"Advancing the Sciences of Molecular Imaging- Worldwide"
Molecular Imaging Community,
is in the spotlight these days. A study from Germany has found that pediatric
patients may benefit from FDG-PET/MRI for staging and clinically evaluating oncologic
disorders, despite a slightly longer scan time, given the hybrid modality's
superior soft-tissue contrast and significantly lower radiation dose.
can also provide high diagnostic performance for restaging gynecological cancer patients compared with
FDG-PET/CT, with only slightly longer scan time and notably reduced radiation
exposure. Researchers found no significant differences between the two hybrid
modalities in terms of sensitivity, specificity, positive predictive value,
negative predictive value, and diagnostic accuracy.
in all, PET/MRI is making progress in moving from a research technology to more
of a clinical modality. We have a special report on its benefits from at least two sites
where PET/MRI is being used.
sure to stay in touch with The PET/CT Training Institute.com on a daily basis
for the latest news and research.
As you may be aware, the Centers for Medicare and Medicaid Services (CMS) has proposed changes to the nuclear medicine Ambulatory Payment Classifications (APCs) in its 2016 proposed rule for the Hospital Outpatient Prospective Payment System (OPPS). The Society of Nuclear Medicine and Molecular Imaging (SNMMI) believes the proposed rule will exacerbate an already existing nuclear medicine reimbursement problem that is impacting patient access and innovation.
Recognizing some of the emerging concerns, SNMMI created an APC Remodeling Task Force, which has spent the last 1½ years collecting and analyzing data and developing a proposal in collaboration with other nuclear medicine stakeholders. In January, an SNMMI delegation met with CMS and shared the proposal, which is broadly supported by other stakeholders including patient groups, manufacturers and medical societies. The SNMMI proposed payment methodology more accurately reflects the cost of all diagnostic radiopharmaceuticals and procedures used in the hospital outpatient setting.
We must urge CMS to withdraw the current proposed language and re-evaluate the proposal put forth by SNMMI. To that end, we have leaders in both the U.S. Senate and U.S. House of Representatives asking all members of Congress to sign the letter urging CMS to withdraw the current proposed language and re-evaluate the proposal put forth by the SNMMI.
We need your help! Please contact your Representative and Senators from your state and urge them to sign the Congressional letter by October 7th. When you contact your member of Congress, please tell them to contact the following Congressional staff:
Sarah Johnson - Senator Portman (R-OH)
Katie Campbell - Senator Donnelly (D-IN)
Andy Flick - Representative Moulton (D-MA)
Helen Dwight - Representative Brooks (R-IN)
Please view SNMMI’s letter to CMS from February outlining our proposal. Also, view our background document on the issue and SNMMI's solution to the problem. Feel free to share these documents.
In your email, please share where you work and where you live. Some employers have policies against sending letters with their names included, so please check with your employer in advance of sending your email. It is essential that you ask your Representative and Senator to sign the letter and also to provide any local examples of delays in care, patient access, or patients receiving alternate or inappropriate tests.
If you do not know your representatives, visit the House of Representatives website and the Senate website to identify your member of Congress. U.S. Postal Service mail to your representative must be scanned for security purposes, which adds additional time for delivery—so instead, please send emails. We need to act quickly to make a strong impact in favor of change. The Congressional sign-on letters will be sent to CMS by the second week of October.
If you have any questions, please do not hesitate to contact SNMMI’s Health Policy and Regulatory Affairs department at firstname.lastname@example.org.
ONLINE COURSES for Nuclear Medicine, PET, MR and CT !!
NEW! Combined CT and SPECT/CT Review Course now available. Meets Florida Administrative Code 64E-3.0033 for PET-CT/ SPECT/CT for Nuclear Medicine Technologists requirements.
**Deadline: December 31, 2015 for Alternative Eligibility and the NMTCB General Nuclear Medicine Boards.**
Must have Alternative Eligibility Course Certificate, Documented Clinical Hours, Application Approved and Payment in by 12/31/2015 to the NMTCB.
A Trusted Source for Nuclear Medicine and PET Information!
Coming Soon! New PET/MR Course
Welcome to The PET/CT Training Institute's E-Campus. Students enrolled in this independent distance learning program have easy access to the latest online educational delivery methods. These NMTCB and Society of Nuclear Medicine Technology Section, ARRT, ASRT, ICANL, ACR and States Department of Health, Bureau of Radiation Control approved courses, can be taken on the Internet, from your home, office or any convenient location where internet access is available.
The PET/CT Training Institute's online programs are web-based courses, designed by qualified faculty and staff to create an interesting, interactive learning environment.
The PET/CT Training Institute's Learning Management System is user-friendly, and courses can be taken easily by anyone with access to the World Wide Web. Lesson plans, assignments, and class schedules are posted online; while student/teacher interaction and student/student interaction can also occur over the Internet. Scheduled discussions, email messages, live chats and real-time group discussions are a few of the opportunities for interacting during your online course.
We now offer Sharable Content Object Reference Model (SCORM) courses that allows learning content from our SCORM conformant Asynchronous Learning Management System (LMS).
For more information, click the link below:
To PAY-AS-YOU-GO No Interest Financing of Course: Click the link below: Pay for each module individually!
*We recommend to check this page on a regular basis for updated material.
|* Work at your own pace! |
* Completely Online!
* Take up to 5 months to complete!
* Instructor Available if needed!
* Virtual Ecampus with Whiteboard!
* All educational materials provided!
* Quiz and Exam Grades results within 24 hours!
* Private Tutoring available!
* Start immediately 24/7/365
* Recognized by the SNMMI-TS, ARRT, ASRT, Accreditation Agencies.
* Anytime, Anywhere, Anyplace!
* Meets ACR NM and PET Accreditation requirements!
These quizzes,exams and documents are copyrighted © 2008-2015 by The PET/CT Training Institute, Inc. The SNMMI-TS, NMTCB, ARRT, ASRT, ICANL,ACR, and all States Department of Health, Bureau of Radiation Control, and others reserve all rights to change the course syllabus, and hours awarded. For updated information, contact the Institute at 239-821-0375.
The hybrid fusion logo, as well as the trademarks identified on the associated documentation, are trademarks of The PET/CT Training Institute and may not be used or reproduced without The PET/CT Training Institute's permission. The information presented here may not under any circumstances be resold or redistributed for compensation of any kind without prior written permission from The PET/CT Training Institute. Students are allowed up to 5 months to complete the courses, or extended. If the student exceeds the enrollment period, he/she may have to pay a reactivation penalty. Partial credit will not be issued. Each course must be successfully completed in the time allotted. A passing grade per test is 80% or greater with two attempts allowed.
NMTCB PET Exam Requirements
The NMTCB PET Examination is a time-limited exam. A successful candidate's certification will last seven (7) years from the exam date, and will expire thereafter. In order to recertify after seven years, one must meet current eligibility requirements and pass the PET Exam again.
PET CE PolicyCertification must be renewed annually AND the PET Certificant must consistently maintain NMTCB (CNMT) certification and/or ARRT(N) and/or CAMRT nuclear medicine credentials either as "Active", "in compliance" or "in good standing"
- PET Certification is valid for up to 7 years as is consistent for all NMTCB Specialty Exams. After 7 years, recertification will be required. This means the certificant must pass a recertification examination in order to maintain the credentials.
- Biennial Continuing Education Requirements:
- The PET Certificant is not required to obtain addditional CE in order to maintain this specialty credential.
Exam Information Introduction to the PET Exam
The PET technologist is a medical imaging technologist who has a high level of knowledge in positron emission tomography and is dedicated to producing high quality, diagnostically accurate results in a manner that is safe and effective for the patient. In addition to meeting all the eligibility requirements for nuclear medicine, radiography or radiation therapy, and passing the respective certification exam, the PET technologist has additional clinical experience and knowledge specific to the use of instrumentation, radiopharmaceuticals and adjunct medications related to positron emission tomography.
The PET Exam is administered by the NMTCB as a specialty examination designed to allow the PET technologist the opportunity to demonstrate his or her expertise in the field of positron emission tomography and properly use the credentials "PET"."
- The NMTCB recognizes the passing of the PET Exam as being the equivalent of 24 hours of CE toward meeting the NMTCB CE requirements.
- 24 SNMMI VOICE credits are awarded for passing the PET Exam. If you are not a member of the SNMMI, contact them at 703-708-9000 or www.snmmi.org to join.
- The ARRT recognizes the passing of the PET Exam as being the equivalent of 24 hours of Category A continuing education
A candidate for examination must show documented evidence of the following:
- Active NMTCB, ARRT(N), or CAMRT(RTNM) certification -and-
- A minimum of 700 hours of clinical experience as a certified/registered nuclear medicine technologist on a dedicated PET scanner or PET/CT scanner
Active CAMRT(RT), CAMRT(RTT), ARRT(R) or ARRT(T) Certificants must fulfill all three requirements below:
- Active CAMRT(RT), CAMRT(RTT), ARRT(R) or ARRT(T) certification.
- 700 hours of documented clinical experience performing all aspects of PET imaging including radiopharmaceutical handling, injection (if permitted by state and/or institutional regulations) and imaging. Imaging may be performed on a PET and/or a PET/CT scanner. Supervision must be performed by a nuclear medicine physician or radiologist AND direct supervision must be performed by a certified NMTCB, ARRT(N) or CAMRT(RTNM) nuclear medicine technologist.
- Satisfactory completion of a minimum of fifteen (15) contact hours of coursework in each of the following areas: radiopharmacy, nuclear medicine instrumentation and radiation safety. Only coursework from an accredited college or university, accredited nuclear medicine program or approved continuing education credits recognized by NMTCB, such as VOICE/ECE, will be accepted.
- The PET/CT Training Institute has this approved course available online and is a Instructor guided self study course.
The following is an abbreviated list of the content for the NMTCB's PET Specialty Exam.
- Diagnostic Procedures (~35%) [70 items]
- Instrumentation/Quality Control (~30%) [60 items]
- Radiation Protection (~10%) [20 items]
- Radiopharmaceuticals (~25%) [50 items)
CT Exam Information
The NMTCB recently developed a new post-primary certification exam for computed tomography (CT). The NMTCB(CT) credential will be considered an extension of the entry-level nuclear medicine exam and is designed to establish the competency of a nuclear medicine technologist to perform CT procedures.
The next examination offering will be Friday, April 17, 2015.
The eligibility requirements are as follows:
- A current active CNMT, ARRT, or CAMRT nuclear medicine technology certification.
- A minimum of 500 total clinical hours in PET/CT, SPECT/CT and/or CT.
The completion of a minimum of thirty five (35) contact hours within the three years prior to application including a minimum of four (4) hours of each of the following categories:
- Clinical hours must be obtained within 3 years of application for the CT exam.
- Clinical hours may be acquired in the role of a student in an accredited nuclear medicine program.
- Clinical hours may be performed on one type of scanner, or a combination of multiple scanners.
- Clinical hours may be obtained prior to being certified as a nuclear medicine technologist.
- Claims of clinical hours will be confirmed with the Program Director, Technical Supervisor or Supervising Physician.
- Contrast administration
- Cross-sectional anatomy
- X-ray physics
- CT radiation safety
- The remainder of these hours must be in CT related topics.
- These 35 contact or didactic hours may be from college credit courses from an accredited college or university, or continuing education approved by any of the organizations listed in our CE Policy, which may be found online at www.nmtcb.org/policies/contedPolicy.php.
- Applicants who graduated from a nuclear medicine program before 2011 are required to have the didactic hours verified via proper documentation. Those who graduated from a JRCNMT accredited nuclear medicine program after June 2011 are considered to have met this didactic requirement. Graduates must apply for the NMTCB(CT) examination within three(3) years of completing a JRCNMT accredited nuclear medicine program.
Until June 1, 2016, the NMTCB will waive the didactic requirements for persons that hold BOTH the CNMT and ARRT's CT credentials. After that time, ALL applicants will be required to meet all of the eligibility requirements.
CT Exam Information
The CT Exam will be offered on CT Exam Date Saturday, November 15, 2014 . The application process for the 2014 exam has ended, but you may submit an application for the next CT examination offering, which will be Friday, April 17, 2015.
The application deadline for the 2015 exam is March 1, 2015
- The NMTCB(CT) Exam will be available in the United States at IQT Testing Centers.
- The examination will consist of 200 multiple choice questions.
- The application fee will be $180.00.
- Annual certification renewal will be $30.00 and certificants must have current active nuclear medicine certification/registration in order to complete renewal of CT certification.
- In order to maintain CT credentials, certificants must complete a total of 12 hours of continuing education specific to CT in each 2 year CE cycle, in addition to the 24 hours of CE required to maintain nuclear medicine certification.
The NMTCB(CT) examination consists exclusively of 4-option multiple choice items. Each item includes a keyed (correct) response and 3 distractors (incorrect responses).
The NMTCB(CT) Examination is copyrighted and owned by the NMTCB. Any attempt to reproduce any portion of the examination is prohibited by law and violators will be vigorously prosecuted.
Calculators are allowed only if they are noiseless and battery or solar-powered. No provisions or time will be allowed or given to repair or replace broken calculators. You may not share calculators. Calculators capable of storing text (i.e., a key for every letter in the alphabet) will not be allowed.
CME Accreditation – AMA PRA Credits
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The SNMMI has been re-surveyed by the Accreditation Council for Continuing Medical Education (ACCME) and awarded Accreditation with Commendation for 6 years as a provider of continuing medical education for physicians.
ACCME accreditation seeks to assure the medical community and the public that SNMMI provides physicians with relevant, effective, practice-based continuing medical education that that supports US health care quality improvement.
The ACCME employs a rigorous, multilevel process for evaluating institutions' continuing medical education programs according to the high accreditation standards adopted by all seven ACCME member organizations. These organizations of medicine in the US are the American Board of Medical Specialties, the American Hospital Association, the American Medical Association, the Association for Hospital Medical Education, the Association of American Medical Colleges, the Council of Medical Specialty Societies, and the Federation of State Medical Boards of the US, Inc."
Pharmacy Accreditation Statement
The Society of Nuclear Medicine and Molecular Imaging (SMMMI) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
CAMPEP - Physics/Science
SNM applies to CAMPEP to offer continuing medical physics credit to physicists that who attend the Annual Meetings, Mid Winter Meetings, and Learning Center Workshops.
VOICE Credit Statement
The Verification Of Involvement In Continuing Education (VOICE) program is a comprehensive Society of Nuclear Medicine and Molecular Imaging Technologist Section (SNMMI-TS) program that provides technologists with continuing education (CE) activities as well as a method of tracking them. VOICE-approved credit is recognized by most licensure states and by the American Registry of Radiologic Technologists (ARRT) and the Nuclear Medicine Technology Certification Board (NMTCB) and as Category A Credit.
The Society of Nuclear Medicine and Molecular Imaging Technologist Section (SNMMI-TS) is recognized by the American Registry of Radiologic Technologists (ARRT) as a Recognized Continuing Education Evaluation Mechanism (RCEEM) to provide continuing education activities relating to nuclear medicine technology and molecular imaging.
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) and SNMMI-Technologist Section (SNMMI-TS) meet the Nuclear Medicine Technology Certification Board’s (NMTCB) criteria for awarding
continuing education credits, therefore educational activities approved by SNMMI/TS will be accepted by the NMTCB. The NMTCB will not recognize continuing education hours that are not approved by one of the
organizations listed. Please note that the NMTCB accepts all CE approved by these organizations, including approved vendor applications training.
Are imaging sites ready for new Joint Commission rules?
June 22, 2015 -- On July 1, a new era of intense scrutiny and documentation will arrive for CT and other imaging modalities, thanks to new Joint Commission accreditation requirements that become effective on that date. Unfortunately, most radiology departments aren't remotely ready to fulfill the requirements, according to a talk at the International Symposium on Multidetector-Row CT.
And while the Joint Commission rules will make a big splash, they're not alone in the pool. New guidelines for CT protocols and radiation dose reporting are coming from every direction, from state laws to federal legislation, to say nothing of accreditation standards from the American College of Radiology (ACR).
Each set of rules is doing its part to close the door on more informal ways of practicing radiology, according to Dr. Myron Pozniak, a professor of radiology at the University of Wisconsin. Still, the Joint Commission is something of a cannonball.
"Starting [July 1] radiology is going to be under much greater scrutiny when the Joint Commission comes walking through the hospital," Pozniak said.
The new Joint Commission accreditation standards codify a level of scrutiny for CT practices that is on top of recent Medicare requirements mandated by the Protecting Access to Medicare Act of 2014, which are built into reimbursement. The requirements cover all CT, PET/CT, and SPECT/CT exams except for interventional studies or those acquired in an inpatient setting.
The Medicare changes work by incentivizing quality -- and not in a gentle way, Pozniak said.
"I thought incentives meant you get a prize when you do something right," he said. "Well, this is a negative incentive. If you aren't following the [National Electrical Manufacturers Association] NEMA standard XR 29-2013, you will have a reduction in your technical reimbursement of 5% next January -- and 15% in 2017."
XR 29-2013, also known as the Medical Imaging and Technology Alliance (MITA) Smart Dose standard, requires that every CT system include four key features: DICOM radiation dose structured reporting; CT dose check, including dose notifications and alerts; automatic exposure control (AEC); and pediatric and adult reference protocols for patients of different sizes.
Most radiologists are already up to speed on DICOM dose reporting, and most have dose alerts on their scanners along with AEC, Pozniak said. But does everyone have multiple sets of preloaded protocols set up for different body sizes and patients? No, everyone does not.
"If you don't do this by 2017 -- let's say you do 10,000 patients a year -- your hospital will suffer almost a half million dollars in revenue loss, and they will be knocking on your door," he said.
Equipment, personnel, and documentation
MITA has committed itself to ensuring that 100% of scanners in the U.S. are equipped to handle all of the requirements, but, unfortunately, things haven't been heading that way, according to Pozniak. At last count, there were 13,000 CT scanners in the U.S., only two-thirds of which are complaint with the standard. Regardless, the Joint Commission will start assessing radiology relative to the newly published standards.
"Hospital administrators are all over this, and hopefully they've been talking to you," he said.
The Joint Commission has identified several areas to evaluate in MRI, CT, PET/CT, and nuclear medicine practice; the accreditation standards incorporate changes in each of them:
- Environment of care
- Human resources
- Medication management
- Provision of care, treatment, and services
- Performance improvement
The Joint Commission's CT review requirements include quarterly review of optimal radiation dose, activities to maintain the quality of diagnostic images, annual measurement and verification of displayed CT dose index volume (CTDIvol), and shielding design.
Human resource requirements include qualification for physicists and training for technologists.
"They're going to be looking at annual training for techs," among other things, and asking the following, Pozniak said:
- Do you document the radiation dose for every study in a retrievable format?
- Do you verify that patients really need the CT scan being performed, and do you protocol them?
- Do you consider the patient's age when you protocol the patient, and are your protocols up to date?
- Are you going to meetings and looking at the literature?
- Are you incorporating new ideas in your protocols, and do you review them on a regular basis?
The Joint Commission wants to be sure that radiation dose is assessed on every study, and that patients who receive inappropriate doses are identified. They want every case of higher-than-optimal dose to be reviewed, analyzed, and documented to determine what went wrong and that the problem has been fixed. Doses must also be compared to national benchmarks, Pozniak said.
"This is a lot of stuff coming down the pipeline, but what's most important is not just doing it but documenting it," he said. When the [Joint Commission] reviewer comes to radiology, they're going to ask to see documentation that you've been accomplishing these things."
How ready are you?
Pozniak's group tested the readiness of CT providers with a survey developed from government and industry research and direct observation. The survey included 87 elements covering leadership, practices, and technology, with responses from 106 healthcare facilities. The results below, selected from questions that apply specifically to Joint Commission rules, show plenty of room for improvement.
|Compliance with Joint Commission standards|
|Procedure||Percentage of sites complying|
|Annual equipment quality check||100%|
|Annual training for technologists||25%|
|Activities to maintain equipment quality||92%|
|Documentation of radiation dose index for every scan||29%|
|Adoption of protocols based on current standards of care||39%|
|Periodic review of protocols||50%|
|Prescan verification of patient information and protocol||23%|
Among the survey's worst moments, it turns out that only about one-fourth of technologists are being trained every year and are documenting dose for every scan, Pozniak said.
Documenting dose came in at just 29% because, for many users, radiation dose levels aren't instantly retrievable. And only 23% said they protocol every scan before acquiring it, a dismally low percentage, according to Pozniak.
But ready or not, the Joint Commission is going to start walking through facilities on July 1, and radiology will find itself facing unprecedented levels of scrutiny, he said.
"Preparation and documentation are going to be critical to satisfy these surveyors," he said. "So good luck."
ACC: PET/CT trumps SPECT for cardiac studies
March 17, 2015 -- Researchers from Utah found that PET/CT is far superior to SPECT for diagnosing myocardial ischemia, with higher sensitivity at a lower radiation dose, according to a paper presented on Sunday at the American College of Cardiology (ACC) meeting in San Diego. PET/CT in particular far outstripped SPECT in determining that patients were free of cardiac disease.
Myocardial perfusion imaging (MPI) with SPECT has long been an important tool in the assessment of heart conditions, but it has disadvantages such as a lack of specificity and relatively high radiation dose. The rise of PET/CT has created the prospect that more accurate MPI scans could be performed at a lower dose.
A group from the Heart Institute at Intermountain Medical Center, led by cardiologist Dr. Kent Meredith, compared MPI scans performed with a SPECT camera in 2012 to those conducted with a PET/CT system in 2013. There were 197 patients in the SPECT group and 200 patients in the PET/CT group.
The researchers found that PET/CT had 100% sensitivity for detecting myocardial ischemia, compared with 94.6% for SPECT. But it was in specificity where PET/CT really outstripped SPECT, at 88% versus only 30.3% for SPECT.
PET/CT's accuracy was also much higher, with a positive predictive value of 98.3%, compared with 72.9% for SPECT. PET/CT's negative predictive value was 100%, compared with 74.1% for SPECT.
SPECT MPI also delivered false-positive results 6% of the time, while there were no false positives with PET/CT MPI. That translates into fewer follow-up procedures, the researchers noted.
Finally, PET/CT's radiation dose is a fraction of what is delivered during SPECT. SPECT typically uses low-energy radiopharmaceuticals that require longer exam times to acquire enough signal to create an image, according to the researchers. Also, the long half-life of SPECT tracers means they can remain in the patient's system for up to two days, producing an average radiation dose of around 30 mSv.
PET/CT radiotracers, on the other hand, typically have half-lives of two minutes, and their higher energy levels mean that images can be produced more quickly, with a radiation dose of around 2 mSv.
In further research, the group plans to analyze PET/CT's effects on cost reduction and the downstream procedures required for working up patients.
In the News......
Setting the Standards for PET/MR......
March 19, 2015 -- The American College of Radiology (ACR) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) have released the first in a series of requirements for physicians and clinicians interested in gaining proficiency in reading PET/MRI scans.
The first document, published online March 5 in the Journal of Nuclear Medicine, provides guidance on how much training and firsthand experience is needed to adequately read and interpret images from PET/MRI brain scans.
"The practice of PET/MRI requires a solid knowledge base of PET techniques and MRI techniques," the document states. "Although the ultimate goal is mastery of simultaneously acquired brain PET/MRI examinations, the physician's education, training, and experience should encompass dedicated brain PET [or] brain PET/CT as well as dedicated brain MRI."
Clinicians looking to achieve competency in PET/MRI will need to know about imaging protocols, contrast agents, and MRI sequences, as well as biologic and clinical parameters such as anatomy, physiology, normal variants, and disease states.
"We wanted to set some parameters -- whether it be a single individual or two individuals reading these studies -- to make sure there is competency in both modalities," said committee co-chair and ACR representative Dr. Rathan Subramaniam, PhD. "Since this marries both PET and MRI, unless someone has very good training in both modalities, it will be a tough task for one individual to report on both of them."
The initiative to develop competency criteria for PET/MRI began in June 2013, when ACR and SNMMI created a 12-member task force with six members from each organization.
The key recommendation in the document is that physicians and clinicians meet certain credentialing guidelines for the modality they are interpreting, be it PET, MRI, or both.
"We need to make sure that all the people reading these images, a single individual or two individuals together, are competent as a combination of both modalities. That is the most important part," explained Subramaniam, who is an associate professor of radiology, oncology, head and neck surgery, and health policy and management at Johns Hopkins University.
The competency criteria create three different categories of readers based on their expertise. There are both initial and continuing competency criteria for clinicians who are board-certified within two years of completing their residency or fellowship; individuals without board certification but with more than two years of a residency or fellowship; and those with board certification in another medical specialty.
"It sets different levels of expectations for those people, taking into consideration what they have done with their training," he said.
For example, the joint statement recommends that a board-certified clinician have experience with at least 30 FDG-PET and 300 MRI brain scans to reach initial competency levels. A noncertified clinician would need to interpret at least 50 FDG-PET and 500 MRI brain exams for initial competency. Finally, a person with expertise in another medical specialty would need to interpret at least 100 FDG-PET and 750 MRI brain exams.
There are similarly scaled requirements for continuing competency for each of those three reader categories.
The committee also noted that there is more to determining competency than just the number of scans a person has interpreted.
"Simple numerical criteria are not an optimal measure of competency," the authors wrote. "Documentation of competency by the use of objective, outcome-based tools related to clinical experience is preferable."
The statement also recommends that clinicians who are proficient in either PET or MRI should combine their expertise in PET/MRI interpretations. The two physicians should reach a consensus on the final interpretation and issue a joint report or two separate correlative PET and MRI reports.
Essentially, when interpreting PET/MR images, two heads are better than one.
"PET/MRI not only has multiple [MRI] sequences, but also the sequences change and are fine-tuned for each body part," Subramaniam added. "For example, the brain has different [MRI] sequences than the head and neck; there is different fine-tuning in the chest; and there would be a different approach with the liver. So our feeling is that if someone is not trained in both PET and MRI, we want to ensure that at least one individual will have knowledge about different sequences that could be applied to the different body parts with MRI."
From the top down
So why address PET/MRI of the brain first?
"One of the biggest benefits of PET/MRI has been with the brain, partly because MRI provides excellent soft-tissue resolution," Subramaniam said. "There is a huge need because the CT part of the PET/CT cannot provide those attributes."
The board will also craft competency guidelines for other parts of the body, moving from the brain down to the torso.
"The brain is the first one in this series," he said. "We are just getting started on the head and neck right now."
The PET/MRI head-and-neck competency document will take six to nine months to complete, he predicted. This is less time than it took to complete the PET/MRI brain guidelines because the committee now has a prototype framework from which to work. The final draft will then be reviewed and eventually approved by the boards at ACR and SNMMI.
The committee plans to proceed to the chest, liver, and other body parts and organs that would benefit from PET/MRI. Pediatric PET/MRI will most likely have its own competency credentialing document, Subramaniam noted.
Why PET/MR is worth the investment!
PET/MR is the "most revolutionary machine since the advent of the MRI" and will become the standard of care in clinical imaging within a decade, said Zwanger-Pesiri Radiology CEO Dr. Steven Mendelsohn. Adoption has been slow, but Mendelsohn said use of the best cancer imaging modalities for diagnosis and staging, lower radiation and the high-quality PET technology won him over. Mendelsohn urged clinicians to look beyond dollar signs. "If you are looking at an ROI, you're not going to find it. The way I can justify the cost of spending money is that it will save lives," he said.
In the news......
North Dakota moves to license technologists
March 27, 2015 -- North Dakota has passed a measure that sets licensing standards and expands the responsibilities of the state's radiologic technologists, radiation therapists, radiologist assistants, nuclear medicine technologists, and sonographers.
Gov. Jack Dalrymple has signed SB 2236, which creates a pathway for radiologic technologists to take verbal orders from physicians and other healthcare practitioners and enter them into the patient's electronic health record, according to the American Society of Radiologic Technologists (ASRT).
The state will create a nine-member State Board of Medical Imaging and Radiation Therapy Medical Examiners to oversee the program. The board will manage the licensing requirements for the personnel who perform medical imaging and radiation therapy procedures. The board will also administer disciplinary measures and penalties, ASRT said.
Enactment of the bill represents a "huge step toward making sure that patient care is provided as quickly and efficiently as possible," said Ann Bell-Pfeifer, from the North Dakota Society of Radiologic Technologists' legislative committee, in a statement.
IN THE NEWS!!
The Nuclear Medicine Technology Certification Board (NMTCB) recently offered the first computed tomography (CT) exam for nuclear medicine technologists (NMTs). On November 15th, a total of 102 individuals passed the first exam with an average passing scaled score of 81.75 (a scaled score of 75 was needed to pass). They all now hold the credential of NMTCB(CT).
Of the 102 new CT credentialed individuals, 94 individuals are certified as CNMTs and eight (8) are registered ARRT(N). Thirteen individuals hold the Positron Emission Tomography (PET) credential and six hold the Nuclear Cardiology Technologist (NCT) credential. Seven individuals hold four NMTCB certifications (CNMT, NCT, PET, and NMTCB(CT)).
The next CT exam will be offered April 17, 2015. The application deadline for this exam is March 1st. As with the other NMTCB exams, we have high standards for eligibility to sit for the NMTCB(CT) exam. All examinees must show proof of education specific to CT. Fortunately, most new NMT graduates meet these educational requirements. All others are required to have a minimum of 35 educational contact hours specific to CT. At least four hours must be in each of the following categories: contrast administration, cross-sectional anatomy, x-ray physics, CT radiation safety. In addition to classroom hours, examinees must also have 500 clinical hours.
For maintenance of certification, anyone holding the NMTCB(CT) credential must earn 12 continuing education hours specific to CT every two years. This is in addition to the 24 hours required to maintain the CNMT credential.
The NMTCB is working with the American College of Radiology (ACR), the Joint Commission and the Intersocietal Accreditation Commission (IAC) to incorporate the NMTCB(CT) credential into their respective accreditation standards. We are also working with states and the Conference of Radiation Control Program Directors (CRCPD).
Many NMT educational programs have adjusted their curriculum to meet the educational and clinical requirements for students to be eligible to sit for the NMTCB(CT) exam upon graduation. The NMTCB will be offering a $30 discount (from the $180 application fee) for new graduates who apply to take the NMTCB(CT) exam at the same time as the CNMT exam.
The vision of the NMTCB is to be recognized as the certification organization of choice for nuclear medicine and molecular imaging. We currently offer five examinations for nuclear medicine professionals: Certified Nuclear Medicine Technologist (CNMT), Positron Emission Tomography (PET), Nuclear Cardiology Technologist (NCT), Computed Tomography (NMTCB(CT)) and Nuclear Medicine Advanced Associate (NMAA). We work hard to keep our finger on the pulse of the profession to make examinations that are both relevant and necessary for nuclear medicine professionals.
WHAT TECHNOLOGIST ARE SAYING...
Good afternoon Prof Marshel,
How are you? Hope you're well, I would like to let you know that today I did the NMTCB exam and I've passed, I don't know yet the score.
Thank you very much for your help.
Alternative Eligibility Course
NM Registry Review E-Books
London, England, UK
Dear Professor Marshel,
The PET/CT Institute helped me pass my boards !! The modules are very informative
and easy to follow!!
Thank you Tim and staff, I would not have passed without them!!!
PET Registry Review Course and Ebooks
Hi Professor Marshel
I took my NMTCB exam on 27th June. I have a happy news for you , now i become a certified nuclear medicine technologist from USA . I really appreciate your efforts for me to conquer this. Thank you so much!
Jeny G., CNMT
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United Arab Emirates
Dear Professor Marshel,
I just want to let you know that I passed my NMTCB Exam! It was a challenging experience for me not only doing all my review but also in getting a testing site outside of US. I took a leave for two weeks to prepare last july and by the end of my leave, i would take the exam which was supposed to be in Malaysia. But, unluckily, the testing body had inform me a week before that the site is no longer available. I was really in panic! I called the isotesting and told me that the nearest country option for me were Australia or India. I have 1 week left and Australia was not possible due to Visa issues and so, I took the risk of getting the India testing Centre.> It was a challenging experience but I have learn so many moments in going to India. I could never forget how anxious i was both the exam and the strange country that i would be going. I had an adventurous time! Anyways, With Grace, I Finally Pass!!
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A million thanks to you for your all-out support in my preparation for the NMTCB exam.
I will not fulfill my dream of achieving the NMT Certification without the PET CT
Training Institute. I appreciate all your effort even when I already completed my
Again, thank you very much!!!!
Cyrus C. C. CNMT
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Jeddah, Saudi Arabia
Just took rhe exam here in the eastern province of saudi arabia. Proctor said, we passed, I didi not know how but he said, we passed, me and cyrus. We'd like to thank you and pet/ct training for helping and assisting us. We couldn't make it here with out you.
We'll be in touch!
Patrick B. CNMT
Alternative Eligibility Course and E-Books
Dear Mr. Marshel,I just wanted to take the time to Personally thank Tim and the staff at the pet/ct training institute. It felt great that anytime i hada question anytime i had a concern my questions were answered immediately. The course content made it so that you actually gainedknowledge it was easy to navigate therefore easy to complete. I would highly recommend The PET/CT TRAINING INSTITUTE to anyone not only for CE but also to challenge you self to gain more knowledge. THANK YOU TIM AND THE PET/CT TRAINING INSTITUTE I will be back in the future!!!!!
Julio P. R.T.(N), CNMT
Coral Gables, Florida
"PET/CT Course for the Nuclear Medicine Technologist"
Dear Tim,Thank you for all your help. With out your information I would not of done it! Thank you !!!!
Neptune Beach, FL.
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PET Registry Review Ebooks