Vol. 27, No. 1 / Spring 2012

IN THIS ISSUE:    WHAT CONTINUING EDUCATION CREDITS DOES THE NMTCB ACCEPT?

  MESSAGE FROM THE CHAIR

  EXECUTIVE DIRECTOR'S MESSAGE

  WHY WOULD YOU WANT TO BE A NMTCB DIRECTOR?

  NMTCB NEW DIRECTORS

  WHAT CONTINUING EDUCATION CREDITS DOES THE NMTCB ACCEPT?

  HAVING FUN WITH THE CT DOSE REPORT

   2011 AT A GLANCE

MESSAGE FROM THE CHAIR

David Gilmore, CNMT, NCT

It gives me great pleasure to be serving as Chair of the NMTCB! I would like to first recognize Robert Pagnanelli, CNMT, NCT as the outgoing Chair. Robert’s foresight and strategic focus over the past year has moved the NMTCB forward and in a positive new direction.

I do support Robert’s vision and look forward to continuing the path forward.

As we start the new year, we start with many new faces on the Board of Directors. As Robert announced in his last message as Chair, we said goodbye to Chad Grant, Dr. Yusuf Menda, Dr. Leonie Gordon, and Leesa Ross who all ended their terms on the NMTCB Board. As with each new year, we welcomed new Board members. Please see our new members and their bios in this newsletter, but please help me in welcoming our new board members Bryan Kerr, Amy Brady, Dr. Jon Baldwin and Dr. Ben Greenspan.

All of us in nuclear medicine see the changing environment around us, including declining procedures, reimbursement cuts and cuts in staff. We recognize these challenges and continue to work with our partners such as SNM, SNMTS, ASNC, ARRT, ASRT, and AEIRS to continue to advance the field of Medical Imaging and, more importantly, the field of Nuclear Medicine and Molecular Imaging. We remain an active participant at the National Council of Representatives of the SNMTS. This allows us to hear the challenges and to participate in discussions that the SNMTS has around initiatives at the national level as well as the chapter and grassroots level.

With regards to the entry-level exam last year, there was a nearly 9% decline in 1st time graduate examinees. We anticipated seeing this as we continue to hear about the declining enrollments in the Nuclear Medicine Technology programs. However, during the same period we have had a slight increase in the PET and NCT exams, both of which are designed to help a candidate demonstrate expertise in the respective field. Please remember that there are new eligibility requirements for the NCT exam which may be found on the NMTCB website at http://www.nmtcb.org/specialty/cardiology.php#Eligibility.

In January, we hosted a very successful Item Writer’s Workshop for the entry-level, NCT, PET, and NMAA certification examinations! A special thanks goes out to Lauren Shanbrun, Kimberly Hicks, Jaime Warren, Donna Mars, Cybil Nielsen, Jimel Carpenter, Angela Foster, Nancy DeLoatch, Patty Reames, Stephanie Land, Bryan Kerr, Ada Courtney, Cindi Luckett-Gilbert, Mark Crosthwaite , Martin Schmitt, Jon Baldwin, Bennett Greenspan, Tony Knight and David Perry for their enormous effort writing questions that are so essential to the success of our examinations. These questions are now being vetted through a psychometric system and analyzed for consideration for future exams.

We are extremely excited to announce that the NMTCB Board of Directors approved the decision to move the NMAA certification exam to our exam administration company, IQT, Inc., making it an online exam like all of our other certification examinations. The 2nd NMAA exam will be offered in Miami during the SNM Annual Meeting in June and we wish much luck and success to the new NMAA candidates that will be graduating this May.

Also at the SNM Annual Meeting will be our now traditional Educator’s Reception, co-sponsored with the SNMTS. This reception is meant to give a much deserved thank you to nuclear medicine educators from the NMTCB for the work that is done for our future technologists in this field!

Finally, I would like to thank the members of the Board of Directors for their hard work and dedication to make the NMTCB the premier certification organization for Nuclear Medicine and Molecular Imaging! Much work is being done to continue to move the NMTCB to the forefront of this field that we all consider our profession!

EXECUTIVE DIRECTOR'S MESSAGE

Dave Perry, CNMT, PET

The NMTCB had another very successful year in 2011. In February, we completed the examination administration vendor transition from ACT, Inc. to Iso-Quality Testing, Inc. (IQT). The Board is very excited about this move. In addition to helping us control the costs of exam administration, IQT offers more testing centers, both domestically and abroad, than their ACT counterparts. IQT also offers more exam development tools that ACT did, which means greater flexibility and a shorter item development to appearance on the exam time than we previously encountered.

The 2011 year also saw the delivery of the very first Nuclear Medicine Advanced Associate (NMAA) certification exam. You may recall that the NMAA is a new career path initially envisioned by the SNMTS as a mid-level practitioner who could serve as a bridge between the technical staff and the interpreting physician. To be eligible to sit for the NMAA, candidates must have completed the Master’s level program offered by a consortium of universities organized by the University of Arkansas for Medical Sciences. Participating in the consortium are the University of Missouri – Columbia, Saint Louis University, and Georgia Health Sciences University.

The first NMAA examination was delivered on Saturday, June 4, 2011 in San Antonio, Texas. This was in conjunction with the SNM Annual Meeting held there. Four recent graduates of the program sat for the exam, and we are pleased to state that all four passed and received their initial certification as Nuclear Medicine Advanced Associates. We are also pleased to announce that the 2012 NMAA exam will be offered through IQT, which means that it may now be taken at any of the IQT testing centers and candidates are not required to go to the site of the SNM Annual Meeting. Beginning in 2013, we will offer the NMAA exam twice per calendar year to accommodate students who complete the program at different times of the year.

In addition to the entry-level and NMAA exams, the NMTCB also offers on-demand testing for the NCT and PET exams through IQT. Qualified candidates can sit for these exams at any of the IQT testing centers at a time of their choosing for greater flexibility. 93 individuals became NCT certified and 129 individuals became PET certified in 2011. For more 2011 statistics, please see our article “2011 at a Glance”.

Closing out our wrap-up of 2011, the NMTCB had to say good bye to four Board members, Leonie Gordon, Chad Grant, Yusuf Menda, and Leesa Ross. Each of them made significant contributions to the Board and we will all miss them. Four new board members were elected in the Fall. They include Jon Baldwin, Bennett Greenspan, Amy Brady, and Bryan Kerr. We welcome each of them to the Board and look forward to working with them. You can read about each of these new Directors in the biography section of this newsletter.

More and more often, certificants are required to maintain continual 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 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 continual certification, to renew early to ensure processing of your renewal and mailing of your updated certification card well before the previous one expires. As additional incentive, the NMTCB requires a $65.00 reactivation fee to reinstate lapsed certification. Please be certain to renew early and avoid this additional fee.

The NMTCB will be at the SNM Annual Meeting in Miami this year from June 9^th through June 13^th. If you go to the meeting, please stop by our booth number 1351 in the exhibit hall. We look forward to meeting you.

WHY WOULD YOU WANT TO BE A NMTCB DIRECTOR?

Nancy DeLoatch, CNMT, NCT

Being a Director for the Board of Directors (BOD) of the NMTCB is one of the most rewarding and multi-faceted accomplishments you can have in your career. The BOD is a place where you can positively “give-back” to the profession and honestly make a difference in the future of nuclear medicine.

Is it a lot of work? Well, you are going to work. You will be participating in all aspects of creating the exams that define and decide who our future professionals will be. Questions for the entry level and specialty exams must be created, rewritten, weighted, tested, and possibly rewritten again. Writing a good test question is an art in itself. Evaluating that question is indeed a science that has its’ own vocabulary and mathematics. You will never look at a test question the same again! Is it a lot of work? No, not really. The BOD meets twice a year traditionally in the spring and fall, a two and three day weekend respectively. The days are spent on committee meetings and related work and of course, test creation. It is during the committee meetings that the rulings that govern the NMTCB as an organization and those that directly affect the technologists are discussed and either accepted or not. Separate “Item Writer’s Weekends” typically occur in January if they are needed. These 2-day weekends are devoted exclusively to the creation of new test items for all of the exams. In-between meetings you may be called upon for a conference call or receive emails regarding a decision that needs to be made. The commitment for a Director is four (4) years and a Director may renew for an additional four year term if he/she is invited back.

Will you grow professionally and personally? Absolutely! You will be working closely with professionals from across the country transversing all aspects of nuclear medicine. Connections will be formed and friendships will flourish. You may engage in some passionate disputes across the table during the day, but when the evening rolls around the only thing crossing the table is laughter and celebration.

What if you don’t know the first thing about creating a test? The administrative staff of the NMTCB is exceptional at what they do. They provide the guidance, support, and references you will need to fulfill your responsibilities. They are always available, incredibly professional and friendly, and amazingly patient. You will learn everything you need to know from them and from the mentorship of your fellow BOD members.

Think you might want to give it a try? The application process and forms can be found on our web site (www.nmtcb.org) under the “Resources” heading. Even if you have applied in the past, try again. Only a few spots on the Board open up each year, so sometimes it takes a few tries – perseverance can pay off.

Being selected as a Director for the NMTCB has been one of the best learning experiences and greatest honors of my career. It is a position that I encourage all technologists passionate about nuclear medicine to pursue. You won’t regret it!

NMTCB NEW DIRECTORS

Bryan Kerr, CNMT, NCT, PET

Bryan Kerr is a proud to be working for the Indiana University Health Goshen Hospital in Goshen, Indiana. His duties include serving as the PET/CT Coordinator, staff Nuclear Medicine Technologist and staff CT Technologist where he daily assists his patients’ needs. His credentials include CNMT, PET, and NCT, RT (N) (CT). In addition to scanning, he is involved with IU Health Goshen’s esteemed Cancer Center’s Research Department, is a member of the Radiation Safety Committee, and has helped get his hospital involved with the SNM’s Clinical Trials Network.

Bryan has worked as a technologist since 2005 and during his young career; he has served as a lead/chief technologist, coordinator and manager. He was a graduate of Columbus State Community College’s first Nuclear Medicine class where he earned his Associates Degree, and worked both in the mobile and hospital settings since graduation. His clinical experience includes: dedicated PET, PET/CT, Rubidium Cardiacs, Pediatrics, General Nuclear Medicine, SPECT/CT and General Computed Tomography. In addition, he has helped facilities achieve accreditation by both the ACR and ICANL. He is also an ASNC member and worked for Astellas as a Lexiscan Consultant shortly after the product’s release.

He is an active member of the SNMTS at both the chapter and national level. He serves on the Central Chapter of the SNM’s Bylaws Committee, and is a member of the national Professional Development Task Force, the Professional Development Fund Committee and the Publications Committee. He was recently selected to attend the SNMTS Leadership Academy as well. He also enjoys researching for interesting abstracts. He has had two abstracts selected for presentation on the national level and has presented four on the regional level. Out of the four presented regionally, he has won the esteemed Renae Henkin award twice.

His background includes growing up on a farm in rural Ohio where he worked on both a dairy farm and pig farm. He is a proud uncle of two wonderful nephews and a beautiful niece. His favorite pastime is spending time with the most beautiful woman in the world (his wife) who is expecting the couple’s first child in July. His hobbies include attending weekly mass with his in-laws, bird watching and making rosaries.

Bryan’s past NMTCB experience includes being a cut scorer for the PET specialty exam and he was invited to be an item writer for the PET exam on three different occasions. Bryan is extremely honored to be appointed to the NMTCB Board of Directors and considers this to be the pinnacle of his Nuclear Medicine career!

Amy Brady, CNMT

Amy is a Nuclear Medicine Technologist in Birmingham, Alabama and serves as a clinical coordinator and teacher in the Nuclear Medicine Technology Program at the University of Alabama at Birmingham. She obtained her nuclear medicine training at the University of Alabama at Birmingham under the direction of Ann Steves and Norman Bolus, to whom she is grateful for the motivation and opportunities they have given her.  

Amy is a graduate of the Society of Nuclear Medicine’s Leadership Academy and is a member of the Educator’s Committee. Amy is the current Treasurer of the Southeastern Chapter of the Society of Nuclear Medicine and is the President of the Alabama Society of Nuclear Medicine. She is the co-author of the Steves’ Review of Nuclear Medicine Technology.

Outside of nuclear medicine, Amy is married to a wonderful husband, Jason. She has a son named Ethan and a new addition, Bella. Amy enjoys spending time with her family, volunteering, and singing.

Jon Baldwin, D.O.

I am indeed honored to be elected to the position of SNM physician representative to the NMTCB Board of Directors. As an educator, it is my passion to teach both residents and technologists. I am fortunate to work at an institution that has allowed me to do so. As I work with our technologists at our training program here at the University of Alabama at Birmingham, I continue to realize how important the technologists are to the profession of Nuclear Medicine. In fact, I would go so far as to say that Radiologists and Nuclear Medicine physicians are only as good as the technologists they employ. If technologists cannot generate quality images and perform QA/QC measures proficiently, physicians have little chance at making the right diagnosis from the studies they interpret. I feel it is our responsibility as physicians to see to the proper training of our technologists as much as to the training of our residents.

To this end, I have felt it important to be involved at the local, state, regional and national level to be both an advocate and educator for technologists. I regularly give presentations to technologists at our school and at state meetings. To promote scholarly activity amongst our trainees, as the chair of the Program Committee for the 2011 Southeastern Chapter of the SNM Annual meeting, I began a program where technologist and technologist students would be able to submit and (if chosen) present abstracts at the Annual Meeting. On the national level, I have had the privilege of working with the NMTCB in the preparation of the initial NMAA board examination, I am a consulting editor for the Journal of Nuclear Medicine Technology, and I sit on the Board of Directors of the SNM Advanced Associate Council.

I am grateful for your consideration for this important position. I pledge to work to hard as the SNM physician representative to the NMTCB to promote the profession of Nuclear Medicine Technology through the certification of competent and skilled technologist.

Bennett S. (Ben) Greenspan, M.D., M.S.

Bennett S. (Ben) Greenspan, M.D., M.S. received his M.D. degree from the University of Illinois in Chicago. He was a resident in Diagnostic Radiology at the West Los Angeles V.A. Medical Center, and a resident in Nuclear Medicine at the Sepulveda V.A. Medical Center, both UCLA affiliates. He received his M.S. degree at UCLA in Medical Physics. He is certified in Diagnostic Radiology and Nuclear Radiology by the American Board of Radiology and in Nuclear Medicine by the American Board of Nuclear Medicine.

Dr. Greenspan is a Fellow member of the American College of Radiology (ACR) and the American College of Nuclear Medicine (ACNM). He has served as President of ACNP, MVCSNM, the Missouri Radiological Society (M.R.S.), the SNM Academic Council, and the ABSNM, and is currently serving second terms as President of the SNM Academic Council and the MVCSNM. In addition to the SNM Board of Directors, he currently serves on the Boards of the SNM Computer and Instrumentation Council, the SNM Academic Council, the SNM Advanced Associate Council, the SNM PET Center of Excellence, ICACTL, ACNM, Academy of Radiology Research, and the Executive Councils of MVCSNM and M.R.S. and has previously served on the Executive Councils of the ACNP and the ACR InterSociety Summer Conference. He serves as an oral board examiner for the ABR and is an item writer for the ABR and ACR. He serves on the Accreditation Committee for Medical Physics graduate programs and is a member of committees of the AAPM on teaching medical physics to radiology residents and development of the medical physics curriculum for radiology residents. He also is a member of the AAPM Nuclear Medicine Subcommittee. He is a member of the Molecular Imaging Education Task Force of SNM, which is working to shape the future curriculum for Nuclear Medicine residency, as well as the future science curriculum for graduate students of NM. He is a reviewer for quality assurance in Nuclear Medicine for the ACR. He has been an active member of SNM, ACNP (now ACNM), ACR and RSNA for over 20 years. He serves on numerous SNM committees and task forces, including Continuing Education, Procedure Guidelines, Government Affairs, the Presidential Task Force on the Job Crisis in Nuclear Medicine, the CT Task Force, and the Committee on Councils. He was involved in the early formation of the Advanced Practice Task Force, and has been a strong supporter of the Advanced Associate Council. For ACR, he is a member of the Guidelines and Standards Committee for Nuclear Medicine. He is a member of the Scientific Program Committee for RSNA and for AUR.

Dr. Greenspan is devoted to teaching of clinical nuclear medicine and also physics of nuclear medicine to nuclear medicine and radiology residents and nuclear medicine technologists. He served as the Radiology Residency Program Director for four years at the University of Missouri, Columbia, and for four years as Associate Program Director of Nuclear Medicine at the Mallinckrodt Institute of Radiology of Washington University in St. Louis.

Dr. Greenspan’s research interests include PET imaging in oncology (including development of new PET tracers), osteoporosis, and the effects of low level radiation. He has been a co-investigator on 11 grants.

WHAT CONTINUING EDUCATION CREDITS

DOES THE NMTCB ACCEPT?

Angela Foster, CNMT, NCT

Continuing education units (CEUs) are required to maintain your NMTCB certification and an average of 1 credit per month, or a total of 24 credits per two year cycle, are needed to fulfill that requirement. Our office receives frequent inquires regarding what continuing education credits are accepted for the requirements set forth by the continuing education policy.

Listed on the NMTCB website is a comprehensive list of organizations that are approved for continuing education credits. These can be accessed under the NMTCB Policies link by selecting Continuing Ed Policy or by clicking on the following http://www.nmtcb.org/policies/continuing-competence . 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 on the NMTCB website.

In addition to obtaining credits from the organizations listed on the website, the NMTCB will recognize certain specific educational activities as being the equivalent to CE. Advanced Cardiac Life Support (ACLS) training is considered the equivalent of 6 CEUs per two year cycle. Pediatric Advanced Life Support (PALS) is also considered the equivalent of 6 CEUs per two year cycle, but the combination of ACLS and PALS can only earn you the equivalent of 9 CEUs per two year cycle. CPR and Basic Life Support (BLS) training or certification as a BLS instructor does not meet NMTCB requirements for continuing education credit.

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) will be recognized as the equivalent to 24 hours of CEUs. Entry level exams for the NMTCB and 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 related to Radiological Health Sciences, Patient Care, Business/ Management, Technology and/or Education that are completed in an accredited post-secondary school will be accepted for continuing education credit. As long as a grade of “C” or better is maintained, the equivalent of 16 CE hours will be recognized for successful completion of one semester college credit or 12 CE hours per quarter college credit.

The NMTCB and the SNMTS have a sharing program for VOICE credits. This service allows for timely and accurate continuing education reporting to the NMTCB. While this service can be beneficial for our certificants, the information on the VOICE transcripts is only as accurate as the information provided. SNM members are encourage to visit www.snm.org periodically and verify the accuracy of your VOICE transcripts and report any missing information to the SNM Education Department at education@snm.org. You may sign up for VOICE Credit Sharing by logging in to the SNM website at www.snm.org and clicking on the “MySNM” tab at the top of the page.

There are many resources available to obtain the credits necessary to maintain your CNMT certification. Additional information regarding continuing education and reporting cycles can be obtained in the FAQ section of the NMTCB website. And on a final note, in the event that you are randomly chosen for an audit of your CEU records, you have 60 days from the postmarked date on the letter to submit your documentation.

HAVING FUN WITH THE CT DOSE REPORT

Bryan Kerr, CNMT, PET, NCT, RT(CT)

When performing either a SPECT/CT or PET/CT scan, the CT portion of the scan sometimes produces a dose report. This report can be somewhat difficult to navigate when the acronyms have quantitative data listed below each one of them. The data is wonderful to have but what does it actually mean? Sure, anyone can rattle off that the DLP (Dose Length Product) for a given scan was 112.86 mGy cm and the CTDI (CT Dose Index) was 6.58 mGy but what does that really mean with regard to a comprehendible patient dose?

Establishing definitions to the three major acronyms on the dose report:

Computed Tomography Dose Index (CTDI)

The CT Dose Index (CTDI) is the primary dose measurement concept in CT. It represents the average absorbed dose, along the z axis, from a single position (usually center or 12 o'clock position). It is measured from one axial slice (one rotation of the x-ray tube). CTDI estimates the average absorbed dose within the central region of the scan volume. It is based on measurements using an ionization chamber placed inside a cylindrical plastic phantom. CTDI is measured in milligray (mGy).

Computed Tomography Dose Index Volume (CTDIvol)

CTDIvol represents the average absorbed radiation dose over the x, y and z directions by averaging the dose from the central and 12 o'clock positions and also taking into account pitch. CTDIvol is the parameter that best represents the average dose at a point within the scan volume for a particular scan protocol for a standardized phantom. While CTDIvol estimates the average radiation dose within the irradiated volume of a CT acquisition for an object of similar attenuation to the original CTDI phantom, it does not effectively represent the average dose for objects of substantially different size, shape or attenuation.

Dose Length Product (DLP)

DLP is defined as an estimate of the total absorbed dose in a phantom over the length of the scan. DLP is quite useful when comparing exam doses and is measured in milligray(mGy) times centimeters (cm) or the CTDIvol times the distance scanned in cm. The DLP reflects the estimated total energy absorbed over the entire scan.

These values are great when trying to build and compare protocols in order to decrease exposure. It is also easy to understand that they are just estimates since patient size, shape and attenuation are not taken into account because this data is based on a phantom. However, we need to know what these numbers mean when a patient asks “How much radiation did I just receive?”

First, we need to define the differences in types of radiation dose. The amount of energy that is deposited in any material by ionizing radiation is how “absorbed dose” is defined and it is given in units of Gray (Gy). Effective dose is defined as an estimate of the stochastic consequence that a non-uniform radiation dose has on a human. Next, we must figure out how to make sense of what the numbers actually mean in a “real world” approach.

 Putting the fun into calculating effective dose:

Sometime during our training, effective dose, measured in Sieverts (Sv), became the primary value we, as technologists, dealt with on a daily basis. Whether we are surveying a package, cleaning a spill or performing daily surveys, the Sievert has become the first degree of measurement used to detect radioactivity. However, a more familiar factor is the millirem. Where 0.001 Sv equals 1 millisievert (mSv) and 1 mSv equals 100 mRem. Since CT dose reports all deal with estimated absorbed dose in mGy and general nuclear medicine/PET labs deal with effective dose measured in mRem, it may be hard to estimate or comprehend what the CT dose can be equated to. In 2000, the National Radiological Protection Board (NRPB) published a generic “shortcut” method to estimate CT dose in effective dose.

The NRPB’s method was to multiply DLP by their “k” coefficients that applied to specific body areas. For example, the “k” factor for a chest is 0.014 and if a technologist performs a SPECT/CT Myocardial Perfusion exam with the total DLP equaling 120.18, the effective dose would be 1.68 mSv or 168 mrem . The “k” factor for a chest, abdomen and pelvis study is 0.015. This factor would roughly be the equivalent to a PET/CT Skull Base to Mid-Thigh Scan. Therefore, if the total DLP for the PET/CT scan was 632.96 then the effective dose would be 632.96 mGy cm x 0.015 = 9.49 mSv or 949 mrem.

Now these “k” factors can help give an estimate of dose when a patient asks the age old question “How much dose did I receive?” Again, these are just estimates, but it helps paint a bit of a clearer picture for the patient to understand. The true beauty is that using the equivalents of effective dose published by the International Commission on Radiological Protection in 1991 (ICRP 60), mrem equivalents can be related to “real-life” functions. The real-life estimates ICRP 60 compares millirem calculations to relatable risks such as the number of cigarettes smoked or the number of miles driven.

With using the SPECT/CT example from above and the calculating the mrem constant from ICRP 60, 168 mrem would equate to about 17 cigarettes smoked or an average of about 750 miles driven. Where the PET/CT example from above would be 95 cigarettes smoked and an average of 4270 miles driven. This is what makes this estimate FUN. These estimates actually give the patient a better comprehension of how much radiation they are receiving and what it compares to in real life!

The only caveat is that the radioisotope still needs to be factored in. According to ICRP 60, 40 mCi of Tc99m Sestamibi (10 mCi for Rest and and 30 mCi for Stress) would equal 119 cigarettes smoked and 5200 miles driven, therefore the grand total radiation dose for a SPECT/CT MPI study would equate to a real-life amount of 136 cigarettes smoked and about 9500 miles driven. In the PET/CT example, 15 mCi F-18 FDG would equal 105 cigarettes smoked and 4725 miles driven. The grand total of exposure would be 200 cigarettes smoked and about 9000 miles driven.

Now these numbers and this “k” factor calculation are just estimates or averages for a standard sized person. This does not take into effect variable slice thickness, kVp, mAs, slice thickness, patient size and shape. This is also in no way meant to be a gold standard in determining effective total dose, however, these averages help make radiation dose a bit more comprehensible to the patients that we work so hard to take care of. This method makes things fun and also the next time a patient asks “how much dose did I just get?, “ instead of answering “You just received 120.18 milligray of dose ma’am,” you can now reply by saying “Congratulations you just smoked 1202 cigarettes!”   That might be scary, but you could also relate it as driving 2108 miles, which is something that they would do in a few montsh of driving, depending on how many miles they put on their car each year.  Now that actually makes the numbers fun.

References and Citations:

1.  AJR (April 2010) “Estimating Effective Dose for CT Using Dose-Length Product Compared With Using Organ Doses:       Consequences of Adopting International Commission on Radiological Protection Publication 103 or Dual Energy Scanning”. Christner, James. Pages 881-889.
2. ICRP (2006) “Managing Patient Dose in Multi-Detector Computed Tomography”. www.icrp.org Rehani, Madan Pages 1-81.
3. European Commission (1999) European guidelines on quality criteria for computed tomography, EUR 16262 EN. European Commission, Luxembourg.
4. ICRP (1991) 1990 Recommendations of the International Commission on Radiological Protection. ICRP Publication 60, Annals of the ICRP 21(1-3) Pergamon Press, Oxford.
5. ICRP (2000) Managing Patient Dose in Computed Tomography. ICRP Publication 87. Annals of the ICRP 30(4) Pergamon Press, Oxford.

2011 AT A GLANCE

2011 was another successful year for the NMTCB. While there was a nearly 9% drop in the total number of entry-level examinations administered, this was not unexpected considering the current state of the profession, and we remain encouraged that the NMTCB is still clearly the certification of choice for nuclear medicine technologists. Just short of 1,200 candidates sat for the examination in 2011and 94.1% of them passed. This pass rate is somewhat higher than the low of 88.2% that passed in 2010 and is a testament to the quality nuclear medicine technology education programs that are in place throughout the country. The pass rate of program graduate first-time examinees is up from 92.3% last year to 94.9% this year.

All told, the NMTCB currently has more than 23,000 CNMT certificants. Of those, 647 are also certified nuclear cardiology technologists (NCT), 580 are certified PET technologists (PET) and 61 hold NCT and PET credentials in addition to their CNMT. The NMTCB also offers the PET and NCT certifications to technologists certified by other credentialing bodies. There are currently 38 NCT technologists and 84 PET technologists who have their primary certification with another organization. The NMTCB has also certified four Nuclear Medicine Advanced Associates (NMAA), and is the only source of certification for this profession.