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Syllabus
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1a: History
1b: Guidelines
1c: Epidemiology
1d: Structure
1e: Circulation
Lesson 1 REVIEW
2a: Anomalies
2b: Dextrocardia
2c: Coronary Arteries
2d: Indicators of Function
Lesson 2 REVIEW
3a: Electrophysiology
3b: Conduction
3c: Action Potential
3d: Autonomic System
Lesson 3 REVIEW
4a: Electrocardiography
4b: EKG Slideshow
4c: EKG Interpretation
4d: Myocardial Damage
Lesson 4 REVIEW
5a: Cardiovascular Disease
5b: Coronary Syndromes
5c: Atherosclerosis
5d: Myocardial Infarction
5e: Cardiac Stress Testing
5f: Cardiac Medications
5g: Revascularization
Lesson 5 REVIEW
6a: Diagnostic Imaging
6b: Radiopharmaceuticals
6c: Thallium Scintigraphy
6d: Tc99m MPI Agents
6e: PET Imaging
6f: Blood Pool Imaging
6g: Cardiac Function
Lesson 6 REVIEW
7a: Planar Cardiac Imaging
7b: Cardiac SPECT Imaging
7c: Cardiac SPECT Anatomy
7d: Interpretation
7e: Attenuation Correction
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LESSON 1b
GUIDELINES FOR THE NUCLEAR CARDIOLOGY TECHNOLOGIST
Nuclear Cardiology uses small amounts of radioactive pharmaceuticals to obtain information about the heart. With this technology, the nuclear cardiologist may assess the heart muscle. Modern imaging techniques provide qualitative and quantitative information with little risk or discomfort to the patient. All nuclear cardiology imaging procedures may be done on an outpatient basis.
Nuclear cardiology imaging procedures are performed under the supervision of cardiologists. Nuclear cardiology testing facilities may be located in hospitals, clinics, or private offices. Such a facility must have a materials license from the federal government, or in the case of agreement states, a state radiation control agency. A materials license is issued after a thorough evaluation of the facility and documented proof of the physician's training.
Nuclear cardiology imaging today consists of complex and highly technologically demanding studies. The role of the technologist has never been greater in a field in which excellence in science and patient care is essential. The nuclear medicine technologist can provide quality nuclear cardiology services only by having a global understanding of all the issues that impact the field of nuclear cardiology. To optimize the clinical impact of nuclear cardiology procedures in patients with coronary syndromes, the technologist must consistently produce optimal image quality. To accomplish this, the technologist must adhere to basic nuclear cardiology principles and practices.
GUIDELINES FOR THE NUCLEAR MEDICINE TECHNOLOGIST
The Nuclear Medicine Technologist working in nuclear cardiology must:
Understand cardiac anatomy and physiology
Understand the appropriate performance of exercise tolerance or pharmacological stress testing
Demonstrate the correct application of patient monitoring techniques during exercise or pharmacological stress testing
Maintain current basic life support certification
Implement quality control procedures to confirm optimal performance of imaging systems, monitoring equipment, radiopharmacy, gating equipment, infusion pumps
Demonstrate appropriate selection of acquisition and processing parameters
Create image displays for the interpreting and referring physician to review
Understand the performance of functional imaging procedures
Understand the process of effective patient management
To sustain a high level of professionalism, knowledge, and skill, nuclear cardiology technologists must actively participate in professional growth through continuing education programs. By having a membership in professional organizations including the Society of Nuclear Medicine, your regional Technologist Chapter and the American Society of Nuclear Cardiology (ASNC), the technologist is afforded the opportunity to maintain skill levels. This can be accomplished by reading journals, interacting with peers, and availing oneself of guidelines- written by experts in the field- to produce optimal nuclear cardiology procedures.
As nuclear medicine technologists, you play a critical role in providing information to the physician for total patient management. It helps to have a global understanding of the many issues that impact the field. The success of your technology is based on the quality of your studies and your understanding of nuclear cardiology as a vital diagnostic and prognostic tool.
Personnel Qualification
In addition to the core requirements noted in the Society of Nuclear Medicine's Curriculum Guide for Nuclear Medicine Technologists, the American Society of Nuclear Cardiology Technologist Committee has made several recommendations (J Nucl Cardiol, 1997). This committee recommends that the technologist who actively practices in the field of nuclear cardiology should have a minimum of 8 weeks of specialized, hands-on training and experience of nuclear cardiology procedures in the following areas:
Acquisition, including equilibrium radionuclide angiography, eg, first-pass radionuclide angiography and perfusion (SPECT and planar) with optional training in first-pass shunt detection and cardiac infarct avid imaging
Processing, including quality assurance and computer processing and reconstruction
Instrumentation, planar and SPECT technology
- Planar imaging, including acquisition and processing
- SPECT and ECG-gated imaging, including acquisition, reconstruction, image processing, technical artifacts, SPECT gamma camera system, PET, and ancillary instrumentation and equipment
Radiopharmaceuticals
- Myocardial perfusion agents
- 99m-Tc-labeled red blood cell imaging
- Myocardial infarct avid imaging
Anatomy and physiology
Basic ECG skills
Stress testing methods
- Physical (bicycle)
- Physical (treadmill)
- Pharmacological
Patient care
- CPR, including cardioversion/ defibrillation
- Laboratory values (serum enzymes, serum electrolytes)
- Cardiovascular drugs
- Cardiac revascularization
- Nonnuclear cardiovascular evaluation
Additional nuclear cardiology guidelines are written by experts in the field and are available on the Web sites of the Society of Nuclear Medicine
(www.snm.org) and the American Society of Nuclear Cardiology (www.asnc.org).
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