MEDLPHYSICS, INC. RICHMOND, CALIF 94806SUBSIDIARY OF HOFFMANN-LA ROCHE INC.

/

-

Technetium Tc 99mGenerator

Secondary shieldto further reducerad ati on

5cc and 10cc elution vials

I elution vialsClilable on request

Elution vial

Adaptors for various elution v@

medi÷pJ@fl@

Featuring:•Indicatedforuseinadultsand

childrenforurinarybladderimaging(directisotopiccystography).

•TheonlyGeneratorwithan“open/closed―valvetoeliminatepossibleleakage,bothduringshipmentandinyourhotlab.

•Uniquehorizontalelutionprocedureincreaseseaseofuseandeliminatesneedle-vialalignmentproblems.

•Anewsterileneedleisutilizedforeachelution,reducingthechancesofa septicorpyrogenic

situationoccurringinroutineclinicalusage.Thismethodissuperiortocompetitivedrycolumnsystemswherethesameneedleassemblyisusedforthelifeoftheproduct.

•Fissionproductmolybdenum99isusedintheTechnetium99mGeneratortoprovideSodiumPertechnetateTc99mactivityconcentrationssufficientforbolusinjections.

•Internalsalinereservoireliminatestheneedtostocksalinevials.

•Evacuatedelutionvialsareavailablein5cc,.10cc,and20ccvolumes,allowingyoutooptimizetheelutionconcentrationtomeetyourneeds.

•Optimumshieldingdesignminimizesradiationtopersonnelinworkareas,providingmaximumprotection.

•Generatoriscompact,providingforoptimummaneuverability.Generatorhandleandshippingcartonprovideforeaseinhandlingandlifting.

medi+p@©@®MEDI-PHYSICS, INC., RICHMOND. CALIF 94806

® SUBSIDIARY OF HOFFMANN-LA ROCHE INC.

TECHNETIUMIc 99m GENERATORfor the PrOdUCtIOnof SodiumPsrtschnetats Ic 99mDESCRIPTiON:TheTechnetiumTc99mGeneratorispreparedwithtissionproducedMolybdenumMo99absorbedonaluminain a lead-shieldedcolumnandprovidesameansforobtainingsterilepyrogen-treesolutionsofSodiumPertechnetgeTc99mInsodiumchlorideiniection.Theeluateshouldbecrystalcfe&WithapHof4.5—7.5,hydrochloricacidand/orsodiumhydroxidemayhavebeenusedforpHadjusbeentOverthelifeoffhegenerator,anelutionwillcontainayieldof80%to100%ofthetheoreticalamountofTechnetiumIc 99mavailablefromtheMofybdenumMo99onthegeneratorcotumn.Eacheluateofthegeneratorshouldnotcontainmorethan0.15microcurieoftheMolybdenumMo99permillicurieTechnetiumIc 99mperadministereddoseatthetimeofadministration,andnotmorethan10microgramsofaluminumpermitfillferofthegeneratoretuate,bothofwhichmustbedeterminedbytheuserbeforeadministration.INDICATIONSAND USAGE:SodiumPertechnetafeSc99misusedftADULTSasanagentfor:brainimaginginctudlr,qcerebrafradionucfideangiography;thyroidimaging;salivary@fandimaging;placentalocafizafion;bloodpontImagingincludingradionuctideangiography;andurinarybladderimaging(directisotopiccystography)fordefectionofvesico-ureteratrellux.SodiumPerfechnefateIc 99mis usedINCHILDRENasanagentfor:brainimagingincludingcerebralradionuctideangiograptiy;thyroidimaging;bloodpoolimaginginctudingradionuclideangiography;andurinarybladderimaging(directisotopiccysfography)forthedetectionofvesico-ureferalreftux.

. CONTRAINDICAT1ONS: None known.

WARNINGS:RadiefionrisksassociatedwiththeuseofSodiumPertechnefateIc 99maregreaterinchitdrenthaninadults.Ingenerat,theyoungerthechildthegreatertheriskowingtogreaterabsorbedradiationdosesandlongerlifeexpectancy.Thesegreaterrisksshouldbetakenfirmlyintoaccountinallbenefit-riskassessmentsinvolvingchildren.PRECAUTIONS:Asintheuseofanyradioactivematerial,careshouldbetakenfominimizeradiationexposuretothepatientconslslenlwithproperpatientmanagementandtoinsureminimumradiationexposurefooccupationalworkers.

Carctnog.nwnle,Mutagnwnie,tmpairmwntofFertilityNotong-termanimalstudieshavebeenperformedtoevalualecarcinogenicpotentialorwhetherTechnefiumIc99mmayaffectfertilityInmalesorfemales.

Ic 99rncancausefetalharmwnenadministeredtoapregnanfwomanorcanaffectreproductivecapacity.TechnetiumIc9901shouldbegiventoapregnanlwomanonlyif Iheexpectedbenefitstobegainedcleartyoutweighthepotentialhazards.Ideally,examinationsusingradiopharmaceuticals,especiallythoseetectiveinnature,otawomanofchitdbearingcapabitityshouldbeperformedduringthefirstfew(approximately10)daysfollowingtheonsetofmenses.

NursingMothersTechnetiumIc 99misexcretedinhumanmilkduringlactation,andthereforeformulafeedingsshouldbesubstitutedforbreastfeedings.

PediatricUseSeelndlcatlonaandUsage,dosageandadministration.Seealsodescripflonotaddihonalriskunderwernlngs.Radiopharmaceulicatsshouldbeusedontybyphysicianswhoarequalifiedbytrainingandexperienceinthesateuseandhandlingofradlonuclides,andwhoseexperienceandtraininghavebeenapprovedbytheappropriategovernmenlagencyauthorizedtolicensetheuseofradionuclides.Thegeneratorshouldnotbeusedafter16daysfromthedateandtimeofcalibration.Attimeofadministration,thesolutionshouldbecrystalclear.ADVERSEREACTIONS:AllergicreactionsincludinganaphylaxishavebeenreportedinfrequentlyfollowingtheadminisfrationofSodiumPertechnetateIc 99m.HOWSUPPUED:SodiumPertechnetaleIc 99missuppliedasaMolybdenumMo99/TechnetiumIc99mgeneratorinsizestromR3Omilticuriesupto16,600milllcuries(inapproximatetyit3OmillicurieIncrements)ofMolybdenumMo99asof10:00P.M.EasternTimeofthedayofcalibration.TheTECHNETIUMIc 99mGENERATORconsists01:1)sterilegenerator,2)SodiumChlorideInjectionsource,3)10ccslerileevacualedvials,4)sterileneedles,5)elufionvialshield'6)finisheddruglabels.Elulionvialsin5ccand20ccsizesareavailableuponrequest.‘initialorderonlyTheTECHNETIUMIc 99mGENERATORshouldnotbeusedaftersixteen(16)claysfromthedaleandtimeofcalibration.

Jointlymanufacturedby:CINTICHEM,INC.Tuxedo,N.Y.10987

June,1983and UNIONCARBIDECORPORATION

Tuxedo,N.Y.10987PregnancyCategoryC

AnimalreproductivestudieshavenotbeenconductedwithTechnetiumIc 99cmII isalsonotknownwhetherTechnetium

TECHNETIUM 99m

GENERATORSTechnetiumIc 99mGeneratorsfortheProduction

of Sodium Pertechnetate To99m

//

,/

//

,

,

Medironic @MedicaI[)ataSystems2311GreenRoad,AnnArbor,Ml 48105 /

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apexECTRotation Control for Specialized NeedsIn Continuous mode, variable rotation speedenables optimum scan selection. Arc is alsoselectable, up to 540°,with full cableprotection through electronic auto-stop.In Step-and-shoot mode, rotational steps arecomputer controlled. A 180°arc begins andendsat any operator-selectedposition.

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Elscint: leader in Nuclear Medicine with theworld's first digital systems. Today, still in thelead—with the world's bestsystemfor SinglePhoton Emission Computerized Tomography:Apex 415 ECT.Apex ECTincludesfar-aheadfeatures:vastcomputer power, circular or elliptical rotation,fully flexible clinical reporting, and operatorselectable Continuous or Step-and-shoot

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apexECTUniversal NM SystemApex ECT is an easily-positioned conventionalsystem, a capable single- or dual-pass wholebody scanner —above or below the table —and an exceptionally versatile, fullyupgradeable rotational ECT scanner.

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16A THE JOURNAL OF NUCLEAR MEDICINE

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Areyourdiagnosticimages

A diagnosticimageshouldtell youthe truth.Nexttimeyou'rereadingthe specificationsona nuclearimagingsystem,watchfor wordslike“compensated,―“selected,―or “operatorcalibrated.“Thesewordsmay be tellingyouthatwhatyouget may not be what you're looking for.

SiemensNuclearImagingSystemstellyouthe truth...Someyearsago, SiemensintroducedZLC@Mthe innovativeenergyand linearitydistortionremovalsystem.ZLCcorrectsintrinsicenergyvariations and spatial non-linearities—themajorcausesof non-uniformitiesin gammacameras.

. . . the whole truth...

DIGITRAC@Mthe newestinnovationin SiemensCameraSystems,is a microprocessorcontrolledPMTgain adjustmentcircuitincorporatedin the detector.DIGITRACautomaticallyadjusts individualPMTgain(ordrift)so that gamma ray photopeaksarepreciselyalignedthroughoutthe camerafieldof view.Usingnuclearradiationas the primarystandard,the camera is recursivelycalibratedfor the isotopebeing imaged.

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Why accept“cosme&aHy―manipulatedimages.

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DIGITRACTMNewtechnologythat makeseverythingelse somethinglessthan

“stateof the art―ZLCwith DIGITRACis the step forwardthatmakesall previouscameratechnologyobsolete.Here'swhatZLCwith DIGITRACoffers:S Improved image quality by precisephotopeak“windowing―—allowingincreasedtargetto backgroundratio. Exclusive system diagnostics to increasepatientthroughputand to allowmaintenanceof maximumsystemperformance. The ability to schedule service when it'sconvenient...becauseyoualwaysknowthestatusof yourPMT'S. Minimalsystemdowntime. Reliable quality control informationS Consistent system performance—monthaftermonth,yearafteryear

Note. Images shown are enhanced for graphic presentation only

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NewZLCLowEnergySmallAreaCamera•Lightweightdesign for easymaneuverability. Add-ondataprocessingforcompletesystemcapabilities. Hardcopyreadouton8―x10―film. ECGgatingavailable. ExpandedcountratecapabilityImproved LEM RZLC Low EnergyMobileCamera.@ rotationalcolumnswivelsforcritical patientpositioningwithlightweightdesign•Uniquepowerdrivefor easiermaneuverability. ZLCwithD1GITRACforimageintegrity

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NOWAV/@JLABLE

Intheevaluationofpulmonaryperfusion

TechnetiumTc99mA@bum@nAggregatedKitAS

ASPOSSIBLE

Morethan90% ofparticlesinoptimal10 to 90 micron rangeTheoveragesizeis20 to 40 microns...and noparlides are greater than 150 microns. You'll get excellent images throughout a full 6 hours afterreconsfitutlon. Meets all your lung perfusion evalualion needs .. .scheduled or stat. Reconslitullon time. . . only 6 minutes.

Morethan80% lunguptakeforreliablebiologicalefficacyLow supernatant activdy (SA)and very high radiochemical purity (RCP)help assure biological efficacy you can depend on time after time.

Pleaseseeadjacentpage forbriefsummary

TheonlyMAAproductIndicatedforuseinisotopicvenography

blI@FreeTechnIcalCustomerServlce/1-800-257.5181/NewJersey/1.800-582.5913

Volume 25, Number 10 21A

SQU1BW, Diagnostics

©SQUiBBTMaDiagnosticsNew

Brunswick,NJ08903C1954ERSquibb&$on@k@cPdnceto@NJ08540 604.502 Sspt1954

DESC@PTIONMacrotec Is a sterile, nonpyrogenIc@Iyophlllzed preparation ofalbumin aggregated Each5m1vial of Macrotec contaInst5 mgof ftJbumlnAggregated, 10.0mgi4JbumlnHuman,O06m9 (minimum)stannouschloride(maximumstannicandstannouschlorideUl6mg), 1.8mg of sodIumchloride with trace amountsof sodiumacetata aceflc acid and hydrochloric acid Macrotec containsno preservatives.ThepH of the reconstitutedproduct isbetweenaeanci&Q

Theaggregated particlesare formed by denaturatlonof AJbummHumanIna heatingandprecipitaffonprocess.Eachvialcontalns1-8millIonparticles,90%of whichare between10and 90micronsin size.Theaverage sizeIs20to 40 mIcrons;no particlesaregreaterthan150microns.

Reconstitutionof Macrotec with sterile sodium pertechnetateTc99mformsan aqueous suspensionof TechnetiumTc99mftJbummAggregated for diagnostic use by intravenousinjection.Nolessthan 90%of the pertechnetate Tc99madded to the reactionvial isbound to the aggregates at preparation time and remainsbound throughoutthe 6-hourlifetimeof the suspension.INDICATIONSANDU&@GELungImagingMacrotec (TechnetiumTc99mAibuminAggregated Injection)isalung imaging agent which may be used as an adjunct In theevaluationofpulmonaryperfusioninadultsandchildren.Itisuseful in the early detection of pulmonary emboll and in the evaiualion of the statusof the pulmonary circulation In suchconditionsas pulmonary neoplasm, pulmonary tuberculosis andemphysemaisotopicVenographyMacrotec isalso indIcated for use in isotopic venography as anadjunct in the screening, diagnosisand management of deepveinthrombosisin the lowerextremmes.

Combined Isotopic venography of the lower extremitiesandthe pulmonaryvasculaturemay be performed

@ONTRAINDICATI0NSTechnetium1c99mAlbuminAggregated injection shouldnot beadministeredto patientswithseverepulmonaryhypertension.

Theuseof TechnetiumTc99mAlbuminAggregated Injection iscontraindicated In personswitha historyof hypersensitivityreactionsto productscontaining humanserumalbumin.WARNINGSThe literaturecontainsreportsof deaths occurringafter theadministrationof frJbuminAggregated to patientswith pre-existing severepulmonary hypertension.Instancesof hemodynamicor Idiosyncraticreactionsto preparationsof TechnetiumTc99mi'JbumlnAggregatedhavebeenreported

@ONSGeneralInpatientswithri9htto leftheartshunts,additionalriskmayexistdue to the rapid entry of AJbuminAggregated into the systemiccirculation.Thesafetyof thisagent Insuchpatientshasnot beenestablished

Hypersensitivityreactionsare possiblewhenever proteincontaining materials such as pertechnetate labeled AlbuminAggregated are used in man. Epinephrine,antlhlstamlnesand corticosteroldsshouldbe kept available for Immediateuse

TheIntravenousadministrationof any particulate materialsuchasAlbuminAggregated Imposesa temporary smallmechanicalimpediment to blood flow.Whilethiseffect isprobably physlologicailyInsignificantin mostpatients,the administrationof AlbuminAggregated is possiblyhazardousIn acute car pulmonale andotherstatesof severelyImpairedpulmonaryblood flow.

Thecomponents of the Macrotec (TechnetiumTc99mAlbuminAggregated Kit)are sterileand non-pyrogenic It is essentialtofollowdirectionscarefullyand adhere to strictasepticproceduresdurIngpreparation.

Contentsofthe vialare intendedonlyforuseinthepreparationofTechnetiumTc99mAlbuminAggregatedInjectionandareNOTtobe administereddirectlytothepatient

Thecontentsof the kit before preparation are not radioactiveHowever,after the sodium pertechnetate Tc99misaddec@ode

quoteshieldingofthefinalpreparationmustbe maintainedThetechnetiumTc99mlabeling reactionsinvolveddepend on

maintainingthestannousIonInthereducedstateHence@sodiumpertechnetate Tc99m containing oxidants should not beemployed

Thepreparation containsno bacteriostatic preservative TechnetlumTc99mAlbuminAggregated Injectionshouldbe storedat2-8°Cand discarded6 hoursafter formulation.

TechnetiumTc99mAlbumin Aggregated Injection is a physically unstablesuspensionand consequentlythe particles settlewith time.Failureto agitate the vial adequately before usemayresultinnon-uniformdistributionof radioactive particles.

If blood isdrawnIntothe syringaunnecessarydelay priortoInjectionmay resultinclot formation.

Radiopharmaceuticalsshouldbe usedonly by physicianswhoarequalifiedbytrainingandexperienceinthesafeuseandhandllngof radlonuclidesand whoseexperienceand traininghavebeen approved by the appropriate governmentagency authorizedto licensethe useof radlonucildes.

Asin the useof any other radioactive material,care shouldbetakento minimizeradiationexposureto patientsconsistentwithproper patient management,and to minimizeradiationexposuretoclinicalpersonnel.Carcinogenesis,Mutagnssls, Impairmentof FertilityNo lang-term animal studieshave been performed to evaluatecarcinogenic potential or whether TechnetiumTc99mAlbuminAggregated Injectionaffectsfertililyln malesor females.PregnancyCategoryCAnimal reproduction and teratogeniclty studieshave not beenconducted with TechnetiumTc99mAlbumin Aggregated Injectlon. It isalso not knownwhetherTechnetiumTc99mAlbuminAggregated Injection can cause fetal harm when administeredtoa pregnantwomanorcan affectreproductivecapacityTherehave been no studiesIn pregnantwomen.TechnetiumTc99mAlbuminAggregatedInjectionshouldbe given to a pregnantwomanonly if clearly needed

Ideally examInationsusing radiopharmaceuticals, especiallythoseelective In nature,of a woman of childbearing capablllt@shouldbe performed during the firstfew (approximately10)daysfollowingthe onsetof menses.NursingMothersTechnetiumTc99m is excreted In human milk during lactation.Therefore,formulafeedings shouldbe substitutedfor breastfeedings.PediatricUssThe lowest possible number of particles should be used in theright-to-leftshunting,in neonatesand in severepulmonarydiseaseADVERSEREACTiONSAlthoughadverse reactionsspecifically attributable to the TechnetlumTc99mAlbuminAggregated Injectionhave not beennoted,the literaturecontainsreportsof deathsoccurringafter theadministrationof AlbuminAggregated to patientswIthpre-existlogseverepulmonaryhypertension.Instancesof hemodynamicor Idiosyncraticreactions to preparations of TechnetiumTc99mAlbuminAggregatedhavebeenreportedHOWSUPPUEDMacrotec (TechnetiumTc99mAlbumin Aggregated) is suppliedasa kitcontaining10reactIonvials(5ml sIze@

22A THE JOURNAL OF NUCLEAR MEDICINE

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GivesYou:

Volume 25, Number 10 23A

the problem..@EOPOROSIS

Precise, Repeatable MeasurementThroughSingle-PhotonRectilinearForearm Scanning Of Both CorticalandTrabecularBoneNow,forthefirsttime,aneasy-to-use,highprecisionosteoporosisscreeningprocedureisavailableforclinical use for patientmonitoringandmanagement.WiththeND1100 BoneDensityScanner,bonemineralcontent (mass),canbe measuredquicklyandinexpensively,providingvaluableearlydetectionoftheonsetor development of osteoporosis or other metabolicbonediseasesanddisorders.Utilizingan improvedsingle-photonbone densitometry systemwith rectilinearscanningof bothtrabecularandcorticalboneof theforearm,theND1100isthe high-precision,low-radiationinstrumentyou'vebeenlookingfor.Bestof all,oncebaselinedataisestablishedfor a patient,minutechangesin bonemineralcontentwhichmayocaurin a relativelyshortperiodoftimecanbemonitored.Usefulfor: Non-invasivescreeningforpatient

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Used successfully inresearch for 15 years, the singlephotonabsorptiometrytechniqueis nowavailableforclinicalosteoporosisscreening.The ND1100 givesyou a newdimensionfor osteoporosismeasurementand monitoring.Thisin vivoprocedureis reimburseablebyMedicare.

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Theall-digitalnuclear medicine department is a realitytodaywith CDA'sMaXDELTATMimagingand informationsystern.This fullyexpandable, multi-usersystemwillhandleallofyour department's current and changing requirementsfromthe most advanced imagingto patient registrationandscheduling,increasing the productivityofyour departmentand irnproving the quality ofthe information on which yourphysiciansmust relyto make rapid and accurate diagnoses.

Asthestateof nuclearmedicineadvances,ourMaXDELTAsystem moves in tandem. ..readyto interfacewith the most advanced SPECF imaging equipment, tospearhead the next major technological thrust in imagingand information.We'vebuilt the future into everyMaXDELTAsystem.Our unique building block concept enables youto expand your system simplyby adding disks and otherexpansion peripherals. Our unique imaginglanguage,MEDICL,TMformsthe base on which to build a whole newlevelofapplications software.Andour advanced systemsdevelopmentgroup is constantlyworking to expand theboundaries of imagingtechnology.CDAis committed tothe needs of nuclear medicine.

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TheBRAIlLER-DETECToffersyoufullyoufomalic R-wovetriggeringand iscompatiblewithall nuclearmedicine computers. Inaddition, the model 211has a stripchart with EKGand event marker mdicafingtheexactlocalionofthe P-DETECTsignal.

SpecialFeatures. FullyautomaticthresholdS Only Iwo electrodes. Highhearfratecapabilily . , . ideal for stresstesling. SelectablePVCrejectionS Digital heartrate readout. Pacemakerpulserejection. FlashingLEDindicatesQRS. LEDindicatesfauliyelectrodeconnections. AnalogECGoutputS Compatible with all nuclear medicine computersS Stripchart with EKG and R-DETECTevent marker (model 21 1 only)

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TheCRC-3OBCisspecificallydesignedtoprovidethe

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CAPINTECCAP-RIATM16SYSTEMWhen you need a high quality radioimmunoassaymeasurement and data handling system count onCap-RiaTM16.

TheCap-RiaSystemisdesignedfor:Computation: Allows a set of assay standards and test

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Analysis: Allows the user to analyze tabulatedand graphic records of the controlresults obtained for each of the last40 assay runs.

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Volume25,Number 10 29A

IS ••

TE 11 RADIOLOGYSome nuclear medical scans may require on-the-spotdiagnoses. Because Slow-Scan Television (SSTV) transmits images by ordinary telephone, you can review scansand make preliminary diagnoses even when you are not atyour primary location. With the visual assistance of SSTV,imaging specialists can order additional tests if necessaryor recommend that treatment proceed. There is little delay,regardless of your location.

Whether used for on-call emergency duty or providingservices to multiple locations, Colorado Video equipmentprovides reliable and efficient delivery of X-rays, CT,nuclear or ultrasound scans with the detail needed to makepreliminary diagnoses.

Portable units -- durable and easy to use -- travel nearlyanywhere and connect to a telephone jack and a powersource.

Colorado Video has been helping medical imaging professionals increase the efficiency of their work through theuse of teleradiology. Call us to learn how visual communications delivered by telephone can help you and yourinstitution.

ro I@RA@ @IIni: Box928,Boulder,Colorado80306USA‘— I-, V U t-JI_ (303) 444-3972 TWX 910-940-3248 COLO VIDEO BDR

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. Measures activity, calculates concentration and

performs @Moassay.

I Calculates and prints out the concentration and

volume for any desired dose, corrected fordecay, at 30-minute intervals.

. Calculates syringe volume required for a patient

dose.

S Provides permanent printed record of date,

time, radioisotope, activity, concentration,syringe volume, @Moassay result and decaychart.

. Measures background and automatically

subtracts it from all radioisotope measurements.

. Enters and prints patient's ID number.

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ThemostimportantinstrumentInyourdepartmentIDAYbe the te]ephone. Unlees it rings—un]ese olin!clansreferpatienteforstudies—thereis nonuclearmedicinepractice.

UndertodaybDRG@.ba@edpaymentsystems,obtalniTIgand maintainingreferralshas becomeevenmoreimportant.Hospitalsare enooura@ngtheircliniciansto minimizethe numberoftests theyorder,selectingthosethat are mostdefmnitive,thaZanswerthe diagnosticquestionin the shortesttime,at the lowestcost.

Howcancliniciansknowwhichtests meetthese criteria?

SupportingNuclearMedicineAtNEN/DuRnt weshareyourbeliefin nuclearstudies.Weunderstandthe@.contributionsthese noninvasivestudiesmaJ@etoquaiitymedicalcareT@knowwhichstudiescserveas low-cost@whichcanbereasilyonan cbasis,whichclansthe procedureofchoicethey seek.

Andwecanhelpyoupresent the casefornuclearmedicinetoyour administratorsand i@ferrthgclinicians.

@brmanyyears,NEN/DuIbntha@supportednuclearmedicinewithteachingprogramsand

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HelpingCliniciansChooseThiseasy-to-usemanualexplainsthe Indications

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tests are reducedandthe patlenthstay

canbe shortened.In additIon@the Glinician@Guidecontainsinformationusefulte

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patientsbeforeandafter their nuclear

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NEN Medical Products @IJIPUt@CallToli-Free:800-225-1672(In Mass.and International:61?-482-9595)@'@―

In responseto a needfor standardizingthe learningexperiencesof student technologists,the LaboratoryManualfor NuclearMedicineTechnologyhas beenpreparedfor nuclearmedicinetechnologytrainingprograms.The exerciseswerewritten by educatorswithyearsof experiencein their respectiveareasof expertise and were field tested by technologistsin nuclearmedicineschools—bothinstructorsand students.

Thismanualwill serveto enhancethe student'sknowledgeof a standardcurriculumanddevelopcornpetencyin clinical practice. It providesthe mostcornprehensivetraining resourceavailableto be usedin alaboratory setting. In addition, this manual will aidresidents in fulfilling the NRC requirements forlicensure.

ABBREVIATEDCONTENTS

Part I: Radiation Safety

lead.

Part II:Part III:Part IV:Part V:Part VI:

Offering optically clear,360 degree visibility,Nuclear Pacificsyringe shields are safe, lightweight and easyto handle. Equally important,their professional appearance reduces patientanxiety.

Usedextensively by hospitalsworld-wide,their anti-roll, no-leak design reduces radiationexposureof99mTcbyafactorof6 HVL.Modelsfor icc, 3cc, 5cc, and 10cc syringeswith orwithout Luer Locks are available.

Remember,for30yearsNuclearPacifichassetthe standard for visibility and protection in theradiationshielding industry.

NuclearmciIic,inc.@iD$ “4'

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InstrumentationPhysicsRadiopharmacyRadiochemistryPatient Care

Softcover format, 8½x 11“,163 pp.Publicationdate: July 1984

ORDER NOW!$12.00 per copy. Add$2.50postageandhandlingfor eachbook ordered. Ifordering in bulk quantities, contactthe Order Dept.for postagefees.Prepaymentis requiredin USfundsdrawnon USbanksonly. No foreignfundsare accepted.For paymentsmade inUS dollarsbutdrawnon a foreignbank,add a bankprocessingfeeof$4.50 for Canadian bank drafts or $40.00 for all otherforeign bankdrafts.Checkor purchaseordermustaccompanyall orders.Makechecks payable to:

The SocIetyof NuclearMedIcIne,TechnologistSection,475 Park Ave. South, New York, NY 10016(212-889-0717)

Pricesarein USdollarsandsubjectto changewithoutnotice.

NEW!Lookintothissyringeshield!Its high visibility lead glass offerstheradiationprotectionofsolid LABORATORY

MANUALforNuclearMedicineTechnologyEdited by Wanda M. Hibbard,CNMT,and Sue P. Lance,CNMT

A Patient's Guideto Nuclear Medicine

Educate your patients with ...2 Patient Information Pamphlets

A Patient's Guideto Nuclear Medicine

Well illustrated, this 16-page pamphlet explains what nuclear medicine is,how the procedures are performed, and how they can help in the earlydetection of disease.

Divided into 3 sections, the guide opens with a general overview ofnuclear medicine. A question-and-answer section follows, addressingsuch topics as safety, the benefits of nuclear medicine procedures, pre

and post-instructions, and testing of pregnant women and children. Thethird section explains some of the more commonly performed proceduressuch as bone, liver, lung, heart, and thyroid uptake scans.16 pp 5@/2x 81/2;in 2 colors;2Oc@per pamphlet; minimum order: 100 copies

Guidelines forPatients ReceivingRadioiodine TreatmentPrepared in collaboration with the U.S. Nuclear Regulatory Commission,this 8-page pamphlet answers patients' questions about home care afterreceiving radiolodine treatment for thyroid conditions.

Easy-to-read language outlines important precautions patients canfollow to help reduce radiation exposure to others. It also contains achecklist that physicians can review with their patients to determine whichguidelines are appropriate for them and how they should be followed.8 pp 5'/2X 8'/@;in 2 colors;

___________________ 30@per pamphlet; minimum order: 25 copies

Healthcare professionals in private practice, hospitals, and clinics will findthat these pamphlets provide a brief, attractive, and inexpensive way to educate patients and their families about the importance of proper health care.

ORDERING INFORMATIONSingle copies are available for review at $1.50 each. All prices include postage and handling. Prepaymentrequired in U.S. funds drawn on U.S. banks only. Make checks payable to: The Society of Nuclear Medicine.

Prices are in U.S. dollars and subject to change without notice.

THE SOCIETY OF NUCLEAR MEDICINEBook Order Department, 475 Park Avenue South, New York, NY 10016

Guideline. forPatients ReceivingRadioiodine Treatment

Volume25,Number 10 35A

$@“.

208 pp; 6 x 9 “softcoverPublication Date: June 1984

$12.00per copy

12 . Inflammatory and Infectious Processes

13. Cancer

Other Contributors: Manuel L. Brown, MD, Frederick L. Datz, MD,

Leon S. Malmud, MD, Isaac C. Reese, PhD, Barry A. Siegel, MD,JamesA. Sorenson,PhD,LeroyA. &igarman,MD,AndrewT.Taylor,Jr., MD, Heidi S. Weissmann, MD, Henry N. Weilman, MD

. . . a basic introductory guide to acquaint medical students

and physicians with the most useful nuclear medicine techniques for detecting and evaluating common disorders.

8. Genitourinary Tract

9. Skeletal System

10. CentralNervousSystem

Imaging Disease Processes

11. Trauma

Nonimaging Diagnostic Techniques14. Nonimaging Procedures

Appendix

Glossary

Index

OrderingInformationAdd $2.50 postage and handling for each book ordered. Prepayment required in U.Sfunds drawn on U.S banks only. For payments made in U.S dollars, but drawn on a foreign

bank, add a bank processing fee of $4.50 for Canadian bank drafts or $40.00 for all other

foreign bank drafts. Check or purchase order must accompany all orders. Make checks

payable to: The Society of Nuclear Medicine. Prices are in US. dollars and are subject to change

without notice.

The Society of Nuclear Medicine475 Park Avenue South, New York, NY 10016 (212)889@O717

36A THE JOURNAL OF NUCLEAR MEDICINE

FundamentalsofNuclear MedicineEdited by

Naomi P Alazraki, MD,and Fred S. Mishkin, MD

AbbreviatedContentsRadiation in Perspective

1. BasicScienceof NuclearMedicineRadiation and Dose

Radiation Effects

Imaging of Radiation

2. The Diagnostic Process and Nuclear MedicineSensitivity, Specificity, and Prior Probability

Organ Imaging With Radionuclides

3. Thyroid Uptake and Imaging

4. CardiovascularSystem

5. PulmonarySystemand Thromboembolism

6. Liver and GastrointestinalTract

7. Biliary Tract

XE 127 + XENAMATIC@ = THE SOLUTION

THE PROBLEM:You would like to do the lungperfusion imagesfirs4 lookattheimagesanddecideifa ventilation study is called for.

THE SOLUTION:Xenon 127. Its higherenergiesallow effectiveelimination ofTc 99m gammasfrom subse•quent ventilation images.

THE PROBLEM:The short half-life ofXenon 133 makes availability aproblem, increasesshipping costs,andwe lose much of it through decay.

THE SOLUTION:Xenon 127. Its 36 day half@llfeeliminates theinherentproblems ofshort llvedXenon 133.

THE PROBLEM:Xenon delivery systems currently beingoffered are not sufficiently shielded forXenon 127.

THE SOLUTION:The XENAMATIC Xenon Gas DeliverySystem with the optionaiXenon 127 leadshielding. Additional lead is providedthroughout the unit. In strategic locationswe provide up to 1/2 inch of lead. Ourgoal to achieve a radiation level of lessthan 2 mr/hr at the surface under normaluse conditions.

THE PROBLEM:Xenon Traps are really delay systems. If itdelays the Xenon long enough for it todecay, then it approaches a trap infunction.With Xenon 127, activated charcoal trapseither must be significantly larger thanpreviously available traps or they must berefrigerated.

THE XENAMATIC@Is THEONLYANSWER!For more information, call or write today:

DIVERSIFIED DIAGNOSTIC PRODUCTS, INC.11603 WindfernHouston, TX 77064 37A(713) 955@5323

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The XENAMATIC. Our Xenon TrapCartridge Pack offers 20 feet of contin'uous activated charcoal pathway (3―indiameter) via nine individual tubes con•nected in series. Additionally, the mdividual tubes are specially constructed toinhibit the normal redistribution of“trapped―Xenon which occurs evenwhen the trap is not being used.

CURRENTISSUESIN NUCLEARMEDICINE

FT@IA—AManagementProgramForYouHere@howitworks.YourNEN/DuRnt representativewillhelpyoucollectsuch dataas costs forper@sonnel,suppliesand instrumentation,the numberand kindofstudiesyouperformand the timethe

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Efficientdepartmentalmanagementis nolongeranelectiveprocedurefornuclearmedicine.

Inthe cost-consciousenvironmentoftOdayshospital,administratorsare lookingmorecarefullyatdepartmentalbudgets.Atthe sametime,ai@,endingphysiciansare orderingtests moreselecthre]@basingtheir decisionsbothonthe diagnosticinformationtheyneedand the cost-effectivenessofthe study.

YourThismeansthatyou arebeingaskedtobecomemoreofa businessman,addingtermslike“efficiency―and“productivity―toyourmedica'vocabulary.Nowyouhavetoknowthe real operai@ingcostsofyour department.What,forexample,doesit costtoperformabonescan? Ora thalliumstudy?Aremostcosts attributableto staff?@Ebequipment?Orto supplies?Canchangesin scheduling,inventoryor piu@eduremixreducethese costs?

AtNEN/Dul@ntwe@vedevelopeda computer-basedprogramtohelpyou@determineand ana]yzecosts.Then,youcan usethe resultsto increasepiuluctivityin yourdepartment.Ith called @nancialManagementAn&ysis(!@MA)andft@availableto all our customers.

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39AVolume 25, Number 10

PLACEMENTUniversity of KuwaitHealth Science CenterFacultyofAlliedHealthSciencesandNursingAppointmentsin RadiologicSciencesApplicationsareinvftedforteachingpostsintheRadiologicSciencesProgram.ThisisaUniversity.baseddegreeprogramw@hspecialtytracksindiagnosticradiography,nuclearmedicineandradiationtherapy.PracticaltrainingiscarriedoutinthehospitalsoftheMinistryofPublicHealth.ThelanguageofinstructionisEnglish.Allappointeeswilltakepartintheoreticalandpracticalteaching,anddevelopmentandmanagementoftheprogram.

1. AcademicDirectorin DiagnosticRadiographyCandidatesmusthaveextensiveexperienceofteachingandclinicaleduca@tioncompetenceevaluationinanAmencan@stylecurriculum

2.AcademicDirectorinNuclearMedicineCandidates'teachingandclinicalexpenencemustbeinNuclearMedicine,andtheymustbeabletomakeasignificantconttibutiontothemanagementoftheNuclearMedicineDepartmentintheUniversityTeachingHospftal.

3.AssistantDirectorinBasicRadiographyCandidatesmusthaveclinicalexpertiseandteachingexpenenceinQualityAssurancetestingandequipment.

GeneralRequirementsforAppointment:1. CandidatesmusthaveaB.Sc.orhigherprofessionalqualificationfroman

appr@dRadielog@Sciencesprogram.kadem@cDirectorcandieatesmustalsohaveahigherdegreeinarelatedfield.

2.Licensetopracticetheprofession.3.AssistantDirectorcandidatesmusthave5years'professionalexperience

foH@in9qualiñcation,includingatieast2@ara'full@timeequivalentteachinginthisfield.AcademicDirectorcandidatesmusthay10years'professionalexperiencefollowingqualification,includingatleast3yearsadministrativeexperience,andatleast5yearsfull-timeequivalentteachingexperienceinthisfield.

4.AssistantDirectorcandidatesmustdemonstrateabilitytoconductresearchinRadiologyorrelatedfields.kademicDirectorcandidatesmusthavepub.lishedoriginalworkintheirfield.

5.Candidatesmusthavecontinuingeducationexperience.

ConditionsofAppointment:1.Totalmonthlysaiaiywillbewfthinthefoll@ingscales,accordingtoqualifica

tionsandexperience:kademicDirector:KD570—720AssistantDirector:KD470-620

(KD1=£2.3U.S.$34approximately.)InadditiontherewillbeamonthlysupplementofKDlOOfor10monthsa@ar,paidbyMinietryofPublicHealth.ThereisnoincometaxinKuwaftandcurrencyietransferrabiewfthoutrestric@tion.

2. Free,furnished,air-conditionedaccommodationisprovided,andelectricityandwatersuppliedfreeofcharge.

3.Sixtydayspaidsummerleaveforeachcompleted@earofempl@'ment,plusvariousnationalholidays.

4. Annualeconomyciassretumairticketstothecountryofcftizenshiporpermanentresidencearepr@idedfortheappointee,spouse,andthreedependentchildrenunder24.

5. End-of-servicegratuityofhalf-month'ssalaryforeachcompletedyearofemploymentupto5years,andonemonth'ssalaryperyearthereafter.

Ap@ican@sho@dsendapplicationsindupbcate,indudingfullcufflculumvitae,2recentpassportphotographsandthenamesandaddressesofthreereferees,to:

TheDean,Department17FacultyofAlliedHeafthSciencesandNursing

P0.Box31470SulaibikhatKuwait

ToarrivenotlaterthanNovember15,1984.

POSITIONS OPENCERTIFIED NUCLEAR MEDICINE TECHNOLOGIST. 445-bed acute

care medical center hasan opening for a Certified Nuclear Medicine Technologist. Full rangeofnuclear medicinetesting includingnuclearcardiology.Sendresume to: Personnel Department, Winchester Medical Center, Inc. , S. StewartSt. , Winchester, VA 22601. EOE.

DISTRIBUTOR. Major U.S. manufacturer of radiopharmaceuticals andreagents for diagnostic imaging seeks qualified distributors in selected countries.Contact: International Sales Department, Box 6950, Richmond, CA 94806.

FELLOWSHIP IN NUCLEAR MEDICINE. One year program availableto Board admissable or BC internists, pathologists or radiologists with emphasison any or all aspects ofnuclear cardiology, nuclear oncologic imaging or generaldiagnostic nuclear imaging. Fulldetails available upon request. Available July1, 1985.Contact: J.A. Prezio, MD, Program Director and Acting Chairman,Dept. ofNuclear Medicine, SUNY/Buflilo, 3495 Bailey Avenue, Building 5,Buffalo, NY 14215.

NUCLEAR MEDICINE PHYSICIAN WANTED.Welltrained and experienced Board Certified Nuclear Medicine Physician with Board Certificationor Board Eligible in internal medicine who has been in solo practice of nuclearmedicine (non-subsidized)for 5-l0years who wouldbe interestedin becominga partner in a successful privately owned outpatient Nuclear Medicine Clinicand lab, fully equipped for in vivo and in vitro studies. Includes private officewith Technical and Mministrative Staff. Must be willing and capable of assuming adminstrative and technical responsibility. Medical School affiliation possible ifdesired. Please send resume to: Box 1001,Society of Nuclear Medicine,475 Park Ave. So. , New York, NY 10016.

NUCLEAR MEDICINE TECHNOLOGIST. lksition now available for anexperienced Nuclear Medicine Technologist certified by SNM or registeredtechnologist in a private progressive outpatient nuclear medicine laboratoryin a large city in a large medical center in the Sun Belt. Knowledgeof radioimmunoassay, imaging, computer, and nuclear cardiology in addition to supervisory, administrative, and teaching experience required. Please send resumeto: Box 1000, Society of Nuclear Medicine, 475 Park Ave. So. , New York, NY10016.

WANTED: PHYSICAL SCIENCE TECHNICAL ASSISTANT.40 hoursper week, 7 am. to 3:30 p.m. , $8.87 per hour. Duties: Radiopharmaceuticalpreparation; quality control of radiopharmaceuticals; calibration of detectionequipment; implementationofdaily and period safetyprocedures in the Sectionof Nuclear Medicine; performance ofmeasurements for in vitro tests; data processing of results. Minimum requirements: 4 years college with BS degree orequivalent in physics and 3 months training in nuclear medicine technology.Near wast side Chicago location. Send resume to: Illinois Job Service, 910 SouthMichigan Avenue, 3rd floor, Chicago, IL 60605; Attention: Shirley Chalem.Reference #3718-S. An Employer Paid M.

CUNICAL EDUCATIONCOORDINATOR.Challengingpart-timepositionin a university-based NMT Program. Applicants must be graduates from anaccredited BS degree NMT program and be certified, with 2 yr experience.The position involves periodic travel to clinical affiliation sites within UpstateNew York and occasional instruction. Candidates must possess excellent communicationskills and a demonstratedcommitmentto the field. Toapply,pleasesend resume and transcripts to: Laurie Fuller, Clinical SciencesAcademic Coordinator, Rochester Institute ofTechnology, P.O.Box 98@7,Rochester, NY 14623.

FOR SALESIEMENS PHO/CON-192EMISSION TOMOGRAPHIC IMAGINGSYS

TEM, 140 keV low energy, all purpose collimators, 300 keV medium energycollimatorsand Mirco Dot Imager. Excellentworkingcondition. Contact: Nuclear Medicine Department, William Beaumont Hospital, Ro@l Oak, MI 48072or call: (313)288-8040

TEXASOperator #596

FLORIDAOperator #37

@I I

RADIATION SCIENTISTTheprimaryresponsibilitiesofthispositionaret@fold:topro#ideprofessionalsupport in health physics training by preparing and presenting health physicslectures and related laboratory exercises; and to support the Radiopharmaceuti@cal Internal Dose Information Center by conducting research designed to rnprove techniques used in calculating radiation dose. Requirements: recent PhDin Health Physics or Radiation Biology, or PhD in Science with experience inhealth physics or internal dosirnetry (preferred); or an equivalent combinationofeducation and experience in health physics. Specialized knowledge ofcomputar usage, advanced math biology, internal dosimetry techrnques, nuclear mothcine concepts and nuclear instrumentation necessary. Send resume and salaryhistory and requirements to:

Employment Office

OAKRIDGEASSOCIATEDUNIVERSITIESRO Box 117

Oak Ridge, TN 37831-0117An Equal Opportunity/AffIrmativeAction Employer

AMR CORPORATIONMilford, CT

(203)877-1610 16AA1OMIC PRODUCTS

Center Moriches, NY(516)878-1074 IBC

BAIRD CORPORATIONBedford, MA

(800) 343-4827 1OA, hA

CADEMA MEDICAL PRODUCTSMiddletown, NY

(9h4) 343-7474 26A

CAPINTEC, INC.Ramsey, NJ

(800) 227-6832 29A

COLORADO VIDEO, INC.Boulder, CO

(303)444-3972 3hACOMPUTER DESIGN & APPLICATIONS

Waltham, MA(617)647-h900 24A, 25A

DIVERSIFIED DIAGNOSTIC PRODUCTSHouston, TX

(7h3) 955-5323 37A

ELSCINT, LTD.Haifa, Israel

(800) 343-9504 h4A, h5A

INTERNATIONAL CISCedex, France

(33)3-043-00-09 h2A,h3ALUNAR RADIATION CORP.

Madison, WI(608)258-8545 4A

MEDICAL ELECTRONICS, INC.Boston, MA

(6h7) 536-8300 27A

MEDI-PHYSICS, INC.Richmond, CA

(800) 227-0492 IFC, hA, BC

MEDTRONIC/MEDICAL DATA SYSTEMSAnn Arbor, MI

(3h3) 769-9353 3A

NEW ENGLAND NUCLEARBoston, MA

(800) 225-h572 33A, 38A

NUCLEAR ASSOCIATES! VICTOREENCane Place, NY

(5h6) 74h-6360 32A

NUCLEAR DATA MEDICAL PRODUCTSSchaumburg, IL

(3h2) 884-3636 23A

NUCLEAR PACIFICSeattle, WA

(206)763-2h70 MA

NUCLEAR PHARMACY INC.Albuquerque, NM

(800) 545-6554 8A

PICKER INTERNATIONALNorthford, CT

(203)484-27h1 6A

SIEMENS MEDICAL SYSTEMSIselin, NJ

(20h) 321-MOO h7A, 18A, 19A, 2OA

SNM PLACEMENTNew York, NY

(212) 889-0717 39A, 40A

SNM PUBLICATIONSNew York, NY

(212) 889-0717 MA, 35A, 36A

ER. SQUIBB & SONS, INC.Princeton, NJ

(800) 257-5181 21A, 22A

SYNACO, INC.Palo Alto, CA

(415)856-2422 28A

40A THE JOURNAL OF NUCLEAR MEDICINE

NUCLEARMEDICINETECHNOLOGISTOur 350-bed teaching hospital is seeking a registered orregistry-eligible Nuclear Medicine Technologist to work inmodern,wellequippedlabincluding5camerasand2cornputers.Excellentexperienceandopportunityforcontinuedlearning. Salarycornrnensuratewith experience and excellent fringe benefits. Send resurne by 10/30/84to:

Charles E. Duxbury, ATDivision of Nuclear Medicine

Upstate Medical Center750 East Adarns StreetSyracuse, NY. 13210

An ANEOE Empk,jer

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