Nuclear Medicine and PET/CT: Technology and Techniques

709 Pages·2016·28.278 MB·English

by  Kristen Waterstram-Rich (editor), David Gilmore (editor)

Nuclear Medicine
PET/CT
and
TECHNOLOGY AND TECHNIQUES
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EIGHTH EDITION
Nuclear Medicine
PET/CT
and
TECHNOLOGY AND TECHNIQUES
Kristen M. Waterstram-Rich, MS, CNMT, FSNMMI-TS
Professor
Interim Associate Dean
College of Health Sciences and Technology
Rochester Institute of Technology
Rochester, New York
David Gilmore, ABD, CNMT, NCT, RT (R)(N), FSNMMI-TS
Chair & Assistant Professor of Medical Imaging
Program Director, Nuclear Medicine & Molecular Imaging
Medical Imaging Department
Regis College
Weston, Massachusetts
3251 Riverport Lane
St. Louis, Missouri 63043
NUCLEAR MEDICINE AND PET/CT: TECHNOLOGY
AND TECHNIQUES, EIGHTH EDITION ISBN: 978-0-323-35622-0
Copyright © 2017 by Elsevier, Inc. All rights reserved.
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Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds, or experiments described herein. In using such information or
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With respect to any drug or pharmaceutical products identified, readers are advised to check the most
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Cover Photo: Courtesy Windsong Radiology Group, Williamsville, NY.
Printed in the United States of America
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C O N T R I B U T O R S
Michele M. Beauvais, RPh, BCNP, FAPhA Nancy McDonald DeLoatch, RT, CNMT, NCT
Associate Professor Clinical Coordinator
School of Health Sciences Nuclear Medicine Technology Program
Oakland University St. Vincent’s Medical Center
Rochester, Michigan; Jacksonville, Florida
Director of Radiopharmacy (Retired)
Nuclear Medicine Gary Dillehay, MD, FACNM, FACR
William Beaumont Hospital Professor of Radiology
Royal Oak, Michigan Department of Nuclear Medicine
Northwestern Memorial Hospital
Erin Beloin, MBA, CNMT, RT(CT) Chicago, Illinois
Assistant Professor of Medical Imaging
Program Director, Post-Licensure Programs Mary Beth Farrell, MS, CNMT, NCT, FSNMMI-TS
Medical Imaging Department Director of Research
Regis College Intersocietal Accreditation Commission
Weston, Massachusetts Ellicott City, Maryland
Leslie A. Bishop, PhD Maureen Ferran, PhD
Associate Professor of Chemistry Associate Professor
STEM Department Thomas H. Gosnell School of Life Sciences
Regis College College of Science
Weston, Massachusetts Rochester Institute of Technology
Rochester, New York
Norman E. Bolus, MSPH, MPH, CNMT, FSNMMI-TS
Director, Assistant Professor UAB NMT Program Deborah M. Gibbs, MEd, RT(N), CNMT, PET, FASNC
Clinical & Diagnostic Sciences Department Radiology Imaging Supervisor
University of Alabama at Birmingham Radiology/Imaging
Birmingham, Alabama Charlie Norwood VA Medical Center
Augusta, Georgia
Crystal Botkin, MPH, CNMT, PET
Assistant Professor and NMT Clinical Coordinator David Gilmore, ABD, CNMT, NCT, RT (R)(N),
Doisy College of Health Sciences FSNMMI-TS
Department of Medical Imaging and Radiation Therapeutics Chair & Assistant Professor of Medical Imaging
Saint Louis University Program Director, Nuclear Medicine & Molecular Imaging
St. Louis, Missouri Medical Imaging Department
Regis College
Lance D. Burrell, MS, CNMT, PET, RT(CT) Weston, Massachusetts
Center for Quantitative Cancer Imaging
Huntsman Cancer Institute Krystle Worthington Glasgow, BS, CNMT, MIS, NMAA
Salt Lake City, Utah Teacher and Clinical Coordinator
University of Alabama at Birmingham
Patrick Byrne, DABR, CHP, DABSNM Department of Clinical and Diagnostic Sciences
Nuclear Medicine Physicist Nuclear Medicine Technology Program
Medical Physics Consultants, Inc. Birmingham, Alabama
Indianapolis, Indiana
Bennett S. Greenspan, MD, MS
Paul E. Christian, BS, CNMT, FSNMTS, PET Professor, Department of Radiology and Imaging
Associate Director, Molecular Imaging Program (Retired) Medical College of Georgia, Augusta University;
Director, Cyclotron Radiochemistry Laboratory Co-Medical Director,
Huntsman Cancer Institute Nuclear Medicine Technology Program
University of Utah College of Allied Health Sciences, Augusta University
Salt Lake City, Utah Augusta, Georgia
v
vi CONTRIBUTORS
William L. Hubble, MA, CNMT, RT (R)(N)(CT), Mary Anne Owen, MHE, RT(N), FSNMMI
FSNMMI-TS Associate Professor Emerita
Academic Chairman and NMT Director, Associate Professor College of Allied Health Sciences
Doisy College of Health Sciences Department of Medical Laboratory, Imaging, and Radiologic
Department of Medical Imaging and Radiation Therapeutics Sciences
Saint Louis University Georgia Regents University
St. Louis, Missouri Augusta, Georgia
Kathy Thompson Hunt, MS, CNMT, FSNMMI-TS Reiko Oyama, RPh
Program Chair, Nuclear Medicine Technology Nuclear Pharmacist and PET Quality Control Manager
Baptist College of Health Sciences Department of Radiology
Memphis, Tennessee Washington University School of Medicine
St. Louis, Missouri
Diwaker Jain, MD
Professor of Medicine Sally W. Schwarz, MS, RPh, BCNP
Section of Cardiovascular Medicine Professor
Director of Nuclear Cardiology Department of Radiology
New York Medical College Washington University School of Medicine
Westchester Medical Center St. Louis, Missouri
Valhalla, New York
Lauren Shanbrun, MS, CNMT, RT(N)(CT)
Frances Keech, DHSc, MBA, RT(N), FSNMMI-TS Assistant Professor of Medical Imaging
Associate Professor and Program Director, Nuclear Medicine Clinical Coordinator, Nuclear Medicine Technology
Technology Program Program
School of Medical Imaging and Therapeutics Medical Imaging Department
MCPHS University Regis College
Boston, Massachusetts Weston, Massachusetts;
Staff Technologist II
Martha Kennedy, MA, ARMRIT, RT(MR) Nuclear Medicine and Molecular Imaging Department
MRI Program Director Beth Israel Deaconess Medical Center
Medical Imaging & Radiation Therapeutics Boston, Massachusetts
Saint Louis University
St. Louis, Missouri Akash Sharma, MD, MBA
Division of Nuclear Medicine
Maria Mackin, MS, CNMT, RT (N), LNMT Mallinckrodt Institute of Radiology
Chief Technologist and Administrative Supervisor St. Louis, Missouri
UR Medicine Nuclear Cardiology Paul N. Yu Heart Center
Ambulatory Care Quality Assurance Liaison Nancy M. Swanston, CNMT, PET, RT
University of Rochester Medical Center Administrative Director, DI Operations
Rochester, New York Division of Diagnostic Imaging
The University of Texas MD Anderson Cancer Center
Donna C. Mars, MEd, CNMT, NCT Houston, Texas
Associate Professor, Nuclear Medicine Technology
Baptist College of Health Sciences Daniel Tempesta, BS, CNMT, RT(N)(CT)
Memphis, Tennessee Nuclear Medicine Technologist
Nuclear Medicine and Molecular Imaging Department
Denise A. Merlino, CNMT , CPC, MBA Beth Israel Deaconess Medical Center
Merlino Healthcare Consulting Corp. Boston, Massachusetts;
Adjunct Lecturer of Medical Imaging
Cybil Nielsen, MBA, CNMT, FSNMMI-TS Medical Imaging Department
NMT Program Director, Clinical Assistant Professor Regis College
Radiologic and Imaging Sciences Weston, Massachusetts
Indiana University
Indianapolis, Indianapolis Kathy S. Thomas, MHA, CNMT, PET
Applications/Technical Support
Capintec, Inc. (Retired)
Battle Ground, Washington
CONTRIBUTORS vii
Helen Timberlake, MS Mathematics Kristen M. Waterstram-Rich, MS, CNMT, FSNMMI-TS
Senior Lecturer Professor
School of Mathematical Sciences Interim Associate Dean
Rochester Institute of Technology College of Health Sciences and Technology
Rochester, New York Rochester Institute of Technology
Rochester, New York
LisaAnn Trembath, CNMT, MSM, CRA, FSNMTS
Associate Director of Clinical Imaging Operations Shanon M. Younglove, BS, MHA, CNMT
Avid Radiopharmaceuticals, Inc. Clinical Instructor Nuclear Medicine
Philadelphia, Pennsylvania Barnes Jewish Hospital
St. Louis, Missouri
Austin Turner, MS, CNMT, PET, RT(MR)
Clinical Coordinator, Magnetic Resonance Imaging Program Katherine A. Zukotynski, MD
Department of Medical Imaging and Radiation Therapeutics Associate Professor
Edward and Margaret Doisy College of Health Sciences Departments of Radiology & Medicine
Saint Louis University McMaster University
St. Louis, Missouri Hamilton, Ontario, Canada
David Wang, BHSc
Faculty of Medicine
University of Toronto
Toronto, Ontario, Canada
R E V I E W E R S
Jonathan Baldwin, BSRT CNMT Kristi Klein, MS Ed(R)(M)(CT)
Clinical Assistant Professor and Clinical Coordinator Program Director
OUHSC MIRS Nuclear Medicine School of Health Education
Oklahoma City, Oklahoma Madison Area Technical College
Madison, Wisconsin
Jeff L. Berry, MS, RT(R)(CT)
Associate Professor, Radiography Program Director Diana E. Mishler, MBA-HM, RT(R)(S), RDMS
University of Oklahoma Health Sciences Center Clinical Assistant Professor and Coordinator
College of Allied Health Medical Imaging Technology Program
Department of Medical Imaging and Radiation Sciences Indiana University
Oklahoma City, Oklahoma Kokomo, Indiana
Nicole Dhanraj, PhD Robin Rayman, AAS in Nuclear Medicine, CNMT,
Independent Researcher/Contractor NMTCB-CT, PET, RT(N), EMT
Mangilao, Guam Nuclear Medicine Technologist
Salem, South Dakota
Kerry Greene-Donnelly, MBA, RT (R)(M)(CT)(QM)
Assistant Professor
Upstate Medical University
Syracuse, New York
viii
P R E FAC E
CONTENT NEW TO THIS EDITION
Writing a book is definitely a labor of love and testament to Each revised edition captures the changes that have occurred
patience, and the production of this book was no exception. since the previous edition and gives a glimpse into changes and
The process takes over 2 years and the work waxes and wanes advancements that are under investigation. The many expert
throughout the time period, but it is not until the very end contributors of the chapters have reviewed and updated the
that one gets a glimpse of how the book will look in print. information in this edition to bring the materials and figures
This book, now in its eighth edition, has stood the test of to the current level of clinical practice. They have also added
time and shows a noteworthy level of enthusiasm among its PET applications to the clinical chapters when appropriate.
authors. In the creation of each edition, information regarding In addition to these changes, three new chapters have been
the current practice of nuclear medicine and the responsibil- added. In recognition in the growth of individualized ther-
ities of nuclear medicine technologists is obtained from pro- apies and consistent with the basics of molecular imaging, a
fessional organizations worldwide. As a result the textbook chapter on cellular and molecular biology is now included.
continues to keep pace with the changes in the field of nuclear With an increase in the need for management skills, a chapter
medicine and health care, as it expands and evolves to meet was created to expand the topics associated with department
the needs of the professionals facing the challenges of chang- administration. The third new chapter provides an introduc-
ing technology and medical practice. Hippocrates once said, tion to the requirements and terms associated with research
“Declare the past, diagnose the present, foretell the future.” and clinical trials. Three chapters have been expanded. The
This textbook follows that instruction. It is current and blends chemistry chapter now includes concepts of biochemistry, the
the old and new while also addressing future developments. informatics chapter has been expanded to include additional
Through all of the revisions it has stayed true to its focus of computer applications in imaging, and the MRI chapter has
providing information that covers all aspects of nuclear med- been expanded to include an introduction to PET/MR. In
icine, thereby serving as a comprehensive introductory text addition to new content, there are many new contributing
for nuclear medicine professionals to enter practice in this authors bringing their expertise to the edition.
field. This book is intended for use by technologists and stu-
dent technologists and as a reference guide for physicians LEARNING ENHANCEMENTS
and scientists entering nuclear medicine. It is used by many
nuclear medicine technologist educational programs and as a Each chapter begins with an outline, learning objectives, and
resource in many nuclear medicine departments worldwide. key terms. The key terms appear in the front of each chapter
The eighth edition is divided into five sections: Foundations to aid student readers in identifying terms with which they
(the basic science chapters); Patient Care, Management, and should become familiar. Each term will appear in boldface the
Research; Physics and Instrumentation; Imaging Procedures and first time that it is used in the chapter. The key terms are also
Protocols; and Special Considerations. A fundamental knowl- defined in the glossary at the end of the book. There are also
edge base is formed from the chapters that precede the clinical summaries at the end of most chapters to highlight a few of
chapters. In the clinical chapters, one can see the complexity the important concepts in each chapter.
of the field of nuclear medicine and how the interconnected- Chapter 1, Mathematics and Statistics, gives readers the
ness of physics, chemistry, anatomy, and physiology results opportunity to practice the basic math skills necessary to
in diagnostic images or is used in clinical and therapeutic function as a nuclear medicine technologist. The answers for
applications. The clinical chapters essentially start at the head these questions are provided at the end of the book so that
and work their way down the body. The last two chapters are readers can assess their knowledge before proceeding to the
special considerations. The chapter on Inflammatory/Tumor/ next chapter.
Oncology Imaging and Therapy includes topics that span all Boxes and tables are used throughout the book to call
body systems, while the chapter on the hematopoietic system attention to important information. The information and
includes procedures rarely performed at the time of the pub- writing style are targeted toward readers new to nuclear
lication but that exist in different locations around the world. medicine. The fundamentals are addressed first, with topics
This coherent framework for the knowledge base of the book becoming increasingly more complex.
provides an efficient and logical approach to study the field
of nuclear medicine for it allows students to see a unifying INSTRUCTOR ANCILLARIES
theme or connectedness of the information. An appendix of
radiopharmaceuticals, which summarizes many of the radio- Evolve is a secure and interactive learning environment
nuclide properties, radiopharmaceutical names, and clinical designed to work in coordination with Nuclear Medicine
applications, is also included as an easy reference. and PET/CT: Technology and Techniques, eighth edition.
ix