Nuts and Bolts Sessions

Back by popular demand! Once again, the SNMMI Annual Meeting will offer "Nuts and Bolts” sessions in a wide variety of sub-specialty areas–giving you practical information you can use immediately when you return to work.

Nuts & Bolts of Myocardial Blood Flow: Clinical Applications

This session will introduce participants to the Nuts & Bolts of implementing PET imaging for myocardial blood flow quantification in clinical practice. Leaders in the field will lecture about applicable tracers and protocols, quality control and clinical applications. New directions in SPECT imaging will also be introduced.

Cardiac Amyloidosis: Introduction and Applications

This session will provide attendees an overview of cardiac amyloidosis and the role of imaging in diagnosing this disease. The pathophysiology of cardiac amyloidosis will be reviewed and new treatments for the disease will be explained. The various imaging modalities used for diagnosis of cardiac amyloidosis will be discussed. Finally, aspects of imaging and reporting nuclear cardiology studies for the diagnosis of cardiac amyloidosis will be presented.

Nuts & Bolts of Ga-68 Radiochemistry

This is a nuts & bolts session on items related to Ga-68 radiochemistry. This session will discuss the available routes for Ga-68 availability as well as how to perform radiochemistry for Ga-68 radiopharmaceutical with both kits and automated radio synthesis modules.

Nuts and Bolts: How Do I Get New Imaging Agents at My Site?

There are several new imaging agents in various stages of development in the US and abroad. Understandably these agents are generating a lot of excitement and clinicians want to know how and when they can use them. This session will review a variety of agents including their indications, their stage of development, and how they may be available for use. The session will describe imaging agents with their complements to be able to distinguish when an imaging agent is more appropriate to use over the other. Upon completion attendees will be able to distinguish the difference between the novel agents used in prostate cancer, neuroendocrine tumors and late-stage disease. The attendees who are interested in using these imaging agents will have a guideline of how these agents can be available to sites.

Nuts and Bolts: Using Lutetium-177 Dotatate

Lutetium-177 dotatate is a Lu-177-labeled somatostatin receptor that is available commercially in the US for the treatment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). 177Lu-dotatate belongs to an emerging form of treatments called Peptide Receptor Radionuclide Therapy (PRRT). This session will discuss the criteria for selecting patients for PRRT from an oncologist, a lecture on preparing and dosing the patients, and advice from a site who has successfully integrated these agents into their practice. If you are just getting started with theranostics – or want to start- this is a must attend session.

The Nuclear Medicine Report – How to Get Paid with PAMA

Beginning January 1, 2020, the Protecting Access to Medicare Act (PAMA) by the Centers for Medicare and Medicaid Services (CMS) will require referring physicians to consult Appropriate Use Criteria via a qualified clinical decision support mechanism prior to ordering advanced imaging services such as CT, MRI, Nuclear Medicine, and PET for Medicare patients. For imaging physicians to receive Medicare payment for these procedures, the PAMA process must be adhered to. This session will review the PAMA requirements and explain how to avoid penalties for noncompliance. The session will also address the necessary components within the Nuclear Medicine report that will optimize reimbursement for nuclear medicine procedures.

Tackling Diversified Clinical Management Questions

Multiple speakers will provide education regarding the practical application of theranostics in various types of clinical practices. Education on the interpretation of PET/CT during immunotherapy. Upcoming educational opportunities in the field of nuclear medicine advanced practice.

Nuts & Bolts: Prostate Cancer: Diagnosis & Therapy

This session will cover the basics and value of Axumin PET/CT, PSMA PET/CT in diagnosis of prostate cancer and therapy with 177Lu PSMA for treatment.

RADAR: Dosimetry Methods and Dose/Effect Relationships

The session will summarize current methods and models for calculating radiation doses from radiopharmaceuticals and give an overview of current knowledge relating radiation doses to biological effects.

Neuroendocrine Tumor Diagnosis and Therapy

This is nuts and bolts session on Neuroendocrine tumor diagnosis and therapy. It will cover over of neuroendocrine tumors, diagnosis, non-radionuclide therapy and radionuclide therapy

US Regulatory Pathways for Diagnostic and Therapy Radiopharmaceuticals

This nuts and bolts session will cover the regulatory pathways that govern FDA review and oversight of new radiopharmaceuticals for human use. The focus will be on regulatory requirements for the various Investigational New Drug applications that can be used to obtain approval for translating radiopharmaceuticals into human use.

New PET Radiopharmaceuticals: Read with the Experts

This session will provide a read with the experts review of novel PET radiopharmaceuticals on PET/CT. Specifically, cases of PET/CT using Axumin, PSMA and DOTATATE will be reviewed and discussed. Also, a primer of PET for predicting dosimetry of radionuclide therapy will be provided.

Pediatric Read with the Experts

The aim of the session is to provide nuclear medicine practitioners of many fields and backgrounds with a review of challenging and interesting clinical pediatric nuclear medicine cases. Discussions will be led by three speakers recognized as clinical experts in the field of pediatric nuclear medicine who have a demonstrated ability to communicate effectively and interactively with the audience. The experts’ teaching points on these challenging pediatric nuclear medicine cases will increase attendees’ knowledge, and thereby enhance study interpretation and improve patient care.

Pediatric PET/MR

The purpose of this course is to provide a primer geared toward pediatric practitioners on the emerging modality of PET/MR. This course will be clinically-oriented with an intended audience of physicians, technologists, residents/students and practitioners of all levels. The course will begin with a brief update on Pediatric Nuclear Medicine Dose Optimization, which ties into this session because PET/MR is expected to make further radiation dose reductions possible due to absence of CT radiation, higher PET detector sensitivity, and longer PET detector bore. A Nuts-and-Bolts presentation given by an experience PET/MR “super technologist” will follow, outlining the basic principles and complicating factors encountered when performing Pediatric PET/MR. The final two speakers will cover clinical topics of interest to the audience, encompassing both body and brain applications of Pediatric PET/MR. Therefore, this course will provide practical, high-yield knowledge for attendees who may be early or yet to embark in providing PET/MR at their home institutions. After attending this course, attendees will have gained fundamental knowledge and competence for early stage implementation of PET/MR at their home institutions. For attendees who already perform PET/MR, this course will improve patient outcomes by providing lessons from already experienced leaders in Pediatric PET/MR.

Practical Radiopharmaceutical Dosimetry

Radiopharmaceutical dosimetry is used in both diagnostic and therapeutic applications and is used both clinically and in research and development. The calculation of dosimetry is a multistep process, which requires an understanding of the data, modelling and assumptions, and supporting software. In this session, we will discuss the context of practical dosimetry and the infrastructure used to support it.

Nuts and Bolts - State of The Art PET/CT: Physics, Instrumentation, Performance and Clinical Application

This continuing education (CE) session will introduce the state-of-the-art PET/CT systems from various manufacturers (United Imaging, Philips, GE and Siemens) while focusing on differences in SiPM detector designs, system configuration, signal processing, and performance characteristics. Lectures will be given by scientists from various academic institutions. Physicists, physicians and technologists wishing to better understand state of the art digital PET instrumentation, technology and their clinical translation are expected to attend this CE session to extend their knowledge and achieve this goal.

Brain Imaging – Read with the Experts

This session will highlight the successes and pitfalls of neuroimaging techniques such as FDG, amyloid and tau imaging. Cases will be presented where the audience participation, followed by a dissection of the findings, providing insight into the technique o it can be translated to clinical practice.

Can we use Quantitative PET in Clinical Practice?

This session will explore the different aspects of PT quantification, from full kinetic analysis with arterial blood input, to simplified tissue ratios, trying to elucidate if a balance between the two can be achieved to use the full potential of PET

Differentiated Thyroid Cancer Theranostics Practicum

This course will focus on the knowledge needed in the clinical practice of thyroid cancer theranostics. The target audience will include the Nuclear Medicine technologists and physicians. Current guidance on performance of diagnostic assessment and selection of activity for radioactive iodine therapy is highly heterogeneous. There is no consistency even within the specialty of Nuclear Medicine and it is even greater discrepancy among the various specialties involved in the management of these patients. The attendees of this course will be offered a logical, comprehensive approach to the diagnostic evaluation and selection of patient-specific activities for scenarios commonly encountered in clinical practice. The state-of-the-art techniques will be reviewed for diagnostic scanning and dosimetry. Attendees will learn how to establish a thyroid cancer theranostics practice at their respective institutions that starts with the initial post-thyroidectomy evaluation and follows through to the advanced and recurrent disease.

Molecular and Radiologic Imaging of Common and Uncommon Musculoskeletal Diseases: Case Based, Interactive Session

This session will present benign and malignant musculoskeletal diseases with radiologic (x-ray, CT and MRI) and correlative molecular imaging (bone scan, SPECT, SPECT/CT, PET/CT) in an interactive case-based format. Approximately 15-20 cases will be presented.

PET/CT Response Assessment

This session will review response assessment on PET in pediatric and adult patients across a spectrum of disease and therapy.

State of The Art PET/CT

This continuing education (CE) session will introduce new and emerging state of the art PET instrumentation and technologies focusing on SiPM PET detector designs, signal processing, system performance characteristics and clinical applications over different manufactures products (United Imaging, Philips, GE and Siemens). Lectures will be given by a diverse group of leading scientists in academic fields. Physicists, physicians and technologists wishing to better understand state of the art digital PET instrumentation, technology and their clinical translation are expected to attend this CE session to extend their knowledge and achieve this goal.

Diabetic Foot Osteomyelitis: Diagnosing and Monitoring Treatment with Imaging

This is a clinical session designed for imaging specialists, investigators, technologists, and clinicians, who want a review of and update on the role of imaging of diabetic foot osteomyelitis. The clinical aspects of diabetic foot osteomyelitis, typical radiologic findings, and the role of molecular imaging, including SPECT/CT and PET/CT for diagnosis and monitoring treatment response will be reviewed. This session will provide practitioners with a guide for recommending, performing, and interpreting the most appropriate tests for diagnosing diabetic foot osteomeyelitis and for monitoring response to treatment. The indications and limitations of radiographs, CT, MRI, SPECT/CT, and 18F FDG PET/CT, will be covered.

Cardiac PET/CT Workshop

This course is intended for nuclear medicine specialists and cardiologists who interpret cardiac PET/CT. This is organized by the Correlative Imaging Council (in collaboration with the PET Center of Excellence and the cardiovascular council) and is in a similar fashion to the prior CT workshops (cased-based) for the attendee to accumulate 30-50 cases for the ultimate intended goal of at least 50 cases (at future sessions) as recommended by the recent 2017 ACRAPR-STR Practice Parameter. The primary focus will be on adult cases, but a few pediatric cases may also be presented.

Imaging and Therapy for Thyroid Cancer: the Theranostics Paradigm

Diagnostic radioiodine (RAI) scintigraphy contributes to the completion of staging and risk stratification in patients with differentiated thyroid carcinoma, thereby defining an individualized 131I therapeutic strategy. Exquisitely relevant is the complimentary diagnostic information provided by chest CT imaging. This includes both pre-thyroidectomy diagnostic chest CT as well as the low-dose CT obtained as a component of SPECT-CT imaging preceding 131I therapy. Specifically, chest CT imaging may demonstrate pulmonary nodules and mediastinal lymphadenopathy, the differential of which may include: radio-iodine avid metastatic thyroid carcinoma, radio-iodine refractory metastatic thyroid carcinoma or a separate process unrelated to the known thyroid malignancy. The diagnostic information provided by chest CT imaging must be integrated with that provided by the 131-I scan to guide treatment decisions and dose selection.