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A

  second-generation beta amyloid tracer for PET scans aimed at measuring brain pathology in Alzheimer's disease patients combines the best features of the two current types of agents.

     The investigational agent, called AZD4694, produced brain images in a clinical trial that were virtually identical to those obtained with Pittsburgh Compound B (PiB) in a head-to-head study, said Christopher Rowe, MD, of Austin Health in Melbourne, Australia.

     But, whereas PiB uses the extremely short-lived ¹¹C isotope as the key element, AZD4694 is based on the more easily handled ¹⁸F.

     "We have a tracer with the strengths of [carbon-11] PiB and the convenience of [a fluorine-18] label," he told attendees at the Alzheimer's Association International Conference.

     PiB has been the gold standard for imaging beta amyloid protein deposits within the brains of living patients. It is very selective for amyloid plaques. But the very short half-life of ¹¹C -- just a few minutes -- makes it hard to use. The material has to be produced in a cyclotron close to the imaging clinic, restricting the availability to major academic medical centers.

     The ¹⁸F isotope is longer lived and can be produced and shipped in a more conventional fashion. One such product, florbetapir (Amyvid) recently won FDA approval, and two others, flutemetamol and florbetaben, are in late-stage development.

     However, these agents are less selective than PiB for beta amyloid protein -- they also bind to white matter in the brain, depressing the signal-to-noise ratio that determines image clarity.

     The data presented by Rowe suggested that AZD4694 offers a signal-to-noise ratio similar to that of PiB.

     In a trial sponsored by the agent's developer, AstraZeneca, the two agents were used sequentially to image the brains of 25 healthy volunteers, 10 patients diagnosed with mild cognitive impairment, and 10 with dementia.

     That last group included three patients with frontotemporal dementia, who would not be expected to show significant beta amyloid burdens, and seven with probable Alzheimer's disease.

     The study's primary outcome measure was the SUVR (standardized uptake value ratio) for each agent, compared at three times points following infusion.

     Mean age of each participant group was about 74, except that the three frontotemporal dementia patients averaged about 68. Cognitive impairments in the patient groups were mild to moderate, with mean scores on the Mini-Mental State Examination of 24 to 27.

     The time course of SUVR values differed somewhat initially between the two agents, but became very similar after the 20-minute point following infusion. Concordance in individual participants during the usual time periods for analyzing PET data was nearly perfect, Rowe indicated.

     Cortex to white matter ratios were also close to identical with the two agents in each participant group. Correlations between the apparent plaque burden and results of episodic memory testing were also similar with AZD4694 versus PiB.

     For the most part, Rowe added, the results indicated that one could evaluate the images accurately as soon as 20 to 30 minutes after AZD4694 infusion, which would make the scans somewhat more efficient to perform.

Sensitivity, specificity, and overall accuracy were the same with the 20- to 30-minute evaluations as with the more conventional 40- to 60-minute readings, using the PiB results as reference. These values all ranged from 94% to 98%.

     But Rowe noted that, when the readers were asked to rate their personal confidence in the accuracy of their readings, they graded the 20- to 30-minute assessments much lower -- 63% compared with 93% for the later readings.

     He also pointed to greater overlap between results in healthy controls versus Alzheimer's disease patients in the early readings.

 Amyvid^TM  

Approved by the FDA on April 6, 2012, Amyvid^TM (¹⁸F-florbetapir injection) is a new PET agent indicated for PET brain imaging to estimate β-amyloid neuritic plaque density in adult patients with cognitive impairment who are being evaluated for Alzheimer's disease (AD) and other causes of cognitive decline as an adjunct to other diagnostic evaluations. Upon injection, ¹⁸F-florbetapir crosses the blood-brain barrier with less than 5% activity present in the blood 20 minutes post-administration and binds to β-amyloid plaques in the brain. A negative scan indicates sparse to no neuritic plaques and reduces the likelihood that a patient's cognitive impairment is due to AD; a positive ¹⁸F-florbetapir scan is indicative of moderate to frequent amyloid neuritic plaques. This quantity of plaque is present in patients with AD, but is also found in patients with other types neurologic conditions, as well as older patients with normal cognition. Consequently, a positive scan does not establish a diagnosis of AD or other cognitive disorder, nor is ¹⁸F-florbetapir indicated for predicting the development of dementia or other neurologic conditions, or monitoring response to therapies. ¹

     In a recent study published in the Journal of Nuclear Medicine², ¹⁸F-florbetapir was compared to ¹⁸F-FDG between patients with Alzheimer's disease and controls. As ¹⁸F-FDG is considered one of the most accurate AD nuclear medicine imaging tests and most widely used PET agent for evaluating dementia patients, it is appropriate standard to compare with ¹⁸F-florbetapir. This study, entitled "Initial Clinical Comparison of ¹⁸F-Florbetapir and ¹⁸F-FDG PET in Patients with Alzheimer Disease and Controls", was the first direct comparison between ¹⁸F-florbetapir and ¹⁸F-FDG in the same subjects. Its purpose was to compare the two agents in the same patients to determine diagnostic accuracy and to compare metabolism with amyloid burden.

     Nineteen patients clinically diagnosed with AD and 21 cognitively normal controls were administered both ¹⁸F-florbetapir and ¹⁸F-FDG scans according to established protocols. The scans were read by two board-certified nuclear medicine physicians who were experienced in interpreting PET brain scans. The interpretation of the scans was not intended to assess how different readers performed when evaluating the images, but instead to make an optimal visual evaluation of the images and compare their ability to diagnose AD. Two assessments were made; the first was to determine AD or not AD based on the pattern of activity in the two scans. The second was to qualitatively rate the activity in three major cortical brain regions for both the ¹⁸F-florbetapir and ¹⁸F-FDG scans, namely, the frontal, temporal, and parietal lobes.

Compared with the patients clinically diagnosed with AD and the controls, the sensitivity and specificity for ¹⁸F-florbetapir were 95% and 95%, and were 89% and 86%, respectively, for ¹⁸F-FDG. There was a significant inverse correlation between ¹⁸F-florbetapir and ¹⁸F-FDG uptake in all three major cortical brain regions when comparing both AD patients and controls, but when comparing AD patients alone, there was only a significant correlation in the frontal lobes. This is consistent with the perception that decreased metabolism is present in areas of amyloid deposition, but the amount of amyloid binding by ¹⁸F-florbetapir does not correlate with the amount of metabolic deficit as related to cognitive impairment.

     The authors concluded that although ¹⁸F-FDG PET is a well-established imaging agent, it has limitations from a diagnostic perspective, particularly considering how other disease processes share a temporoparietal hypometabolism pattern. It appears that ¹⁸F-florbetapir has a higher sensitivity and specificity for AD than ¹⁸F-FDG. This was an expected result, as ¹⁸F-florbetapir is more disease-specific for AD. However, unlike ¹⁸F-FDG, ¹⁸F-florbetapir is not a suitable agent for measuring disease severity. It was also noted that future studies are needed to determine the interreader reliability of ¹⁸F-florbetapir interpretations.

Column 1 - Code/Description: The numeric CPT and alpha-numeric HCPCS Level II codes for the services covered in each section are followed by the procedure descriptor.

Column 2 - Modifier: "Global" indicates the global service: "TC" indicates the technical component (TC); and "26" indicates the professional component (PC). (Note: The global service includes both the TC and the PC, and physicians who furnish both components of the service bill using this method.)

Column 3 through 5-MPFS: From left to right, you will find SC (status code), which indicates how the code is paid, and RVU, which applies to the code in the first column. RVUs listed apply to both non-facility and facility-based services unless otherwise noted. (A = Active code. These codes are separately payable under the PFS if covered. There will be RVUs for codes with this status. The presence of this indicator does not mean that Medicare has made a national coverage determination regarding the service. Carriers remain responsible for coverage decisions in the absence of a national Medicare policy.)

Columns 6 through 8-Hospital OPPS: From left to right, you will find the APC; the SI (status indicator), which indicates how the code is paid; and the rate of the code listed in the first column.

An infiltrated radiopharmaceutical dose can cause a lot of problems including: delayin diagnostic information, delay in therapeutic benefit, scheduling time lost, patient inconvenience to repeat study, patient anguish for delayed study results, and excess radiation burden to the patient. However, is the radiation dose or amount of drug enough to cause any real physical harm?

     The answers to these questions depend on the drug, the dose, and the volume infiltrated. Fortunately, most diagnostic radiopharmaceutical injections will not cause physical harm if infiltrated. The table below is from an article in the May 1991 JNM, and details dose estimates to the tissues in the infiltrated area from some commonly used radioisotopes.

     Tissue damage has been noted after exposure of 49,000 rad or greater. Though there is a pretty large margin of safety with most of the diagnostic products, no such margin exists when infusing mCi quantities of I-131 or other therapeutic products such as Y-90, P-32, Sm-153.

     Also keep in mind that other injectable drugs used in nuclear medicine may cause damage if infiltrated (i.e., dipyridamole, dobutamine, etc.). Specific procedures for treating infiltrations exist, and are commonly dealt with by Nursing and/or Pharmacy departments.

For many years, thyroid gland function and structure has been evaluated using uptake and scintigraphy studies. ¹³¹I-iodide, introduced in the late thirties, was the first radiopharmaceutical used for measuring thyroid uptake, and for many years it was the main study agent used in the evaluation of thyroid function.Despite the fact that the sensitivity and specificity of in vitro tests for evaluation of thyroid function have evolved, thyroid uptake and scintigraphy still play an important role in various clinical situations, such as the detection of ectopic thyroid tissue in neck masses. Physicians commonly used this test in order to identify the underlying pathology of a thyroid when laboratory results of thyroid function are abnormal. Other uses for thyroid uptake and scan include the detection of ectopic thyroid tissue in neck masses, the functional assessment thyroid nodules and in the calculation of the therapeutic dose of ¹³¹I iodide.

     In the past when much higher dosages of ¹³¹I were used (ex. 100 uCi), studies with ¹³¹I-iodide (¹³¹I NaI) delivered a high radiation doses to the thyroid gland ( ~ 80 rad/study). Additionally, its 365 keV gammaphoton is inadequately collimated by most conventional scintillation cameras, and therefore poor quality images were produced. With the availability of new techniques, ¹³¹Iodine-iodide should not be used for routine thyroid imaging.  

       However, a much lower dosage of ¹³¹I is adequate (ex. 5-10 uCi) for uptake determinations only.   If thyroid imaging is required, ^99mTc Na-Pertechnetate may be used.

       ^99mTechnetium, in the chemical form of pertechnetate (^99mTcO₄^-), is used for thyroid imaging, and also gives an indication of uptake. The similarity of volume and charge between the iodide and pertechnetate ions is the explanation for the uptake of ^99mTcO₄^- by the thyroid gland. ^99mTc-pertechnetate has a short half-life (6 hours), short retention in the gland, and no β^- radiation emission; and thus delivers a low radiation dose to the thyroid gland and total body. Its 140 keV gamma photon is ideal for imaging. See accompanying images at right of the same patient. ^99mTcO₄^- is very readily available, and is relatively inexpensive.

     ¹²³Iodine-iodide became commercially available about 30 years ago. Because it delivers a much lower radiation dose per mCi than ¹³¹I, and because it emits gamma photons more suitable for imaging (159 keV), ¹²³I is currently is most often utilized isotope for thyroid uptake and imaging. However, it is significantly more expensive than ¹³¹I, and supply is much less reliable. Additionally, if a lower dosage of ¹³¹I NaI (ex. 5-10 uCi) is used, the radiation dose to the thyroid is actually higher from an ¹²³I study than from a combined ¹³¹I uptake/^99mTc imaging study. The difference in total body exposure is insignificant. See the table below. Dosimetry information is from the manufacturers' product package inserts.

 Hope for Harlie

arlie Bryant is the 6 year old daughter of Lisa Bryant, a nuclear medicine technologist that many of you know from Owensboro Heart & Vascular in Owensboro, KY. About a year ago, Harlie was having a routine eye exam, as required for admission to kindergarten, when she was diagnosed with astrocytoma, a type of brain tumor.

       We would like to let you know that you can help support Lisa and her family in their fight to save Harlie. Become one of "Harlie's Angels"!   Go to HopeForHarlie.org to show your support and help pay medical bills, ease their financial worries, and allow them to focus on taking care of Harlie.

HopeForHarlie.org
115 Green Meadows Dr.
Beaver Dam, KY 42320
(270)991-2513  info@HopeForHarlie.org 

HAZMAT Training Help

WHAT THE HAZARDOUS MATERIALS REGULATIONS REQUIRE

The Hazardous Materials Regulations (HMR; 49 CFR Parts 100-185), issued by the Department of Transportation's Pipeline and Hazardous Materials Safety Administration (PHMSA) under authority of the Federal hazardous materials transportation law (49 U.S.C. 5101 et seq.), establish requirements governing the commercial transportation of hazmat by highway, rail, vessel, and air.

     Under the HMR, hazardous materials are categorized by analysis and experience and assigned hazard classes and packing groups based upon the risks they present during transportation. The HMR specify appropriate packaging and handling requirements for hazardous materials, and require a shipper to communicate the material's hazards through use of shipping papers, package marking and labeling, and vehicle placarding. The HMR also require shippers to provide emergency response information applicable to the specific hazard or hazards of the material being transported.

THE HAZARDOUS MATERIALS REGULATIONS' TRAINING REQUIREMENTS

The HMR mandate training requirements for persons who prepare hazmat for shipment or who transport hazmat in commerce. The intent of the regulations is to ensure that each hazmat employee is familiar with the HMR, is able to recognize and identify hazardous materials, understands the specific HMR requirements applicable to the functions he or she performs, and is knowledgeable about emergency response, self-protection measures, and accident prevention methods. The regulations are performance based to provide a baseline set of training requirements while acknowledging the need for flexibility due to the diversity of the hazmat workforce.

     Training requirements are located in Subpart H of Part 172 of the HMR. The training requirements apply to hazmat employers and hazmat employees as defined in §171.8. The HMR require all hazmat employees to be trained including hazmat employers with direct supervision of hazmat transportation functions.

     Training must be completed within 90 days of the first day of employment or the fi rst day of a change in job function. Until training is completed, a hazmat employee must be directly supervised by a person who has been trained. Further, each hazmat employee must be provided with recurrent training at least once every three years. Each hazmat employee must be tested upon completion of training. Training may be provided directly by the hazmat employer or by other public or private sources. Regardless of who provides the training, the hazmat employer is responsible for ensuring that appropriate testing occurs and that the training is effective, appropriate, and successful in achieving the intended objectives of providing employees with the knowledge and skills necessary to perform their job functions safely.

THE FIVE TYPES OF TRAINING REQUIRED

GENERAL AWARENESS/FAMILIARIZATION TRAINING: Training that provides familiarity with the general requirements of the HMR and enables the hazmat employee to recognize and identify hazardous materials. All hazmat employees must receive general awareness training.

FUNCTION-SPECIFIC TRAINING: Training that provides a detailed understanding of HMR requirements applicable to the function(s) performed by the hazmat employee. Each hazmat employee must be trained on the specifi c functions they are required to perform.

SAFETY TRAINING: Training that covers the hazards presented by hazardous materials, safe handling,memergency response information, and methods and procedures for accident avoidance. All hazmat employees must receive this training.

SECURITY AWARENESS TRAINING: Training that provides a general understanding of the security risks associated with hazardous materials transportation and the methods designed to enhance transportation security. This training should include methods on how to recognize and respond to possible security threats. All hazmat employees must receive this training.

IN-DEPTH SECURITY TRAINING: Training that provides a detailed understanding of a company's security plan including company security objectives, specific security procedures, employee responsibilities, actions to take in the event of a security breach and the organizational security structure. This training must be provided to hazmat employees who handle or perform regulated functions related to the transportation of the materials covered by the security plan or who are responsible for implementing the security plan.

RECORDKEEPING REQUIREMENTS

The hazmat employer is responsible for maintaining training records for each hazmat employee. These records must be kept for the duration of the three-year training cycle while the hazmat employee is employed and for 90 days after the employee leaves employment. Training records must be made

available by the employer for audit and review by regulatory authorities upon request.

1. Training records must include the following:

The hazmat employee's name

The most recent training completion date

A description of, copy of, or reference to training materials used to meet the training requirements

The name and address of the person providing the training

A certification that the person has been trained and tested as required

Certification that the hazmat employee has been trained and tested shall be made by the hazmat employer or a designated representative.

"What You Should Know: A Guide to Developing a Hazardous Materials Training Program"

Program Guide

Nuclear Medicine:  Sources of Error

¹¹¹In-Leukocyte Scintigraphy for Suspected Infection/Inflammation

•  Potential causes for focal ¹¹¹In-leukocyte soft tissue localization other than infection: intravenous line localization, accessory spleen, acute bleeds, hematomas, inflammatory response to foreign body, neoplasm, localized bile collections, bowel inflammation, endometritis, vaginitis, myositis ossificans, bladder catheters, nasogastric and tracheostomy tubes, and recent infarcts. Rare cases of false-positive ¹¹¹In-leukocyte scans caused by increased numbers of labeled platelets have been reported.
•  Potential causes of false-negative ¹¹¹In-leukocyte studies: chronic abscess more than 3 weeks of age, lymphocytic mediated infection (tuberculosis, sarcoidosis, granulomatous process, viral infection, etc.), hepatic or splenic abscesses, abscess adjacent to the liver or spleen, low-grade or chronic osteomyelitis, especially in the central skeleton, such as vertebral osteomyelitis. False negative scans for detection of osteomyelitis can occur when the patient is imaged after being on intravenouslya administered antibiotics for several weeks. If intravenous antibiotics have been stopped for 2-4 wk before imaging, a false-negative scan is not likely to occur.
•  Bowel ¹¹¹In-leukocyte localization not caused by infection: irritative bowel lesion(s) such as stomas or from multiple enemas, gastrointestinal bleeding or infarction, fistula to bowel from an adjacent abscess, swallowed labeled cells (bronchitis, sinusitis, pneumonia).
•  Noninfectious causes of ¹¹¹In-leukocyte m bone/joint localization: active rheumatoid or traumatic/degenerative arthritis, gouty arthritis, acute fractures (less than 2 mo), traumatic or neuropathic arthropathy, acute bone infarcts, foreign body reaction. Rarely neoplasms such as lymphoma, adjacent soft tissue inflammation such as myositis, or active heterotopic bone formation can cause ¹¹¹In-leukocyte uptake.
•  Errors in interpretation in suspected osteomyelitis cases can be minimized by obtaining ^99mTc-sulfur colloid marrow studies in cases where ¹¹¹In-leukocyte images are indeterminate (neither clearly positive nor negative).

a. Concordant ¹¹¹In-leukocyte and 99mTc-sulfur colloid marrow uptake is normal, whereas a discordant pattern, with ¹¹¹In- leukocyte uptake without corresponding marrow uptake, is highly suspicious for infection.

b. Simultaneous acquisition of ¹¹¹In-leukocyte/ ^99mTc-diphosphonate bone images helps distinguish adjacent soft-tissue in fection from bone infection, increasing the

specificity for osteomyelitis.

•  Extensive soft tissue surrounding bone may give the appearance of underlying bone involvement. (In this circumstance SPECT may be helpful.)
•  If a 20-30-mCi dose of 99mTc bone tracer is injected on the same day as the ¹¹¹Inleukocyte images, the intense ^99mTc activity can produce photon overload in the lower 111In window, which may cause a corresponding false-positive focus. Use of the lower ¹¹¹In window should be avoided if 99mTc bone tracer is injected just before ¹¹¹In-leukocyte imaging. Similarly, on the delayed images, intense ¹¹¹In activity may scatter into the ^99mTc window. The contribution that scatter makes to the final image varies from camera to camera and should be evaluated.
•  False-positive scan interpretations can occur in patients with very active soft-tissue infection adjacent to a thin and/or relatively vascular bone, such as the maxilla, mandible, or pelvis.
•  Causes for abnormally decreased ¹¹¹Inleukocyte accumulation:

a. Osteomyelitis of the spine will often appear

as focal decreased uptake compared with adjacent bone marrow.

b. Decreased uptake can also be seen in severely hypovascular/avascular sites (e.g.,

cysts). Implants (e.g., prostheses and pacemakers) can also have this appearance.

^99mTc-Exametazime (HMPAO)-Labeled Leukocyte Scintigraphy for Suspected Infection/Inflammation

•  Note that the normal biodistribution of ^99mTc-leukocytes differs from that of ¹¹¹Inleukocytes. In adults, a changing pattern of bowel activity prior to 4 h is likely from intraluminal transit of labeled cells secondary to inflammatory bowel disease or bleeding, or may indicate a fistula from an abscess. In children, progressive physiologic bowel activity can be present by 1 h. Delayed imaging alone is often misleading in inflammatory bowel disease. Bone marrow expansion or hyperplasia can alter the normal marrow patterns. (See the Society of Nuclear Medicine Procedure Guideline for ¹¹¹In-Leukocyte Scintigraphy for Suspected Infection/Inflammation, section IV.J. for other sources of errors.)
•  False-negative results occur as a result of rapid bowel clearance of labeled leukocytes from inflamed bowel, particularly in the small bowel. Bladder activity may mask a pelvic site of infection (voiding or, when necessary, catheterization is suggested before pelvic imaging). Normal renal activity can make it difficult to detect pyelonephritis and/or a small renal abscess. Chronic walled-off abscesses or low-grade infections, particularly in bone, have less ^99mTc-granulocyte accumulation and are more likely not to be visualized. Residual diffuse lung activity, particularly in patients with heart or renal failure, may obscure focal lung infections even as late as 4-6 h after injection.
•  False-positive results can occur from rapid small bowel transit of hepatobiliary secretion and focal accumulation of activity in the cecum, particularly if imaging is done after 1 h in children or 4 h in adults. Active gastrointestinal bleeding or swallowed cells can be mistaken for an inflammatory bowel process. Focal collections of inflamed peritoneal fluid or sites of focal bowel inflammation can be mistaken for abscess. Hematomas and inflammation around neoplasms such as lymphomas lymphomas may also mimic an abscess. Noninfected vascular grafts and/or shunts can show increased localization because of bleeding or noninfected reparative process.

Gallium Scintigraphy in Inflammation

•  Residual bowel activity is probably the most common cause for both false-positive and false-negative interpretations.
•  Hilar nodal localization (usually low-grade) can be seen as a normal variant in adult patients, particularly in smokers.
•  In children and teenagers, increased activity can be seen in thymic hyperplasia after chemotherapy. Below 2 y of age, increased thymic activity is common.
•  Gadolinium administered for MRI enhancement within 24 h before gallium injection has been observed to decrease gallium localization.
•  Saturation of iron-binding transferrin sites (e.g., hemolysis or multiple blood transfusions) causes altered gallium distribution.
•  ⁶⁷Ga uptake at sites of bone repair secondary to healing fractures or prior orthopedic hardware sites, loose prostheses, or after successful treatment of osteomyelitis may complicate interpretation in patients with suspected osteomyelitis.
•  Recent chemotherapy and radiation therapy.
•  Desferoxamine therapy.
•  Increased breast activity.
•  Hilar, submandibular and diffuse pulmonary localization in patients with lymphoma during therapy.
•  Radiation sialadenitis causing increased localization.
•  Uptake in a variety of tumors (lymphoma, hepatoma, lung cancer).

--SNM Guidelines

KSNMT member $60.00
Non-member $85.00
Student $15.00

(prices increase after October 6th)

Hotel:  Baymont Inn and Suites ($69.99 plus tax--mention KSNMT when making reservations)  
Free High Speed Internet, Indoor Pool, Recreation Area, Guest Laundry and is connected to a Denny's.    
The address is I-65 south Bowling Green Exit #22, 4700 Scottsville Road 42103.  To reserve room please call 270-782-3800

This program has been submitted to SNMTS (VOICE) for CE approval. VOICE approval is accepted by the KY Radiation Operator Certification Program. To obtain official credit you MUST go online and evaluate the program.

For more information please call Radiopharmacy, Inc.

@ 812-421-1002  

NUCLEAR MEDICINE REIMBURSEMENT: BASICS & UPDATES

By: Dave Koerber from Mallinckrodt/Covidien

                When: Monday, October 8th @ 6:30pm

                Where:    Radiopharmacy, Inc.

                                1409 E. Virginia St.

                                Evansville, IN 47711

When: Tuesday, October 9th @ 12:00 pm

Where: Regional Medical Center

Commonwealth Meeting Room

(First floor -- in the cafeteria)

900 Hospital Drive

Madisonville, KY 

When:  Tuesday, October 9th @ 6:30 pm

Where:  Salem Hospital

Mobley Community Room

(Enter through the front entrance)

1201 Ricker Drive

Salem, IL 62881 

Refreshments will be served  

This is a one hour live presentation approved by the Society of Nuclear Medicine for 1 CEH. 

Please RSVP to Radiopharmacy, Inc. at (812) 421-1002. You may also fax your reservation to (812) 421-1004.

Sponsored By:

      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.

Products and Services

• Radiopharmaceuticals - Diagnostic and therapeutic
• Radioactive Sealed Sources
• Brachytherapy Sources (I-125 and Pd-103)
• Lab Testing
• Nuclear Medicine Department Computer Software,
• Reimbursement Assistance
• Continuing Education
• Health Physics Consulting
• ICANL and ACR Accreditation Assistance
• Professional Consultation regarding radiopharmaceuticals and their clinical use.