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"Post-Primary Structured Educational Courses for Nuclear Medicine, CT, MR, and Molecular Imaging"  

                                    نرحب بجميع أصدقائنا المسلمين رائع!

     "The world's first online self study Asynchronous Learning Management System dedicated exclusively for Nuclear Medicine and Molecular Imaging Education."

        "Advancing the Sciences of Molecular Imaging- Worldwide"


Welcome to The PET/MR Training Institute's Asynchronous Learning Management System platform.

Students enrolled in this independent Asynchronous Learning Management platform have easy access to the latest online educational delivery methods.

These NMTCB, Society of Nuclear Medicine and Molecular Imaging Technology Section, ARRT, ASRT, ICANL, ACR and States Department of Health, Bureau of Radiation Control  accepted CE 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/MR 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).

Accepted/Requirements Satisfied by our Courses:
  • Courses are ASRT accepted for Category A credit
  • All courses meet ARRT CE reporting requirements
  • All courses are accepted by ARDMS and NMTCB
  • All MRI courses are accepted by ARMRIT
  • All PET, CT, MR, and Nuclear Medicine Courses are accepted by ARRT, NMTCB, ACR, ICANL, Joint Commission, and States DOH.
  • CAMRT recognizes the Category A credit assigned to each of these courses 
  • All  courses meet California CE requirements  
  • All courses are accepted by the Florida Department of Health, Bureau of Radiation Control.

In the news this week!

Two documents developed jointly by the American Society of Nuclear Cardiology (ASNC) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) highlighting myocardial perfusion positron emission tomography (PET) were e-published today in the Journal of Nuclear Cardiology. Myocardial perfusion PET imaging is increasingly used because of its high diagnostic accuracy, low radiation exposure, short image acquisition time, strong prognostic power, and quantification of myocardial blood flow. The Position Statement on the Clinical Indications for Myocardial Perfusion PET and the Updated PET Guidelines provide comprehensive guidance on appropriate indications and procedure standards for myocardial perfusion PET.

“Myocardial perfusion PET is a robust nuclear cardiology test that supports the Centers for Medicare and Medicaid Services’ initiatives to improve the quality and efficiency of healthcare while controlling costs. Myocardial perfusion PET, because of its unique properties, is the right test, at the right time for certain patient populations,” noted Brian Abbott, MD, ASNC President.

The Position Statement upgrades PET to a Preferred test for patients who meet criteria for stress imaging but are unable to complete a diagnostic-level of exercise. The Statement also identifies five distinct clinical situations where cardiac PET is recommended: 

  • poor quality, equivocal, or inconclusive prior stress-imaging study
  • patients with certain body characteristics that commonly affect image quality
  • higher-risk patients
  • younger patients to minimize accumulated life-time radiation exposure
  • when myocardial blood flow quantification is identified by clinicians to be a needed adjunct to the image findings     

"The extensive evidence base supporting myocardial perfusion PET for patients requiring pharmacologic stress imaging prompted the development of this joint societal Position Statement," says Timothy Bateman MD, lead author of the statement and Professor of Medicine at the University of Missouri in Kansas City. "Importantly, the Position Statement included substantive input from more than 25 experts in SPECT and PET from around the world, before undergoing rigorous review by the two professional organizations most knowledgeable on this subject. This assessment directly supports value-based quality health care."

“For diagnosing coronary artery disease, myocardial perfusion PET imaging outperforms other tests because of its high diagnostic accuracy, low radiation exposure, short image acquisition time and its ability to accommodate ill or high-risk patients and those with large body habitus,” says Vasken Dilsizian, MD, lead author of the Guideline and Professor of Radiology and Medicine at the University of Maryland School of Medicine in Baltimore.

The PET Position Statement provides an expert consensus on the clinical indications for myocardial perfusion PET imaging. The updated Guideline provides the most up-to-date information to support physicians and technologists in appropriate patient selection and procedure performance standards.

Both documents will appear in the September 2016 issue of the Journal of Nuclear Cardiology and can be downloaded now from the ASNC website (

Dear SNMMI -TS Florida Members,

As you may already be aware, the State of Florida currently does not allow Nuclear Medicine Technologists who have received their NMTCB(CT) certification to perform CT procedures. Florida only provides a pathway for technologists who are certified by the ARRT to perform CT studies.

SNMMI-TS is aware of this issue, and recognizes that technologists who have their NMTCB(CT) certification are equally qualified to perform CT procedures as technologists who have received their ARRT(CT) certification. As such, SNMMI is actively working to resolve this matter.

In speaking with Florida regulators, it was communicated to SNMMI-TS that regulators will not recognize the NMTCB(CT) credential unless it is included in the ASRT’s Practice Standards. To resolve this, SNMMI-TS is currently working diligently with ASRT to include the NMTCB(CT) credential in the ASRT Practice Standards, which are currently under revision.

The ASRT standards will be available for public comment in mid-November or mid-December and SNMMI will submit comments supporting the inclusion of the NMTCB(CT).  We also encourage you to make comments during this important time. In February, the ASRT will review the public’s comments and revise the standards accordingly. The revised standards will then be sent to the ASRT House of Delegates at their June 2017 meeting so the revised standards can be published in July.

Additionally, in the hope that Florida regulators will recognize the SNMMI-TS NMT Scope of Practice and Performance Standards (SOP)the technologist section is revising the SOP to state more explicitly the society’s stance on CT requirements from all credentialing/licensing bodies. This document should be published by the end of the year.

By working with the ASRT and revising the SNMMI-TS SOP, we hope to achieve Florida’s recognition of the NMTCB(CT) exam as quickly as possible. We fully understand the need for a timely resolution to this issue and appreciate your patience while we attempt to resolve this with Florida regulators.

If you have any questions about the ASRT’s revisions or this issue, please contact Kendall Horvath at


Sara G. Johnson, MBA, CNMT, NCT, FSNMMI-TS
SNMMI-TS President


The final day to submit comments on the U.S. Department of Veterans Affairs regulatory proposal that would allow advanced practice registered nurses full practice authority without clinical supervision or mandatory collaboration with physicians is Monday, July 25, 2016. The ASRT strongly opposes Section 17.415(d)(1)(i)(B) of this measure as only registered radiologic technologists should perform procedures that use ionizing radiation. This regulation, as proposed, grants full practice authority to certified nurse practitioners and includes the ability to "order, perform, supervise, and interpret laboratory and imaging studies" in VA facilities. Certified nurse practitioners do not have the education, experience or skills required to perform highly technical procedures like conventional radiography and fluoroscopy, computed tomography, magnetic resonance, nuclear medicine, vascular-interventional procedures, cardiac-interventional procedures or bone densitometry.

ASRT encourages all radiologic technologists to join in our effort to oppose this shortsighted proposal and demand that “perform, supervise and interpret” be removed from Section 17.415(d)(1)(i)(B). Please submit your comments to the federal government and let them know that you strongly oppose the VA’s efforts to bypass patient safety measures by allowing nonqualified certified nursing professionals to perform medical imaging procedures. You can submit comments directly through the ASRT Advocacy Action Center. ASRT has created a comments template that you can easily customize. Please go to the ASRT Advocacy Action Center to voice your concerns about this proposed regulation. The deadline for comment submission is Monday, July 25, 2016, so your urgent action is needed today!


Sal Martino, Ed.D., R.T.(R), FASRT, CAE
Chief Executive Officer and Executive Director

In the news this week!

On May 25, 2016, the Department of Veterans Affairs (VA) released a proposed rule to grant advanced practice registered nurses (APRNs) the authority to, among other things, perform advanced imaging services.

The purpose of the proposed rule is to increase veterans’ access to qualified health care professionals and services. Section 17.415(d)(1)(i), specifically, would allow certified nurse practitioners to “order, perform, supervise, and interpret laboratory and imaging studies.”

"SNMMI is strongly opposed to the implementation of this section and urges you to submit comments on this matter."

It is imperative to help the VA understand the complexities of this significant issue. As Nuclear Medicine professional, we ask you to submit comments stating your opposition to Section 17.415(d)(1)(i).

We applaud the VA’s efforts to provide a higher level of care for veterans, but do not believe APRNs are qualified to be able “perform” and/or “interpret laboratory and imaging studies”. An APRNs education and training does not compare to that received by Nuclear Medicine professionals to practice Nuclear Medicine.

Comments are due by July 25, 2016.

Included here are some talking points, however, SNMMI encourages you to personalize your submissions to the VA. When submitting comments, please indicate that you are responding to “RIN 2900-AP44-Advanced Practice Registered Nurses”.

Joint Commission Announces Changes to Elements of Performance (EP's) for Technologists

Earlier this year, The Joint Commission announced revision to the Standards for Diagnostic Imaging Services for hospitals, critical access hospitals and ambulatory care organizations. The changes required CT technologists to be CT certified by January 2018 and recognized certification from the American Registry of Radiology Technologists (ARRT) and Nuclear Medicine Technologist Certification Board (NMTCB). In addition, the revisions also required organizations to demonstrate that CT technologists participate in education that prepares them to achieve advanced-level CT certification.

On June 16, 2016, The Joint Commission announced that it has decided to delete Note 1 at EP 19 that refers to advanced-level CT certification, and suspend implementation of EP 26. (Please note that HR.01.02.05, EP 19, which establishes minimum qualifications for technologists performing computed tomography (CT) exams, will still go into effect on September 1, 2016.

To read The Joint Commission announcement, click here or visit The Joint Commission website.

ec2 Software Solutions is pleased to pass along the following FDA announcement:

The U.S. Food and Drug Administration has approved Netspot, the first kit for the preparation of gallium Ga 68 dotatate injection, a radioactive diagnostic agent for positron emission tomography (PET) imaging.
This radioactive probe manufactured by Advanced Accelerator Applications USA, Inc. will help locate tumors in adult and pediatric patients with the rare condition, somatostatin receptor positive neuroendocrine tumors (NETs).  NETs have receptors for somatostatin, a hormone that regulates the endocrine system. Ga 68 dotatate, a positron emitting analogue of somatostatin, works by binding to such receptors.

Netspot is supplied as a sterile, single-dose kit for preparation of Ga 68 dotatate injection for intravenous use. The uptake of Ga 68 dotatate reflects the level of somatostatin receptor density in NETs. This uptake can also be seen in a variety of other tumor types or other pathologic conditions, or might occur as a normal variant. The uptake of Ga 68 dotatate may need to be confirmed by histopathology or other assessments.

For more information, please visit: Netspot.
Released by: The Division of Drug Information (DDI)- serving the public by providing information on human drug products and drug product regulation by FDA.

Open Access

 This Institute follows the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction of any articles in any medium.

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ARRT: CT and MRI Post Primary Structured Educational Requirements: Effective January 1, 2016.

NMTCB(CT) Credential recognized by
The Joint Commission

Effective September 1, 2016

The Joint Commission has recently approved new standards for accredited hospitals, critical access hospitals, and ambulatory care organizations (including those that have achieved Advanced Diagnostic Imaging certification) that provide diagnostic imaging services:
Standard HR.01.02.05 The [critical access] hospital verifies staff qualifications. Element of Performance for HR.01.02.05 A 19.
Technologists who perform diagnostic computed tomography (CT) exams have advanced-level certification by the American Registry of Radiologic Technologists (ARRT) or the Nuclear Medicine Technology Certification Board (NMTCB) in computed tomography or have one of the following qualifications:
● State licensure that permits them to perform diagnostic CT exams and documented training on the provision of diagnostic CT exams or 
● Registration and certification in radiography by ARRT and documented training on the provision of diagnostic CT exams or 
● Certification in nuclear medicine technology by ARRT or NMTCB and documented training on the provision of diagnostic CT exams (See also HR.01.02.01, EP 1; HR .01.02.05, EPs 1-3; HR.01.02.07, EPs 1 and 2; and HR.01.05.03, EP 26) 
Note 1: Effective January 1, 2018, all technologists who perform diagnostic computed tomography (CT) exams will be expected to have advanced-level certification in computed tomography. 
Note 2: This element of performance does not apply to CT exams performed for therapeutic radiation treatment planning or delivery, or for calculating attenuation coefficients for nuclear medicine studies
Note 3: This element of performance does not apply to dental cone beam CT radiographic imaging studies performed for diagnosis of conditions affecting the maxillofacial region or to obtain guidance for the treatment of such conditions. 
Standard HR.01.05.03 Staff participate in ongoing education and training. Elements of Performance for HR.01.05.03 C 26. Technologists who perform diagnostic computed tomography (CT) exams participate in education that prepares them to achieve advanced-level CT certification by January 1, 2018. 
Note 1: This element of performance does not apply to CT exams performed for therapeutic radiation treatment planning or delivery, or for calculating attenuation coefficients for nuclear medicine studies. 
Note 2: This element of performance does not apply to dental cone beam CT radiographic imaging studies performed for diagnosis of conditions affecting the maxillofacial region or to obtain guidance for the treatment of such conditions.
For more information regarding the NMTCB(CT) credential, please see:
As always, the NMTCB is happy to assist you. Please let us know if you have any questions or concerns.
Thank you! 

Katie Neal, BS, MS
Executive Director
Nuclear Medicine Technology Certification Board
3558 Habersham @ Northlake, Bldg. I
Tucker, GA 30084

p  404 315 1739   |  f  404 315 6502   |

"The PREMIER Certification Board for Nuclear Medicine Technologists"

Oncology PET/MRI shows strengths, but faces hurdles

March 17, 2016 -- While the use of PET/MRI is feasible across all types of cancer, it may be tough to show its superiority to PET/CT due to the latter modality's proven track record in detecting and evaluating the disease, according to a review in the March issue of the Journal of Nuclear Medicine.

Researchers from the University of California, Los Angeles (UCLA) surveyed the use of PET/MRI across a broad range of cancers using published literature. They found that while PET/MRI is comparable to PET/CT in many cases, it's particularly beneficial for prostate cancer and bone metastases; however, it falls short in lung nodule assessment.
To what degree PET/MRI becomes a mainstay in oncologic imaging will also greatly depend on economics and if "reasonable workflows can be established," wrote lead author Dr. Claudio Spick and colleagues from UCLA's David Geffen School of Medicine. Future studies also should explore the multiparametric potential of MRI. (JNM, March 2016, Vol. 57:3, pp. 420-430).

PET/CT's ascension

After PET/CT was introduced some 15 years ago, it quickly became clear that the hybrid modality improved the diagnosis and assessment of cancer, Spick recalled. While PET/MRI can provide similar evaluations, its adoption has been slower than PET/CT for various reasons.

"One reason is because PET/CT already assesses cancer patients with very high accuracy," Spick told "So it is difficult to be better than PET/CT already is."

In addition, PET/MRI's higher price tag, operating costs, and logistics are a hindrance for many imaging centers and institutions. Spick said that is why the scanners are found primarily in research centers or universities with greater financial resources.
Yet PET/MRI's advantages include high soft-tissue contrast and the ability to perform functional MRI, according to the authors.

"However, rather than focusing on potential synergy between the capabilities of functional MRI and molecular PET, most research has used MRI almost exclusively to provide the anatomic framework for the PET signal," they wrote. "Thus, most studies have compared the diagnostic accuracy of predominantly anatomic PET/MRI with that of FDG-PET/CT in cancer."

For their review, Spick and colleagues examined PET/MRI versus PET/CT in a wide range of cancer studies, including head and neck, gastrointestinal, gynecologic, and breast cancers, as well as lymphoma and neuroendocrine tumors. The most noteworthy findings were for prostate, bone, and lung cancers.

Prostate cancer

Because FDG-PET is not commonly used in the workup of patients with prostate cancer, most published papers explored the use of different PET probes in conjunction with PET/MRI, the researchers found.
Spick and colleagues identified three studies with a total of 88 patients in which the performance of carbon-11-labeled (C-11) or F-18-labeled choline and gallium-68 (Ga-68) prostate-specific membrane antigen (PSMA) PET/CT was compared with that of PET/MRI.

According to National Comprehensive Cancer Network (NCCN) guidelines, multiparametric MRI is effective for staging, characterizing, and evaluating the suspected recurrence of prostate cancer, while CT is preferred for clinical assessment after the diagnosis of prostate cancer, when there is insufficient information to assess the prostate gland.

After their review, the UCLA researchers concluded that C-11- or F-18-labeled choline and Ga-68 PSMA PET/MRI studies for prostate cancer are feasible. Anatomic lesion detection within the prostate was more accurate with PET/MRI -- an advantage that could help in biopsy planning.

On the downside, PET/MRI T1- and T2-weighted sequences were "not superior to PET/CT for prostate characterization and bone lesion localization," they noted.

Metastatic bone cancer

Skeletal scintigraphy with subsequent radiography, if needed, is recommended for staging patients at high risk for bone metastasis. Individually, CT and MRI can help when initial findings are inconclusive.

FDG-PET/CT is considered complementary to bone scintigraphy, while MRI may be "more sensitive for detecting early lesions and marrow-based metastases than plain radiography, CT, or radionuclide bone scanning," the authors wrote.

While data are somewhat limited in this area, Spick and colleagues found three studies that compared FDG-PET/CT with PET/MRI among a total of 295 patients with suspected bone metastases.

One paper reported that lesion identification was nearly identical between the two modalities, with T1-weighted turbo spin-echo (TSE) performing better than CT or T1-weighted Dixon in-phase MRI.

In another study, PET/MRI detected all 48 bone metastases, whereas PET/CT detected only 45 (94%). The paper credited hyperintensity on T2-weighted images and increased FDG uptake for PET/MRI's superior results.

In another retrospective study, PET/MRI was superior by detecting bone involvement in more patients and more individual bone lesions.

Lung cancer

In this application, the researchers reviewed six studies with 194 patients who had non-small cell lung cancer or lung nodules. PET/MRI was found to have comparable accuracy to PET/CT, due primarily to FDG-PET's contribution of glucose metabolic information to both modalities. PET/CT and PET/MRI also had comparable accuracy for tumor, node, and metastasis (TNM) staging.

One study of 66 patients found high tumor stage concordance between PET/CT and PET/MRI, while three other papers concluded that the two modalities were equally proficient in assessing lymph node involvement and distant disease. PET/CT was "superior for lung nodule detection, but PET/MRI was equivalent for characterization of pulmonary lesions in a patient-based analysis," the authors added.

The final word

In summary, the authors wrote that PET/MRI protocols "are feasible across all types of cancer. Clear diagnostic advantages of PET/MRI, when used mainly for providing the anatomic framework, have not been established and will be difficult to demonstrate given the high accuracy of PET/CT."

They reiterated that PET/MRI is an "expensive technology that should not be used simply to replace PET/CT," and they recommended that additional comparative studies be performed between the two modalities to determine which protocols may yield the best results.

Spick said that PET/MRI still has "an interesting future," with an overall goal of determining the clear advantages of PET/MRI, including which functional MRI sequences will improve cancer assessment and which combination of different PET radioligands should be used.

                     Fact Sheets:
Nuclear Medicine and Molecular Imaging

* Work at your own pace!
* Completely Online!
* Instructor Available if needed!
* Virtual Ecampus with Whiteboard!
* Paperless!
* 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, and other    Accreditation Agencies.
* Anytime, Anywhere, Anyplace!
* Meets ACR NM and PET Accreditation requirements!

These quizzes, exams and documents are copyrighted © 2008-2016 by The PET/MR Training Institute, Inc. The SNMMI-TS, NMTCB, ARRT, 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/MR Training Institute and may not be used or reproduced without The PET/MR Training Institute's permission. The information presented here may not under any 12 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"."

Continuing Education

  • 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 to join.
  • The ARRT recognizes the passing of the PET Exam as being the equivalent of 24 hours of Category A continuing education

Eligibility Requirements

A candidate for examination must show documented evidence of the following:

  1. Active NMTCB, ARRT(N), or CAMRT(RTNM) certification -and-
  2. 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:

  1. Active CAMRT(RT), CAMRT(RTT), ARRT(R) or ARRT(T) certification.
  2. 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.
  3. 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.
  4. The PET/CT Training Institute has this approved course available online and is a Instructor guided self study course.

Exam Content

The following is an abbreviated list of the content for the NMTCB's PET Specialty Exam.

  1. Diagnostic Procedures (~35%) [70 items]
  2. Instrumentation/Quality Control (~30%) [60 items]
  3. Radiation Protection (~10%) [20 items]
  4. Radiopharmaceuticals (~25%) [50 items)

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