Orientation/General Concepts of Radionuclide Scintigraphy
1. Assumptions:
(1). None (radiation physics and biology are far beyond the categories of general medicine).
(2). If possibly, rough knowledge of radiology.
2. Objectives: able to describe the general concept of following subjects
(1). Definition of radioactive materials.
(2). Principles and clinically applicable apparatuses of detection of radioactivities.
(3). Similarities and differences between radiology and nuclear medicine.
(4). Comparison of advantages and disadvantages with other diagnostic images.
(5). Approaching examinees: study-specific clinical information for facilitation of image interpretations.
Bone Scintigraphy
1. Assumptions:
(1). Histology and Physiology of bone.
(2). Possibly, basic knowledge of radiography.
2. Objectives: able to describe the general concept of following subjects
(1). Common indications.
(2). Pathophysiology of bone remodeling process: mechanisms of uptake of bone-seeking radiopharmaceuticals.
(3). Three-phase studies.
(4). Manifestations of skeletal malignancies on bone scans
(5). Pearls and pitfalls of interpretation.
(6). Sensitivity, Specificity and Accuracy: combined interpretations with other more disease-specific imaging studies.
Myocardial Perfusion SPECT
1. Assumptions:
(1). Anatomy of heart.
(2). Coronary vascular innervation.
(3). Energy provision: general concepts of cardiac nutritional utilization.
(4). Possibly, basic knowledge of tomography.
2. Objectives: able to describe the general concept of following subjects
(1). Common indications.
(2). Cardiac stress and coronary arterial reserve.
(3). Common scenarios of coronary artery disease: relation of symptoms, signs and manifestations among various medical examinations in different stages.
(4). Accommodations of stenotic vessels versus ischemia.
(5). Comparison of digital-subtracted X-ray angiography, multi-row multi-detector X-ray tomography and myocardial perfusion SPECT.
(6). Single Photon Emission Computed Tomography (SPECT).
(7). Mechanisms of radiotracer uptake: presence or absence of redistribution.
(8). Dual-phase studies and image interpretation.
(9). Myocardial scar versus hibernating myocardium.
Inflammation Scan
1. Assumptions:
(1). Physiology: inflammatory response of microbes and neutrophils.
(2). Human physiological distribution of iron.
(3). Chemistry: chelating agents.
2. Objectives: able to describe the general concept of following subjects
(1). Common indications.
(2). Mechanisms of uptake of commonly used radiotracer.
(3). Selection of radiopharmaceuticals: complexity of clinical consideration, financial consideration, availability of radiopharmaceuticals and availability of instrumentations.
(4). Interpretations: combination of multi-discipline image findings, interventions and current condition of patients.
Positron Emission Tomography
1. Assumptions:
(1). Physiology: the fate of ingested glucose in human.
(2). Possibly, basic knowledge of atomic physics, nuclear physics and radioactive decay.
2. Objectives: able to describe the general concept of following subjects
(1). Production of positron: cyclotron.
(2). Annihilation gamma rays.
(3). PET scanner.
(4). 18F-fluoro-deoxy-glucose (FDG).
(5). Common indications of FDG PET.
(6). Special consideration: current indications of national health insurance coverage.
(7). Combined functional/anatomic image modalities: PET/CT and SPECT/CT.
教學目標Course Objectives
1. 認識核子醫學影像檢查及治療在臨床上之應用。
2. 介紹各項核子醫學影像檢查的檢查方式及所需儀器。
3. 介紹游離輻射在核子醫學上的應用以及輻射防護的概念。
4. 培養實習醫學生對核子醫學的興趣，從中啟發未來有志於核子醫學學門的後進。
1. To know the clinical applications of nuclear medicine imaging examinations and treatments.
2. Introduction of the method and required instruments of nuclear medicine imaging examinations.
3. Introduction of the applications of ionizing radiation in the nuclear medicine and the concepts of radiation protection.
4. To elicit the interests of the students in the nuclear medicine and possibly to inspire the ambition of future career in the nuclear medicine.
先修科目Prerequisites
內科學概論、外科學概論、生理學、病理學、藥理學、一般化學、有機化學、近代物理學。
Introduction to internal medicine, introduction to general surgery, physiology, pathology, pharmacology, chemistry, organic chemistry and modern physics.
教學方式Teaching Methods
案例或故事討論
Case study or event discussion
講課
Lecturing
小組討論
Group discussion
學生實作
Student hands-on practice
評量方式Assessment
實作測驗
Practical exam
實作作品與反思
Practical work and introspection
出席狀況
Class attendance
課堂參與與表現
Class involvement
1. 學生需完成學習護照上要求的項目始得評分。
2. 評分方式：
i. 於學生完成線上學生回饋作業後，臨床教師們以本院之線上教師評分系統依臨床技能、病歷繕寫能力、學習熱忱、工作態度、人際關係及整體印象給分，此部分占核子醫學科考核的100%成績。
ii. 評分者為全體核醫科醫師，分數所佔比例為主治醫師及住院醫師各50%。
參考書目Reference
1. Sandler MP. Diagnostic nuclear medicine. 4th ed. Philadelphia: Lippincott/Williams & Winkins; 2003.
2. Ell PJ, Gambhir SS. Nuclear medicine in clinical diagnosis and treatment. Edingurgh; New York: Churchill Livingstone; 2004.