MESSAGE FROM THE CHAIR
NMTCB REPORT - 2012
David Gilmore, CNMT, NCT
Greetings from the Nuclear Medicine Technology Certification Board (NMTCB)! First, I am happy to announce that we have two additional Nuclear Medicine Advanced Associates (NMAA), making the total number six individuals who hold the NMAA credentials. In June 2011 was the first time that the NMAA exam was offered and at that time there were 4 individuals who took the exam and passed. In June of this year, at the SNMMI Annual Meeting, two additional individuals took the NMAA exam and were successful as well! The NMTCB is pleased to offer the NMAA exam for this new profession in nuclear medicine.
As of November 21st, there are 26,723 active CNMTs, 634 active NCTs, and 746 active PET certificants, in addition to the aforementioned 6 NMAAs. The numbers of PET and NCT certificants have increased by more than 10 percent in the past year. We are pleased to see the growing number of technologists seeking specialty certification and encourage individuals who may be interested in a specialty certification to check out our website at www.nmtcb.org for more details.
Prospective certificants are reminded that the NMTCB has announced new requirements for becoming eligible to take the entry-level examination that take effect on January 1, 2016. These will require new applicants to be a graduate of a programmatically accredited nuclear medicine technology program. In the United States, the Joint Review Committee on Educational Programs in Nuclear Medicine Technology (JRCNMT) is currently the only programmatic accreditation organization. For a list of programs accredited by the JRCNMT, please see their website at www.jrcnmt.org. Programs in Canada that are recognized by CAMRT also fulfill this programmatic accreditation requirement as do programs in Australia that are authorized by the Australian government to offer a nuclear medicine degree/certificate. The Board of Directors is currently reviewing other programmatic accreditation mechanisms in the US and abroad.
As a reminder, the eligibility requirement for the NCT exam will change in March 2013. After then, the NMTCB will no longer recognize a minimum of 2,000 hours of clinical nuclear medicine experience in order to become eligible to sit for the NCT exam. Instead, all applicants will be required to demonstrate a minimum of 700 hours of clinical experience performing nuclear cardiology, in addition to holding active nuclear medicine technology credentials.
The NMTCB completed comprehensive PET and NCT Task Analysis Surveys earlier this year and the results were reviewed at the fall board meeting and will be announced in this newsletter. A certificant survey was also completed this summer and we hope to publish the results in early 2013. This comprehensive survey asked questions about education, job status and salary, and should provide a good look into the current state of the profession.
I am very happy to be the first to welcome our newest board members - Angela Macci Bires and Mary Beth Farrell. They will be great additions to the board. Michele Beauvais has been appointed to serve another year on the board as her expertise in radiopharmacy has been instrumental in not only the entry-level exam, but also the NCT, PET, and now the NMAA exam. We also have three board members who have been elected to second terms. These are Cindi Luckett-Gilbert, Greg Passmore and Angela Bruner. With the new additions, we must say good bye to the board members whose terms have expired. I am one of these individuals as I have served on the Board of Directors for eight years. Anne Fisher is the other board member whose second term has ended. Anne actually served an extra year to continue her instrumental work with the development of the NMAA certification exam.
I am very proud to serve my last year with the NMTCB as Chair of the Board of Directors. The NMTCB has made great strides during my service on the board, developing and administering new and ground-breaking examinations and serving and advancing our profession. Serving with the NMTCB has been one of the highlights of my career and I am extremely grateful for the experience.
ENTRY LEVEL CERTIFICATION EXAM
As a means of staying up-to-date with the approval of new drugs through the Food and Drug Administration (FDA), the NMTCB periodically reviews and updates its pharmaceutical list. Cr-51 sodium chromate used for labeling red blood cells is no longer commercially available. Effective immediately, it will no longer appear on the entry level exam.
Three new FDA approved drugs will be added to the exam beginning January 1, 2014. These include:
- I-123 ioflupane (striatal dopamine transporter visualization)
- F-18 sodium fluoride (identifying bone mets)
- F-18 florbetapir (detection of beta-amyloid plaque in the brain)
These drug updates can be found on our website under the pharmaceutical list.
Addition of Radiopharmaceuticals to PET and NMAA Exams
The following is a list of newly approved FDA PET and research radiopharmaceuticals that will be added to the PET and NMAA specialty exams beginning January 1, 2014:
- F-18 sodium fluoride
- F-18 florbetapir
- F-18 flurpiridaz
- F-18 choline
- Ga-68 dotatoc
- Ga-68 dotanoc
- Ga-68 dotatate
- C-11 choline
In addition to the radiopharmaceuticals listed above, I-123 ioflupane will also be added to the NMAA exam. These drug updates can be found on our website under the PET and NMAA pharmaceutical lists.
EXECUTIVE DIRECTOR'S MESSAGE
Dave Perry, CNMT, PET
We are pleased and proud to have celebrated our 35th anniversary this past year. The NMTCB was incorporated on June 17, 1977, having been formed because many believed that other organizations were not focused enough on nuclear medicine technology as a unique profession. Thirty-five years later, the NMTCB is still about the certification of nuclear medicine technologists by nuclear medicine technologists.
In addition to a celebration of our past, the Board must also say good-bye to two long time Directors. Anne Fisher has been with the NMTCB Board of Directors for nine years. She served as the Chair of the Board in 2009 and was also the driving force behind the development and delivery of the NMAA exam. Under Anne’s direction, a quality NMAA exam was delivered under budget and in time for the first graduates to sit for it just a few weeks after they finished school. We appreciate all that Anne has done for the NMTCB and we will truly miss her. Also leaving the Board this fall after serving for eight years is David Gilmore. David is just finishing his term as Chair of the Board and his “good bye” article is at the top of this newsletter. We will miss both Anne and David very much.
More and more often, certificants are required to maintain continuous certification in order to avoid penalty at their workplace. The NMTCB mails certification renewal applications to certificants approximately 10 weeks prior to their expiration, which is typically on the last day of their birth month. Please be certain that the address we have on file for you is current in order to be sure you receive your renewal application. You may check the information we have on file for you by logging in to our website at https://www.nmtcb.org/certificants/certificants.php using your last name and certification number. Online renewal is open to active certificants approximately 60 days prior to the expiration date. All renewals are processed by hand to ensure compliance with our ethics and continuing education policies. We encourage all certificants, especially those who must demonstrate continuous certification, to renew early to ensure processing of your renewal and mailing of your updated certification card well before the previous one expires. Note that the NMTCB requires a $65.00 reactivation fee to reinstate lapsed certification. Please be certain to renew early and avoid this additional fee.
During 2012, the NMTCB completed major task analyses for both nuclear cardiology and PET this year. The results of both surveys are included in this newsletter but I would like to thank all of the PET and NCT certificants that participated. The Task Analysis Committee discussed the surveys at our most recent Board Meeting and are committed to making the process more streamlined and easier in the future.
The NMTCB would like to thank the following for their hard work writing items for our exams this year: Lauren Shanbrun, Kimberly Hicks, Jaime Warren, Donna Mars, Patty Reames, Stephanie Land, Ada Courtney, Mark Crosthwaite and Martin Schmitt. We would also like to thank the following for helping to validate our nuclear cardiology exam at ASNC2012 in Baltimore: Roger Blaine, Maria Costello, Melanie Earles, Mary Beth Farrell, Metta Hachtmann , Mark Hyun, April Mann, Jeffery Meden, Patty Reames, Sue Slack and Barb Zeigner.
I would like to close by wishing every one of our certificants and friends in the imaging community, a very happy and safe holiday season and best wishes for a wonderful new year.
POLICY ON CONTINUING EDUCATION
Updated November 8, 2012
Rationale: The NMTCB entry-level examination is a test of knowledge. The knowledge base for nuclear medicine technology continues to change. Therefore, persons certified by the NMTCB must demonstrate a continued accumulation of knowledge about the field.
Definition of terms:
NMTCB Certificate: A certificate granted by the Nuclear Medicine Technology Certification Board (NMTCB) signifying recognition that an individual has met certification qualifications set from time to time by the NMTCB, including, but not limited to education, experience, examination, and good moral character.
Certificant: An individual who holds any NMTCB certificate.
Types of NMTCB Certificates:
- Active: A duly issued NMTCB certificate currently in good standing.
- Inactive: A duly issued NMTCB certificate which is no longer active and is not in good standing due to non-payment of renewal fees.
- Retired: An inactive certificate of a certificant who has claimed retirement from the field of nuclear medicine technology.
- Emeritus: An inactive certificate of a certificant with either 15 years active certification, or 10 years active certification and over the age of 62.
- Probation: The certificant maintains certification, but specific requirements must be met within a given time frame in order to return to Active status. If the probation requirements are not met, the certificant may be subject to further administrative discipline.
- Suspension: The certificant has his/her certification removed. There is a possibility of the certification being reinstated after specific requirements have been met.
- Revoked: The certificant has had his/her certification removed with no possibility of reinstatement.
Methods: NMTCB certificants will be required to demonstrate involvement in educational activities by completing the following:
Continuing education (CE) credits: a minimum of one (1) hour of continuing education is required for each month of the CE Cycle.
Mechanisms: Certificants are responsible for keeping records of CE hours obtained. The NMTCB shall base each certificant's CE Cycle on the individual's birth month and shall use an odd-even system based on initial certification year for tracking certificants. The NMTCB requires certificants to record the hours of CE obtained during the CE Cycle. The annual renewal statement requires certificants to attest to their current CE status. Excess CE credits (more than the number of hours required for the current CE Cycle) may not be carried over into the next CE Cycle.
Certificants will be randomly chosen for an audit of their CE records. These individuals will be required to provide documentation of the CE activities for the previous CE Cycle within 60 days of the postmark on the letter from the NMTCB. If a certificant is audited and fails to provide documentation and/or does not meet the CE requirements, he/she will be placed on 6 months probation, and will be required to complete the deficient CE hours for the audited cycle by the end of the probation period. If the certificant fails to meet all the CE requirements by the end of the probationary period, his/her certification will be suspended. If after six additional months the CE requirements have not been met, the certificant will be required to meet the current eligibility requirements and pass the Entry Level Exam in order to be certified again. The CE credits obtained during the probation period may not be counted towards the CE hours that are required for the subsequent CE Cycle.
Falsification of CE documentation may result in the revocation of certification(s), monetary fines to cover costs of investigation, and/or permanent disbarment from any and all NMTCB examinations.
Many organizations offer continuing education opportunities online or through meetings or journal activities. Many of these organizations only prepare the activities and are not approval organizations. However, most organization have their activities approved by a recognized continuing education approval organization. Before participating in a continuing education activity, please check with the sponsor to be certain that the activity is approved by one of the organizations listed below.
The following organizations meet the NMTCB's criteria for awarding continuing education credits, therefore educational activities approved by any of these groups will be accepted by the NMTCB. The NMTCB will not recognize continuing education hours that are not approved by one of the organizations listed. Click on each organization's name to visit their website(this list is reviewed and updated on an annual basis):
With the exception of Basic Life Support (BLS) and CPR, continuing education activities approved by the following state licensing agencies will be accepted:
g. New Mexico
i. Puerto Rico
NOTE: Technologists should contact organizations directly from which they are acquiring continuing education hours to submit a request for addition to the NMTCB approved list if the organization is not currently listed. NMTCB will not contact individual organizations.
Sources of CE Equivalency: The NMTCB does recognize certain activities as being the equivalent to a specific number of CE hours, even though these are not approved by one of the recognized organizations listed above.
- Specialty examination: Successful completion of any post-primary specialty examination offered by the NMTCB, American Registry of Radiologic Technologists (ARRT), American Registry for Diagnostic Medical Sonography (ARDMS) or American Healthcare Radiology Administrators (AHRA). Successful completion of a specialty exam will be recognized as the equivalent of 24 hours of CE. Note: The entry level examinations for the NMTCB and the ARRT (Radiography, Nuclear Medicine Technology, Radiation Therapy, Sonography or Primary Magnetic Resonance Imaging) are not considered the equivalent to CE hours.
- Certain college level courses: Official grade transcripts from an accredited post-secondary school must be submitted as proof of successful completion (grade of C or better) of college courses related to the Radiological Health Sciences, Patient Care, Business/ Management, Technology and/or Education. The equivalent of sixteen CE hours will be recognized for successful completion of one semester college credit or 12 CE hours per quarter college credit.
- Successful completion of American Heart Association Advanced Cardiac Life Support (ACLS): Will be recognized as the equivalent of 6 CE hours per 2-year cycle. A signed and dated copy of the ACLS certification card must be submitted for the credits to be recognized. Successful completion of Basic Life Support (BLS) or CPR training is NOT recognized as meeting the continuing education requirements of the NMTCB. Certification or licensure as a BLS or CPR instructor also is NOT recognized as meeting the continuing education requirements of the NMTCB.
- Successful completion of American Heart Association Pediatric Advanced Life Support (PALS): Will be recognized as the equivalent of 6 CE hours per 2-year cycle. A signed and dated copy of the PALS certification card must be submitted for the credits to be recognized. Successful completion of Basic Life Support (BLS) or CPR training is NOT recognized as meeting the continuing education requirements of the NMTCB. Certification or licensure as a BLS or CPR instructor also is NOT recognized as meeting the continuing education requirements of the NMTCB.
- Successful completion of both ACLS and PALS (as described above): Will be recognized as the equivalent of 9 CE hours per 2-year cycle. A signed and dated copy of the ACLS and PALS certification cards must be submitted for the credits to be recognized. Successful completion of Basic Life Support (BLS) or CPR training is NOT recognized as meeting the continuing education requirements of the NMTCB. Certification or licensure as a BLS or CPR instructor also is NOT recognized as meeting the continuing education requirements of the NMTCB.
Certificants who have not maintained Active status continually: The NMTCB provides limited mechanism for certificants who have let their certification lapse.
In order to return to Active status after less than 5 years, a certificant may reactivate by completing both of the following requirements:
- Paying back dues up to a total of no more than the current examination fee, plus a $65 reactivation fee, AND
- Documentation of completion of 12 continuing education credits for each year he/she was inactive
In order to return to Active status after 5 years or more, you are no longer considered a certificant and must pass the entry-level examination in order to reactivate. To reactivate, you must submit a new application to the NMTCB under current eligibility requirements - either as a program graduate or an Alternate Eligibility applicant.
2012 PET TASK ANALYSIS SURVEY REPORT
2012 PET Task Analysis Survey Summary
On January 20, 2012, a task analysis survey was distributed by mail to 500 current PET certificants. The survey was quite lengthy (23 pages) and was designed to take a very comprehensive look at all aspects of PET technology as it is applied to Oncology, Neurology and Cardiology. Participants were asked to complete the survey, filling in the most applicable Optical Mark Recognition (OMR) “bubbles”, and return it to us in the prepaid envelope by February 15, 2012. A total of 107 (21.4%) surveys were returned.
Of the survey respondents, just under half (46%) work in a hospital. Also just under half (44%) work in a large city, while 38% work in a suburban or small city setting. There was a fairly even response across most states with Kentucky and Wisconsin having the most respondents. Forty three percent of those who responded claim to work in PET full time and 44% have been working in PET 7-10 years, while another 28% have been in the field 4-6 years. Most respondents are responsible for starting the IV and injecting the radiopharmaceutical (90% and 93% respectively). Many fewer are responsible for insulin loading, monitoring patients and delivering interventional pharmaceuticals.
Chart 1 - Are you responsible for monitoring blood glucose levels?
Thirty nine percent perform research studies and 77% participate in The National Oncology PET Registry (NOPR), as seen in Chart 2.
Chart 2 – percentage of respondents that participate in NOPR.
Cardiac, Oncology and Neurology PET
Based upon the responses to items about Cardiac PET, only approximately 20% of PET Technologists perform these studies. Among those that do, however, it is clear that all of the tasks listed, as well as the pharmaceuticals and radiopharmaceuticals associated with Cardiac PET are important to understand.
In contrast, it appears that 93.5% of respondents perform Oncology PET exams. As demonstrated in Chart 3, most believe that it is important to have an understanding of indications for oncology PET exams. Lastly, it appears that almost half (48%) of respondents perform Neuro PET.
Chart 3 – How important is an understanding of indications for the effective practice of positron emission tomography?
Regardless of the types of PET exams performed, most respondents (90%) seemed to be in agreement that all aspects of anatomy and physiology, as well as general characteristics of radiopharmaceuticals and radiation safety, are important to understand (Chart 4).
Chart 4 – How important is it to understand the physical properties of radioactive materials?
Among respondents, regardless of the types of exams they perform, it is clear that F-18 Flurordeoxyglucose plays a vital role in PET with 71% claiming it very important and 21% calling it important. Only one respondent said it was not important, while 7 chose not to answer the question (Chart 5).
Chart 5 – How important is an understanding of F-18 Fluorodeoxyglucose for the effective practice of PET?
F-18 Fluorodopa is thought to be important by 60% of respondents, F-18 sodium fluoride by 85%, F-18 Fluorothymidine by 52%, N-13 Ammonia by 57%, Rb-82 Chloride by 58% and O-15 Water by 50%. Less important F-18 Estradiol at 34%, C-11 Choline at 38%, and the aggregate of other O-15 labeled radiopharmaceuticals at 35%.
Among those that answered the questions, about half stated that each of the ancillary drugs mentioned was important. Notable exceptions included contrast media with 75% claiming its importance, glucose with 80% claiming its importance, oral diabetic medications at 86% and insulin with 84% stating it is important or very important to understand (Chart 6). Understanding sedatives was also important to 63% of all respondents and steroids was important to 68%.
Chart 6 – How important is an understanding of insulin to the effective practice of PET?
Nearly everyone agreed that understanding the operation of a survey meter (93%), a dose calibrator (93%) and a well counter (87%) are both important to the practice of PET. The theory of PET and CT operations are also important (89% and 87% respectively).
The Task Analysis Committee has thoroughly reviewed the responses to the survey and reported the results to the PET Exam Subcommittee and the Board of Directors. As a result of this PET Task Analysis Survey, the NMTCB has determined that there will be no changes to the PET Content Outline at this time. However, the Board has approved the addition of the following FDA approved radiopharmaceuticals, F-18 sodium fluoride and F-18 florbetapir. Also added are the research radiopharmaceuticals F-18 flurpiridaz, F-18 choline, GE-68, Ga-68 dotatoc, Ga-68 dotanoc, Ga-68 dotatate, I-124 and Cu-64
2012 NCT TASK ANALYSIS SURVEY REPORT
NMTCB 2012 NCT Task Analysis Survey Summary
In February 2012, NMTCB conducted a Task Analysis survey of the Nuclear Cardiology Technology (NCT) subspecialty of nuclear medicine. This survey was conducted online utilizing Open Source LimeSurvey software hosted on the NMTCB website (www.nmtcb.org). The survey consisted of 59 question groups divided into eleven major categories: demographics, myocardial perfusion imaging, gated blood pool imaging, cardiac shunt imaging, first pass angiography, cardiac PET, anatomy & physiology, radiopharmaceuticals, interventional pharmaceuticals, exercise stress testing and a miscellaneous category. The survey was constructed to closely mirror the NCT Content Outline, published on the NMTCB website at http://www.nmtcb.org/specialty/examContentSpec.php%20 and supplemented with additional items that the NMTCB Task Analysis Committee thought important to add. An email invitation to take the survey was sent to 660 Active NCT certificants and measures were taken to allow only invitees to take the survey while maintaining anonymity. A total of 137 (20.7%) completed the entire survey and another 91 (13.8%) completed part of the survey. All 228 responses were considered when analyzing this survey.
The hospital setting (chart 1) was the most common place of practice for 52.6% of respondents, followed by the cardiology office where 33.7% work, and the outpatient radiology practice where 4.4% are employed. Of the remaining 21 respondents, five chose not to answer this question, nine work in a hospital based outpatient testing facility, one worked for a state radiation protection agency, one in industry, one as an instructor, one is unemployed, one retired, and two left the option blank.
Chart 1 – Setting where majority of working time spent
When asked the type of area (chart 2) in which they practice, 48.7% claimed a suburban or small city setting while 36.8% claimed a metropolitan or large city environment. A rural setting was selected by 11.4% and 3.1% chose not to answer this question. Interestingly, Missouri topped the charts with 13 participants, followed by New York, Virginia and Texas, all with 12 respondents each.
Chart 2 – Type of area where respondents practice
When asked what percentage of their time they are spending performing nuclear cardiology procedures, 63% of all respondents answered 60% or more of their time is spent doing this. Also, 53.1% of all respondents have been practicing nuclear cardiology for 15 years or longer with another 17.1% having practiced nuclear cardiology for ten to fifteen years and 13.6% from seven to ten years. Blood pressure monitoring is one of their responsibilities for 64% of respondents, and 30% are ACLS certified (chart 3).
Chart 3 – Respondents that are ACLS Certified
Other responsibilities include starting the IV (89.5%), placing ECG electrodes (49.1%), acquiring a baseline ECG (37.3%), monitoring patients during stress (36%), injecting stress pharmaceuticals (61.8%), injecting radiopharmaceuticals (93%), and monitoring patients post stress (34.7%). The remainder of the NCT Task Analysis Survey was devoted to the procedures, equipment, radiopharmaceuticals, interventional pharmaceuticals and exercise stress testing (chart 4).
Chart 4 – Other responsibilities of NCT Certificants
Clearly, Myocardial Perfusion Imaging (MPI) is the most commonly performed imaging study among NCTs, with nearly 90% of respondents claiming that all of the tasks associated with MPI are important to understand. Although there has been much more information about dose reduction appearing in the literature, as well as in the public media, it is worthwhile to note that only 4% of respondents claimed that it is not important to have an understanding of dose reduction when performing MPI.
Gated blood pool imaging (ERNA/MUGA/RVG) continues to be significant for the NCT to understand with just under 60% of respondents claiming its importance, though it appears that an understanding of solid state detectors with regards to these procedures is not as vital with 19% responding that it is not important.
Cardiac shunt studies are performed less often with an average of 35% of respondents stating that the associated tasks are important. Likewise with 1st pass angiography, for which about 32% claim that the associated tasks are important; and cardiac PET with approximately the same response. Less than 2% of those who responded thought that an understanding of all parts of the cardiac anatomy and pathology is not important and less than 1% thought that an understanding of cardiac physiology is not important.
An understanding of MIBG, sestamibi, tetrofosmin, thallium and Tc-99m labeled red blood cells all were considered important among respondents, as the PET radiopharmaceuticals, though there were fewer responses to these questions. Among the stress pharmaceuticals, all of them were considered important to understand with the most responses being about adenosine and the least being about esmolol. Of the remaining pharmaceuticals (aspirin, anticoagulants, antiarrhythmics, calcium channel blockers, ACE inhibitors, nitrates, cholesterol lowering drugs, diuretics and digoxin, 40-80% of respondents claimed that an understanding of these was important, while 10-30% claimed they were not.
An understanding of exercise stress testing in general is very important to more than 85% of those that responded and important to an additional 11%. However, while understanding treadmill exercise protocols held importance for nearly all of the respondents, 27% of those who answered the question stated that understanding bicycle and isometric exercise protocols was not important.
ECG acquisition is also important to the NCT as described in chart 5.
Chart 5 – Understanding ECG acquisition
Also important is the ability to differentiate between normal rhythms, abnormal rhythms, heart blocks, indicators of ischemia and indicators of infarction. With regards to emergencies, only one respondent didn’t think that knowing CPR was important. Lastly, while only 30% of respondents are ACLS certified, nearly 82% think that ACLS certification is important or very important.
The Task Analysis Committee has thoroughly reviewed the responses to the survey and reported the results to the NCT Subcommittee and the Board of Directors. As a result of this NCT Task Analysis Survey, the NMTCB has determined that there will be no changes to the NCT Content Outline at this time.
NMTCB sincerely appreciate the efforts and perseverance of the many NCTs and PET Technologists that took the time to complete these Task Analysis Surveys. Thank you to all of those that participated. While long and, to many, arduous, these surveys permitted the NMTCB to gain a better understanding of the actual duties and knowledge required of an NCT and a PET Technologist. They also served as validation of the current exams and content outlines. Now that we have successfully completed an NCT Task Analysis Survey online, the Task Analysis Committee will next consider ways to make the process more streamlined and less repetitive in the future.
EXPANDING THE ROLE OF THE
NUCLEAR MEDICINE TECHNOLOGIST IN RESEARCH
Deborah Gibbs, CNMT, PET
Evolving and adapting to change is crucial to viability in Nuclear Medicine. Over the past twenty years, our profession has evolved and grown into many aspects of related fields. The future of nuclear medicine and molecular imaging is now dependant on research, looking retrospectively at protocols and procedures, measuring every aspect of qualitative and quantitative statistics. Knowing the end result will be the most accurate when we control all variables is critical to every study. Variables in a clinical trial procedure, whether known or unknown, can make or break a study. Specific examples of changing variables are the patient’s blood glucose level, incubation delay, or bed acquisition time prior to a PET procedure. When working with a trial sponsor, it is crucial to follow the protocol exactly, but what happens when you just don’t understand the terminology?
nuclear medicine professionals must prepare themselves, as well as their departments, when it’s time to participate in clinical trials. The items listed below, will assist in introducing new terms, measures and processes.
CITI Training - Collaborative Institutional Training Instruction
CITI includes Human Subject Protection Training policies requiring that all individuals involved in clinical research are trained in human research protection issues. Most healthcare institutions require their employees to complete CITI training if involved in clinical research at any level. This is an on-line course accessible via: https://www.citiprogram.org. Most academic institutions require all authors and co-authors to be CITI certified before being included on articles, abstracts, and poster submissions. The instructional modules are designed for all levels of participation in clinical trials.
SNMMI Clinical Trials Network - Clinical Trials Network (CTN) was formed by SNMMI in 2008 to help facilitate the effective use of molecular imaging biomarkers in clinical trials. The CTN provides tools and resources to promote faster, more cost-effective drug development and increase the availability and performance of molecular imaging biomarkers for use in the clinic. Benefits to the drug development industry include access to a registry of qualified imaging facilities, biomarker manufacturers, a robust scanner validation program, access to standardized imaging protocols, and clinical research education and training for site personnel. Sites' participation in the CTN contributes to improved imaging, not just in research but also in clinical practice. The molecular imaging community benefits as well: Increased standardization in trials leads to better data which then result in expanded utilization of molecular imaging biomarkers.
NOPR- National Oncologic PET Registry was developed in response to the Centers for Medicare and Medicaid Services (CMS) proposal to expand coverage for positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) to include cancers and indications not currently eligible for Medicare reimbursement. This presents a very viable pathway to get reimbursement for some of the diagnoses that are not currently covered by CMS guidelines. Through the CMS proposal, Medicare allowed reimbursement for these cancers to be obtained under the CMS coverage with an evidence development program, if the patient's referring physician and the PET provider submitted data to a clinical registry to assess the impact of PET on cancer patient management. The NOPR implemented this registry for CMS. The NOPR is sponsored by the World Molecular Imaging Society (WMIS) and managed by the American College of Radiology (ACR) through the American College of Radiology Imaging Network (ACRIN). The NOPR received input from, and is endorsed by the ACR, the American Society for Clinical Oncology (ASCO), and the Society for Nuclear Medicine and Molecular Imaging (SNMMI).
Caisis - Oncology Research Databases, Caisis was developed by Memorial Sloan-Kettering Cancer Center and is now utilized by many of the Comprehensive Cancer Centers to exchange data to create larger populations and cohorts for study. Caisis is a no cost open source, web-based cancer data management system that integrates research with patient care. The system is freely distributed to promote scientific collaboration, and over the course of the last five years many other institutions have adopted the system. Collaboration with multiple centers has allowed Caisis to develop and evolve in an environment of constant feedback and scrutiny.
All nuclear medicine professionals should be encouraged to enhance their skill set, build on their knowledge base, and utilize the tools available to be the significant force in clinical practice and trials. As our past SNMMITS President, Scott Holbrook (2006) has stated, “The evolution of nuclear medicine into molecular imaging will significantly impact nuclear medicine technologists over the next decade”. This statement has proved to be true on a daily basis if you are a technologist who performs research. As the pharmaceutical companies create, develop and grow their products, nuclear medicine and molecular imaging are and will continue to be the chosen modalities used to accurately measure outcomes.
Chair of the Board
David Gilmore, CNMT, NCT
Jimel Carpenter, CNMT, NCT
Marcia Hess Smith, CNMT
Robert Pagnanelli, CNMT, NCT
Jon Baldwin, DO
Michele Beauvais, RPh, BCNP
Amy Brady, CNMT
Angela Bruner, Ph.D.
Jimel M. Carpenter, CNMT, NCT
Anne M. Fisher, CNMT
Angela Foster, CNMT
Deborah L. Gibbons, CNMT, PET
David Gilmore, CNMT, NCT
Bennett Greenspan, MD
Marcia Hess Smith, CNMT
Byan Kerr, CNMT, NCT, PET
Cindi Luckett-Gilbert, CNMT, PET
Nancy McDonald DeLoatch, CNMT,NCT
Cybil Nielsen, CNMT
Robert Pagnanelli, CNMT, NCT
Gregory G. Passmore, PhD., CNMT
James Patton, PhD
David J. Perry, CNMT, PET
Associate Executive Director
Katie Neal, BS, MS
Dbase Manager/Desktop Publisher
Alfred L. Shellman
Certificant Services Manager
Elizabeth Rhodes, BS, MBA
Barbara T. Dixon
HAVE YOU MOVED? Please keep your NMTCB file up to date by making sure your contact information is accurate. Updating the NMTCB with your current information takes just a couple of minutes online and will assure you that you receive important notices from us. Please visit www.nmtcb.org and choose "Address Change" under "Certificants" to make corrections to your contact information.
A N N O U N C E M E N T S
Always check the NMTCB website www.nmtcb.org or call the NMTCB office (404/315-1739) for the most current information.
PET Exam Fee Increase
Robert Pagnanelli, CNMT, NCT
Effective January 1, 2013 there will be a modest increase of the PET Exam processing fee from $200 to $225. This registration has been previously unchanged since the inception of the exam in 2006. It is required to offset the increasing cost of exam delivery. The current number of PET certificants is at 716 with all 50 states represented. The PET exam remains on demand meaning that once your application is approved, you may schedule yourself to sit for the exam at any time within six months of the eligibility decision. For additional information, please visit our website at www.nmtcb.org.