THE SNMTS NEWSLETTER
Volume 15 No. 6
November/December 2009
SNMTS is dedicated to the advancement of molecular and nuclear medicine technologists by
providing education, advocating for the profession, and supporting research to achieve clinical
excellence and optimal patient outcomes.
Call for Nominations: Technologist Section
2010-2011 General Election
By Mark Wallenmeyer, MBA, CNMT, RT(N)
T
he SNMTS would like to announce the following positions that will be elected by the general
membership during the 2010-2011 general election; President-Elect, Secretary, Delegate-atLarge and Finance Committee (3-year position).
Each position has specific qualifications for office. All candidates must be active members of the
SNMTS, hold or have recently held a national position (for example, chair of an SNMTS committee/
task force, elected NCOR member or member of the executive board) and be endorsed by their local
chapter. Qualifications, duties and responsibilities for specific offices will be detailed in the call for
nominations and on the Web site.
The first call for nominations was distributed to general members in September. For more information and a copy of the full call for nominations, please visit the SNMTS Elections webpage at: http://
interactive.snm.org/index.cfm?PageID=1678.
Nominations must be submitted to Nikki Wenzel-Lamb at [email protected] by December 14.
Page 2
Adding Definition to the
Abstract Experience
Page 3
Update on the
Molybdenum-99 Shortage
Page 6
Annual Meeting Brings
Together an International
Community
Page 7
VOICE Box
Page 8
Calendar
Myocardial Perfusion Imaging with Rubidium-82
By Donna Newman, RT(R), CNMT, PET, NCT
I
n recent years, we have seen an increase in the utilization of
PET as a modality to assess myocardial perfusion. The increase
in the number of PET MPI scans being performed in the U.S. is
primarily due to the proliferation of PET and PET/CT scanners in
hospitals, imaging centers and private practice cardiology offices.
Over the same period of time, there has also been an improvement
in scanner software capabilities for cardiac imaging. Additionally,
there is an increasing body of literature supporting the clinical
value of PET MPI, specifically demonstrating high diagnostic accuracy, excellent image quality and improved detection of multivessel disease compared to conventional SPECT. With the continued
shortage of Tc-99m on all of our minds, PET MPI may offer an
alternative method of providing high quality patient care. With
that in mind, let’s review cardiac PET!
There are currently two commercially available PET myocardial
perfusion tracers: N-13 ammonia and Rb-82. N-13 is cyclotronproduced and has a 10-minute half-life; therefore, use of N-13
ammonia requires either an onsite cyclotron or a cyclotron in
very close proximity. As many laboratories do not have access to
a cyclotron, Rb-82 is the most commonly used PET radiotracer in
the U.S. Rubidium was approved by the FDA in 1989 for use in the
detection of coronary artery disease, and the Health Care Financing Administration has approved reimbursement for Rb-82 PET
MPI since 1995. Rubidium is uniformly available through generator production in the U.S. and is used in conjunction with an
automatic infusion system. Because Rb-82 is generator-produced,
it is not affected by the current Tc-99m shortage and therefore
has on-demand availability. Many labs that currently perform PET
imaging are afforded an option to shift patients from SPECT to PET
MPI in the setting of the Technetium supply issues.
If you are one of these labs, take time to check with insurers from your
state and see if they are willing to give you a temporary policy with the
same indications as the SPECT studies until the shortage is over. A letter
of request needs to be sent stating the specific wording you want in the
Continued on page 4, see Myocardial
Adding Definition to the
Abstract Experience
By Nancy M. Swanston, CNMT, PET, RT(N)
A
BSTRACT (ab strakt’) n. 1. A brief statement of the
essential thoughts of a book, article, speech, etc.;
a summary 2. A brilliant opportunity to pose an
abbreviated version of the new science you wish to debut at the
SNM 57th Annual Meeting in Salt Lake City, Utah, June 5 – 9,
2010. 3. A chance to showcase a performance improvement, or
practice management project. 4. A mechanism to build rapport
with other like-minded professionals in the field. 5. A chance to
receive awards and recognition for work performance.
The abstract process can be intimidating, but expressing
your thoughts in a summary of your research is an important
aspect of propelling the science of molecular medicine forward,
improving patient care and processes within the modality, and
fostering additional creativity in others. Abstract writing is not
an easy task, and it requires hard work and dedication. Many
of you may already be participating in research. The next steps
are to write it up and submit your work. Some of you may feel
that research is not a part of your everyday clinical life, but
even small changes in processes and practices can be explored
and reported on at the annual meeting. Even though these
modifications may be slight, they can still aid in assisting others in the field.
The key actions are to get started, stay committed and ensure
that the critical pieces of your “experiments” are summarized in
your abstract submission. There are a few other tips that might
assist you in being successful. First, at the submission step,
make sure that you select the Technologist Section Abstract
category that most closely identifies with your topic. You might
want to peruse the SNM Archives, in addition to other peer
reviewed journals, to check for redundant science. Think about
where we have gaps in our technology. Research your topic so
you are an authority on this “niche.”
The Society is always looking for innovative and fresh
practice ideas. This also might be a good opportunity to spur
your own creativity or put a new spin on a concept for future
projects. Think about the topic, your personality and the situation. Make the decision whether your topic is best presented as
an oral presentation or as a poster. Evaluating the potential to
present the material in either medium may bring new opportunities for growth.
Next, ensure that you fill in all of the sections (i.e., on the
application) fully. If areas are left blank, reviewers may not get a
clear picture of the message you are trying to convey––the sections in the submission process will guide you. The title should
be short, yet descriptive. It must relate to the investigation. A
critical piece of the abstract is your motivation for writing it.
Create your aim statement. What problem are you trying to
Editorial Board
Christina Coe, BS, RT(R)(M)(N)
Mary Beth Farrell, CNMT, NCT, RT(N)
Glen David Heggie, RT(N), EdD, FCAMRT, Chair
Lyn M. Mehlberg, CNMT, FSNMTS
David J. Perry, CNMT, PET, FSNMTS
Kathy Thomas, CNMT, PET, FSNMTS
Eleanor S. Zimmer, CNMT, RT(N)
Issue Editor
Lyn M. Mehlberg
Managing Editor
Jane Kollmer
Graphic Designer
Laura Mahoney
Uptake is published six times a year by SNMTS.
All editorial communications should be directed to
Glen David Heggie, 573-884-7843, [email protected].
©2009 by SNM
solve? How are nuclear medicine professionals, patients, the
modality, etc. affected by this science? Does the abstract affect
a large group, or is it an incremental step in a larger process?
Explain your method of attacking the problem. Did you use
simulations, analysis, patient data, or field information? Review
your project for bias. Could you be positioned in a conflict
of interest? Is there commercial/product bias? Clearly state
your results and supply sufficient detail. Then discuss your
conclusions. Does this work change outcomes? It doesn’t have
to be something that is a global change. Minor advances and
modifications can be strong indicators of future directions we
should take.
Finally, proofread your work prior to submitting. It is best
to shoot for over the word limit. In this way, you the author
decide what is best to cut. Eliminate the unnecessary and
add any necessities that might be missing. You determine the
message that is given; remember that the extra verbiage can
still be used at presentation time. Spelling and grammatical
errors detract from your work and jeopardize the clarity and
integrity of the submission. Be sure you have presented your
best effort––one that is coherent, concise and accurate. The
abstract should be able to stand alone and your topic should
be able to be understood by a reviewer without seeing the full
presentation.
Once an abstract is accepted, you then have the opportunity
to showcase your hard work. Make sure it is organized. Read it
or practice it aloud to ensure the message is smooth. Use tranContinued on page 5, see Abstract
2
Update on the Molybdenum-99 Shortage
By Danny A. Basso, CNMT, NCT, FSNMTS, SNMTS Advocacy Chair
Robert W. Atcher, PhD, MBA, SNM Government Relations Chair
Why We Need Mo-99
Low-energy, single-photon imaging is still the most frequently used nuclear medicine procedure in the world.
Of the 20 million nuclear medicine studies performed per
year in the United States, 18 million are performed using
SPECT and 16 million use Technetium-99m (Tc-99m).
Worldwide, at least 80% of the nuclear medicine procedures use Tc-99m. The global medical community relies
on five main nuclear reactors for the production of Mo-99.
The location and the percent produced by each are as follows: Canada (33%), The Netherlands (32%), South Africa
(15%), Belgium (6%), France (6%), with others supplying
the remaining 8%. The average age of these reactors is 47
years. The United States uses 50% of all of the Mo-99 produced in the world. Nearly all of the Mo-99 used in the
U.S. comes from the two reactors in Canada and the Netherlands. There are currently no facilities producing Mo-99
in the U.S. The other important point is that those reactors
identified as “other” are not qualified to produce Mo-99 for
consumption in the U.S.
One important observation on this issue is to note the
surplus production capacity of the NRU reactor in Canada.
In addition to losing its production, we also lose its ability
to ramp up production when another reactor goes offline.
So when NRU is not functioning, we see a decrease in production plus an inability to provide backup for the other
four reactors when they have anticipated or unanticipated
outages.
Reactor Shutdowns
The number of unscheduled shutdowns of reactors pro-
ducing Mo-99 and Tc-99m at generator production sites
has been increasing. Unanticipated interruptions led to
major problems in the supply chain and in the eventual
care of patients. Currently, the Canadian reactor is still shut
down to investigate and hopefully fix leaks caused by corrosion related to the facility’s age. The Canadian Government has stated that the reactor will be relicensed in 2011
but all production will cease in 2016. It is scheduled to
be up and running early in 2010, although this date has
already been pushed back three times. The reactor in the
Netherlands was shut down for a few weeks during the
summer in 2009 for preventive maintenance (PM) and is
scheduled to be shutdown for four to six additional months
in 2010 for more PM.
Bring New Options Online
There are several ways to increase the supply of Mo-99.
The first is to try to increase the level of production in the
other reactors. The simplest option is to increase the operation schedule of reactors in Belgium, France and South
Africa. But cost estimates approach
$30 million per reactor for the increase
in fuel cost, additional operating expenses and radiation waste disposal.
The real bottleneck exists in the lack
of processing facilities that have been
approved by FDA or other regulatory
authorities. It is estimated that the capacity could be increased by 40% in
some instances if the processing facilities were expanded.
It has been proposed that the quickest way to establish a source in the U.S.
is by converting the reactor at the University of Missouri to include Mo-99
production as part of its mission. The
problem with this solution is it also
needs an expanded processing facility.
This would take 3.5 years to complete,
with an estimated $150 million price
tag and a location only 1 mile from the
Tigers’ football stadium. Babcock &
Wilcox and Covidien partnered to develop the aqueous homogenous reactor, while TRIUMF/Nordion and others are pursuing accelerator production of Mo-99, but both
would be years away from being brought online.
What Is the SNM Doing?
The SNM is working with Congress to promote four options for developing a domestic source of Mo-99, including
the University of Missouri expansion and the Babcock &
Wilcox/Covidien projects. The SNM is petitioning CMS for
coverage for non-Tc99m methods of imaging such as F-18
NaF bone scans. The Society is also trying to educate its
Continued on page 7, see Mo-99
3
Myocardial continued from page 1
temporary policy along with some supporting documentation regarding
the shortage. This will give PET departments an opportunity to move
patients from SPECT cardiac studies to PET cardiac studies with those
insurers.
Kinetically, Rb-82 is very similar to our old friend Tl-201. It is a
potassium analogue and is incorporated into the myocardium via
the Na+/K+/ATPase pump. As with Thallium, Rb-82 has superior
linearity to blood flow compared to the Tc-99m myocardial perfusion agents with reported first-pass extraction of 60% to 65%.
Clinically, this aids in accurately detecting and assessing the extent
and severity of coronary artery disease. Rubidium is the daughter
product of Sr-82 and is an extremely short-lived radionuclide.
Rubidium’s 75-second half-life allows for rapid sequential imaging
and results in an extremely efficient protocol. An entire rest and
stress Rb-82 protocol can be completed in an average of 30 to 45
minutes. The tables below provide examples of typical protocols
for dedicated PET and PET/CT.
•
•
•
DEDICATED PET
PET/CT
•
Sample PET/CT Protocol
Rb - 82
scout
CT - trans
Approx
Approx 1
1 min
min
Dipy
0.56 mg/kg
Rb - 82
gated
stress
gated
rest
Approx
Approx 7
7 min
min
Approx 6 min
CT - trans
Approx 1 min
Approx 7 min
Protocol
Protocol courtesy
courtesy of
of Marcelo
Marcelo DiCarli,
DiCarli, MD
MD
Approximately 30 minutes
Pre-Test Patient Preparation
Patient preparation for a PET MPI study with Rb-82 is the same
as for a pharmacologic SPECT MPI study. Currently, all rubidium
PET MPI studies are acquired with pharmacologic stress using
either vasodilator stress or dobutamine. Patient preparation should
be in accordance with published guidelines. Patients should be
NPO for four to six hours prior to the study and all methylxanthine
containing products should be held 12 to 24 hours, per ACC/AHA/
ASNC guidelines.
Once the patient has been prepared, the following steps must
take place to complete the scan:
• Patient arrives 30 minutes prior to appointment
o Obtained signed consent
o 18-20g IV placed
o Electrodes placed
• Patient positioned on the imaging table:
o Supine, arms above head
o Feet-first for dedicated PET and head-first for PET/CT
• Perform positioning scan or “scout” to verify that the heart is
in the field of view.
• Perform a transmission scan for attenuation correction. The
4
transmission scan will typically take less than a minute for
PET/CT and two to four minutes for dedicated PET.
Inject the resting dose of Rb-82 via the automatic infusion
system. The Rb-82 dose will range from 30-60mCi depending
on your PET scanner and is delivered at a rate of 50mL/min.
Following a brief delay for clearance of Rubidium from the
blood pool, a five-minute gated rest emission scan is acquired.
One favorable aspect of PET MPI is that counting statistics
are very high and allow for gating of both rest and peak stress
acquisitions.
With the patient in scanning position, the stress protocol
begins with the introduction of the pharmacologic stress agent.
At maximum hyperemia, the stress dose of Rb-82 is delivered
via the automatic infusion system. The injected stress dose
should be the same activity as the rest dose. Due to the short
half-life of Rubidium, it is not necessary to utilize a 1:3 ratio,
as with conventional Tc99m-SPECT protocols.
The five-minute stress emission scan may be followed by an
optional post-stress transmission scan for attenuation correction. Note: some facilities that have a PET/CT system with
misregistration correction software may opt to forego the second transmission scan in order to reduce radiation burden to
their patients.
Scan complete!
A very necessary piece of the cardiac PET puzzle is to have access
to a PET camera with cardiac capabilities—either a dedicated PET
scanner (utilizing internal rod sources for attenuation correction)
or a PET/CT scanner (CT used for attenuation correction). Regardless of the PET scanner used, there are certain considerations that
are necessary in order to perform high-quality cardiac PET imaging, including:
Acquisition Considerations:
• Gating capabilities for cardiac images
• Acquisition in real-time dynamic and/or list mode
• Simultaneous acquisition, processing and display without
interference2
• Optimal system sensitivity (counting statistics/dead time)3
• Acquisition in 2-D mode, 3-D mode or both2
• Adequate slice CT system to meet the needs of cardiac procedures3
• Quantification software for myocardial blood flow3
Processing Considerations:
• Minimal reconstruction time for a gated cardiac study
• Fully integrated software to process cardiac perfusion and
function1
o Perfusion data
o Ejection fraction
o Wall motion/wall thickening
o Cardiac volumes
• Scatter correction techniques3
• Misregistration correction techniques2,3
• Artifacts introduced with the CT attenuation vs. Ge-68 rod
source attenuation2
• Specifications of the processing and display workstation
o Processor speed
o Hard drive space
•
Correction software for metal artifacts2
or
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Display Considerations:
• Cardiac Quantification Software2
o QGS/QPS, Emory Toolbox, 4DM, etc.
o Accuracy of the EF and Wall Motion data for PET
For cardiac PET imaging, optimal components include gated
cardiac acquisition, processing and display capabilities. It is
also important to have software that allows for correction of
misregistration between the emission scan and the attenuation
correction scan.
In summary, Rb-82 PET MPI provides excellent image
quality,1,2 improved count statistics (511 KeV) and robust
attenuation correction resulting in a high degree of interpretive certainty and superior diagnostic accuracy. As we face the
challenge of current Tc-99m supply-and-demand issues and
are evaluating alternative options, PET MPI offers a method of
providing a high standard of patient care.
References
1.) Cardiac PET and PET/CT Imaging
Marcelo F. Di Carli, MD
Martin J. Lipton, MD
2007 Springer Science-Business Media, LLC
2.) Procedure Guideline for Myocardial Perfusion Imaging 3.3
H. William Strauss, MD et al
J Nucl Tech 2008;36;3:155-161
3.) Positron emission tomography myocardial perfusion and glucose metabolism imaging
Josef Machac, MD et al
J Nucl Cardiol 2006;13:e121-51
November/December 2006
Abstract continued from page 2
sition words to guide the audience and tie ideas together.
Polish your presentation, and massage the mechanics of it.
Proofread your work again for spelling, formatting errors,
etc. Your credibility as an author is many times evaluated
by not just your science but your style, organization and
precision. Two abstracts may both have very good conceptual information, but if one is presented in a more solid
manner, it will score higher.
Writing an abstract can provide financial reward in
addition to academic incentives. In recent years, SNMTS
has provided travel awards to presenting authors. In this
economic climate, an award can help to partially cover
costs for airfare and hotel. Awards are also given for 1st,
2nd, and 3rd place oral and poster presentations at the
meeting––after final scoring is complete. In addition to
a lovely plaque detailing the accomplishment, winning
authors receive a check with the amount awarded based
on the placing of their material. Lastly, certain councils inside of SNM give monetary rewards for winning
abstracts inside a niche. For example, both the Nuclear
Oncology and Cardiovascular Councils aim to give awards
in those respective categories for authors in Utah at the
57th Annual SNM Meeting.
We hope this year you will consider submitting an
abstract for your compelling research. We have the following categories designed to encompass all of molecular
imaging:
• Cardiology Basic & Clinical
• Cardiology PET
• General Nuclear Medicine
• Inflammation & Infection
• Instrumentation & Data Analysis
• Neurology Basic & Clinical
• Neurology PET
• Oncology PET
• Oncology Therapy
• Professional & Educational Practices
• Radiopharmaceuticals
• Radiation Safety, Dosimetry & Radiation Biology
Watch the SNM Web site for more information. The
abstract deadline this year is Wednesday, January 6,
2010. We encourage all of you to take this opportunity
to showcase your ideas. Redefine yourself. Add a new
dimension to your career whether it is writing, reviewing,
posting or presenting. We look forward to working with
you and hope to see you in Salt Lake City in 2010.
d
5
Annual Meeting Brings Together an International Community
By Eleanor S. Zimmer, CNMT, RT(N)
By
T
he 56th Annual Meeting was held in Toronto, Canada,
which was an ideal location given one of Mark Wallenmeyer’s, outgoing President of the SNMTS, goals was
to continue to develop our relations with our international colleagues. As with previous years, the meeting was well attended
by technologists, physicians and other members of the nuclear
medicine community from all over the world. The meeting began with the SNMTS leadership gathering to conduct business
important to our membership.
The SNMTS Strategic Planning Task Force has worked extremely hard to develop a Strategic Plan that will help guide us
into the future. Every committee participated in developing the
plan that will then be implemented over the next five years. After
much review, the members of the National Council of Representatives approved the Strategic Plan and submitted it to the Executive Board for final approval. The leadership will use this as
a guide moving forward to continue our success. Another main
topic of discussion at the meeting was the ongoing shortage of
Mo-99. Robert Atcher, outgoing president of the SNM, met with
representatives of the Canadian government to discuss this ongoing issue.
Many technologists are recognized at the awards ceremony
during the annual meeting.
After the completion of the leadership meetings, the educational program began. This year, we offered attendees the ability to obtain continuing education credits covering all aspects
of nuclear medicine and molecular imaging. Our program was
expanded to include MRI, CT, as well as mammography for the
nuclear medicine technologist. Since our field is ever growing
and changing, the program committee felt it necessary to offer
educational opportunities in these modalities. The response from
the attendees was an overwhelming success. The program committee also selected these and a few other sessions to be captured
in an effort to offer them to our membership throughout the
year. This will give those members who were unable to attend
the meeting the ability to benefit from these exceptional speakers. We had an incredible response to our call for abstracts from
technologists and students alike. There were five sessions of each
technologist (34) and student oral presentations (43) and many
posters (54) were exhibited. Many of these students and technologists received travel awards to attend the meeting.
In addition to the educational sessions, the meeting included
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Mark Wallenmeyer (right) presents David Gilmore with an SNMTS
Fellowship Award.
technologist governance sessions, business meetings and award
ceremonies. Mark Wallenmeyer presided over the awards ceremony at the business meeting, naming William Hubble as Outstanding Educator and Aaron Scott as Outstanding Technologist.
He presented Mimi Owen, MaryBeth Farrell, David Gilmore and
Harish Vaidya with Fellow honors, and this year’s Presidential
Distinguished Service Award was presented to Kathy Thomas.
Kathleen Krisak announced the winners of the student abstract
presentations, the technologist abstract presentations and the
technologist poster abstracts. The student abstract winners
were Chris Nation (1st place), Stephanie Chacko (2nd place) and
Abigal Rosenthal (3rd place).
The highlight of the awards ceremony was when Wallenmeyer
presented Sue Weiss with the SNMTS Lifetime Achievement
Award for all of her many years of service and dedication to the
SNMTS and the nuclear medicine community. At the conclusion of the business meeting, Mark installed Cybil Nielsen as the
next Technologist Section President. The meeting ended with
the Technologist Party at the Royal Fairmont York Hotel.
Mark your calendar!
NEW! Technologist training for participation in industrysponsored clinical trials at The Clinical Trials Network
Workshop 2010
SNM Conjoint MidWinter Meetings
Albuquerque, NM
Monday, February 1, 2010 and Tuesday, February 2, 2010
Come learn more about clinical research regulation and the Network’s
new Molecular Imaging Research Technologist Curriculum. Both introductory and advanced classes will be offered.
Highlights include:
*
*
*
*
*
Standard Operating Procedures in Clinical Trials
Industry Perspectives
Quality Assurance
Tips and Tricks of the Trade
Protocol Adherence and Source Documents
2010 SNM Conjoint
Mid-Winter Meetings
SN
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VOICE Box
President-Elect continued from page 1
By Jannine Henderson, Associate Director of Education
2009-2010 Continuing Education Chair
Each June, following the annual meeting,
our new officers and committee chairs take
over the leadership positions within the
Technologist Section. I would like to take
this opportunity to introduce Sara Johnson,
CNMT—the new chair of the Continuing
Education Committee for SNMTS, 20092010.
Important note: If you have technical difficulty signing up for the
VOICE credit transfer process, please contact SNM Internet Services at [email protected]. For non-technical questions
related to your SNM login and password, please contact SNM’s
Membership Department at 703.708.9000 ext. 1231
What you need to remember for accurate VOICE reporting:
SARA JOHNSON
SNMTS/ARRT VOICE Credit Transfer Now Available!
VOICE Credit transfer with the ARRT is a new benefit offered
to all SNMTS members. This new service will assure timely and
accurate CE reporting to the ARRT and will save members time
and frustration when collecting CE data to forward at the time of
recertification.
•
Your VOICE transcript is only as accurate as the information that has been provided to it. Technologists should
periodically visit the SNM Web site to verify the accuracy
of their VOICE transcripts and report any missing or inaccurate information to the Education Department.
•
VOICE transcripts will be forwarded to the ARRT on a
monthly basis for all credits earned up to 60 days prior
based on a technologist’s birthday. CE credits recorded
after the electronic mailing date of the VOICE transcript
will not be submitted to the ARRT. It is the technologist’s
responsibility to forward any CE credits acquired after the
electronic mailing date to the ARRT.
•
In the event of an audit, you should do the following:
Technologists who have signed up for credit transfer need
not be concerned if they are selected for an audit. Those
who meet the required minimum number of credits for
the reporting period will be informed that an audit was
conducted and that they successfully demonstrated meeting the CE requirement. They will not be required to
produce additional proof of attendance.
To activate your VOICE transfer account, you will need to:
1. Visit http://www.snm.org/arrt
2. Sign on using your SNM login and password
3. Enter your ARRT ID
4. Enter your Social Security Number
5. Enter your birth date
6. Use the pull-down menu to select ‘Yes, Share SNM VOICE
with ARRT’
7. Click ‘Save’
Mo-99 continued from page 3
membership on alternatives such as the Tl-201, as demonstrated by the review of cardiac imaging in the last “Uptake”,
as well as articles on the SNM Web site that offer other suggestions.
Obviously, if you are in the business of selling generators,
you would like to have them rotate through the radiopharmacy as often as you can. However, in a time of shortage,
one would like to be able to extend the useful life of the
generator beyond its current limit, which is generally two
weeks. It would be ideal if we could get limited extensions
beyond this point for some applications such as flood sources, linearity studies, and other uses that do not necessarily involve human administration but are still important to
our being able to practice nuclear medicine in a responsible
fashion. Our colleagues in Europe have proposed that we
suspend all veterinary imaging in times of shortage.
SNM has also made clear to the producers that informing
the nuclear medicine community about anticipated outages
will facilitate appropriate scheduling, triage, and other measures that can assist us in managing the imaging needs of
our patients. Obviously, this is more difficult when we expe-
rience unexpected problems, but many of the problems we
have experienced with the aging population of reactors are
anticipated as their maintenance needs have increased, or
we have seen short outages that still affect whether Mo-99
production will be at the usual levels.
What Can You Do?
Stay informed about potential dates of shortages through
updates from the generator manufacturers. Being prepared
to adjust your schedule and methodology of imaging procedures is a must in this environment. Nights and weekends should not be excluded from consideration for doing routine imaging studies. In times of Tc-99m shortage,
we should all be proactive in the use of other radiopharmaceuticals to save the Tc-99m for those procedures that
have no alternatives. Tell your Congress person to support
H.R. 3276, the American Isotope Production Act of 2009.
This bill provides funding for the production of medical
grade radioisotopes in the U.S. This can be done through
www.MIMarchforHealth.org.
7
1850 Samuel Morse Drive
Reston, VA 20190-5316
Calendar
November 6–8
Central Chapter - SNM Fall Educational Symposium, Columbus, Ohio
Host: Central Chapter - SNM
Contact: Merle Hedland, [email protected]
(630) 323-7028
November 6–8
Northeast Regional Meeting, SNM, Rye Brook, N.Y.
Host: Greater NY and New England Chapters, SNM
Contact: Mitchell Stromer, [email protected]
(718) 405-8468
December 5
Mickey Williams Memorial Meeting, Duarte, Calif.
Host: Pacific Southwest Technologist Chapter
Contact: Susan Gavel, [email protected]
(818) 676-4107
January 21–26
ABNM-82nd Meeting, St. Louis, Mo.
Host: ABNM
Contact: ABNM, [email protected]
(314) 367-2225
November 7
Pittsburgh Chapter Fall Workshop, Cranberry, Pa.
Host: Pittsburgh Chapter, SNMTS
Contact: Dave Mayle, [email protected]
(412) 861-6737
November 13
PET/CT for Radiation Oncology, Pittsburgh, Pa.
Host: UPMC
Contact: Eileen Milakovic, [email protected]
(412) 623-3671
January 27–February 2
2010 SNM Conjoint Mid-Winter Meetings, Albuquerque, N.M.
Host: SNM
Contact: SNM Meetings Department, [email protected]
(703) 708-9000