Spotlights Newsletter - September 2015



President’s Message
Rathan Subramaniam, MD, PhD, MPH, FACNM
‘Courage, Ideas & Inspiration’…..American College of Nuclear Medicine embarked on a journey, this year, inspired by these words.  The future of nuclear medicine and molecular imaging is more promising than ever before in the history of medicine, and the momentous hurdles we see – training and economic issues – give us the challenge to move forward in a strategic direction with purpose. (Read more)…. ___________________________________________________________________________________________________

Submit Your Abstract for the ACNM Annual and SNMMI Mid-Winter Meeting

Attention young professionals—including those in training (residents, physicians, nuclear pharmacists, or scientists) or in practice within 10 years of graduation—abstracts are now being accepted for the ACNM Annual Meeting and SNMMI 2016 Mid-Winter Meeting, January 28-31, 2016 in Orlando, Florida. (Read more)…. ___________________________________________________________________________________________________

2016 ACNM Abstract Awards
The ACNM is pleased to offer several abstract awards this year:

  • The Ursula Mary Kocemba-Slosky, Ph.D., awards for the Best ACNM Nuclear Medicine Research Abstracts presented by NM Residents at the ACNM Annual Meeting.
  • ACNM Annual Meeting Best Abstract Award (non-resident/trainees).

To apply for the above grants, you MUST submit an abstract to the ACNM Annual Meeting.  You will be prompted to select which of the awards you would like to apply for during the abstract submission process. (Read more)…. ___________________________________________________________________________________________________

For Those of You Taking An Exam Soon
Don’t forget the new NUCORE Quevlar questions which are available and FREE to ACNM members via IMAIOS. If you are a member, you should have received an e-mail for access in June. (Read more)…. ___________________________________________________________________________________________________

ACNM Webinars in Fall 2015
DON’T MISS THE REMAINING UPCOMING WEBINARS FOR THIS YEAR!! This year, ACNM introduced a webinar series, free to members.  There are two more CME opportunities (including one SAMs) that we are sure you don’t want to bypass, so be looking for announcements on these. (Read more)…. ___________________________________________________________________________________________________

Nomination for Annual Mentorship Award
ACNM is currently accepting applications for the Mentor Awards. The deadline is for the 2016 award is December 1, 2015. ACNM values the outstanding ACNM mentors who have assisted the residents/ fellows to achieve their goals throughout the past year. The NEW ACNM Best Mentor Awards for Best Clinical and Best Personal Mentor Awards are given to exceptional individuals who have dedicated their lives to mentoring others. (Read more)…. ___________________________________________________________________________________________________

Upcoming ACNM Fellowship Nomination Information
Twyla B. Bartel, MFellowship Committee Chair  
A call for 2016 ACNM Fellowship nominations will occur in the near future.  In general, three or four fellowships are awarded each year.  Some of the important qualifications and expectations are listed below:

  • Can be nominated by another ACNM Fellow or be self-nominated
  • Must have been a member of ACNM for a minimum of three years
  • Must be a board-certified nuclear medicine physician who has made outstanding contributions to the field of nuclear medicine and/or significant and sustained service to the College (ACNM or ACNP)
  • Fellows are expected to continue as active members of the College and expected to uphold the values of the College and the nuclear medicine community as a whole


Q&A with Otolaryngologist/Head & Neck Surgeon Brendan Stack
Tracy Yarbrough, MD, PhD
We invited Dr. Brendan Stack, Professor of Otolaryngology-Head and Neck Surgery at the University of Arkansas for Medical Sciences, to talk with us about his perspective, as a clinician, on the use of PET-CT. Interviewer: Dr. Stack, what are the commonest indications for which you order PET-CT? Dr. Stack: Pre-treatment staging, assessment of response to chemotherapy or radiation therapy given for an organ-sparing approach, determination if salvage surgery will be required, search for an unknown primary and, less commonly, to search for multiple primaries. (Read more)…. ___________________________________________________________________________________________________

Lymph Node Levels
Twyla B. Bartel, DO, MBA, FACNM
This is an interactive powerpoint presentation. (Click here to view presentation)....

Contrast Enhanced CT in Head & Neck Cancers

Pareen Mehta, MD
Head and neck cancers represent a wide spectrum of malignancies, most commonly squamous cell carcinoma, involving the many different anatomic compartments extending from the skull base to the mediastinum. History of smoking, alcohol abuse and HPV exposure are the main underlying risk factors for head and neck malignancies. Nevertheless, accurate staging is vital in these patients, as this guides treatment options and prognosis. Contrast enhanced CT is the most commonly used imaging modality for staging head & neck malignancies, the goals of which are to assess extent of local invasion, evaluate for nodal metastasis and to examine for distant metastasis (or concurrent second primary neoplasm). CT is also frequently used in the surveillance of these patients, offering a sensitive modality to identify recurrent disease.  (Read more)…. ___________________________________________________________________________________________________

A Brief Review of Sentinel Node Localization and SPECT-CT for Head and Neck Cancers
Twyla Bartel, Jaideep Sohi, Tracy Yarbrough
History of Neck Dissection for Head and Neck Cancer T. Kocher in 1880 described the first surgical removal of tongue cancer en bloc with regional lymph nodes (1).  The Polish surgeon Jawdynski performed and published on en bloc radical neck dissection in 1888, and a similar publication with illustrations was reported by Crile in 1906 (2,3). Thereafter, Martin was responsible for the worldwide dissemination of the radical neck dissection technique in the 1950s, and Suarez described modified radical neck dissection in 1962.  By 1972, Lindberg was able to describe the typical distribution of neck metastases in patient with primary head and neck cancers.  Shah then classified deep cervical neck nodes into five (I through V) levels in 1990 which was subsequently standardized by The American Academy of Otorhinolaryngology – Head and Neck Surgery (AAO-HNS) with the addition of level VI (4).  (Please see our Spotlights separate article for a description of neck node levels).  (Read more)…. ___________________________________________________________________________________________________

18F-FDG-PET/CT in Head and Neck Cancer
Ni C, Thenkondar A, Berenji GR
Head and neck cancer account for approximately 3% of malignancies in the United States.1 18F-FDG-PET/CT plays a major role in head and neck cancer for improved disease detection, staging, restaging, and therapy response. This article briefly reviews the application of 18F-FDG-PET/CT in some of the more common pathologies in head and neck. (Read more)…. ___________________________________________________________________________________________________

Top TEN articles in Head and Neck Cancer
Lesley Flynt, MD
1.  Diagnostic Accuracy of Follow-Up FDG PET or PET/CT in Patients With Head and   Neck Cancer After Definitive Treatment: A Systematic Review and Meta-Analysis.  Sheikhbahaei S, Taghipour M, Ahmad R, Fakhry C, Kiess AP, Chung CH, Subramaniam RM.  British Journal of Cancer (2015) 112, 238–250. doi:10.1038/bjc.2014.610. (Read more)…. ___________________________________________________________________________________________________

Laryngeal Cancer Staging
Pareen Mehta, MD
Laryngeal cancers represent a lethal, head and neck malignancy, accounting for over 12,000 new cases annually in the United States and 130,000 cases worldwide1,2. Histologically, most tumors are squamous cell carcinomas with a history of smoking representing the major underlying risk factor1. However, alcohol abuse and HPV are also contributing factors. Other histologic tumor types do occur, albeit with much less frequency. (Read more)…. ___________________________________________________________________________________________________

Nuclear Medicine at Hacettepe University, Ankara, TURKEY
Department of Nuclear Medicine at Hacettepe University in Ankara Turkey was founded in 1968 by Prof. Coskun BEKDIK , M.D and has kept its leadership position in the field of nuclear medicine in  both education and research since inception. As being one of the most exclusive nuclear medicine departments in Turkey, it has been among the most preferred centers for residency training in nuclear medicine and so far 55 medical doctors completed nuclear medicine training program and are practising nuclear medicine  at academic or private centers in Turkey and abroad.. The department of Nuclear Medicine at Hacettepe University has been certified as a “Center of Excellence” by the International Agency for Atomic Energy (IAEA) in the year 2004 and has been accredited by “the European Union of Medical Specialists Section and Board of Nuclear Medicine (UEMS/EBNM)” in the year 2003. (Read more)…. ___________________________________________________________________________________________________

International Affairs Committee News
Lida Jafari, MD
As a new representative to the International Affairs committee of the ACNM and the third year resident at VA Hospital at Greater Los Angeles, I am delighted to invite and engage residents from other countries in the activities of the ACNM. The following educational opportunities would be available for ACNM international members: (Read more)…. ___________________________________________________________________________________________________

Government Relations Committee
Erica Cohen DO, MPH
Here are your important updates from the Joint GR Committee: Public commentary on the MPFS (Medicare Physician Fee Schedule) proposed rules for 2016 are due on September 8, 2015. The rules address several key issues for nuclear medicine, including reimbursement rates, quality measure reporting, and a new payment system designed to replace the SGR (Sustainable Growth Rate). It also contains a process for the establishment of AUC (Appropriate Use Criteria) to be implemented within the next 2 years. The SNMMI-ACNM Joint Government Relations Committee has already submitted commentary on these important topics. (Read more)…. ___________________________________________________________________________________________________

Answer to July 2015 Case of the Month

HISTORY: A 59 year-old female presented for imaging with a history of pancreatic neuroendocrine tumor with liver metastasis.  What is the likely cause of the different uptake pattern in the tumor for the two radiotracers utilized? Please click here for entire case.  ANSWER:  Well-differentiated neuroendocrine tumors are often seen on Ga 68 SSTR imaging with increased uptake, while poorly-differentiated neuroendocrine tumors tend to be more FDG avid. The same patient may exhibit varying degrees of differentiation. ___________________________________________________________________________________________________

September 2015 Case of the Month
The case involves a 55 year-old male with recently resected cutaneous melanoma of the left cheek.  What are the findings, or what other information do you need for a diagnosis? (Please click here for images…) ___________________________________________________________________________________________________

Editors and Contributors
Chief Editor: Simin Dadparvar, MD
Twyla Bartel, DO, MBA
Gholam R. Berenji, MD
Murat Fani Bozkurt, MD
Erica Cohen, DO
Patrick Colletti, MD
Lesley Flynt, MD
Lida Jafari, MD
Pareen Mehta, MD
Chiayi Ni, MD
Jaideep Sohi, MD
Rathan Subramaniam, MD, PhD
Anuradha Thendonkar, MD
Tracy Yarbrough, MD, PhD