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Case Study of the Month
Improper Energy Window
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Free Continuing Education
(see article to right)
Anatomy and Physiology Review for Nuclear Medicine Technology - 2009 Update
Cardiac Electrophysiology for Nuclear Medicine Technology - 2007 Update
Correct Coding for Diagnostic Nuclear Medicine Procedures, Part 1
Myocardial Perfusion Imaging - 2009 Update
Stress Testing in Cardiac Nuclear Medicine Technology - 2009 Update
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ACR: Medicare Cuts May Ultimately Cost Lives
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 The American College
of Radiology (ACR) released a statement yesterday charging that medical
imaging cuts contained in the 2010 Medicare Physician Fee Schedule may
restrict imaging services to large hospitals, produce longer commutes
and wait times to receive care, and could cause delays in diagnosis and
treatment of cancer and other serious illnesses. Go to article
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Product Pipeline
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Current diagnosis of Alzheimer's disease is based on cognitive tests that can only indicate a probability of having the disease. A definitive clinical diagnosis of Alzheimer's disease is only possible through a post-mortem autopsy or brain tissue biopsy.
Florbetaben (BAY 94-9172) is an investigational positron emission tomography (PET) imaging tracer. In the global Phase II, open-label, non-randomized, multi-center study, florbetaben was used to detect or exclude the presence of cerebral beta-Amyloid plaques.
Results showed that PET images using florbetaben had a specificity of approximately 90 percent. This means that the florbetaben scan indicated the presence of cerebral beta-Amyloid plaques in approximately 10 percent of the healthy volunteers. The results also showed a sensitivity of approximately 80 percent, meaning that about 80 percent of the subjects with probable Alzheimer's disease had florbetaben scans indicating the presence of cerebral beta-Amyloid plaques. This is consistent with the results of studies where the clinical diagnosis of Alzheimer's disease was compared with the definitive post-mortem histopathological diagnosis. Additional data analysis is still ongoing in this study.
TransMolecular, Inc., a developer of innovative oncology drugs through targeted delivery technologies, recently announced final results from its Phase 2 clinical study comparing the toxicity and overall survival of three versus six intracavitary injections of its anti-cancer compound 131I-TM601 in the treatment of recurrent malignant glioma.
Scientists at the Cedars-Sinai Medical Center in California took a synthetic version of venom of Leiurus quinquestriatus, aka the Giant Yellow Israeli scorpion, labeled it with radioactive iodine (131I-TM601) and found it to be an effective delivery vehicle for targeted radiotherapy against glioma.
TM601 is a novel,
wholly synthetic peptide found to have exceptional tumor-targeting
properties as well as robust anti-angiogenic activity in neovascular
diseases, including cancer. TM601 is highly specific and selective in targeting both primary tumors and metastases in the periphery and in the central nervous system. The peptide has the unique properties of highly specific tumor cell binding, uptake and internalization. Preclinical studies confirm that TM601 targets and binds to Annexin A2, a receptor expressed on a wide range of tumor cells but not on normal, healthy cells. The peptide alone has in vivo anti-angiogenic activity, but can also be labeled for imaging and therapy.
TransMolecular is expanding the TM601 tumor-targeting platform to deliver a range of therapeutic agents to tumor cells, including novel and currently used chemotherapeutic agents as well as RNAi molecules.
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Returning Waste to Radiopharmacy, Inc.
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Title 49 of the Code of Federal Regulations 49 (CFR 49) contains regulations for shippers of radioactive materials. Radiopharmacy is the shipper of orders you receive, but you are the shipper of material returned to us for disposal.
Boxes returned for disposal must be limited quantity (as defined in 49 CFR) and be packaged and labeled appropriately (as specified in 49 CFR). To be a "limited quantity" all three of the following must apply;
- It shall contain no more than the amounts of activity listed below.
- The exposure rate on any surface may not exceed 0.5 mrem/hour.
- Non-fixed (removable) radioactive surface contamination on the external surfaces of the package may not exceed 6600 dpm from a wipe of 300 square centimeters (22dpm/square centimeter).
In order for the package to be labeled properly as a "limited quantity", both cards on the Radiopharmacy delivery cases must be turned over and placed on opposite sides of the box.
As always, if you are unsure of anything regarding returns, please give us a call.
Tc99m - 11 mCi
I-123 - 8.1 mCi
Tl-201 - 11 mCi
In-111 - 8.1 mCi
Co-57 - 27 mCi
P-32 - 1.4 mCi
I-131 - 1.9 mCi
I-125 - 8.1 mCi
Ga-67 - 8.1 mCi
Xe-133 - 270 mCi
Sr-89 - 1.6 mCi
Y-90 - 8.1 mCi
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Coding Webinar
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This webinar will focus on new, revised and deleted CPT and HCPCS codes  pertaining to nuclear medicine in 2010 and how to properly use them. Topics will include the latest information on codes for drug and radiopharmaceuticals; a review of both the Hospital Outpatient Prospective Payment System and Medicare Physician Fee Schedule 2010 final rates, as well as policy changes, and; updates on the newest regulatory requirements from the Centers for Medicare and Medicaid Services that will affect you in 2010.
Upon completion of this webinar, the attendees will be able to:
Understand Final 2010 CPT and HCPCS codes pertaining to nuclear medicine
Learn the 2010 HOPPS and MPFS rates
Understand new regulatory requirements from CMS for 2010
Date: December 8, 2009
Time: 1.00PM - 2.30PM (Eastern)
Speaker: Denise Merlino, MBA, CNMT, CPC, FSNMTS
Cost: Non-members: $185
Members: $150
Group Rate: $400 (up to 10 people)
For more info click here.
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Renal Imaging
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Radiopharmaceuticals are used for a number of functional and anatomical  assessments of the kidneys. Two of the most common radiopharmaceuticals used in the assessment of the kidneys are 99mTc diethylenetriaminepentaacetic acid (DTPA) and 99mTc mercaptoacetyltriglycine (MAG3).
One area radiopharmaceuticals are used in the assessment of kidney function is the diagnosis of renovascular hypertension. Patients undergo renal scintigraphy before and after administration of an ACE inhibitor (commonly captopril) to determine underperfused segments of the kidney in patients with renal artery stenosis. Diagnostic accuracy is equal between MAG3 and DTPA in the assessment of renovascular hypertension. However, because MAG3 is significantly more expensive, DTPA is more likely to be used.
Diuresis renography is another area that radiopharmaceuticals are used in the assessment of kidney function. Diuresis renography is used to differentiate an obstruction in urinary tract from dilation in the urinary tract without obstruction. MAG3 is preferred in this situation because it has a higher extraction ratio and better evaluation of urinary drainage.
The assessment of function of a tranplanted kidney is also a major issue in the radionuclide study. There are many potential complications after transplant with a cadaveric kidney, including rejection, cyclosporine toxicity to the kidney and acute tubular necrosis, MAG3 and DTPA are both acceptable options in accessing renal function following kidney transplant, but MAG3 is preferred due to its higher extraction efficacy, especially in patients with decreased renal function.
Radiopharmaceuticals are also used to access glomerular filtration rate (GFR) and in determining renal tubular function. The ideal GFR marker is freely filterable at the glomerulus and shows no renal tubular secretion or reabsorption. Because DTPA is eliminated by glomerular filtration and MAG3 is eliminated by glomerular filtration and active tubular secretion, DTPA is the preferred agent in determining GFR. Because DTPA shows no renal tubular secretion, MAG3 is preferred for determining tubular function.
--Matt Pfister, PharmD. Candidate, Purdue University
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Radiopharmacy Inc's Annual Christmas Party
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It is that time of
year again. The Radiopharmacy Christmas party will be upon us  before
we know it. As a gesture of our appreciation to our customers and
employees, Radiopharmacy will be hosting our annual party on Saturday
December 12, 2009. The party will once again be held at the Casino
Aztar. For Casino Aztar Hotel room availability and group discount,
phone Becky Skelton at (812) 433-4389 or (800) 342-5386 and reference
"Radiopharmacy Block." Please RSVP to Radiopharmacy by November 30th,
2009. Mark your calendars now, we hope to see many of you on the
12th.
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Free Continuing Education
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 There are currently 26 NucMed credits available on the Covidien www.nucmeded.org web site. All classses are free of charge. See below some of the offerings.
Anatomy and Physiology Review for Nuclear Medicine Technology - 2009 Update
Cardiac Electrophysiology for Nuclear Medicine Technology - 2007 Update
Correct Coding for Diagnostic Nuclear Medicine Procedures, Part 1
Myocardial Perfusion Imaging - 2009 Update
Stress Testing in Cardiac Nuclear Medicine Technology - 2009 Update
Enrollment Instructions:
Go to www.nucmeded.org
Click on the self-enroll button
Fill out the information and click on submit
A link will pop up taking you back to main page
Login into site. Go to the site now
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For Sale....Slightly used, heavily discounted
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 Lead Bricks..........$60.00 each
Rectangular Lead Brick; 8" l x 4" w x 2" h (20 x 10 x 5 cm), 27 lb (12.5 kg)/each
Thyroid Uptake Neck Phantom....$295.00
(Complete with Bottle Carrier, Capsule Holder and 12 Polyethylene bottles)
Lead Apron...................$100.00
......a protective shield of lead and rubber that may be worn by a patient, radiologic technologist or radiologist.
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Technologist Job Line
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If you are interested in the following position please feel free to contact the department directly, or give us a call at the pharmacy. Technologists looking for full-time or part-time position.
Karen Foncannon: 731-661-9287 Wk: 731-541-7866
Contact info: Karen.foncannon@hotmail.com
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Radiopharmacy Services
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Survey Meter Calibration: 
Radiopharmacy's price for survey meter calibration is $50.00/meter. Shipping and handling from and back to your location is $20.00. Shipping will be by FedEx ground unless otherwise specified. We will pick up the instrument, send it to Mid-America Calibrations, and after calibration return it directly to you. If required, Radiopharmacy has rental survey meters while your unit is being calibrated.
Co-57 Flood Sources and Dose Calibrator Reference Sources 
Don't forget; Radiopharmacy, Inc. sells all types of radioactive sources for all types of cameras and equipment. We supply sources from a variety of major vendors in our efforts to pass along the best products at the lowest cost. Just give us a call for a price quote or for information about anything your department may need.
Linearity Check
Radiopharmacy, Inc. has a Lineator for performing dose calibrator linearity. The Lineator allows linearity to be performed in minutes rather than days. Call Radiopharmacy for more information.
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Radiopharmacy, Inc. is staffed by
Board Certified Nuclear Pharmacists (BCNP's) with advanced education, training
and experience in the preparation, distribution, and pharmacology of
radiopharmaceuticals. Our staff is always available to answer questions or
research information regarding radiopharmaceuticals and nuclear medicine
studies, unexpected biodistributions, adverse reactions, drug interactions,
radiation safety, regulatory requirements, and reimbursement strategies. We also offer assistance with literature
searches, research design preparation, investigational drug procurement,
specialized labeling procedures, pharmacokinetic analyses, and dosimetry
estimations.
Radiopharmacy's services are
designed to assist your department in offering the newest, most progressive therapies
and diagnostic tests available, and to help you maximize your overall
efficiency in order to improve patient satisfaction and your profitability. To go to our website click on the image above.
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NOTE TO READERS: In an
effort to keep the Monthly Scan relevant, useful and informative,
feedback on the contents of the newsletter is welcome. Readers desiring
to contribute articles, suggestions for future articles, bulletins,
website postings, and other items of interest to the Monthly Scan
readership, should contact a pharmacist at Radiopharmacy, Inc. Sincerely,
CONFIDENTIALITY NOTICE
This
communication is for the sole use of the intended recipient(s) and may
contain information that is confidential, privileged, or otherwise
exempt from disclosure under applicable law. If you are not the
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this message is strictly prohibited. If you have received this
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