PET and PET/CT Study Guide: A Review for Passing the PET Specialty Exam

316 Pages·2013·3.12 MB·English

by  Adam Sciuk (auth.)

P ET and PET/CT Study Guide
A ndrzej M oniuszko ● A dam S ciuk
P ET and PET/CT Study
Guide
A Review for Passing
the PET Specialty Exam
A ndrzej M oniuszko A dam S ciuk
D epartment of Nuclear Medicine D epartment of Radiology
R esurrection Medical Center R esurrection Medical Center
C hicago, I L, U SA C hicago, I L, U SA
I SBN 978-1-4614-2286-0 I SBN 978-1-4614-2287-7 (eBook)
D OI 10.1007/978-1-4614-2287-7
S pringer New York Heidelberg Dordrecht London
L ibrary of Congress Control Number: 2012947031
© Springer Science+Business Media, LLC 2 013
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I would like to dedicate this work to my
brother Jerzy, my sister-in-law Teresa,
and my dear nieces Jola, Violetka, and
Margie for all their help and indefatigable
support at the beginning of my new medical
journey.
A ndrzej Moniuszko
T o my lovely wife Kasia, son Jakub,
and daughter Ola for their love, support,
and inspiration.
A dam Sciuk
P reface
T he P ET and PET/CT Study Guide is designed for technologists, practitioners, and
trainees in medical imaging to serve as a practical tool to study multiple aspects of
PET and PET/CT. The book was written and reviewed by individuals from a wide
spectrum of nuclear medicine expertise: an experienced nuclear medicine technolo-
gist, a new graduate of nuclear medicine technology program, a practicing nuclear
medicine physician, and a nuclear medicine college teacher. A broad assembly of
authors and contributors, with different nuclear medicine experiences, provides an
array of problems that technologists, practitioners, and trainees can, and will,
encounter in everyday practice. Some of the questions are easy, and some of them
are not. In either case, the book is not designed to test the reader’s knowledge.
Rather, it should be viewed as tool to learn and build the skills necessary in utilizing
this compelling modality in daily practice. It is said that a picture is worth a thou-
sand words. Our book includes more than 75 images, graphics, and diagrams. It is
our goal for these illustrations to help readers get to the bottom of the problem and
to come up with the right solution quickly.
T he book is divided into fi v e chapters and an appendix. We kick things off with
a chapter on test taking strategies, which is designed to equip readers with practical
tools and methods to successfully navigate through the multiple-choice exam. It
was written by a recent graduate and the hands-on experience provides readers with
valuable insider tips.
C hapters 2–5 contain the test problems. Each test includes multiple-choice ques-
tions with a total number of 650 problems; chapters are organized into levels of
complexity, from the easiest to the most diffi c ult.
G enerally, tagging questions as easy or diffi c ult is a tricky matter, and highly
subjective. Nevertheless, for learning purposes, the proposed classifi c ation will be
benefi c ial to readers. Each chapter is a separate entity with answers and optional
short explanations included. This will work like building blocks, where the comple-
tion of the fi r st test will prepare the reader to progress to the second test, and so on.
A ppendix A consists of the critical formulas, numbers, and normal range values
for some of the quantitative nuclear medicine procedures. It is suggested, for those
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viii Preface
preparing for the licensee examination, to commit these to memory; for others, it is
for reference purposes only.
A ppendix B offers a list of commonly used abbreviations that are encountered in
everyday nuclear medicine practice, and beyond. The list can appear as too short or
simply too long. Some readers will fi n d the included terms as “unnecessary”; some
readers will not fi n d the abbreviation they are looking for. One size never fi t s all,
and thus the subjective choices, as is our selection, are not perfect. Use it to your
advantage. There is enough space between the lines, and in the margins, to modify
to your own preferences. Understanding the acronyms will pay off in the long run;
simply being able to decode it, will be short-lived. Therefore, a thorough review of
the abbreviations before the examinations can be very helpful, and highly
suggested.
A ppendix C presents a glossary of frequently used terms in nuclear medicine,
and again, we strongly advise a thorough review of the terms.
A ppendix D is comprised of web site addresses that offer priceless and free
information on many topics related to the nuclear medicine fi e ld.
T he present collection of problems mirrors the exam content as provided by
NMTCB. The questions cover radiation safety, radionuclides, and instrumentation
to name a few. The reader should never be discouraged when the type of “never
heard of” or “it is over my head” problem is encountered. We advise students to go
through these questions carefully, and answer diligently—you will be surprised how
much you already know and how much you can still learn. Both factors serve as
great motivators. Learning should be fun, entertaining, and contagious. Positron
emission tomography is a powerful, challenging, and rapidly evolving fi e ld of med-
icine and the only way to keep pace with its development is through continuous
learning. Make it fun, and make it a habit—this is the kind of addiction that you can
afford. The benefi t s are overwhelming. You can receive the 24 continuing education
credit hours and keep your professional license. You can read, you can study, you
can investigate, and you can challenge yourself and others. Best of all you can
exceed…your own expectations. The choice is yours.
W e want to thank Prof. Joanne Metler, Coordinator of Nuclear Medicine
Technology Program, College of DuPage, IL, for her patience in reviewing our
manuscript. Her dedication, helpful criticism, and detailed oriented effort deserve
nothing but our sincere appreciation. It is beyond the scope of words to express our
appreciation for the opportunity of knowledge and her enthusiasm, suggestions,
inspiration, and encouragement to write this book. Thank you for being with us
through every chapter of our book.
W e would also like to thank Mrs. Sabina Moniuszko for devotion and intractable
eagerness when preparing diagrams and drawings we used in this book, to Dharmesh
Patel for authoring math questions, and to Mr. George Chang, PACS coordinator,
Resurrection Medical Center, for his priceless help in preparing clinical images.
About the Authors
Andrzej Moniuszko received an MD degree in 1977 from Medical University in
Bialystok, Poland. In 1995 he moved to the US and two years later passed all exams
required by the United States Medical Licensing Examination (USMLE). He com-
pleted a Nuclear Medicine Technology Program in College of DuPage, Glen Ellyn,
IL and now works as a Nuclear Medicine Technologist in Resurrection Medical
Center, Chicago, IL and holds CNMT, ARRT (N), PET and NCT certifi c ations.
The dualistic nature of nuclear medicine, which combines interdisciplinary,
state-of-the-art diagnostic imaging with the softer side of taking care of patients and
helping people, perfectly fi t s Andrzej’s (Andy’s) personality. During the many years
of his medical experience he has viewed revolutions of treatment regimens and
transformations of imaging protocols. Through these changes he has learned that
the only things that have not changed over time are the patients’ fears, worries, and
concerns, all of which he calls a lesson in humbleness.
Adam Sciuk is a polish-born physician who received his initial medical training at
the Military Medical Academy in Poland. After fin ishing his internship he emi-
grated to United States and completed Diagnostic Radiology residency program at
the Louisiana State University in Shreveport. Throughout his residency he partici-
pated in several clinical research projects, some of which resulted in presentations
on the national level. For his achievements he was awarded with the Roentgen
Resident/Fellow Research Award. Dr. Sciuk has also completed fellowships in
Nuclear Medicine and Diagnostic Magnetic Resonance Imaging at the University of
Wisconsin in Madison, where he focused on Positron Emission Tomography, its
applications in oncology imaging, and correlation with whole body diffusion imag-
ing. Dr. Sciuk is currently an attending radiologist at Resurrection Medical Center
in Chicago where he combines clinical work with his research passion.
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