 Artifacts
5 Diagnostic/prognostic value of the study
6 Evaluation of technical quality
7 Correlative tests
a Imaging
b Nonimaging