1. Distance Assisted Training for Nuclear Medicine Technologists RAS 6029 / RAS2006003 The Next Phase: SPECT/CT & PET/CT Heather Patterson Westmead Hospital, Sydney, Australia Brian Hutton University College London, UK

2. Proposed Work plan: Approval of draft syllabus – appoint technical writers/authors First draft of new materials ready Oct/Nov 2007 - Advisory meeting for main technical writers Thailand November 2007 Develop DAT website and web-based tools - registration, code access - online assignments, self-assessment, final examinations - interactive image manipulation - monitor progress - feedback, questions/answers - ongoing updates Train the Trainer course on utilization of web-based support system Assessment of student performance using web-based tools

3. Proposed Syllabus: Introduction to CT principles4 SPECT/CT3 Cross-sectional anatomy (revised)1 Introduction to basic science of PET3 Clinical PET/CT4 Units / subjects 15 Units delivered in 4 modules each module ~ 30 - 40 hrs study over 2 months = ~160 hrs of study

4. Proposed Syllabus: Introduction to CT principles Basic CT physics and operation parameters CT safety and dosimetry Clinical procedures and protocols: use of contrast Specific issues in use of CT with SPECT and/or PET SPECT/CT Advanced SPECT physics (revision) Choices of SPECT/CT system and specific QC Clinical applications of SPECT/CT Cross-sectional anatomy (revised) use of web package

5. Proposed Syllabus: Introduction to basic science of PET Background on cyclotron and available PET tracers Basic PET physics and operation parameters: QC procedures Radiation safety for positron emitters Clinical PET/CT Understanding the basis for imaging with FDG: - normal patterns of uptake for FDG, - application of FDG in Oncology Work-flow and protocols for PET/CT Artifacts and issues in PET/CT; measurement of SUV Use of tracers other than FDG in oncology - application in cardiology and neurology

6. Points for consideration: Small number of technologists practicing PET/CT in different countries - different training backgrounds initially how many will have completed DAT basic & advanced? - suitable for other staff eg: registrars in training Need to define pre-requisites Ensure understanding of necessity for equipment and practical issues - all students need to complete practical exercises & assessment

7. Points for consideration: Website: still a necessity for paper based materials? provide a database with images – who supports it? encourage student discussion + interaction other students / tutors country internal monitoring – improved communication? eg: monitoring assignments, setting examinations, feedback CT component to include: a) diagnostic CT including use of contrast b) CT for attenuation correction and localization

8. Pre-requisites: Establish entry level for participants eg:- successfully completed DAT basic & advanced levels - practicing in department with SPECT/CT & PET/CT or SPECT only and PET/CT ? or SPECT/CT and PET ? Minimum requirements: Functioning NM dept, qualified NM physician…as per current guidelines PET/CT or PET with access to SPECT/CT Other options: - senior NM technologist with some PET experience - CT radiographer- sufficient NM knowledge? - revise / complete previous SPECT units – plus other subjects?

9. Web Platforms: ANENT Asian Network for Education in Nuclear Technology IAEA affiliated website - KAERI

11. Web Platforms: ANENT Asian Network for Education in Nuclear Technology IAEA affiliated website - KAERI Web-CT (Blackboard) Utilized by many Distance Education institutions Moodle Modular Object-Orientated Dynamic Learning Environment Course management system Utilized by Open University, UK + a growing number of DE institutions Being replaced by Recent meeting deciding on special regional requirements

12. moodle.org Software package producing internet based courses & websites Designed to support a ‘social constructionist’ framework of education ie: creating a culture for shared knowledge. New developments and ideas shared with other moodle users Support system to help users solve problems (moodle.com) - Updates on revisions, new versions

13. moodle.org Focus on Student learning Teacher interaction Ease of monitoring Student learning: Text on-line, assignments answered on-line Inter-active illustrative materials, case studies eg: rotating MIP PET images (maximum intensity projection) Additional quizzes to reinforce learning – self assessment Results, interaction and progress recorded - prompts for student to continue to next stage Active discussion groups that force student to communicate

14. moodle.org Focus on Student learning Teacher interaction Ease of monitoring Teacher / coordinator interaction: Discussions, questions / answers with local tutors Review assignment results & progress - interactive or automatic reminders / emails Ease of monitoring Results, progress and student interaction displayed on one page - all student results and feedback displayed Regular reports to DAT – web administration and IAEA

16. Introduction to CT principles Basic CT physics and operation parametersN. Keat CT safety and dosimetryN. Keat Clinical procedures and protocols: use of contrastR. Endozo Specific issues in use of CT with SPECT and/or PETJ. Dickson / B. Hutton SPECT/CT Advanced SPECT physics (revision)B. Hutton Choices of SPECT/CT system and specific QCB. Hutton Clinical applications of SPECT/CTJ. Bomanji

17. Introduction to basic science of PET Background on cyclotron and available PET tracers S.Eberl Basic PET physics and operation parameters: QC procedures J.Dickson Radiation safety for positron emitters J.Towson Clinical PET/CT Understanding the basis for imaging with FDG: P. Thomas - normal patterns of uptake for FDG, - application of FDG in Oncology Work-flow and protocols for PET/CT C. Constable Artifacts and issues in PET/CT; measurement of SUV W L Wong Use of tracers other than FDG in oncology P.Thomas - application in cardiology and neurology