Spotlights E-Newsletter - July 2016

July Issue Highlights

Dear ACNM Members,

Once again, ACNM publication committee is presenting another unique issue of the popular ACNM online Spotlights. The July issue includes many outstanding topics of interest for nuclear medicine physicians and scientists with the intent to provide easy access and immediate notification to our members of important ACNM events and areas of involvement. In addition, this month’s issue is dedicated to leadership and emerging educational technologies in PET/MRI/CT of brain and liver. If you are interested in participating, please contact us.

This July 2016 issue also includes:

  • ACNM president’s message
  • government relations including FDA approval of two new PET radiopharmaceuticals
  • nuclear medicine practice in India, and more….

A brief summary paragraph will be given in this original document, then you can click on “read more” to gain further information on the topic.

Simin Dadparvar MD, FACNM

Twyla Bartel, DO, MBA, FACNM
Associate Editor

ACNM 45th President’s Midterm Message
Patrick Colletti, MD
We are reenergized from our Board meeting in San Diego, with continued focus on our mission:
“ACNM’s mission is to foster the highest standards in Nuclear Medicine consultation and service to referring physicians, hospitals, and the public, advance the science of Nuclear Medicine through study, education, and improvement of the socioeconomic aspects of the practice of Nuclear Medicine and thereby to improve Nuclear Medicine consultation and service and to promote the continuing competence and socioeconomic awareness of practitioners of Nuclear Medicine through a program of continuing professional development emphasizing high standards of Nuclear Medicine practice.” (Read more)…

ACNM Annual Fund
The ACNM Fund for Nuclear Medicine and Molecular Imaging is made up of gifts from ACNM's loyal members, supporters, and friends.  One hundred percent of these contributions benefit ACNM members and Residents, paying for grants, awards, stipends and scholarships to advance their education, training and research objectives. This fund is kept at the Research & Education Foundation for Nuclear Medicine and Molecular Imaging and absolutely separated from ACNM operational funds for the life of the fund. Please generously give at: (Read more)…

ACNM in SNMMI Annual Meeting
KG Bennett, MD
The ACNM has been busy this year. We have a new management contract with SNMMI. Our bylaw amendments passed, and we are in the process of electing our Vice President elect for the first time.  Alan Klitzke, MD and Tracy Brown, MD are our two candidates. We have become an Amazon Smile charity. ACNM gets 0.5% of the purchases made at (Read more)…

Update from the ACNM Educational Committee
Twyla Bartel, DO, MBA, FACNM - Educational Committee Chair
We have been extremely active in trying to provide good products to you, our members.  
Please clink this link to see further. (Read more)…

Government Relations Update
Erica J Cohen DO, MPH
The FDA recently approved 2 new imaging agents, F-18 Fluciclovine (Auxumin) for suspected recurrent prostate cancer based on elevated PSA, and Ga-68 DOTATATE (NETSPOT) for localization of somatostatin receptor positive neuroendocrine tumors. Both agents are awaiting commercialization. (Read more)…

Consensus Decision Making
Ashley Prosper, MD
Consensus. Moving a group forward with it certainly sounds preferable to doing so without it. But how do we go about attaining it?  Consensus decision making has a long history in North America. Some of the earliest examples of consensus building are found in the deeply rooted traditions of Native American governance. The Iriquois Confederacy, for example, has utilized consensus governance for centuries. For Iriquoian government, consensus building was designed to “achieve the One Mind of Consensus.”  (Read more)…

Nuclear Medicine Practice in India
Dr. BR Mittal, MD – Editor-in-Chief, Indian Journal of Nuclear Medicine
Dr. Baljinder Singh, PhD – Dean, Indian College of Nuclear Medicine
The specialty of Nuclear Medicine in India began with the inception of mainly two Institutes i.e. INMAS, DRDO, Delhi and Radiation Medicine Centre (RMC, Parel, Mumbai) under the important union Ministries of Defence and Atomic energy (DAE) respectively. Later on the department of Clinical Nuclear Medicine also came up in the country’s premiere Institutes i.e. in AIIMS, New Delhi and PGIMER, Chandigarh governed directly by the Union Ministry of Health and Family welfare. The Nuclear Medicine department at SGPGIMS, Lucknow & TMH, Mumbai are other public sector active Nuclear Medicine centres in the country. The clinical Nuclear Medicine services are also available since long time in other big corporate hospitals located in Mumbai i.e. Hinduja, Jaslok , Bombay Hospital, KEM Hospital & Kokilaben Dhirubhai Ambani Hospital etc. The two Institutes in the country i.e. INMAS & ACTREC, TATA Mumbai has ‘state of the art’ Pre Clinical PET/SPECT/CT imaging systems and are involved in the development of Newer PET/SPECT Tracers and clinical trials of newer antic-cancer drugs respectively. (Read more)…

Computed Tomography of the Brain
Sumera Ali, MD
The brain is strategically placed inside the cranial vault where it is protected by the thick bony skull. For the ease of understanding, the cranial space is divided into anterior, middle and posterior cranial fossae. The cranial vault is made of several bones including frontal, occipital, paired parietal and squamous temporal bones which are connected by fibrous sutures. (Read more)…

Introduction to PET Brain
Kristina E Hoque, MS, MD, PhD
This brief article is not intended to definitively cover the wide breadth of Brain PET applications, but rather, to serve as an introduction to Brain PET. The basic normal appearance of Brain PET must be recognized along with potential pathology. (Read more)…

Introduction to Brain MRI
Manohar Kuruva, MD
Magnetic resonance imaging (MRI) is one of the most commonly used imaging modality in the field of neuro imaging. With advent of new hybrid imaging techniques like PET/MRI it is becoming essential for nuclear medicine physicians to develop basic overview of MRI knowledge. Also the knowledge of imaging findings of different pathology on MRI allows for better correlation of findings and increased diagnostic confidence in day to day reporting. In this article we aim to review basic sequences of MRI imaging of brain and provide examples of MRI imaging of few pathologies which are of relevance to nuclear medicine physician. (Read more)…

Liver Imaging Anatomy: Review of Classics and Emerging Theories
Michael Morris MD, MS and Babak Saboury MD, MPH
In this brief review, we explore practical and applied cross sectional anatomy of liver as it can be applied to cross sectional imaging, such as CT or MRI. The historical and etymological* connotations of “liver” can help us to appreciate our fascination with the nuanced anatomy and physiology of this organ. The localization of hepatic lesions step by step using Couinaud classification will be discussed. Then classification emphasizing on modern hepatic surgery and emerging interventional techniques is discussed. (Read more)…

PET Imaging of the Liver
Saabry Osmany, MD
PET isotopes used in imaging the liver include C11 (half life 20.4min), F18 (half life 109.8min) and Ga68 (half life 68min). Several PET tracers are used clinically worldwide for imaging the liver. The roles of all PET tracers include diagnosis, staging and treatment assessment. PET tracers used for hepatic imaging include C-11 and F18 choline, F18 NaF, Ga68 somatostatin receptor tracers (e.g. DOTANOC, DOTATOC, DOTATATE etc), C11 acetate and F18 FDG.  (Read more)…

Brief Overview of Primary Sequences Utilized in MRI of the Liver and the Liver Segments
Twyla B Bartel, DO, MBA, FACNM
This brief article is not intended to discuss and explain the physics of or advanced MRI, but rather, to serve as an introduction to MRI of the liver.  The very basic sequences utilized with abdominal MRI must be recognized along with what pathology may be shown before comprehension of additional special sequences.  In summary, this is referring to the T1-weighted (T1) and T2-weighted (T2) sequences. (Read more)…

Answer to May 2016 Case of the Month
An 87 year-old man has a history of cardiomyopathy (EF = 25-30%), atrial tachycardia, COPD, and CKD.  Further investigation is warranted for possible cardiac amyloidosis. 
There is intense PYP uptake in the myocardium, more than blood pool, consistent with  transthyretin-related carciac amyloidosis (TTR).
Please click here for entire case.  

July 2016 Case of the Month
A 45 year-old female has short-term memory loss, behavior changes, increased irritability/agitation/confusion, motor weakness, and coordination problems.  MRI and PET were performed.  What is the likely diagnosis?
Please click here for images.  

Editors and Contributors:
Editor in Chief: Simin Dadparvar, MD
Associate Editor:  Twyla Bartel, DO, MBA

Sumera Ali, MD
Twyla B. Bartel, DO, MBA
KG Bennett, MD
Erica J Cohen, DO, MPH
Patrick Colletti, MD
Yamin Dou, MD
Kristina E. Hoque, MS, MD, PhD
Lida Jafari, MD
Manohar Kuruva, MD
BR Mittal, MD
Michael Morris, MD, MS
Saabry Osmany, MD
Ashley Prosper, MD
Babak Saboury, MD, MPH
Baljinder Singh, PhD