new england chapter e-journal of nuclear medicine technology

A Journal from 1978

National Council Delegate Report on the SNM annual meeting in San Diego

from Frances K. Keech, MBA, RT(N), FSNMTS

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New England Chapter E-Journal of

Nuclear Medicine Technology F A L L 2 0 0 6

President Dan Leahey, MA, BA, CNMT President-elect Mary Cross, BS, CNMT Past President Gwen Meunier, BS, CNMT, NCT, RT(N) Treasurer Erin Kistler, BS, CNMT Secretary Mark Corbin, CNMT, RT(N) National Council Delegate Frances K. Keech, MBA, RT(N), FSNMTS Editor Leo Nalivaika, MBA, CNMT Newsletter Publisher & Website Administrator Jana Lee Hogan, CNMT

Plan to attend the

Northeast Regional Scientific Meeting

Greater New York and New

England Chapters, Society of Nuclear Medicine

October 27-29, 2006 Mystic, Connecticut

Mystic Marriott Hotel and Spa

See program details on page 22

Physician Officers: President: Elizabeth Oates, M.D. President-Elect: John Vento, M.D. Treasurer: Alan Siegel, M.D. Secretary: Rachel Powsner, M.D.

V O L U M E 2 . I S S U E 1

The SNM annual meeting in San Diego was a total success from attendance to the scientific and commercial content. At the National Council of Representatives we were honored with presentations from the leadership of the SNM and SNMTS, the NMTCB, ARRT, JRCNMT, ERF and PDEF. The SNM leadership introduced the council to the re-branding of the Society. In January the Society leadership hired a consultant to look at the SNM brand and see if changes were needed. The consultants report talked of using the “SNM” as the catchy “new” name rather than Society of

Nuclear Medicine. The leadership also looked at impact of Molecular Imaging and how to embrace that entire community under the SNM banner. Along those lines the SNM and ERF launched the Molecular Imaging Capital Campaign. The goal of this campaign is to raise $5 million over 5 years to be used of the development of its work in the area of Molecular Imaging. The leadership so far has pledges of $1 million from General Electric Corporation and $500,000 from BMS and Siemens and over $50,000 from members attending the meeting. In the area of Advocacy and Government Relations the SNM is still working with our consultants and lobbyists to reinstate the Department of Energy funding for radioisotope research and develop-ment. The Federal licensure bill for Nuclear Medicine Technologists now has more sponsors than ever before but is still languishing waiting for someone to attach it to some bill or other. On the state level we have just been given word that the state of New York has finally passed legislating licen-sure for NMTs. This is a tremendous coup for the technologists of New York who were originally left out of the initial radiologic technologists bill passed over 20 years ago. This situation presented enormous problems for NMTs when PET/CT devices appeared. The SNMTS is continuing to move forward with its policy of Bachelors as the entry level degree for NMTs by 2015. They are working with the educators and technologists to develop appropriate edu-cation models, working on the curriculum, the pre-professional and professional courses and content areas. Another policy initiative of the SNMTS is to develop a new middle level provider, the Nu-clear Medicine Practitioner, for the practice of nuclear medicine. These practitioners will be masters educated nuclear medicine technologists who will be used in department as the assistant to the radi-ologist, cardiologist or nuclear medicine physician similar to the role of the Radiologist Assistant in radiology and Physician Assistant in the general and specialty practices. Continued on Page 4

Editor’s Note by Leo Nalivaika, MBA, CNMT

P A G E 2 V O L U M E 2 I S S U E 1

The summer has cruised right by and the fall will soon be upon us. This has been a very busy couple of months for everyone. The chapter has added a future technologist Kate Marianna Hogan to its ranks, daughter of our publisher. Congratulations to both mom and dad on a beautiful young lady. The fall seems to be shaping up to be a very busy schedule in regards to continuing education. The Worces-ter Grassroots Group headed up by Ed Kofton will have a meeting at the end of September. The physicians group will be having their annual regional meeting at the end of October in Mystic CT. Considering that the NMTCB is requiring mandatory continuing education I am sure that there will be increased attendance. Also for those not able to attend meetings this fall, the spring meeting for the technologists will take place in Provi-dence in the spring.

Congratulations to Mary Cross our new President-elect! Mary has hit the ground running, setting up a great venue for the 2007 spring meeting in Providence R.I. We anticipate a larger turnout for this meeting than this past spring so please do not delay when it is time to start reserving rooms. As for the spring 2006 meeting, a final thank you to our excellent speakers and everybody involved. The venue site was quite comfortable with the exception of some high volume attempts at singing next door while some of our speakers bravely carried on. Oh, the pleasures of working at an overbooked hotel. My experiment with a different reservation/pricing scheme failed in that attendance dropped from the previous year so we will return to the more traditional meth-ods of discounts for advance reservations and members compared to onsite and non member higher fees. Another strategy for improving attendance at our chapter spring meeting is of course to continue to provide relevant and stimulating educational programs. Past, present, and on the fence presenters are urged to contact Mary Cross as soon as possible so that you do not lose the chance to contribute your highly valued expertise to our spring program. Remem-ber, anybody presenting to our spring or fall meeting will receive reimbursement for one night’s lodging at the meeting site. Presenters who wish to attend the rest of any meeting for CEU purposes will register on their own. Also, our chapter must enforce a long standing agreement that we will not in any way support any other meeting that falls within one month before or after our annual spring meeting (usually late April). This means no financial support from the chapter, no announcements on the chapter web site, etc. no help obtaining speakers. However, any grassroots chairperson who puts together a program offering 3 or more CEU hrs not violating the above mentioned “blackout rule” will receive free registration at a chapter spring or fall meeting within one year after the grassroots event. We are fortu-nate to have many fine grassroots events and dedicated grassroots organizers. Keep up the great work – these events are a terrific value for time and money! Finally, a subject close and dear to me- please be good to your students and encourage them to present at the spring meeting. Everybody has a great time and it is the first official networking event for their new profession. A little for-ward thinking and effort can be greatly rewarded, short term and long term. Respectfully submitted, Dan

President’s Report by Dan Leahey, MA, BA, CNMT


By Gwen Meunier, BS, NCT. CNMT, RT(N) One of the final duties of Past-President is to manage and assemble the NEC-TS ballot for our new batch of elected officials. The following offices are due: President-Elect, Treasurer, Secretary and National Council Delegate. All members are encouraged to run for office. Any member in good standing is able to submit a nomination and any member in good standing may nominate himself or herself. Member participation is the only way to ensure the continued success of our chapter and enable us to continue to meet our primary objective: • To promote the discussion and communication of knowledge and to stimulate research in the field of Nuclear Medicine through

scientific and educational meetings. All nominees should complete a nominating form and attach their current curriculum vitae. The nominating form can be downloaded here. The office of President-Elect is a three-year commitment (President-Elect, President, Past-President). The offices of National Coun-cil Delegate and Treasurer are both two (2) year commitments or until their respective successors are elected. Candidates for Na-tional Council Delegate must have previously been an officer of the NEC-TS and must have been an NEC-TS member for a mini-mum of three (3) years. Full duties and responsibilities of each office are spelled out in the NEC-TS bylaws. Again, it is the responsibility of each of us to participate in our chapter. NEC-TS has a long-standing tradition of offering stimulat-ing and informative continuing education opportunities to it members. It is only with active member participation that we can ensure the continued viability of our chapter. Respectfully, Gwen Meunier BS, NCT, CNMT, RT(N)

Past Presidents’ Report

By Mary Cross, BS, CNMT Plans for the spring meeting are well under way. The meeting will be held Friday, April 27 and Saturday, April 28, 2007 at the Mar-riott Providence Downtown, Providence, RI. The student program will follow the same track as usual on Friday. Roughly one fifth the needed speakers are already scheduled for the technologists meeting. If you heard a great talk elsewhere and would like to hear more on that topic, please contact me. If you are interested in learning more about a particular topic, let me know. This is your meeting, I would love to get your input and will do what I can to schedule interesting talks. I am still looking for topics, speakers and moderators. If I can moderate and speak at these meetings you can, too. Please consider helping out. You can email me at [email protected], or speak with me at the fall meeting. See you in Mystic! Mary

President-Elect’s Report

NEW ENGLAND CHAPTER FALL BUSINESS MEETING SATURDAY OCTOBER 28TH, 2006 AT 7:30 AM

Mystic Marriott Hotel

http://www.nects.org/Bylaws.pdf


National Council Delegate Report, continued from page 1

Membership committee successfully brought two resolutions to the Council and Executive Committee. The first allows for all active duty military personnel to be given a 50% discount on membership dues but with all rights and privileges of full membership. They will receive the JNM and JNMT on-line so there will be minimal costs involved. Marc Cote will be our military liaison to implement this plan. The second gives a $5 cost saving for technologist dues to those members that sign up for an automatic renewal credit card billing system. The CEO of the SNM Virginia Pappas announced the reorganization of the leadership department and the appointment of a new em-ployee Mike Nelson as the SNM’s Chief Operating Officer and the technologist sections direct liaison at head quarters. The SNM office is work-ing hard to meet the needs of its members and I urge anyone in the New England chapter to contact if that effort is not translating into getting tasks completed or member satisfaction. The SNM is still active as it moves towards another fiscal year with many exciting projects keeping everyone in leadership busy. Speaking of leadership in the latest election for officers from the New England chapter were honored with one of our members being elected to the position of president-elect, David Gilmore. Congratulations to David and to all other winners Secretary Mary Beth Farrell and Finance Com-mittee chair Mark “Wally” Wallenmeyer. SNM President (Peter Conti) Welcome to Southern California. I will give my report later but at this time I want to give y’all an opportunity to address me. We need to refocus

and rebrand the SNM and I don’t want to say it again. We want to focus on Molecular Imaging and be careful about acronyms. Molecular imaging has been part of our tag line for so long but we need to start introducing this concept to the membership and it is our duty to be aggressive now. It is a time to act! We have a really big packet of information outlining the strategic plan of action. Industry has already stopped saying NM but has started calling it Molecular im-aging so we are behind the times. It has been 5 years so we paid $$$ for a survey to rebrand the SNM. There is a lot of information about jargon and what it means to “rebrand” the organization. Key findings are outlined on p.76. The SNM has a strong brand equity internationally and it is on target w/its program focus. There is confusion in the future and it needs to define its future direction and molecular imaging needs to play a greater role in the SNM. We have an

opportunity to enhance communication w/ the mb and key audiences to articulate the SNM and MI. We need to know our core purpose which is to advance molecular imaging and therapy. We need to be the member’s resource for education, knowledge, research, training and networking. We will advance patient care and maintain the highest standards in the world. Industry wants the SNM to step up to the plate and play hardball and we need to launch this campaign here at this meeting and thanks for industry representatives like GE who pledged $ 1M to make it happen. BMS and Siemens have pledged $500K each so we currently have $ 2 M. My personal goal is to get $3M by the end of this meeting. We do not have the resources ourselves as the SNM and we need sponsorships to make things happen and so we need to centralize and consolidate some of our operations b/c they have been too scattered through the years. We have a leadership and administration structure in place already and we have an advisory molecular imaging board. The brochure has been distributed to every member called “bench to bedside”. We need the mbs to partici-pate 100% and industry will join as they see the CNMTs joining in. I will be addressing the SNM membership later on next week at the HOD and the CNMTs plenary session. We need to aggressively recruit the laboratory technicians who are conducting research b/c they have no profes-sional organization that represents them. We need to expand our membership categories to include them. We are still aggressively after the DOE funding issues. I will be all over them trust me. I will be attending the academy of scientists later on in the year in Washington, DC. SNMTS President’s report (Val Cronin) This has been a busy year for me and I attended AHRA (San Antonio), ERF (Chicago), BOD (Reston) and HPN (Louisville). I attended the meet-

ings to learn about leadership skills and balancing the budget and knowledge based governance. We brainstormed to-gether as a group to review the current and future trends facing Nuclear Medicine. We met w/ Allied health organiza-tions to see where we are. I was able to travel to several chapters like the Eastern Great lakes, EANM (Istanbul) and Pittsburgh Chapter meetings where I partnered up w/ Scott Holbrook to present several talks on CT and the CNMT. We had an educational summit in Reston to discuss entry level requirements and advanced practice issues. We identified 4 major areas like program transition from 2 year to 4 year NMT programs at the college or university. The core curricu-lum of NM, U/S, MRI, PET and CT needs to be standardized throughout the USA. That way, we can develop national standards of education and certification. We also determined that SNM is not alone as a stakeholder. Industry, schools,

students, hospitals and clinics all have a vested interest in the success and outcome of this organization b/c they will cater their focus in education and technology accordingly. We must remember that we are not alone in this field and so we need to do a better job of outreach to our members and the general public to educate them about what it is that we do in Nuclear Medicine. I would like to say a very special thanks to Martha Pickett and Bill Hubble for all their “Never say die” attitude during the past year as difficult as it has been. It has been emotionally draining tak-ing the “dish” from fellow educators, technologists, doctors, regulators and credential bodies during the past several years working on the concept and then developing a curriculum for the entry level requirements and the Advanced practice technologist. I was invited to attend the SNM BOD strategic planning session (Dallas) and the Nuclear Medicine Advisory Board (Portsmouth, VA) where I addressed members from the Army, Navy and Air Force. This is the only school of NM for all military personnel. As the year winds down, we can see that much has been accom-plished but there still remains much more to do. We have a goal of establishing entry level requirements in the next decade --- CT inclusion in the NMT training programs (2010) and the B.Sc. minimum (2015). We applied a $20K grant to jumpstart the CT training in Reston and at centers throughout the US. To help jumpstart the college and university based APNM programs, each school was presented with a $20K check to help get the programs online. We currently have 3 schools offering the APNM program --- Medical College of Georgia (Atlanta), Massachusetts Col-lege of Pharmacy (Boston) and University of Arkansas (Norman). Our membership has been very strong during the past year and we are up by about 11% from the same period in 2005. The CARE Act currently has 125 cosponsors in the House and 16 cosponsors in the Senate. Though I hand over the reins over to my successor at the conclusion of this Annual meeting, I will continue to help chair the ERF advisory board and the Nominations Committee and I will continue to work hard to push for CT licensure for CNMT’s. I will be attending the Japanese meeting in July 2006 and the WCFNMB in Seoul, Korea where both Scott and I will have certain honors of chairing the meeting and the TS. Continued on page 5


SNMTS President-elect (Scott Holbrook) We have brought PET and CT courses online and we have set up several educational meetings around the country thanks to grants from the $ 20K from PDEF, Eastern isotopes and $ 1 M unrestricted educational grant generously donated by GE. Thanks for all the donations w/o which we

would not be able to advance CT and PET education. As I’ve moved up to the duties of President, there were some issues that have loomed in the air unresolved for several sessions which I would like to address once and for all. Peter Conti gave us a charge during the Mid Winter Meeting in Phoenix, AZ about technicians working in research laboratories as part of the university setting performing microCT, microPET, optical imaging and other molecular imaging modalities as research scientists and adopt a plan to recruit them as SNM members. Their situation is bleak in that they are in essence performing the same job as us but they are scientists and not licensed CNMTs. As such, they do not have any professional organization to which they can belong that shares in their interests or affiliated field of expertise. This would give them a forum to learn about affiliated scientific research going on around the world and also give them an avenue where they can exhibit their research and post displays. We need to be proactive instead of

always lagging behind and being reactive. This was adopted in committee and by the executive board. The 2nd major resolution was the question of a discount program for Active Duty Military Personnel who serve the USA at home and abroad at a significantly reduced salary and put their lives in danger’s way in such a noble cause. The least that we could offer them is a reduced fee for dues which is 50% of full price and they will receive the JNM and JNMT electronically since it is too difficult to lug around hard copies of the journal when their duty station changes. This resolution was also adopted. Lastly, we wanted some incentive for members to set up an automatic payment plan to renew membership dues. This would help offset the costs of servicing our members which is currently around $19 per member. Establishing an electronic payment method would decrease SNM operational costs to like stamps to mail out renewal notices, folding papers and processing cheques from members. This year, I decided to divide up the duties of the Secretary / Historian into 2 separate offices because the duties could not possibly be performed by any one person. Mary Beth Farrel will be the elected Secretary of the SNMTS. I exercised presidential power to appoint Alan Pan as historian which he accepted. David Gilmour vacated his elected posistion as Finance committee chair to become the elected president-elect. Therefore I invoked presidential power to appoint Karen Martin as the new Finance committee chair which she accepted. This completes all open seats of office to allow me to begin my term of office as president on solid ground. Membership Committee (Scott Holbrook) Resolution #1 was SNMTS expand membership category to include researchers and educators to follow Dr. Conti’s directive to aggressively recruit the laboratory technicians and non-traditional members working in affiliated careers. The executive board approved this but this will require a bylaws change from membership. This will be open to everyone MRI, CT, RT and future groups. SNM membership has remained steady b/c we aggressively market to MD groups and we have personally called past members to find out why they lapsed and to get them back. We also want to grow as a society. When we talk about outreach to broaden our technology and physician specialties, we need to work w/ industry to sell more cameras to more different associated fields. There are some negative forces like reimbursement which will limit the growth of NM so we need to attract a broader base of imaging fields. Resolution #2 was designed to attract Active Duty Military Personnel to give them a 50% discount with all rights and privileges of full membership. They will receive the JNM and JNMT on-line so there will be minimal costs involved. Marc Cote will be our military liaison to implement this plan. Resolution #3 will give a cost savings of $5 technologist dues to those members that sign up for an automatic renewal credit card billing system. This is because there may be a lapse b/c of an oversight and this will save in personnel labor costs as well. Executive Director’s Report (Virginia Pappas) This year’s annual meeting in San Diego, CA will be another smashing success with pre-registration way ahead of projections and the vendors are at 99% of budget. We won’t know the total numbers until registration opens on Saturday morning but if Tempe, AZ was any indication, we will be bulging at the seems again. Both major events have been opportunities for CNMTs, MDs, scientists and industry people to interact and unveil the latest technologies available. The CT workshops held around the country have been very successful once again. We have increased the education courses to include PET and CT along w/ radiation safety. Once again, there will be a game show ala the “Hollywood squares” theme so please come and have fun. The SNM Inc. annual report detailing the events of 2005 is available and contains the reports from SNM President, SNM CEO, SNMTS President as well as all the business of the SNM as a whole. The activities of the PET COE remains strong and this year we added the Molecular Imaging COE as a world leader in education for MDs, CNMTs and scientists. Thanks to everyone’s hard work, the JNM and JNMT remains as the flagship scientific journal of molecular imaging. As reported during the MWM, the SNM learning modules are in place as a resource for MDs to update their education and self-test their skills. At this time, I would like to introduce some new SNM HQ staff members. Deb Barnes was hired in winter of 2005 just before the MWM in Tempe, AZ and was a big help in the financial department. She has opted to stay aboard with the society and will now be functioning as the CFO for the SNM. I would also like to introduce Dr. Mike Nelson just recently started with the SNM. As you know, we are always experiencing a turnover in personnel as most organizations and companies do and we are very excited b/c he brings many years of experience into this organization. He will be a valuable help to me in administrating the operations of the SNM. He will be the assistant to the CEO and will now be officially occupying the position as the SNM’s Chief Operations Officer (COO). Even though Mike has been here for only a very short period of time but he sees the dedication of the SNM staff and leadership to excellence. We have a dynamic stream of energy and we have all the building blocks in place. That is the key in building the organization for the future. The SNM has solicited vendor support from commercial industry and GE has pledged $1M toward education. This is an unrestricted educational grant that is available when putting on an educational meeting. The $$$ will be used to pay for a speaker’s honorarium, travel and food costs. This will help chapters that are financially struggling to put together meeting or don’t have access to speakers to be on par with all the rest. The SNN CE dep’t has a list of speakers and you can choose the speaker that you want to come to your local meeting and then the SNM staff will make all the arrangements for you so it won’t cost the chapter any headaches or financial hardships. The SNM is committed to adapting itself to face the changes in the industry in the coming years. However, the SNMTS also needs a strategic plan to rebrand itself in parallel with the direction of the SNM. Your will need to plot out your roadmap to achieve your goals and the time frame to fit under the umbrella of the SNM’s focus as a world leader in molecular imaging. The challenge is on the table, now it’s up to the SNMTS to sound the charge.



SNMTS Treasurer’s Report / Finance Committee (Peggy Squires) As of 2006, the revenues up 11% and the operational budget of the SNMTS is extremely high. As you can expect, the costs of doing business has also translated into higher expenses too. After the 2nd quarter, we are a little bit behind from 2005 figures b/c we are missing the projected revenue from the distance learning education and the book release which is expected to generate some additional revenues. SNMTS revenues has grown steadily over the years and with the advent of computer DSL and faster ISPs, the revenues from education on-line has been significantly greater than MWM and Annual meeting participation. Don’t be alarmed by the high expenses figures b/c there was an allocation of $$$ to support some 2004 projects and a systematic formula of repayment was added to the expense side of the balance sheet. The net assets have increased over the past 4 years and we have cash reserve is currently 37% of our total operating budget but we would like to get to 50% of $1.8M just to be safe. The goal of the Finance committee is to establish a balanced budget each year. SNMTS biggest expense each year is in salaries for administrative staff and meetings. Remember that in 2005, there was a decrease in $$ b/c of several key mergers in commercial industry partners resulting in a huge drop in advertising revenues. Publications Committee (Dave Perry) Please salute Beth Harkness as the reader of the JNMT for the past 4 yrs. She has done a stellar job along with her group of volunteers Anne Steves and Elpida Crawford. Their efforts have made the journal a world leader in the science of NM. Though she is not here, we offer her our applause anyways. We will be increasing her annual stipend b/c of the amount of work involved. NMTCB (Lynn Faulk) The organization was founded in 1977 and shortly afterwards, offered its 1st NM exam in 1978. After it started, Barbara Horton started her long career at the helm of the organization and acted as the administrative director from 1979-1985. It currently has 18,500 active members and by 2005, there were 1200 1st time examinees for NM. The CEUs for members is dependent upon the birthdate so for those who birth year is an odd year, you are required to obtain 12 CEUs/yr. However, for those whose birth year is an even year, you are required to obtain 24 CEUs/2 yr and it doesn’t matter if you spread it out during the 2 year period or if you wait until the last weekend to do an all intensive class. Occasionally, there are random audits of CEUs and the member is required to submit documentation w/in 30 days. The disciplinary branch of the NMTCB will bind the non-compliant member with 6 months of probation initially. If there is no action after 6 months, that person will be suspended. That person can be reinstated but there is a fee and penalty structure. If the person has been inactive < 5yrs, they must pay reactivation fees and back dues for all those years. If the person has been inactive > 5 yrs, there is no recourse but to take exam again. There is an Emeritus category but this is only for non- working CNMTs. If the person were to go back to work, they must follow the directions for re-entry and reactivation of their license. In the area of specialty exams, qualified candidates must demonstrate expertise in Cardiology or PET and maintain active certificates from either the NMTCB, ARRT or CAMRT with over 700 hrs of cllinical work experience. Furthermore, they must have completed at least 45 hrs of CEUs in the areas of RP, clinical didactics and instrumentation. The CT specialty requires 2 years of experience and was 1st offered in 2001. The NMP exam is a conjoint effort b/w the ARRT & NMTCB and will be formatted in the style of essay and multiple choice questions. There will be 50/50 revenues split b/w the 2 organizations writing and adminstering the exam. We are working on a unilateral system of VOICE and CEU automatic tracking b/w the SNM, NMTCB and ARRT. ARRT Report (Jerry Reid) The ARRT has completed the NMP certification exam as a joint project b/w the ARRT & NMTCB since the students for the programs have already enrolled in their prospective schools. There are currently 3 schools offering the NMP program. We are committed to staying abreast of the wave b/c of what happened during the RA program. We were unprepared for the graduates coming out of the program and we still did not have the certification exam ready yet. Of course, there was only 1 school in California offering the RA program at the time. We’ve learned that the ARDMS is also offering an AP for U/S. From last year’s figures, the number of 1st time examinees has been making a steady rise each year. We are challenged by the speed at which new technology is entering the market. The educators have also been bombarded with the challenge to provide education to train students and prepare them to operate the new emerging technologies. advancing faster than cert XMs ASRT wanted ARRT re-exam q.10 yrs. Not true at all. Need ongoing competencies Regional accreditation spc. To radiology vs. hospital wide and non-radiology. JRCNMT Report We are more concerned about an accreditation process that is more geographically global vs. regional b/c that allows us to enforce standards to large numbers of people. This prevents small groups of people from escaping by special exclusions. In order for us to succeed to maintain the highest standards of SOP and SOC, we must be able to set practice guidelines and enforce them. I will be stepping down from my position within the next year but I would like to introduce my replacement Jan Wynn. She has been the director of Radiology services @ the University of Oklahoma and has worked in close association w/ Technologist Section for many years. I will remain as the CFO through 2007 during which time, Jan will be teaching director. I will stay on to work with Jan for about 1 complete year so that she will be fully capable of running the show before I retire completely. We will be having a workshop on Friday @ 1 PM and the FDA will be present as well so please come and address your concerns about your practice at that time. Professional Development Task Force (Ed Lyons) This morning we held an NCOR orientation just before the NCOR itself to welcome new friends and leaders coming from each of the chapter Jim Kritzma (Michigan), Paul Reahme (Central), Dave Blea (SWC), Howard Teng (Northern California) and Sug Duggal (PNW). Thanks to all the SNMTS leadership that came to address the newbies and offer then a word of encouragement. I would like to remind everyone that there will be an Emerging leaders seminar on Saturday from 10AM-2PM and we will need a lot of help b/c we currently have exceeded the registration at this event of the past 3 years combined as we currently have 40 people registered. It will take on a more philosophical approach this year different from the years past. If last year was any indication of this year’s turnout, we expect to be bombarded this year at the 1st timers brunch on Sunday 10 AM til whenever. Come one come all.



SNM Education and Research Foundation ERF (Frances Keech, Michael Devous) If anyone has the time, please drop by the booth and pledge. We are rewarding all contributors w/ a ribbon. I am pleased to announce that this past year we have given away grants & awards through the funds amounting to > $135,000 in 2006 ! We still need your $$$ b/c only 420 SNMTS members contributed to the ERF on their dues statement. That is only a small fraction of the total number of members in the SNMTS. We gave 34 individual $1000 Paul Cole scholarship to students of NMT. Unfortunately, we only received enough $$$ for 20 such scholarships so we were operating at a deficit. Looking at our membership as a whole, it just takes $10 per person/yr to keep up with the amount of scholarships and grants that we can offer. However, if we want to do more, we could make an impact on more people by giving away more scholarships and grants. Trust me, it can make a huge difference in their lives as a student. Professional Development and Eduational Fund (Frances Keech) This program was started to help fund education efforts in NM with commercial vendors who became our corporate friends. Each “friend” pledged $10K to be renewed annually and set the foundation of what it is today. There are 3 people here at this year’s SNM meeting from St Louis University b/c they were recipients of grant $$$ from the PDEF. Even though they were invited to present their papers and posters, the travel costs were prohibitive but b/c they received PDEF funding, they were able to cover their travel expenses. The PDEF also awarded 2 separate grants of $10K each to 2 universities to set up NMP programs. We all know that the NMP program will play a prominent role in the field one day and this is $$$ well spent to help meet the needs of the profession. We were able to grant 10 individuals with $500 travel grants so that they could be present to present their abstracts or posters at the SNM. We also granted 2 separate $5000 scholarships. We would lilke to thank our corporate friends who have generously donated $ 55,000 in 2006 to advance the field of NM through education. We have elected a new advisory board for the PDEF composed of members from the SNM, SNMTS and Industry. Bylaws Committee (Karen Martin) There were only 2 issues submitted to this committee by the membership committee and they were both passed w/ 95% vote. As Scott had mentionned already, we adopted the name change to include lab research assistants working on optical imagers, microPET, microCT and other modalities to join the SNM as members in affiliated sciences. We will also permit them to receive the electronic journal instead of the hardcopy saving $$$ and increasing the revenues. A discount program of $5 will be for those who renew automatically by credit card and a 50% discount from full price will be offered to Active Duty Military personnel as incentive to join the SNM. Nominating Committee (Nanci Burchell) As we decided last year, we adopted the electronic ballot system this year thinking that we have a more tech-savvy generation which would increase of ballot returns. We also wanted to save $$ and work in tallying up the votes but we received only an 8 % return which was very surprising. However, we were able to elect officers for SNMTS leadership for next year. I would like to thank all the candidates for running and congratulate those that won office. At this time, I would like to introduce the winners: President-elect David Gilmore, Secretary Mary Beth Farrel and Finance Committee chair Mark “Wally” Wallenmeyer. We decided to split the title and duties of the Secretary/historian position into 2 separate positions. The secretary will be the elected position while the historian will be a presidential appointed position. I would like to announce that Alan Pan will be our historican since he is Mr. photo already. During the MWM in Tempe, AZ, we elected a new speaker of the house with > 95% vote and that will take effect during MWM 2007. We had a really hard time maintaing a ballot to elect representatives from industry and other specialty areas. Holding office involves time and financial commitments which are difficult and we do understand why candidates must drop out and abstain. During the SNM National meeting, we will have a large gathering of potential leaders that qualify for office. This will be our last ditch attempt to fill the vacant positions so in order to allow us to hold an election, we are asking the NCOR to temporarily suspend article 10 of the bylaws which states that election notices will be sent 60 days in advance and that election results will be finalized 30 days b/f the SNM National meeting in June. We have elected Kathy Thomas as Executive Board representative Delegate at large from NCOR. The specialty area representatives include Nancy McDonald (Cardiology), Mark Wallenmeyer (Educator), Carol Bonanno (Industry), Lynne Roy (Management) and Christina Cook (Student). We also have a new nominating committee for 2007 composed of Martha Pickett, Debra Gibbs, Lyn Mehlberg and Cindy Luckett. Practice issues (Scott Holbrook) We received a letter from the cardiovascular council asking us for helping in endorsing the creationn of a limited license CT tech to operate the CTA and PET/CT for cardiac only. This letter was not endorsed by the executive board. This endorsement would give individuals CT qualifications to operate machines to do CTA and EBCT and function as a limited scope CT or specialty exam permit. Currently, 50% of NM is cardiology and then need some form of certification right now. We need to act right now. Very few states are doing it now. Let’s credential it now. Cardiac council is the biggest in SNM The last time we didn’t respond, ASNC was bourne. This would be Cardiac CT only. Would this be a specialty exam? This is a very broad scope of practice. Cardiovascular council drafted the letter w/ SNM permission but they want SNMTS approval. We need the ASRT, ASNC, ARRT, NMTCB, SNM players meet to form a TF to study this FAST. Executive council will reconvene to discus this and send a letter to Cardiovascular council. The NCOR recommends that the CV redraft a letter w/ verbage changes to spell out exactly what this would entail.



Advocacy Committee (Lyn Mehlberg) What we lack is consistent standards b/c only 25 states license CNMTs and only 18 states license RT’s. Believe it or not, 9 states have no license at all for X-ray or NMT. This leaves around 23 states w/ some kind of license for RT, NM or RTT. This loose legislation puts the CNMTs in a very difficult position when it comes to the issue of dual modalities. PET/CT was the 1st test but SPECT/CT and MRI/PET will no doubt stretch the CNMT or put him in hot water. In the state of Vermont, PET/CT units can only be operated by individuals holding CT and PET licenses. Finding this individual truly is 1 in a million so it comes at no surprise that there are no PET/CT units in operation in VT. In Kentucky, CT techs need RT training b/f they are eligible to sit for the boards. This pretty much walls off CNMTs from trying. The definition of physician supervision (CMS v. NRC) is different and allows many O/P centers to get away w/o an MD on site. That’s OK until something terrible happens. Then watch out. If the law is written such that no IV injx’ns of contrast is permitted w/o an MD on site, this could problematic for the PET /CT tech. Yes, there is a danger when it comes to injecting IV contrast. Don’t try to be a hero and inject w/o an MD present. For which procedures is it necessary to have an MD present. Does an MD need to be pressing on our backs when I comes to compounding an RP using lyophilized kits by a CNMT. Does he need the permission of an MD to mix up MAA, albumin colloid, HDP or MDP? In New Mexico, a sentinel case was cited in which a patient brought up criminal charges against a CNMT who mixed up an RP kit. Where do we draw the line? If JACHAO has it way, they will classify RPs as Rx so it becomes illegal for the CNMT to inject any/all kinds of Rx’s or RPs. Many of us probably don’t this one but if any of our dep’ts analyze components of blood for glucose, RBC, WBC etc, we must be credentialed by CLIA. Any kind of In vitro testing even something simple like RBC survival requires separate certifications. This means that all PET facilities require CLIA certification b/c we are doing glucose testing prior to injecting FDG. If you are certified, you are a CNMTs working outside the SOPs. How about some examples … how about the NMT who used to write the impressions of the scans into the patient’s medical records. How about the CNMT who was performing pediatric sedation w/o MD on-site? Of how about the NMT administering contrast, glucose or insulin w/o MD present? How about the mammo tech who called about administering miraluma @ o/p clinic? Don’t go anywhere b/c there a whole lot more. I’ve heard about EEG and EKG techs administering RP during the ETT. Of course there are some minor infractions like CNMTs capping IV needles or CNMTs injx’ns for sentinel nodes. But what about the CNMT injex’n morphine, Doby, adeno, persantin, aminophylline, lasix and insulin? It’s one thing to inject it when the MD is present but what if he is not? Can we sit idly by while JCHAO regulates us out of the field of NMT? Can we watch the FDA reclassify RP’s as Rx’s? No I say!!! They want CNMTs to document the storage, compounding, dispensing of all injections. This means being subject to nursing stds of administration of injectables. But how will we maintain our competencies & documentation? How many people are familiar with USP 797 regulating CGMP and pharmaceutical compounding? If this goes unopposed CNMTs will not be able to draw up IV flushes from an NS bag hanging up on a hook. These must be performed in a fume hood. In future, everything in NM must be in tight storage which means locked down and kept inaccessible even from housekeeping. Will this profession survive if we must adopt nursing standards wrt administration of RPs & NS injex’n, IV placement, and charting of patient status and verbal orders? You might ask what brought this on and that’s b/c of several recent sentinel events involving recent deaths in dep’ts. Med Marx report on the dismal nature of NMT dep’ts. Unfortunately, NMT is so obscure, Congress ways & means doesn’t know a whole lot about it and that translates into low $ from CMS. W/o adequate reimbursement, there are no jobs and no way of recruiting the brightest people into the field for the future. PET/CT is a Diagnostic CT procedure and if the CT information is not interpreted, there will be legal liability and malpractice lawsuits. Recently, a patient died on the camera when the machine got hooked up on something and the CNMT didn’t know where the e-stop was to stop the camera motions. The camera had been operated by an uncertified technologist. During a recent VQ scan, a patient coded b/c PE which is possible. But, the patient was transported from the outside and the EMTs did not bring the patient to the ER but brought the patient directly to NM dep’t. There was another case of a MIBI injx’n infiltration and now the patient is suing for nerve damage. There is another case of a patient claiming Ulnar nerve damage/severed during IV placement b/c no documentation was available. How about the wrongful death of a patient in radiology b/c he was injected w/ cleaning sol’n instead of contrast. The dep’t decided to buy bulk syringes and the tech didn’t know if it was contrast or saline? There was the mammo tech who falsified QC data to MQSA and consequently, the imaging facility had to re-screen about 1500 cases. We really need to define our practice guidelines, SOP, PPM, SOC & state guidelines. The ASRT & their lobbyists met w/ senate already and after their bill was signed, I received a copy of it. What are we waiting for? The NCOR must address practice issues and work closely with HCPP and develop a roadmap & strategic vision of the profession or else our profession will be taken away from us one piece at a time. Will we sit idly by on the issue of administration of RPs, clinical competencies. Do we even have a NMT/PET job description available? We need desperately to establish an on-line forum to serve as a resource for licensure, regs, certification etc. SOP Document (Lyn Mehlberg) SOP document must be evaluated regularly as the practice and the field evolves. The Health Care Policy and Practice group will be meeting this Saturday so please come on out to listen and find out what is going on. It affects our future. We have been drafting words but we need a directive from the SNMTS board. Where are we going w/ the PET/CT and NucCard stuff. We need some kind of TF or Exec council. NCOR needs to initiate a triad concensus conference on standards w/ accredition and credentialing bodies in SNM of labs and education to establish comms b/w ourselves and allied health agencies. This is a huge job for a TF and I’m not sure it can be done but it’s worth a try. Through advocacy, we must define a roadmap and formulate a strategic plan. Then, we need to bring the stakeholders together. This is a job for the outreach TF as well. Practice issues from the Chapters (Mike Nelson) I’ve listened to everyone’s feedback about the problems they’ve experienced regarding VOICE and CEU recording challenges. We’ve been bombarded by the number of applications for CEUs and we are processing them as fast as we can. We should be caught up in a month. Our current methods of recording CEUs online & at meetings need to be retooled. We do need to investigate some system of shared expenses equipment, computers, software etc. that the chapters can use to facilitate their operations.



Chapter issues (Nanci Burchell) Chapter representation is the XO, Chapter president, NCD to come for the summitl Speaker’s bureau is administered through Lyn Barnes to support chapter level educational programs. GE has supplied $$$. All we require is for each chapter to look at a list of speakers available and then we will pay to have the speaker come out and come to your local chapter meeting. Committee on Chapters (Sandy McEWAN) Accept minutes. Review of committee minutes. We need to make changes b/c the committee was ineffective in the past and w/o making any changes, there is no future. A retreat was held in May 2006 and not everyone was able to attend. This committee needs to be chaired by an SNM member for some time. I.e. a retiring chapter president appointed by the president-elect. The chair will take issues to the HOD or Exec board and be an effective link b/w the bodies. This will be a 2 yr term of office to have continuity. Electing the Vice chair is not good b/c it would become a 4 yr commitment. That would be too long. I know there is a problem b/c group members cannot always get to meetings. Every geographical chapter should be represented by the President, President-elect from both MD and TS so there should be a total 4 people. If someone is not able to attend, one can appoint proxy representation. I'm opposed to the idea of the immediate past President b/c he may be an old fart and not conducive to forward thinking. So what are the duties and responsibilities of the chair? We need to define this rather quickly. Teleconference is probably the fastest and cheapest way of communicating with everyone across the country? How active should this committee and members be? We will have a teleconference in October 2006 to discuss issues further. What are the boundaries of this committee? Advocacy, chartering etc.. I think we definitely need to mentor new leaders. I hope that each time we meet, we solve 1 problem. We want SNM leadership present to facilitate the discussion to action. I propose that we use the MWM Sunday post-HOD time to have a strategic planning session. In keeping with the new organizational structure for the SNM à nimble. Following the MWM in Tempe, AZ we now have CFO and COO branches and everything will fall underneath these 2 branches. We need to develop a welcome packet for new chapter leadership i.e. Pres-elect. This needs to be sent out annually to each chapter and then we need to follow-up the mailers w/ a phone call. We need to post the Calendar of events on the SNM website. I think that the SNM should foot the $$$ to bring SNM leadership to the local chapter meetings each year. We need an orientation manual and a policy manual which each chapter can use as a guideline and then customize to suit its particular needs. We have a speaker’s bureau that is funded by an unrestricted educational grant from BMS and GE and Cardinal health. What we want each chapter to do after each SNM and chapter meeting is to choose the top 3 or 4 speakers and the abstract of the talk and make it available to the SNM and other chapters. The SNM speaker's bureau grant will pay all expenses for 2 speakers / chapter to come to your local meetings. We may need this committee to work on advocacy issues. No doubt there will be individual differences for each state and chapter but we can certainly share in some information and means. We need this committee to develop local and national leadership which I see that the SNMTS>>SNM. As for the MDs, it is often the same old farts here every year. That has got to change and now is the time. I would like to thank SNMTS Historian Alan Pan, CNMT for the detailed information in this report. Frances K. Keech, MBA, RT(N), FSNMTS


PLEASE LET US KNOW!

We are looking for Nuclear Medicine Departments who still does perform the following studies:

• Schillings • red cell masses • and esoteric studies

Please contact Leo Nalivaika at [email protected] and let us know if your department can perform these studies or if you know of a department that does.

mailto:[email protected]

P A G E 1 0 V O L U M E 2 I S S U E 1

These three cases illustrate the vital role that all nuclear medicine technologists make daily as they acquire and preview data before releasing a patient.

FDG PET/CT Case Study Submitted by Dan Leahey, MA, BA, CNMT

Image 1: The first is pretty basic. It is known that the patient has pathology in the left arm so the right arm is used for injection. Even though this site as many typically prefers arms up for FDG PET scans, the left arm must remain at side to view the pathology.

Image 2 A,B: In this FDG scan, there is significant infiltration of dose, creating a streak artifact, making it impossible to evaluate adrenal in this patient with lung cancer. The aware technologist who previews data before releasing the patient can easily acquire another limited view of the unresolved area with the infiltrated activity out of the field of view.

Image 2A

Image 2B

Case Studies continued on page 11

P A G E 1 1 V O L U M E 2 I S S U E 1

Image 3: Of all the luck, it was a clean injection of FDG but arterial, so we see the classic “glove” effect. The single lung lesion is seen but SUV calculations are affected and there may or may not be more subtle areas not appreciated. A delayed scan may have been appropriate.

FDG PET/CT Case Study Submitted by Dan Leahey, MA, BA, CNMT

Help Wanted/Mark Your Calendars

Moderators and speakers are needed for the next

NECTS Spring Symposium

Friday, April 27-Sunday, April 29, 2007 Marriott, Providence, RI

Please contact: Mary Cross, President-elect

[email protected] Phone: (401) 378-8591-work cell phone-please leave a message.

(508) 543-7505- home

2006 Spring Symposium Student Presentation Abstracts

The following pages are abstracts from the student presentations during the 2006 Annual Symposium.

Congratulations to all of our students!

Students L to R - Chris Benker, Kelly Carlin, Janet Semensi, Karl Prophet,Tam Pham, Melisaa Jokinen, and Lisa Morris

Outstanding paper award winner Christopher Benker 2nd from Left with R to L Tony Scianno, Mark Sarri & Gwen Meunier

President Gwen Meunier BS, CNMT, NCT, RT(N) UMass Memorial Medical Center Memorial Campus 118 Belmont Street Worcester, MA. 01605 Tel: 508.334.1235 E-mail: [email protected] President-Elect Dan Leahey, MA, BA, CNMT 53 Iroquois St. Worcester, MA 01602 Tel: (508) 756-4104 E-mail: [email protected] Past President Kathleen M. Krisak BS, CNMT Holyoke Hospital Nuclear Medicine 575 Beech Street Holyoke, MA. 01040 Tel: (413) 534-2545 Fax: (413) 534-2767 E-mail: [email protected] Treasurer Erin Kistler, BS, CNMT Children's Hospital Division of Nuclear Medicine 300 Longwood Avenue Boston, MA 02115 Tel: 617-355-7010 Fax: 617-730-0623 E-mail: [email protected] Secretary Mark Corbin CNMT, RT(N) St. Vincent’s Hospital 123 Summer Street Worcester, MA 01608 E-mail: [email protected] National Council Delegate Frances K. Keech, MBA, RT(N), FSNMTS MA College of Pharmacy & Health Sciences Assistant Professor 179 Longwood Avenue Boston, MA 02115 Tel: (617) 732-2928 E-mail: [email protected] Editor-In-Chief Leo Nalivaika MBA, CNMT UMass Memorial Healthcare Division of Nuclear Medicine 55 Lake Avenue North Worcester, MA 01655 Tel: (508) 856-5241 Fax: (508) 856-6867 E-mail :[email protected]

NEW ENGLAND CHAPTER TECHNOLOGIST SECTION SOCIETY OF NUCLEAR MEDICINE

The 37th Annual Spring Symposium

April 21st and 22 nd 2006 Marriot Hartford Downtown

Hartford, CT **Oral Presentations Only**

Systemic Radionuclides for Palliation of Osseous Metastases: Past, Present, and Future Concepts Abstract: Bone pain is a common complication for terminal patients with bone metastases from prostate, breast, lung, renal cancers and other malignancies. Multi-site bone metastases, a secondary consequence of these solid malignant tumors can lead to various complications including fractures, hypercalcemia, as well as reduced performance status and a quality of life. These types of metastases occur as a result of complex pathophysiological process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. The process is mediated by parathyroid hormones, cytokines, and tumor derived factors, while requiring a multidisciplinary approach in treating the resulting bone pain. The approach to treatment is generally required not to only address the origin of the pain and its complicating factors,but also to treat the patient appropriately. Currently the treatment of bone pain from metastases remains palliative with systemictherapy (analgesics, hormones, steroids, biophosphonates, and chemotherapy) as well as local treatments (such as surgery, nerve blocks, and external beam radiation). However, many of these treatments are limited in their efficacy or duration and have significant side effects that seriously limit the cancer patients’ quality of life. Over the years, treatment of bone pain using bone-seeking radiopharmaceuticals has been explored extensively. Evidence supporting the use of pharmaceuticals labeled with energetic beta particle emitters such as P-32, Sr-89, Sm-153, and Re-186, in addition to the low energy electron emitters Sn-117m and Ra-223, will be reviewed in this paper. Metabolic radiotherapy is simple to administer, complements other treatment options, improves patient mobility and reduces the dependence on narcotic analgesics. Yet, bone marrow toxicity as a consequence of chronic irradiation by the energetic beta particles is a general problem associated with this form of treatment. It is therefore desirable to identify radiochemicals that minimize the dose to bone marrow and at the same time deliver therapeutic doses to the bone.

TYPE FULL NAME OF AUTHOR PRESENTING PAPER Christopher Benker

Name Institution Division/Dept. Street City State Zip Code E-mail Phone

Christopher Benker University of Massachusetts Medical Center Nuclear Medicine Dept.

List the name, address, e-mail and telephone of the author who should receive all correspondence.






Lymphoscintigraphy Utilization in the Detection of the Sentinel Lymph Node for Malignant Melanoma Lymphoscintigraphy has a long history of utilization in the detection of the sentinel lymph node in cancer patients with malignant melanoma. The sentinel lymph node has been an important predictor of the metastatic status of the spread of cancer cells via the group of lymph nodes surrounding the cancer site. Mapping of the lymph nodes via lymphoscintigraphy aids in the location and dissection of the sentinel node and is a less invasive and the preferred technique for removal of the draining node versus the radical lymph node removal that had been done in the past.1 This paper will examine the history and development of lymphoscintigraphy from the blue dye method to current nuclear medicine techniques. Variations in lymphoscintigraphy techniques such as injection distances from the melanoma site will be discussed along with an overview of melanoma in its various stages and the physiology of the lymph system and the role lymphoscintigraphy plays in the management of malignant melanoma.

TYPE FULL NAME OF AUTHOR PRESENTING PAPER Janet Semensi


Janet Semensi UMass Medical School Nuclear Medicine Dept. 370 Mechanic St. Leominster, MA 01453 [email protected] 978-537-1088







Correlation Between Extensive Coronary Artery Disease (CAD) and Transient Ischemic Dilation (TID). Transient Ischemic dilation (TID) or transient left ventricular cavity dilation is the result of a lack of perfusion to the sub-endocardium caused by exercise/pharmacological stress-induced ischemia. TID is often observed in myocardial SPECT images and has been found to be a marker for multi-vessel or extensive coronary artery disease (CAD).

Over the past 25 years many studies have been performed to provide a better understanding of the TID phenomenon, its origin, how it works, factors affecting TID ratios and its prognostic value for predicting high risk for severe CAD or likely cardiac events.

The three main causes behind TID were described as subendocardial ischemia, systolic dysfunction and physical dilation. Sub-endocardial ischemia was determined to be the most common source of TID and physical dilation the least common. Actual TID values were derived and studied in order to determine high or low probability of multiple vessel disease and extensive CAD in different groups of patients. From the many studies performed a strong correlation was found between CAD and TID values. Even though this strong correlation exists between CAD and TID when evaluating potential for high risk cardiac events, TID threshold values obtained from one type of study may not be valid for a different type of study: thallium-201 vs Tc-99m sestamibi and pharmacological versus exercise stress test or dual isotope studies or planar projection imaging and SPECT imaging. The cut off for abnormal TID values may range anywhere from 1.12-1.36.

TYPE FULL NAME OF AUTHOR PRESENTING PAPER KARL R.PROPHETE


KARL R.PROPHETE UMass [email protected]







Single Photon Computed Tomography and the Affect of Attenuation and Attenuation Compensation

in Myocardial Perfusion Imaging The early detection of coronary artery disease (CAD) is important for the preservation of the myocardium. Radionuclide imaging is a non-invasive and highly effective way to assess coronary perfusion. SPECT imaging is the dominant method preferred over planar when imaging the heart, but it is prone to attenuation artifacts from soft-tissue and other body habitus. The most common artifacts can be seen from the attenuation of breast tissue in women and diaphragmatic attenuation, which is more common in men. These artifacts may result in false-positive cardiac SPECT studies in the healthy patient and can cause unnecessary risks and exposure to them with further testing. The correction for that attenuation, known as attenuation correction (AC), is constantly being evaluated and is even implemented in numerous nuclear medicine departments. It has been proven that AC will minimize artifacts associated with attenuation and will also increase the specificity of cardiac SPECT imaging. In AC scans, transmission imaging is used to create patient specific attenuation maps to help correct for artifacts associated with attenuation. The Picker Irix (Phillips) camera with Beacon is an example of this and is the camera used at the UMass Medical Center in Worcester, Mass which utilizes a point source for transmission imaging along with the 201Tl cardiac studies. Attenuation corrected images are a step into the right direction for future more precise myocardial perfusion interpretated studies.

TYPE FULL NAME OF AUTHOR PRESENTING PAPER Kelly Carlin


Kelly Carlin [email protected] 603-801-7491







Baclofen Shunt Patency

Background: Baclofen shunt studies are rarely performed in Nuclear Medicine. This study was done to evaluate the effectiveness of the Baclofen shunt. Two weeks prior to the study the patient presented with increased leg spasms and it was determined there was a possible leak. Method: Patient was injected with .625 mCi In111-DTPA into the pump reservoir. At the current pump rate, it is expected that the In111-DTPA willreach the catheter tip in 48 hours, and should reach the ventricles in the brain by 72 hours. An immediate image was obtained to insure proper administration of the radiotracer into the pump reservoir. 48 hour post injection images were obtained to see the flow of radiotracer through the catheter tubing. 72 hour post images were obtained to determine flow of radiotracer to ventricles of the brain. Results: The immediate image showed proper administration into pump reservoir. 48 hour images showed the tracer flowing through catheter to patient’s spine and stopping. 72 hour images showed same tracer flow as 48 hour image. Due to the 48 and 72 hour images being identical the physician determined there was a leak in the catheter and the Baclofen was being pumped into patient’s abdomen. Radiographs were obtained to determine exact location of pump and they showed that the pump tubing had a split. Conclusion: The pump tubing was replaced and further evaluation occurred.

TYPE FULL NAME OF AUTHOR PRESENTING PAPER Lisa M. Morris


Lisa M. Morris


MCPHS

[email protected] 781-844-6592






The pitfalls of thyroid imaging

Thyroid imaging has proven useful in the assessment of the

functionality of thyroid nodules, hypothyroid goiters, hyperthyroid goiters,

neonatal hypothyroidism, ectopic thyroid tissue (lingual, substernal, or

pelvic (struma ovarii) thyroid tissue), suspected thyroiditis, and uptake

function prior to radio-iodine treatment.

There are a few potential pitfalls while imaging thyroid tissue that

will be further discussed. Some things to consider are the differences in

the two isotopes, soft tissue attenuation, varying patient position, parallax

error while using a pinhole collimator, patient medications, foods that

contain iodine, salivary gland activity using pertechnetate, the possibility

of lingual or substernal thyroid tissue, or the possibility of struma ovarii,

the time of uptake and scan after the dose is administered, the amount of

the dose that is absorbed by the body, and contamination due to sweat or

urine.

TYPE FULL NAME OF AUTHOR Melissa Jokinen


Melissa Jokinen UMASS [email protected]







“Diagnosis of Osteomyelitis in Diabetic Patients Found in Nuclear Medicine”

Abstract:

Osteomyelitis, or inflammation of the bone, is usually caused by

bacterial infections. It is a leading problem for diabetic patients, due to

high-risk susceptibility of the disease. These high-risk foot problems

often lead to infection, and often undergo amputation, if left untreated

for long periods of time. Using diagnostic imaging in nuclear medicine,

to show the function and anatomy of body organs by using very small

amounts of radioactive tracers that can accumulate in certain organs

and tissues of infection, will certainly help lead to findings used to

diagnose osteomyelitis.

TYPE FULL NAME OF AUTHOR: Tam Hoan Pham PRESENTING PAPER








Radionuclide Cystogram (RNC) The Radionuclide Cystogram is the voiding test using radioactive

material that is placed into the bladder to determine whether a child has Vesicoureteral Reflux. This is a condition that causes urine to move backwards from the bladder, through one or both of the ureters, and up to the kidneys. Two techniques may be used: Ether mix radiotracer with saline and slowly fill the bladder or instill the full dose of radiotracer into the bladder and then slowly fill the bladder with non-radioactive saline. A normal result is no reflux or other abnormal urine flow, and no obstruction to the flow of urine occurs. An abnormal result is backflow of urine may be revealed when the bladder is full or during urination. Reflux is an important cause of renal scarring and reflux nephropathy, a type of kidney damage that can lead to hypertension and even kidney failure. Further testing, such as a renal scan or DMSA scan may be needed if renal scarring is suspected.

TYPE FULL NAME OF AUTHOR PRESENTING PAPER Truc Vo


Truc Vo UMass Medical/Worcester State College Nuclear Medicine 178 Powell St Lowell MA 01851 [email protected] 978-970-0681


Approved for 3.0 CEU’S by the Society of Nuclear Medicine

8am “REVIEW OF PET FOR THE NUCLEAR MEDICINE TECHNOLOGIST” DON YOO, MD DIRECTOR, NUCLEAR MEDICINE, THE MIRIAM HOSPITAL 9am “NUCLEAR PHARMACY PRIMER” ELIZABETH J. CARP BERNOTAVICIUS, PharmD, BCNP STAFF PHARMACIST, CARDINAL HEALTH, NPS

10am “OVERVIEW OF CARDIAC PET ” JAMES A. ARRIGHI, MD

DIRECTOR, NUCLEAR CARDIOLOGY, RHODE ISLAND HOSPITAL

$15 fee (per CEU )- $45.00 fee for 3.0 CEU's for nuclear medicine technologists who are not members of the SNM- payable to the NEC-TS NO FEE for nuclear medicine technologists who are members of the SNM

$10 fee for 3.0 CEU's for all non-nuclear medicine technologists, payable to RIH Diagnostic Imaging

FAX or MAIL pre-registration form to PAM MAISANO

Rhode Island Hospital School of Diagnostic Imaging, 3 Davol Square Box 162, Bldg A, Providence, RI 02903 FAX 401-457-0219

Name____________________________________________________Date_________________

Address_______________________________________________________________________

SNM Membership #________________________________________No Fee_______________

Payment Enclosed - nuclear medicine technologist - non member Payment Enclosed - Non-nuclear medicine technologist

Greater New York and New England Chapters of the

SOCIETY OF NUCLEAR MEDICINE

Twentieth Annual Northeast Regional Scientific Meeting

OCTOBER 27 – 29, 2006Mystic Marriott Hotel and Spa, Mystic, Connecticut

MEETING DESCRIPTIONThe Annual Scientific Meeting of the Greater New York and New England Chapters ofthe Society of Nuclear Medicine is a continuing education course designed for nuclearmedicine physicians, radiologists, technologists and scientists. Nationally recognizedfaculty will provide attendees with information that will enhance clinical practice. Thisyear’s program will review nuclear medicine applications to such fields as cardiology,neurology, oncology, and therapy. Advances in topics such as PET, PET/CT, SPECT/CT,infection imaging, and molecular targeting and therapy will also be included.

GENERAL INFORMATIONDATES: October 27 – October 29, 2006

LOCATION: Mystic Marriott Hotel and Spa, 625 North Road (Route 117),Groton, Connecticut 06340, 1-860-446-2600

REGISTRATION: Marriott Ballroom Foyer, Friday, Oct. 27, 2006, 7:30 AM.

EDUCATIONAL OBJECTIVES: At the conclusion of this course, the attendees willbe able to:

• Integrate PET imaging, PET/CT imaging, and SPECT/CT imaging into their daily practice in conjunction with other imaging procedures.

• Have an understanding of recent developments in SPECT scanning, PET, and PET/CT as they relate to Cardiology, Oncology, Endocrinology, and Orthopedics.

• Recognize the differences between conventional therapy options and radioimmunotherapy.

• Understand the current standards and strategies for cancer staging.• Review the current data for prognosis and risk stratification among

patients with diabetes mellitus.• Evaluate the need for early and accurate diagnosis of breast cancer.

ACCME ACCREDITATION STATEMENT: This activity has been planned andimplemented in accordance with the Essential Elements and Standards of theAccreditation Council for Continuing Medical Education through the joint sponsorshipof the Society of Nuclear Medicine (SNM) and the Greater New York and New EnglandChapters, SNM. The SNM is accredited by the ACCME to provide continuing medicaleducation for physicians.

AMA/PRA DESIGNATION 1 STATEMENT: The Society of Nuclear Medicine designates this education activity for a maximum of 16.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

VOICE CREDITS: VOICE credit is pending approval from the SNMTS.

ACCOMMODATIONS: A block of rooms has been reserved at the beautiful Mystic Marriott Hotel and Spa. The hotel is located off of Exit 88 on I-95. All guest rooms are equipped with high-speed Internet access, data ports, voice mail, cable television, and in-room safe. Recreational facilities include an indoor pool, fitness center, whirlpool, and the Elizabeth Arden Red Door Spa. Nearby attractions include Olde Mistic Village, Mystic Seaport Museum, Mystic Aquarium, and Foxwoods and Mohegan Sun casinos. Reservations can be made at 1-866-449-7390. The rate for single or double occupancyis $165.00 per night, excluding tax. Please identify yourself as an attendee at the Society of Nuclear Medicine meeting. The hotel will hold reduced room rates until September 27, 2006.

CALL FOR ABSTRACTSAbstracts must be received by September 15, 2006POSTER SESSIONS: The Scientific Program Committee of the Greater New Yorkand New England Chapters of the Society of Nuclear Medicine invites the submissionof original abstracts for the Northeast Regional Scientific Meeting to be held October27-29, 2006 at the Marriott Mystic Hotel in Mystic, CT. Papers on all aspects ofnuclear medicine will be considered. Basic science presentations are encouraged. All accepted presentations will be made in poster format (4’ vertical x 8’ horizontalboards). Meet-the-author(s) sessions on October 27 and 28 will culminate in an awardceremony on October 28, at 5:00 p.m. for the top three posters as determined by theJudging Panel. Abstracts will be published in Clinical Nuclear Medicine and shouldbe no longer than 250 words. Tables and figures should be included in the “Results”section. Abstracts must be submitted on a floppy disk or CD-Rom in a standard wordprocessing format: Microsoft Word or Corel WordPerfect is preferred. The authors’names and affiliations should be included with the title of the abstract. Each submitted disk must be clearly labeled with the presentation title and the word processing program and version. Each disk should contain only one file – the abstractto be presented. If you are submitting multiple abstracts, you must submit a separatedisk for each one. Each disk must be accompanied by a printout of the abstract.Please include a cover letter with the corresponding author’s name, address and contact information. The disk, printout, and cover letter should be sent to:

Salil Sarkar, M.D.Jacobi Medical CenterDepartment of Nuclear MedicinePelham Parkway and Eastchester RoadBronx, NY 10461Phone (718) 918-4894e-mail: [email protected]

7:30AM REGISTRATIONMarriott Ballroom Foyer

PET IMAGING AND RADIOIMMUNOTHERAPYModerator: Victor Gerbaudo, PhD

8:30 National Oncology PET Registry Kenneth McKusick, MDDenise Merlino, CNMT

9:30 Radioimmunotherapy of Prostate CancerStanley J. Goldsmith, MD

10:30 COFFEE BREAK & VISIT THE EXHIBITS – Exhibit Hall

11:00 Radioimmunotherapy of Melanoma and Infection Ekaterina A. Dadachova, PhD

12:00 LUNCH

ENDOCRINE NUCLEAR MEDICINEModerator: Maroun Karam, MD

1:15 Treatment of Hyperthyroidism and Differentiated Thyroid CancerSalil D. Sarkar, MDORTHOPEDICS AND INFECTION IMAGINGModerator: Josephine N. Rini, MD

2:10 SPECT/CT in InfectionElizabeth Oates, MD

3:05 REFRESHMENT BREAK & VISIT THE EXHIBITS – Exhibit Hall

3:35 SPECT/CT in Orthopedic Nuclear MedicineStephen C. Scharf, MD

4:30 Role of FDG-PET Imaging in Fever of Unknown Origin Hongming Zhuang, MD, PhD

5:25 ADJOURNMENT

5:30 RECEPTION – Exhibit Hall

Saturday, October 28, 20067:30 AM REGISTRATION

Marriott Ballroom Foyer

UPDATES IN NUCLEAR MEDICINEModerator: Scott Britz-Cunningham, MD, PhD

8:00 Molecular Imaging of Alzheimer’s Disease Masanori Ichise, MD

8:45 Hepatobiliary ImagingHarvey A. Ziessman, MDNUCLEAR CARDIOLOGYModerator:Mark I. Travin, MD

SCHEDULE Friday, October 27, 2006

9:30 Quantitation of Myocardial BloodFlow Using Rb-82 PET Georges El Fakhri, PhD


10:45 Future of Nuclear CardiologyKim A. Williams, MD

11:30 Read with the Expert: There’s an Alien in My ScanKim A. Williams, MD

12:15 BERSON/YALOW AWARD PRESENTATIONRecipient: Josef Machac, MD

12:30 CHAPTER LUNCHEON HOLMAN/KAPLAN AWARD AND LECTURE

1:45 The Evolving Role of PET in DementiaRonald L. Van Heertum, MDPET/CT AND SPECT/CT IN ONCOLOGY Moderator: Renee M. Moadel, MD

2:30 Receptor Imaging and Its Clinical Management Potential David Mankoff, MD

3:15 REFRESHMENT BREAK

3:45 PET/CT of Breast CancerDavid Mankoff, MD

4:30 SPECT/CT in OncologyHarvey A. Ziessman, MD

5:15 POSTER PRESENTATION AWARDSSalil D. Sarkar, M.D

5:30 ADJOURNMENT

Sunday, October 29, 20068:30 CONTINENTAL BREAKFAST

NEW ENGLAND & GREATER NEW YORK BUSINESS MEETINGS

NUCLEAR CARDIOLOGYModerator: Robert Jaros, MD

9:00 Diabetes Mellitus and Coronary Risk Factor StratificationMark I. Travin, MD

10:00 PET/CT of the HeartSharmila Dorbala, MDPET AND GENERAL NUCLEAR MEDICINEModerator: Simin Dadparvar, MD

11:00 Read with the ExpertsRachel Powsner, MD Renee M. Moadel, MD Nataraj Shanmugam, MD

12:00 ADJOURNMENT

TECHNOLOGIST SECTION Saturday, October 28, 20067:30AM REGISTRATION – Marriott Ballroom Foyer

7:55 Opening Remarks Lynne Sabo, CNMTPresident, Greater New York Chapter, SNMDan Leahey, CNMTPresident, New England Chapter, SNM

8:00 Technical Design and Operation of a PET and PET/CT LabSteve Wozniak, BS, CNMT, RT(N

8:55 Clinical Implications of the Physiology and Anatomy of FDG Uptake Philip H. Kuo, MD, PhD


10:20 The Key to Unlocking ArrhythmiasKristen Hallisey, RN, BSN, CVN

11:15 An Overview of Cardiac CTAJustin Lundbye, MD

12:15 BERSON/YALOW AWARD PRESENTATIONRecipient: Josef Machac, MD

12:30 CHAPTER LUNCHEON

1:45 Cross-sectional Anatomic Correlation in PET, CT, MRI & SPECTAnthony Yudd, MD, PhD

2:40 Hepatobiliary Scanning: Beyond Acute CholecystitisRonald N. Kaleya, MD

3:35 REFRESHMENT BREAK

4:00 Current Trends in Nuclear Medicine SafetyIra M. Garelick, MS, DABR

5:30 ADJOURNMENT

PROGRAM DIRECTORSVictor Gerbaudo, PhD Renee M. Moadel, MD

PROGRAM COMMITTEESusan Dahl, CNMT Josephine Rini, MDMargaret Doonan, CNMT Salil D. Sarkar, MD

ADMINISTRATORSApril Mann, CNMT Mitchell H. Stromer, MBA

FACULTYScott Britz-Cunningham, MD, PhDEkaterina A. Dadachova, MDSimin Dadparvar, MDSharmila Dorbala, MDGeorges El Fakhri, PhDIra M. Garelick, MS, DABRVictor Gerbaudo, PhDStanley J. Goldsmith, MDKristen Hallisey, RNMasanori Ichise, MDRobert Jaros, MDRonald N. Kaleya, MDMaroun Karam, MDPhilip H. Kuo, MD, PhDJustin Lundbye, MDDavid Mankoff, MD

Kenneth McKusick, MDDenise Merlino, CNMTRenee M. Moadel, MDElizabeth Oates, MDRachel Powsner, MDJosephine N. Rini, MDSalil D. Sarkar, MDStephen C. Scharf, MDNataraj Shanmugam, MDMark I. Travin, MDRonald L. Van Heertum, MDKim A. Williams, MDSteve Wozniak, CNMTAnthony P. Yudd, MD, PhDHongming Zhuang, MDHarvey A. Ziessman, MD


SOCIETY OF NUCLEAR MEDICINETwentieth Annual Northeast Regional Scientific Meeting

October 27 – 29, 2006

MEETING REGISTRATION FORM (Please Print)

Name_______________________________________________________________Last First Degree/Certification (MD, PhD, CNMT, ARRT)

Mailing Address_______________________________________________________

City/State_______________________________________________ Zip__________

Telephone ( ) ____________________________________________________

email_______________________________________________________________

SNM Member Number__________________________________________________

Check Appropriate Box: Pre-Registration On Site

All fees include handouts and coffee breaks. Lunch is not included as part of anyregistration fee. Lunch on Saturday may be purchased for $25.00 by checking theappropriate box

❏ If you have a disability which requires special accommodations, please checkhere and advise us of your needs at least two weeks in advance of the program.

Please make check payable to: GREATER NEW YORK CHAPTER, SNM

(U.S. Dollars drawn on U.S. Bank Only) and mail to:

Mitchell H. StromerNortheast Regional Meeting, SNM360 Cedar LaneEast Meadow, NY 11554Telephone: (718) 405-8468

$250.00 ❏300.00 ❏

90.00 ❏90.00 ❏

180.00 ❏No Fee ❏

Physician/Scientist, SNM Member $220.00 ❏Physician/Scientist, Non-Member 275.00 ❏Resident or Fellow 70.00 ❏Technologist, SNM Member 70.00 ❏Technologist, Non-Member 140.00 ❏Technologist Student No Fee ❏Lunch (Saturday) 25.00 ❏


SOCIETY OF NUCLEAR MEDICINETwentieth Annual Northeast Regional Scientific Meeting

October 27 – 29, 2006

New England Chapter - Technologist Section Society of Nuclear Medicine

NOMINATION FORM 2007-2008

Instructions: The following is required from each nominee: • Nominee’s Curriculum Vitae (C.V. form attached) [NOTE: Faxed CV forms will

NOT be accepted. CV form must be submitted in electronic format] • Personal Statement: Typewritten statement; for President-Elect 200 words or less;

all other nominees (except nominating) - 100 words or less which addresses question (see #15).

Nominations will not be accepted unless all information is submitted The nominee is prepared to stand for the position(s) of: ___ President-Elect

[Qualifications: Experience as an Officer or Committee Chair or Member at the chapter or national level, Must be a member of NEC-TS]

[Term of office/time of commitment: 3 years = President-Elect, President, Past President]

___ Secretary [Qualifications: Entry-level, must be member eligible to vote NEC-TS] [Term of office/time of commitment: 1 year] ____ Treasurer [Qualification: Entry-level, must be member eligible to vote NEC-TS] [Term of office/time of commitment: 2 years] ____ National Council Delegate

[Qualification: Experience as an officer of NECTS and must have been an NECTS member for 3 years]

Please fill out the form below and email it to Gwen Meunier at: [email protected]


NEW ENGLAND CHAPTER - TECHNOLOGIST SECTION

C.V. NOMINATING FORM 2007 - 2008

1. Position: 2. Name: 3. SNM Member #: 4. Work Address: 5. Work Phone: 6. Work Fax: 7. E-mail: 8. Professional Title: 9. Education (indicate academic institution and degree for programs attended after high school, e.g. Associate, Bachelors, Masters etc.) • Institution Academic Degree Earned 10. Certifications: (indicate institution and certifications for programs attended after

high school, e.g. CNMT, RT(N), etc.) • Institution Certificate Earned

11. Organizational Affiliations (other than SNM): 12. Publications and Presentations: (Note: The Election Bulletin will give only the

number of publications and presentations, however please provide complete information in this space)

• Presentations:

Total #: ____ • Publications:

Total #: ____

13. Awards and Recognition’s related to Nuclear Medicine

14. Offices held, including appointments: (please list in chronological order beginning with the most recent offices held. Please indicate year(s) served, office (chair, member, etc.) and sponsoring organization, i.e. National Chapter, local/state, or related organization. 15. In 100 words or less, please address the following question: Why are you running for office and how can you make a difference? 16. Additional Information: The following summarizes the financial reimbursement associated with each office. Please initial below indicating your understanding of the information provided. • The President-Elect, Secretary and Treasurer are expected to attend the Annual

Spring Symposium and fall meeting and at least two executive committee meetings. Hotel, per-diem, and travel costs are reimbursed for the spring and fall meeting.

• National Council Delegate shall represent NECTS at National Council Meetings. Hotel, per-diem and travel costs are reimbursed as approved by the Executive Committee.

I have read, and understand the time commitment and financial reimbursement associated with the position I am seeking:)_____________________________________ If you have any questions please contact Gwen Meunier, BS, NCT, CNMT, RT(N) at Tel: (508) 334-1224 or E-mail: [email protected]


new england chapter e-journal of nuclear medicine technology

Health & Medicine

citystate zip code

city statezip code

md sharmila dorbala

ct oral presentations

nuclear medicine dept

md david mankoff

national council delegate

unrestricted educational grant