45-hour Curriculum:

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This structured remediation plan consists of 45 individual instructional hours, with each hour including 45 minutes of focused lecture content followed by a 10-question multiple-choice assessment. Students must achieve a minimum score of 80% or higher on each assessment to earn credit for that hour. 

Physics principles and clinical procedure applications are intentionally embedded throughout every section to ensure a truly comprehensive remediation experience that reinforces conceptual understanding, promotes critical thinking, and optimally prepares students for success 

1. Defining Radiopharmaceuticals and Their Clinical Roles
• Define a radiopharmaceutical and its essential components
• Differentiate diagnostic vs therapeutic radiopharmaceuticals vs pharmacologic intervention drugs
• Identify the role of the authorized user and RSO in radiopharmacy

2. Radionuclide Production and the Mo-99/Tc-99m Generator
• Explain radionuclide production methods (reactor, generator, cyclotron)
• Describe Mo-99/Tc-99m generator function
• Identify common radionuclides and adjunctive medications used in NMT

3. Radioactive Decay and Half-Life Calculations
• Define radioactive decay and decay constant
• Calculate half-life and remaining activity using T½
• Explain physical vs. biological vs. effective half-life

4. Generator Elution, Mo-99 Breakthrough, and QC Requirements
• Explain generator elution process and quality control checks
• Define and calculate Mo-99 breakthrough
• Understand USP limits and documentation requirements

5. Radiochemical, Radionuclidic, and Chemical Purity Testing
• Explain radiochemical purity vs. radionuclidic purity vs. chemical purity
• Identify common QC tests (ITLC, chromatography)
• State acceptance criteria for common Tc-99m kits

6. Mechanisms of Localization
• Differentiate particulate, receptor, and metabolic radiopharmaceutical mechanisms
• Match common radiopharmaceuticals to their physiological localization method
• Predict biodistribution errors based on mechanism failure

7. Dose Calibrator Operation and QC Concepts
• Describe dose calibrator setup and measurement process
• Define accuracy, precision, constancy
• Identify common dose calibrator QC requirements

8. Kit Preparation, Aseptic Technique, and Sterility
• Explain kit preparation and sterility procedures
• Define aseptic vs. clean vs. sterile technique
• Identify types and steps for RBC labeling and non-radioactive drug co-administration (e.g., heparin, ascorbic acid)

9. Matching Radiopharmaceuticals to Clinical Indications
• Match radiopharmaceuticals and adjunct drugs (Lasix, CCK, regadenoson, insulin, perchlorate) to indications
• Explain agent selection based on organ system physiology
• Recognize contraindications for both radiopharmaceuticals and adjunctive medications

10. Normal vs Abnormal Biodistribution and Patient Prep Impact
• Define biodistribution and normal vs abnormal uptake patterns
• Explain patient prep impact on biodistribution
• Identify common biodistribution artifacts

11. Adult vs Pediatric Dosing Strategies and ALARA Considerations
• Explain pediatric vs adult radiopharmaceutical dosing strategies
• Understand weight-based vs fixed dosing
• Identify ALARA considerations in dosing

12. Labeling Methods, Efficiency, Stability, and Expiration
• Describe radiopharmaceutical labeling methods
• Identify factors affecting labeling efficiency
• Understand stability and expiration timing

13. PET vs SPECT Agents and Time-Activity Curve Applications
• Identify radiopharmaceuticals used in PET vs SPECT
• Compare 18F-FDG kinetics vs Tc99m-labeled agents
• Explain time-activity curves for imaging optimization

14. FDA, NRC, and USP Oversight of Radiopharmaceutical Use
• Explain FDA vs NRC vs USP oversight roles
• Identify labeling vs dispensing vs administration responsibilities
• Understand record retention requirements

15. Investigational Drug Use (IND, Compassionate Access, Research)
• Describe investigational new drugs (IND) and research protocols
• Define compassionate use and expanded access programs
• Identify documentation requirements for investigational use

 1. Core Components and Function of the Gamma Camera
• Identify the basic components of a gamma camera
• Explain the function of the collimator, crystal, and PMTs
• Trace the signal path from photon detection to image formation

2. Collimator Types and Clinical Applications
• Compare parallel-hole, pinhole, and converging collimators
• Match collimator types to clinical applications
• Evaluate tradeoffs: resolution vs sensitivity

3. Energy Window Selection and Photopeak Optimization
• Explain energy window selection and keV peak alignment
• Define photopeak, scatter, and Compton interaction
• Identify consequences of incorrect energy window settings

4. Uniformity QC: Daily Floods and Artifact Recognition
• Describe uniformity QC (intrinsic vs extrinsic)
• Explain daily flood test purpose and interpretation
• Recognize artifacts from poor uniformity

5. Spatial Resolution and Linearity Testing with Phantoms
• Define spatial resolution and linearity in gamma imaging
• Explain bar phantom testing methods
• Identify common resolution and linearity artifacts

6. Center-of-Rotation Calibration and SPECT Acquisition Requirements
• Explain center-of-rotation (COR) calibration and correction
• Identify artifacts caused by COR misalignment
• Describe SPECT acquisition requirements

7. Image Reconstruction and Filter Selection (Butterworth vs Hanning)
• Compare filtered back projection vs iterative reconstruction
• Explain role of Butterworth and Hanning filters
• Match filter selection to study type and clinical goal

8. CT System Fundamentals in Hybrid Imaging
• Describe CT components in hybrid SPECT/CT and PET/CT systems
• Explain CT fundamentals (tube, detectors, Hounsfield units)
• Compare diagnostic CT vs attenuation correction CT

9. Attenuation Correction Principles and Fusion Artifacts
• Explain attenuation correction principles
• Recognize CT misalignment artifacts on fused images
• Identify causes and fixes for mismatched fusion

10. PET/CT Detector Systems
• Describe PET/CT detector design and LSO/LYSO crystals
• Explain coincidence detection and time-of-flight PET
• Understand SUV calculation fundamentals

11. Dose Calibrator QC: Accuracy, Linearity, Constancy, Geometry
• Explain dose calibrator QC (accuracy, linearity, constancy, geometry)
• Identify test frequency and acceptance thresholds
• Interpret common dose calibrator QC failure causes

12. Well Counter Function and Bioassay/Wipe Applications
• Define well counter function and application
• Compare dose calibrator vs well counter sensitivity
• Explain QC for wipe tests and bioassays

13. Quality Assurance vs Quality Control in Imaging Systems
• Define quality assurance vs quality control
• Recognize required daily, weekly, and annual tests
• Explain ACR/NRC minimum QC compliance expectations

14. Software, Motion, and Artifact Sources in SPECT/PET
• Identify software-based artifacts (e.g., truncation, motion, metal)
• Describe phase/frequency of motion effects on SPECT/PET images
• Propose corrective strategies

15. System Maintenance Red Flags and Removal from Clinical Use
• Summarize common gamma camera service/maintenance issues
• Identify red-flag instrumentation failure warning signs
• Determine when to remove a system from clinical use

 1. ALARA Principles and Practical Application Strategies
• Explain ALARA principles and their regulatory origin
• Differentiate time, distance, and shielding strategies
• Identify ALARA application examples in daily practice

2. Exposure, Dose Units, and Diagnostic vs Occupational Contexts
• Define exposure, dose, and dose equivalent
• Describe units: Gray, Sievert, rem, rad
• Match measurement units to diagnostic vs occupational scenarios

3. Key NRC Regulations and Restricted vs Unrestricted Areas
• Identify major NRC regulations (10 CFR Part 19, 20, 35)
• Explain licensee responsibilities under NRC guidance
• Describe “restricted area” vs “unrestricted area” requirements

4. Personnel Dosimetry Monitoring and Exposure Interpretation
• Explain dosimetry monitoring (TLD, OSL, ring badges)
• Identify deep vs shallow dose measurements
• Interpret occupational exposure report limits

5. Contamination Types, Wipe Tests, and Action Thresholds
• Describe types of radioactive contamination (fixed vs removable)
• Explain wipe test procedures and action thresholds
• Identify common sources of contamination in the lab

6. Survey Meter Types, Calibration, and Use Cases
• Explain survey meter types and applications (GM, ion chamber, scintillation probe)
• Calibrate and perform pre-use instrument checks
• Match instrument type to appropriate use scenarios

7. Radioactive Package Receipt and Immediate Response Protocols
• Describe radioactive package receipt procedures
• Interpret Type A vs Type B labels and TI numbers
• Explain immediate steps if package arrives damaged

8. NRC Patient Release Criteria and Discharge Counseling
• Explain patient release criteria per NRC (e.g., I-131 thresholds)
• Identify instructions required for post-therapy patients
• Document release conditions and education

9. Radiation Spill Response and Emergency Notification Sequence
• Describe radiation emergency procedures
• Differentiate major spill vs minor spill protocol
• Explain notification sequence (AU, RSO, NRC if required)

10. Sealed Source Inventory and Leak Testing Requirements
• Explain sealed source inventory and leak testing requirements
• Identify frequency and documentation standards
• Understand consequences of missing leak test compliance

11. Waste Decay-in-Storage and Disposal Documentation
• Explain waste decay-in-storage protocols
• Identify half-life rule and label removal requirements
• Document disposal and retention practices

12. Bioassay Indications, Thyroid Assessment, and Reporting Levels
• Define bioassay testing and when it is required
• Explain thyroid bioassay procedure post I-131 handling
• Recognize reportable levels to NRC or RSO

13. Shielding Design Principles and PET vs SPECT Room Requirements
• Explain shielding design in imaging rooms (lead, density, TVL/HVL)
• Identify typical walls, windows, and shielding test procedures
• Understand shielding requirements for PET/CT vs SPECT/CT

14. Occupational vs Public Dose Limits and Area Classifications
• Describe patient and public dose limits (e.g., 1 mSv annual public limit)
• Compare occupational vs non-occupational dose thresholds
• Explain controlled vs uncontrolled area classifications

15. NRC Inspection Expectations and Preventing Common Violations
• Summarize NRC inspection expectations
• Identify commonly cited violations and how to prevent them
• Describe corrective action and documentation process