Cardiac imaging has benefited from the integration of cardiac PET. Perfusion PET studies are performed using Rubidium-82 and metabolic studies using F-18 FDG. Quantification of perfusion and metabolism is performed on selected cardiac scans using application of mathematics to tracer kinetics and compartmental modeling.

Therapy Training
As part of the clinical radiation safety and radiobiology lectures, NMPITs receive instruction in the use of unsealed sources. This material covers the use of I-131 in the treatment of hyperthyroidism and thyroid cancer, phosphorous-32 in the treatment of polycythemia vera and malignant effusions, and Strontium-89/Samarium-153 for treatment of painful bone metastases. NMPITs also participate in the treatment of patients with lymphoma using Ytterium-90 and I-131 labeled immunoconjugates and the infusion of Y-90 Microspheres for hepatic malignancies.
Clinical Rotations
These are on a month-to-month basis, alternating between the VA, Vanderbilt University Hospital, PET, and nuclear cardiology. Time is also spent in the in-vitro lab and radiopharmacy.
Duties of the NMPIT include:

1. Clinical:

1. Review the QC floods for each camera daily.
2. Review of the schedule and requests for nuclear medicine procedures each morning.
3. Obtain relevant clinical information from computerized medical records and the patient and/or the referring physician in order to evaluate the appropriateness of each study. If the procedure ordered does not appear to be the most appropriate, communicate with the referring physician.
4. Prescribe appropriate radiopharmaceuticals and dose for each patient.
5. Assist the technologist performing the procedure when needed.
6. Review the final images with the technologist before the patient leaves the department.
7. Correlate the nuclear medicine image findings with other diagnostic studies (nuclear medicine, radiology, pathology, etc.).
8. Formulate a preliminary interpretation and differential diagnosis for each patient.
9. Review each procedure with the nuclear medicine faculty for final interpretation and ibox the interpretation on PACS.
10. Dictate the final report on all patients from that day.
11. Communicate the findings to the referring physician when appropriate.
12. Edit the transcribed reports as necessary.
13. For the diagnostic areas of Cardiology, Radiology, and Neurosciences, the Interpreting Provider in the diagnostic area will immediately notify the qualified responsible individual when a critical result is identified. The Interpreting Provider will include the following comment: "notified and discussed with (qualified responsible individual's name) this critical diagnostic report." This documentation must include the name of the person receiving the interpretive report rather than a "location" or "position of the receiving person". In Radiology, we also iBox all of these, especially for the ED.