Syllabus
Syllabus of the English course in nuclear medicine *) items 01-03 are supposed to be known from previous education - they are not fully presented in the course again but they are (in a very basic form) required for exam 01*) Basic atomic and nuclear physics - organization of the atom, structure of nucleus, atomic and mass number, nuclides, isobars, isotopes, isotones, isomers 02*) Radioactive decay - alpha decay, beta-plus, beta-minus, gamma emission, units of activity (Becquerel, Curie), specific activity, kinetics of radioactive decay (general equation, half life, effective half life), statistics of radiation counting 03*) Interaction of radiation with matter - ionization and excitation, charged particles (specific ionization, linear energy transfer, range, bremsstrahlung, annihilation), ionizing electromagnetic radiation (coherent scatter, photoelectric effect, compton interaction, pair production) 04) Radiation biology - cellular radiation biology (effect of radiation on cells, direct and indirect action of radiation, radiosensitivity of cells), repair of radiation injury, factors affecting cell response to radiation (dose rate, linear energy transfer, chemicals, stage of the cell cycle), short-term effects of total body irradiation (acute radiation syndrome, hemopoietic death, gastrointestinal death, central nervous system death), late effects of ionizing radiation (somatic effects, genetic effects, deterministic effects, stochastic effects), assessment of low dose - low dose rate effects on human health, hormesis 05) Radiation safety and protection - radiation exposure (quantities and units), radiation regulations, dose limits, principles of radiation protection, guidelines for personnel, radiation monitoring, internal radiation dosimetry, radiation dose - quantities and units, ALARA program 06) Production of radionuclides and radiopharmaceuticals - cyclotron-produced radionuclides, reactor-produced radionuclides, radionuclide generators, methods of radiolabeling, diagnostic radiopharmaceuticals, PET radiopharmaceuticals, quality control (radionuclide purity, radiochemical purity, chemical purity, sterility, apyrogenicity, toxicity), examples of most frequently used radiopharmaceuticals including their most important clinical applications 07) Nuclear medicine instrumentation - radiation detection and instrumentation, gas- filled detectors, scintiallation and semi-conductor counters, imaging devices, scintiallation or gamma cameras, multicrystal cameras, performance parameters of imaging devices (spatial resolution, sensitivity, uniformity, contrast, quality control), whole-body imaging, tomographic imaging devices, hybrid systems ET/CT 08) Computers and data processing in nuclear medicine - acquisition (static, dynamic, whole-body, tomographic, list mode, matrix mode, gated mode), storage, processing, and display of image data, analogue and digital images, image filtering, image arithmetic, background subtraction, functional or parametric images, regions of interest, curve generation, tomographic image reconstruction - simple backprojection, filtered backprojection, iterative techniques, quantitative imaging, image fusion or registration (correlative imaging), information storage and retrieval, statistical decision theory (sensitivity, specificity, diagnostic accuracy) 09) Principles of emission tomography - single-photon emission tomography, positron emission tomography, radiopharmaceuticals, principles of detection, instruments, tomographic image reconstruction, whole-body imaging, spatial resolution, sensitivity, principles of clinical applications, examples of clinical applications 10) Cardiovascular system - anatomy and physiology, radionuclide ventriculography (first pass, blood pool), myocardial perfusion imaging, infarct-avid imaging, metabolic imaging, new methods (neuronal imaging, atherosclerosis, thrombus imaging, apoptosis), lymphoangioscintigraphy, radionuclide phlebography 11) Central nervous system - anatomy and physiology, cisternography, brain perfusion study - SPECT, clinical applications (acute stroke, brain trauma, focal epilepsy, dementia and depression, Parkinson's disease and parkinsonian syndromes, tumours, receptor systems, brain death) 12) Endocrine system - anatomy and physiology, thyroid imaging, parathyroid imaging 13) Gastrointestinal system - anatomy and physiology, gastric emtpying study, gastrointestinal bleeding study, gastroesophageal reflux, detection of Meckel's diverticulum, hepatobiliary study 14) Genitourinary system - anatomy and physiology, static imaging (renal cortical scintigraphy), dynamic imaging (basis renogram), pharmacological intervention studies (diuretics, ACE inhibition), renal transplant scintigraphy, radionuclide cystography, scrotal imaging (testicular scan) 15) Pulmonary system and thromboembolism - anatomy and physiology, lung ventilation scintigraphy, lung perfusion scintigraphy, venography 16) Skeletal system - anatomy and physiology, bone scintigraphy (planar, SPECT), three (multiple) -phase bone imaging 17) Inflammatory processes - gallium scintigraphy, leukocyte scintigraphy, labelled antibodies, 18F-fluorodeoxyglucose (FDG) 18) Tumour imaging - cancer staging, evaluation of treatment response, imaging of the sentinel nodes, a role of PET in cancer diagnosis 19) Radionuclide therapy - benign disease, thyroid carcinoma, myeloproliferative disease, MIBG therapy, palliative therapy of painful skeletal metastases, logoregional applications of radionuclide therapy, radioimmunotherapy, peptide therapy, antisense radiotherapy, new radionuclides
Annotation
Nuclear medicine is a medical specialty dealing with diagnostic and therapeutic use of unsealed radionuclides. It is based on a tracer principle: unstable radionuclides of a chemical element react identically as the stable ones and can be used to trace radio-labelled substances in chemical and physiological processes.
Molecules labelled with a small amount of radionuclides are administered into the human body and traced by external detection of gamma rays. Amount of a specific tracer accumulated in the tissue provides quantitative information on local function.
Radionuclide therapy is similar to radiotherapy. It differs in that the source of radiation is administered into the body and acts locally.
The course provides a review of diagnostic medical imaging and explains the specific role of nuclear medicine. Scintigraphic methods are explained with their applications in cardiology, oncology, neurology, nephro-urology, endocrinology, gastro-enterology, pulmonary and inflammatory diseases.
Lecture on radionuclide therapy is also included. Technical subjects cover basic science of nuclear medicine, including atomic and nuclear physics, radiation biology and protection, radiopharmaceuticals, instrumentation, interpretation of digital images, functional imaging, and principles of emission tomography.
Theory is completed by interactive seminars and clinical demonstrations. Recently, an importance of nuclear medicine methods increases because they are well designed to transfer the results of molecular biology and genetics into clinical practice (molecular imaging).