Summary

I've worked in medical imaging since 1994, both in the military and in the civilian sector. Much of my experience in medical imaging has involved independence and responsibility. As a newly graduated X-ray tech, I was entrusted with covering the night shift solo at Fort Knox. I served a long stint as the only X-ray tech at Camp Carroll in Korea. I was solely responsibile for film quality control at Fort Eustis (including mammography). I served the interim supervisor of the nuclear medicine department at Fort Leonard Wood. At Miami Valley Hospital I have had responsibility for several aspects of quality control, creating workflows and programs, improving patient flow, and personnel training. I even did research to back up our facility's decision to stop performing combined gastric emptying studies.

Copies of patient handouts, Standard Procedures (Protocols) and training materials, and Xeleris "Aladdin Scripts" for you to modify and use at your own facility.

Please note the legal disclaimer (a requirement for anything vaguely medical).

Legalese

Disclaimer Of Warranty: These scripts, handouts, and the like are currently or have been used in a real hospital with real patients. I have made every attempt to ensure that they are correct in all ways.  I make no guarantee or warantee, express or implied. I am not responsible for any outcome on your system.

Regarding the Xeleris scripts: You must have a basic understanding of the Aladdin script language (or virtual basic) to make these work correctly! You will get uncompiled Aladdin scripts (and review templates, when applicable) so that you can modify these scripts to work properly on your own Aladdin system, contained in a ZIP archive. Click on the thumbnails for larger images. These scripts are written specifically for my site; your acquisition protocols almost certainly differ and will require that you modify these scripts.

Regarding SOPs/Protocols: There are also selected SOP (standard operating procedures or protocols) for various studies available here. These may or may not be relevant to your facility. Please confer with your authorized user, medical supervisor, and radiation protection committee prior to ensure they comply with your site license.

Distribution These are all released under a Creative Commons Attribution-ShareAlike license. I ask that you email me any modifications and improvements so that I can place them here. We are allowed to share these scripts;  I checked.

Handouts

History Template Download A one-page template our facility uses to convieniently record history, dosages, technologist involvement, and other pertenient data.

Myocardial Perfusion Information: PDF A two-page information sheet (intended as a front/back single sheet) information sheet for patients at our facility for a same-day Cardiolite myocardial perfusion study.

General Nuclear Medicine Information Pamphlet: PDF This pamphlet was never used due to style guidelines at my facility (i.e. it's not dull).  However, a variant was used at the facility I was at before this one, with many good reviews.  You may find its format or material useful in revising and creating your own site-specific general information pamphlet.

Xeleris

Patient Rename: Download This script allows you to conveniently rename most aspects of any study in the Xeleris database.  It automagically forces you to add an accession number, and then using "Mass Rename" will walk you through renaming up to sixteen images... while you're able to see what you're renaming!  It also has defaults for renal renaming and gastric emptying (two of the pickier default Xeleris scripts).  You can also, on the second page, rename the study, patient name, and more with ease.  It has been updated to include setting the Institution ID for ACR accreditation; it is a HARDCODED VARIABLE and REQUIRES editing lines 73 & 77 of the script to put in your instition's name.

Whole Body Scan: Download This script displays anterior and posterior whole body images, along with up to eight spot films, on one screen.  The whole body displays have one set of images that are of higher intensity displayed alongside the original whole body images.  It can be used with bone scans and other whole body (I-131, Ga67, In-111) scans.  There is also a built in dynamic section, which accepts a two-stage dynamic image (a flow, then an eight frame 60 second/frame phase dynamic for a blood pool).  Both the flow and blood pool are composited and displayed next to the appropriate delay image.It has been updated to include automatic labeling of most routine images and setting the Institution ID for ACR accreditation; Institution ID is a HARDCODED VARIABLE and REQUIRES editing lines 206 & 210 of the script to put in your instition's name.

Brain Flow (Brain Death): Download This script takes three dynamic acquisitions (90sec, 1.5s/fr) and compresses/composites them into a flow and blood pool for the determination of brain death.  This methodology was necessary due to software incompatibilities between our old ADAC Transcam camera and the Xeleris software;  if you acquire your brain flows differently it should be relatively easy to modify the script. It has been updated to include automatic labeling of most routine images and setting the Institution ID for ACR accreditation; Institution ID is a HARDCODED VARIABLE and REQUIRES editing lines 110 & 114 of the script to put in your instition's name.

Lung Scan (Xe133/Tc99m/Co57): Download At our facility, we acquire lung scans with a ventilation (Xe-133) and six perfusion images (Tc-99m MAA).  We also perform a Co57 transmission image to assess lung size/shape instead of a CXR.  The "first breath" section of the image is extracted by the script from the acquisition.  It has been updated to include automatic labeling of most routine images and setting the Institution ID for ACR accreditation; Institution ID is a HARDCODED VARIABLE and REQUIRES editing lines 136 & 140 of the script to put in your instition's name.

Renal Analysis (ERPF): Download I modified the Renal Analysis program to allow the calculation of an ERPF.  The second modification allows the addition of an accession number.  These are written up as "modification" files - follow the directions to modify your own files in place.

Gastrointestinal Bleed: Download At our facility we moved to acquiring two 45-minute serial dynamic scans for gastrointestinal bleed studies.  This script compresses them to 5min/fr to allow displaying each 45 minute segment at a time, then also allowing all 90 minutes to be viewed on the same screen.  At the bottom right of that screen is a location where the whole study can be displayed in 1min/fr cine mode.  Up to two delayed images can also be displayed on the main review screen.  It has been updated to include automatic labeling of most routine images and setting the Institution ID for ACR accreditation; Institution ID is a HARDCODED VARIABLE and REQUIRES editing lines 115 & 119 of the script to put in your instition's name.

Procedures

All procedures are in PDF format, save a few archives which hold standard Excel that should be compatible with Office XP and up, Open Office, and Libre Office. Extra forms are marked with the disk icon. Some Flash tutorials are also included, and noted as such.

Red Cell Volumes (Without RISA): worksheets This archive is two Excel sheets to aid in the calculation of red blood cell volumes using Cr51.  It includes the DuBois method of determining BSA.  The protocol is here for Red Cell Volumes (without RISA) in PDF format.

Gastric Emptying Worksheets Two Excel sheets to calculate gastric emptying.  The first is a straightforward Tc solid gastric emptying;  the second is a more complex one that includes In-111 spilldown for solid/liquid combined studies.  Both include radioactive decay in calculating the T1/2.

You can see our SOPs for Solid Gastric Emptying, Liquid Gastric Emptying, and Combined (Liquid/Solid) Gastric Emptying (PDF format). Our facility no longer performs combined gastric emptying studies. Please see the research I did which led to this decision.

Flash tutorials on how to calibrate the peak on a Mirage Acquisition station (in this case, hooked up to a DSX system). Section One Section Two.

These protocols are presented without comment: