Core Adult Internal Medicine Disciplines

Nuclear Medicine

Topics

• Cardiovascular system:
  • Understands the principles of and indications for myocardial perfusion imaging using exercise and pharmacological stress, and for radionuclide ventriculography.
  • Understands the role of myocardial perfusion imaging in the post infarct patient, in patients who have undergone revascularization procedures and its use in the detection of viable myocardium, stunned and hibernating myocardium.
• Respiratory system:
  • Understands the principles of and indications for lung ventilation and perfusion imaging.
  • Understands the role of contrast venography, compression ultrasound and pulmonary angiography in the diagnosis of pulmonary embolism.
• Musculoskeletal system:
  • Understands the principles of and clinical indications for bone scanning with particular reference to oncology and rheumatology.
  • Understands the role of bone scanning in the diagnosis of disease and the integration of bone scan findings with plain radiography, CT scanning and MRI.
  • Understands the role of therapeutic radiopharmaceuticals in the palliation of pain from metastatic bone disease.
  • Understands the principles of dual photon absorptiometry and its role in the diagnosis and management of osteoporosis.
• Gastrointestinal system:
  • Understands the principles of and indications for oesophageal motility studies; gastric emptying scans; colon transit studies; hepatobiliary studies; gastrointestinal bleeding studies; cavernous haemangioma studies; urea breath tests and labelled white cell scans.
  • Understands the clinical indications for oesophageal motility studies; gastric emptying scans; colon transit studies; hepatobiliary studies; gastrointestinal bleeding studies; cavernous hemangioma studies; urea breath tests and labelled white cell scans.
  • Capable of interpreting the results of these scans and integrating those results with the results of abdominal CT scanning and abdominal ultrasound.
• Nephrology:
  • Understands the principles of and indications for renal perfusion scanning, renal cortical scanning and glomerular filtration rate estimation.
  • Understands the use and limitation of pharmacological intervention (diuretics, ACE inhibitors) in dynamic renal scanning.
  • Understands the role of renal perfusion imaging in the detection of renovascular hypertension.
• Haematology:
  • Understands the principles of gallium scanning, white cell scanning, Schilling test, and red blood cell volume and plasma cell volume estimations.
  • Understands the clinical indications for gallium scanning in the detection and monitoring of inflammation and malignancy.
  • Understands the clinical indications for white cell scanning in the detection of inflammation and infection.
  • Understands the role of therapeutic administration of Phosphorus-32 in the treatment of polycythaemia rubra vera.
• Neurology:
  • Understands the principles of and indications for cerebral perfusion imaging.
• Endocrinology:
  • Understands the principles of and indications for thyroid scanning, parathyroid scanning, In-111 octreotide scanning and I-131 MIBG scanning.
  • Understands the role of I-131 therapy in the treatment of thyrotoxicosis and thyroid cancer.

Practical Skills for all Trainees

Nil.

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