Mark H. Crosthwaite, M.Ed., CNMT, PET, RS, FSMMI-TS Thursday 1000 to 1150 Hrs
828-3264 CHP - Room 2019

Spring 2024

CLRS 407 - Introduction to PET/CT

Course Description

Semester course; 2 lecture hours. 2 credits. Prerequisite: CLRS 408. Overview of PET and PET/CT focusing on instrumentation, radiopharmaceuticals and its diagnostic application in neurology, oncology and cardiology. 

Required text/reading

Nuclear Medicine Instrumentation, 2nd Edition by Jennifer Prekeges

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Date - Per Week Lecture - Due Dates Chapter(s)
Pre-Course Work Basic Instrumentation for those who do not have a nuclear medicine background (you must meet with the professor) Click Here
The week of Content Link
1/16-18 PET Instrumentation Quiz 1 and HW due 1/22 14
1/23 PET Imaging and Sinograms Quiz 2 due 1/29 15
1/30 PET - Time of Flight Quiz 3 due 2/5 14
2/6 CT Instrumentation Quiz 4 due 2/12 18
2/13 Resolution of PET Quiz 5 due 2/19 15
 2/20 PET/CT Attenuation Correction and Artifacts Quiz 6 due 2/26 14
2/27 Image Reconstruction and Filtering Quiz 7 due 3/11 Link
3/5 Spring Break  
3/12 Exam I - Midterm (everyone must have completed the above quizzes in order to take the midterm exam)  
3/19 Normal PET Uptake MC notes
3/18 Radiation Safety in a Molecular Imaging Department MC notes
3/26 Negative Ion Cyclotrons and FDG Synthesis MC notes
3/26 Positron Radiopharmaceuticals Quiz 8 and HW due 4/1 MC notes
 
Clinical PET
 MC notes
4/02 Oncology - No quiz see oncology see "Assignments" in Canvas  
4/16 Cardiology Quiz 9 and HW due 4/24 MC notes
4/23

Neurology Quiz 10 due 4/29 and Final Exam Review scheduled for 4/30

 MC notes
 

Additional Lecture material will  be acquired from
Clinical Molecular Anatomical Imaging by GK vonSchulthes (2004)
PET and PET/CT A Clinical Guide 2nd edition by EC Lin and A Alava (2009)
Basics of PET Imaging: Physics, Chemistry, and Regulations (2nd edition) by GB Saha (2010) - recommend purchase (Amazon)
PET Study Guide - Second Edition by PE Christian and NM Swanson (non-credit version). Available at the SNMMI website.

Evaluation

Grading Policy:
Grades will be based on objective tests consisting of registry type multiple choice questions as well as discussion questions. The grading scale is as follows:

Percent Grade
93-100 A
85-92 B
77-84 C*
69-76 D
68 > F
*minimum passing grade

Students are expected to score at least a cumulative grade of 77% according to the weighting factors described below. 

tr> tr>
Instrumentation PET Quiz I 20%
Instrumentation CT Quiz II 10%
Radiopharmacy Quiz III 10%
Clinical Quiz IV (Cardiology /Neuro) 20%
Oncology Assignment 10%
Kahoot / Attendance 10%
Final Exam 20%


Exams/Quizzes, Assignment, and Discussion Board
  1. Quizzes will make a large component of your course grade.
  2. Kahoots will be given throughout the course in which you will receive 100% credit for taking the Kahoot no matter what your score. Lack of attending class will result in a 0%. Makeups will not allowed.
  3. Please note that the deadline for students to provide written notification to instructors of intent to observe religious holidays is January 26, 2024.
  4. Failure to complete a quiz prior to the next lecture may result in a drop of up to 7 percentage points.
  5. The Department Chair establishes policies and schedules for the CLRS final exams. The Department Chair must approve any changes regarding scheduling the course final exam. A 7% penalty may be imposed for missing a scheduled final exam.

  6. Any assignment or homework given in class must be completed in a time designated by the instructor.  Late assignments will not be accepted.
  7. This is one of your professional courses in which the lowest passing grade is “C”.

Teaching/Learning Methods

  1. This course will be taught face-to-face, pandemic pending.
  2. Presentations can be found at in Canvas with the following link: https://people.vcu.edu/~mhcrosthwait/PETW/index.html
  3. Quizzes and HW will be assigned.
  4. Oncology assignment will be completed in the following format.

Course Objectives:

  1. PET instrumentation
    1. Define the method in which a PET scanner acquires counts and apply the following terms: β+, annihilation reaction/photons, LOR, and Sinograms.
    2. Compare various crystal applied in PET imaging.
    3. Describe the composition of crystal block design.
    4. Define the application of a timing window and PHA.
  2. Sinograms and Imaging Format
    1. Describe that pathway of generating a random corrected Sinograms.
    2. Identify normal and abnormal blank scans.
    3. Identify the process of Normalization and the process in which the image system corrects counts at the pixel level.
    4. Compare direct-plane to cross-plane events.
    5. Identify how scatter and random events occur in PET.
    6. Identify the process a transmission scan corrects for attenuation.
    7. Define radial elongation.
    8. Identify the affects of dead time.
  3. Time of Flight (TOF)
    1. Define TOF.
    2. Calculate TOF.
    3. Compare data acquired in TOF vs non-TOF.
  4. PET Resolution
    1. Define and apply the multiple factors that affect PET resolution.
    2. Discuss methods that affect PET sensitivity.
    3. Review Noise Equivalent Count Rate (NECR).
    4. Define the different aspects that affect image contrast.
  5. CT and the PET connection
    1. Review the method in which CT transmit x-rays and collect data to generated an image.
    2. Apply linear attenuation coefficients and relate them to Housfield unit.
    3. Relate window level and window width to image contrast.
    4. Identify applications that improve image contrast in a CT scan.
    5. Define quantum mottle and beam hardening artifacts.
  6. PET Attenuation and its Artifact
    1. Apply the components of CT that generate attenuation correction on a PET scan.
    2. Identify imaging artifacts that occur when CT attenuation is applied to a PET image.
    3. Identify mis-registration and motion artifacts in a PET scan.
  7. Image reconstruction and Filtering (this has been covered in CLRS 322)
    1. Review the application of filtered backprojection and iterative reconstruction
    2. Review Nyquist Frequency and aliasing.
    3. Review methods of image filtering.
  8. PET Radiopharmaceuticals
    1. Given the different radiopharmaceuticals in this lecture understand their Pathophysiology and application in diagnosing disease.
    2. Discuss the method in which a negative cyclotron generates a radiopharmaceutical. Link
    3. Discuss the production of FDG. - Link
  9. Review FDG Pathophysiology. - Link
  10. PET Imaging in Oncology
    1. Discuss the applications of PET imaging in oncology.
    2. Outline and compare PET imaging in oncology with other imaging modalities. (homework assignment)
  11. PET Cardiology
    1. Review the application of 15O and 13NH3 in cardiac imaging.
    2. Apply the use of 82Sr/82Rb generator in cardiac imaging.
    3. Calculate 85/82Sr breakthrough. (Homework assignment)
    4. Outline the rest/stress protocol for 82Rb imaging.
    5. Compare the extraction fraction on the different radiopharmaceutical used in cardiac imaging.
    6. Discuss the use of FDG in myocardial viability.
    7. Compare the β+ energies of FDG and 82Rb.
    8. Assess the future of PET myocardial imaging.
  12. PET Neurology
    1. Understand the variation of imaging protocol when imaging the brain.
    2. Define the physiology FDG in brain imaging.
    3. Identify the affects of target to background when imaging with FDG.
    4. Review the use of brain imaging with FDG with the following diseases: Epilepsy, Dementia, Extrapyramidal Disorders, Huntington disease, TIA, Moyamoya, Stroke, and brain cancer.
    5. Review the use and application of the different PET tracers that image Alzheimer.
  13. Review the components of Radiation Safety as it applies to molecular imaging. - Link

VCU Honor Code and Student Conduct
Students are responsible for being familiar with and adhering to the VCU Honor Code and student conduct policy as outlined in the current VCU Resource Guide, available at: http://www.policy.vcu.edu/sites/default/files/Honor%20System%20-%20Interim.pdf

Technology Requirements
- Participants need access to a personal computer (Mac or Windows) and the Internet for this course.
- Browser that is compatible with Canvas. To see if your browser is compatible with Canvas, visit the Canvas Browser Checker webpage.
- Your computer will need speakers to hear sound for videos and audio files.
- Adobe Acrobat Reader or an equivalent PDF reader.
- A web-cam and microphone on your computer. A cell phone camera and microphone may suffice, depending on the quality of the cell phone. You are responsible for ensuring your cell phone and microphone allow for real-time video conferencing and video and audio recording.

Technology Skills Required
- It is expected that you will be able to use and check your official VCU email address daily.
- You should be able to upload documents to Canvas.
- You should be able to use word processing software.
- You may be expected to interact with me and your peers using Canvas tools. Instruction for using each tool will be given when the tool is introduced.

VCU Honor Code and Student Conduct
Students are responsible for being familiar with and adhering to the VCU Honor Code and student conduct policy as outlined in the current VCU Resource Guide, available at: http://www.students.vcu.edu/rg/

Policies Regarding the Academic Calendar and Course Schedule
The Department of Radiation Sciences abides by the VCU academic calendar for the MCV campus (see http:www.vcu.edu/academiccalendars/)

Institutional Policies

Accommodations for Students with Disabilities
Disability Statement: If you are a student with a disability requesting reasonable accommodations in this course, please visit Student Accessibility and Educational Opportunity. All requests for reasonable accommodations require registration with SAEO (on 1/1/2024 this link was broken) in advance of need. Faculty, students and DASS will work together regarding classroom accommodations. You are encouraged to discuss approved accommodations with your faculty.

Counseling Services
Resources for Online students can be found through the Online Counseling Center.

Tutoring
The Campus Learning Center offers appointment, drop-in and group tutoring in undergraduate courses across the disciplines.

Writing Center
The Writing Center assists at all stages of the writing process, from brainstorming to final draft.

Cheating and Plagiarism
- Plagiarism is stealing and passing off the ideas or words of another as one’s own; it is using another’s production without crediting the source. The best way to avoid plagiarism is to cite properly in any assignment information and concepts that are not your own originally. If a student is discovered to have plagiarized, that student will fail that particular assignment.
- Academic integrity is expected in all aspects of the university, including this course. Don’t expect less of yourself than you do of your students For more information: https://students.vcu.edu/studentconduct/

Students should visit http://go.vcu.edu/syllabus and review all syllabus statement information. The full university syllabus statement includes information on safety, registration, the VCU Honor Code, student conduct, withdrawal, and more.

How to Prepared for Emergencies at VCU

  1. Sign up to receive VCU text messaging alerts (http://www.vcu.edu/alert/notify). Keep your information up-to-date.
  2. Know the safe evacuation route from each of your classrooms. Emergency evacuation routes are posted in on-campus classrooms.
  3. Listen for and follow instructions from VCU or other designated authorities.
  4. Know where to go for additional emergency information (http://www.vcu.edu/alert).
  5. Know the emergency phone number for the VCU Police (828-1234).
  6. Report suspicious activities and objects.

ADA Policy
Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 require VCU to provide academic adjustments or accommodations for students with documented disabilities. Students seeking academic adjustments or accommodations must self-identify with the Coordinator of Services for Students with Disabilities on the appropriate campus. After meeting with the Coordinator, students are encouraged to meet with instructors to discuss their needs and, if applicable, any laboratory safety concerns related to their disabilities. Please refer to the the department Disability Support Services at http://www.students.vcu.edu/dss/.

Policies Regarding the Academic Calendar and Course Schedule
The Department of Radiation Sciences abides by the VCU academic calendar for the MCV campus (see http:www.vcu.edu/academiccalendars/)

Policy Regarding the Independent Testing Room (If needed)

If there is a need your exam would be scheduled over at the testing center in the VMI building.

Academic Calendar
The Department of Radiation Sciences abides by the VCU academic calendar for the MCV Campus (see http://www.vcu.edu/academiccalendars/).

UNIVERSITY POLICIES:

The updated statements for syllabi and blackboard pages are available at https://provost.vcu.edu/academic-affairs/operations/syllabus-statements/

Topics Include:

  1. Campus emergency information
  2. Class registration required for attendance
  3. Honor System: upholding academic integrity
  4. Important dates
  5. Managing stress
  6. Mandatory responsibility of faculty members to report incidents of sexual misconduct
  7. Military short-term training or deployment
  8. Student conduct in the classroom
  9. Student email standard
  10. Student financial responsibility
  11. Students representing the university - excused absences
  12. Students with disabilities
  13. Withdrawal from classes
        1. Faculty communication about students

How to Prepared for Emergencies at VCU

  1. Sign up to receive VCU text messaging alerts (http://www.vcu.edu/alert/notify). Keep your information up-to-date.
  2. Know the safe evacuation route from each of your classrooms. Emergency evacuation routes are posted in on-campus classrooms.
  3. Listen for and follow instructions from VCU or other designated authorities.
  4. Know where to go for additional emergency information (http://www.vcu.edu/alert).
  5. Know the emergency phone number for the VCU Police (828-1234).
  6. Report suspicious activities and objects.

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