Nuclear Medicine Technology

Below are the ARRT category specifications for exam coverage.

ARRT Nuclear Medicine Technology exam categories

200 Total Questions
1. Patient Interactions and Management
A. Ethical and Legal Aspects
1. patient’s rights
a. informed consent (*e.g., written, oral, implied)
b. confidentiality (HIPAA)
c. American Hospital Association (AHA) Patient Care Partnership (Patient’s Bill of Rights)
1. privacy
2. extent of care (e.g., DNR)
3. access to information
4. living will, health care proxy, advanced directives
5. research participation
2. legal issues
a. verification (e.g., patient identification, compare order to clinical indication, exam coding)
b. common terminology (e.g., battery, negligence, malpractice, beneficence)
c. legal doctrines (e.g., respondeat superior, res ipsa loquitur)
d. restraints versus immobilization
3. ARRT Standards of Ethics
B. Interpersonal Communication
1. modes of communication
a. verbal/written
b. nonverbal (e.g., eye contact, touching)
2. challenges in communication
a. interactions with others
1. language barriers
2. cultural and social factors
3. physical or sensory impairments
4. age
5. emotional status, acceptance of condition
b. explanation of medical terms
c. strategies to improve understanding
3. patient education
a. explanation of current procedure (e.g., risks, benefits)
b. verify informed consent when necessary
c. pre- and post-examination instructions (e.g., preparation, diet, medications and discharge instructions)
d. respond to inquiries about other imaging modalities (e.g., CT, MRI, mammography, sonography, nuclear, medicine, bone densitometry regarding dose differences, types of radiation, patient preps)
C. Physical Assistance and Monitoring
1. patient transfer and movement
a. body mechanics (e.g., balance, alignment, movement)
b. patient transfer techniques
2. assisting patients with medical equipment
a. infusion catheters and pumps
b. oxygen delivery systems
c. other (e.g., nasogastric tubes, urinary catheters, tracheostomy tubes)
3. routine monitoring
a. vital signs
b. physical signs and symptoms (e.g., motor control, severity of injury)
c. fall prevention
d. documentation
e. immobilization
f. sedation
D. Medical Emergencies
1. allergic reactions (e.g., pharmaceuticals, latex)
2. cardiac or respiratory arrest (e.g., CPR)
3. physical injury or trauma
4. other medical disorders (e.g., seizures, diabetic reactions)
E. Infection Control
1. cycle of infection
a. pathogen
b. reservoir
c. portal of exit
d. mode of transmission
1. direct
2. indirect
e. portal of entry
f. susceptible host
2. asepsis
a. equipment disinfection
b. equipment sterilization
c. medical aseptic technique
d. sterile technique
3. CDC Standard Precautions
a. hand hygiene
b. use of personal protective equipment (e.g., gloves, gowns, masks)
c. safe injection practices
d. safe handling of contaminated equipment/surfaces
e. disposal of contaminated materials
1. linens
2. needles
3. patient supplies
4. blood and body fluids
4. transmission-based precautions
a. contact
b. droplet
c. airborne
5. additional precautions
a. neutropenic precautions (reverse isolation)
b. healthcare associated (nosocomial) infections
1. Radiation Physics, Radiobiology, and Regulations
A. Physical Properties of Radioactive Materials
1. decay of radioactivity
a. atomic structure
b. decay modes (e.g., alpha, beta, gamma)
c. decay rate
d. half-life
e. parent-daughter relationship
2. interaction of radiation with matter
a. photoelectric effect
b. Compton scattering
c. pair production and annihilation
d. internal conversion
e. Auger electron
f. bremsstrahlung
B. Biological Effects of Radiation
1. cellular biology
2. effects of radiation on cells
a. direct and indirect action
b. radiolysis of water
c. LET and RBE
3. stochastic and deterministic effects
4. acute effects of total body radiation
a. radiation sickness
b. hemopoietic syndrome
c. gastrointestinal syndrome
d. central nervous system syndrome
5. long term effects of radiation
a. somatic
b. genetic
6. relative tissue and organ sensitivity (e.g., law of Bergonié and Tribondeau)
7. effects of radiation on embryo/fetus
C. Basic Concepts of Radiation Protection
1. units of radiation exposure
2. principles of time, distance, and shielding
3. personnel protection equipment (e.g., gloves, lab coats
4. personnel monitoring devices
a. types
b. use, care, and placement
6. Release of patients
D. NRC Regulations for Radiation Exposure
1. occupational
2. public
3. pregnancy or nursing
4. internal dosimetry and bioassays
5. personnel exposure records
E. Medical Events
1. definition
2. NRC regulations for reporting and notification
F. Area/Facilities Monitoring
1. Basic Concepts
a. units of measurement
b. exposure rates
c. definition of contaminated area
2. Survey Equipment and Techniques
a. well counters
b. survey meters
c. wipe test technique
3. NRC Regulations
a. frequency of surveys and wipes
b. classification of areas
1. work
2. treatment
3. storage
c. posting of signs (e.g., types, locations)
d. documentation of survey and wipes results
1. interpretation
2. reporting (corrective action)
3. record retention
4. Radioactive Spills
a. major spills
b. minor spills
c. processes for decontamination
d. reporting procedures
G. Radioactive Materials
1. inspection of incoming and outgoing materials (e.g., DOT and NRC regulations)
a. shipping labels
b. measurement of exposure rate
c. measurement of surface contamination
d. removable contamination limits/trigger levels
e. documentation
2. storage
a. radiopharmaceuticals
b. sealed sources
c. consequences of improper storage
3. disposal of radioactive waste
a. release to environment
b. decay in storage
c. transfer to authorized recipient
H. Disposal of Pharmaceuticals
1. expired pharmaceuticals
2. partially used pharmaceuticals
1. Instrumentation
A. Survey Meter
1. operating principles
a. Geiger Müller
b. ionization chambers (cutie pies)
2. quality control
a. frequency and types of checks
b. interpretation and record keeping
B. Dose Calibrator
1. operating principles
2. quality control
a. frequency and types of checks
1. accuracy
2. constancy
3. linearity
4. geometry
3. interpretation and record keeping
C. Scintillation Detector System
1. operating principles
a. well counter
b. uptake probe (e.g., thyroid, surgical)
2. quality control
a. radionuclide source
1. energies
2. type of source
b. parameters
1. energy resolution
2. efficiency
3. high voltage calibration
4. resolving time
5. sensitivity
6. energy linearity
7. chi-square
c. interpretation and record keeping
D. Gas and Aerosol Delivery Systems
1. operating principles
2. exhaust system (e.g., negative pressure, gas traps)
3. interpretation and record keeping
E. Gamma Camera
1. operating principles
2. quality control
a. frequency and types of checks
b. performance characteristics
1. flood field uniformity
2. high count uniformity correction
3. spatial linearity
4. spatial resolution
5. energy resolution (e.g., FWHM)
6. detector sensitivity
7. extrinsic versus intrinsic methods
8. center of rotation
9. SPECT phantom measurements
c. interpretation and record keeping
3. image acquisition
a. detector system
1. count or time mode
2. detector orientation
3. photopeak energy setting and window width
4. multi-energy acquisition
b. collimator selection
1. types (e.g., parallel hole, pinhole)
2. parameters (e.g., energy,resolution, sensitivity)
c. dynamic/static acquisition
1. matrix selection
2. framing (e.g., number and length)
3. gating
4. list mode
d. SPECT acquisition
1. angular sampling/number of views (e.g., 180° versus 360°)
2. matrix selection
3. attenuation correction
4. duration of acquisition
F. PET/CT Scanner
1. PET operating principles
2. PET quality control
a. frequency and types of checks
b. characterization and correction calibration
1. energy window calibration
2. gain setting
3. reference (blank) scan
4. normalization calibration
5. absolute activity (well counter) calibration
c. interpretation and record keeping
3. PET image acquisition
a. 2D versus 3D
b. list mode
c. respiratory gating
d. time-of-flight
4. CT operating principles*
5. CT quality control*
a. tube warm-up
b. CT number (water phantom)
6. CT image acquisition*
a. kVp
b. mA
c. pitch
d. slice thickness
e. noise and uniformity
f. artifacts
G. Data Processing
1. quantitative analysis (e.g., region of interest selection, ejection fraction, time activity curves, SUV)
2. reconstruction
a. registration (image fusion)
b. orientation
c. filter parameters
d. attenuation correction
e. gated images
f. motion correction
3. image management
a. archiving
1. Radionuclides and Radiopharmaceuticals
A. Production of Radionuclides
1. methods
a. reactor
b. accelerator
c. cyclotron
d. generator
2. purity
a. radionuclide
b. chemical
3. physical form (e.g., gas, solution, capsule)
B. Radiopharmaceutical Characteristics
1. method of localization
a. capillary blockade
b. active transport
c. phagocytosis
d. diffusion
e. compartmentalization
f. chemisorption
g. receptor binding
h. antigen antibody
i. filtration
j. metabolism
k. sequestration
2. half-life
a. physical
b. biological
c. effective
3. biodistribution
a. pharmacokinetics
b. critical organs
c. target organs
C. Preparation and Administration
1. kit preparation
a. labeling process
1. principles
2. compounding techniques
3. factors that affect labeling quality
b. shelf life and storage
c. quality control
1. radiochemical purity
2. particle size
3. specific activity (e.g., millicuries per mass)
4. color and clarity
2. calculation of radiopharmaceutical and pharmaceutical dosage
a. units
1. conversions
2. calculations
b. volume determination
1. formula
2. decay tables
3. concentration
4. activity
3. pharmaceutical and radiopharmaceutical administration
a. preparation
1. syringe
2. needle selection
3. shielding
b. radiopharmaceutical label
1. name of radiopharmaceutical
2. assay date and time
3. lot number and expiration date
4. concentration
5. volume
6. activity
c. administration techniques
1. routes
2. aseptic
3. uniform distribution (e.g., mixing, agitation)
4. complications and reactions
5. documentation
2. Cardiac Procedures
A. Gated Blood Pool
B. Myocardial Perfusion
C. Viability
3. Endocrine and Oncology Procedures
A. Endocrine
1. thyroid uptake/imaging
2. parathyroid
3. neuroendocrine
4. adrenal imaging
B. Tumor
1. whole body
4. lymphoscintigraphy
C. Therapy
1. procedures
a. palliative bone
b. thyroid ablation
c. hyperthyroidism
d. non-Hodgkin lymphoma
e. selective internal radiation therapy with hepatic artery perfusion study (HAPS)
2. regulations
4. Gastrointestinal and GenitourinaryProcedures
A. Gastric Emptying
B. Gastroesophageal Reflux
C. Meckel Diverticulum
D. GI Bleed
E. Hepatobiliary
F. RBC Hemangioma
G. Damaged RBC Spleen
H. Liver/Spleen
I. Renal Function
J. Renal Cortical
K. Radionuclide Cystogram
5. Other Imaging Procedures
A. Abscess/Infection
B. Bone
1. planar
2. 3-phase
3. whole body
C. Central Nervous System
1. brain death
4. cisternography/CSF leak
5. shunt patency
D. Lung
1. perfusion
2. ventilation – gas and aerosol
3. quantitative

Nuclear Medicine Technology Exam

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