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Background
Nuclear medicine is a field of radiology that represents a unique amalgamation of anatomy, physiology, and biochemistry. The complex interaction between these entities in addressing a clinical question, renders the interpretation of nuclear medicine studies challenging. This is especially true for first year radiology residents being exposed to a variety of studies for the first time. For gamma imaging in particular, the myriad of studies with associated radiotracers and pharmaceuticals, the complexity of timing between tracer administration and imaging, and the dynamic and interactive nature of imaging can be a source of great confusion for residents.

Educational Goals / Teaching Points
The objective of this work is to create an easily accessible educational resource, primarily for first year radiology residents at our institution and beyond, that introduces the basic concepts of gamma nuclear imaging and many of the common studies encountered. For each type of study, we will describe the typical indication, the radiotracer used, our institutional imaging protocol and quality control process, the interpretation of the images, and correlation with other imaging modalities where applicable.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will introduce basic concepts such as radiotracer decay, gamma camera physics, important imaging concepts (such as collimation), and the use of adjunctive SPECT/CT imaging when necessary. This information will be conveyed in the context of illustrative and interesting cases to expose residents to many of the pathologic entities associated with the different types of studies encountered in the clinical setting. The head-to-toe studies we will present include brain imaging (perfusion imaging in brain death, cerebrovascular reserve, epilepsy, and neurodegenerative disease evaluation); thyroid and parathyroid imaging (iodine tracer imaging for evaluation of thyroid function and thyroid ablation); cardiac imaging (cardiac perfusion, amyloidosis, and cardiomyopathy); lung imaging (ventilation and perfusion scans for suspected pulmonary embolism, COPD, and pre-operative evaluation of lung function); bowel imaging (gastric emptying, colonic transit, and Meckel’s diverticulum evaluation); hepatobiliary imaging (evaluation of acute cholecystitis, evaluation of hepatic and splenic function); renal imaging (differential renal function, evaluation for genitourinary obstruction); musculoskeletal and soft tissue imaging (oncologic evaluation for bone metastasis, prosthesis evaluation, and diagnosis of infection); and lymphatic system imaging (sentinel lymph node mapping). For the purpose of this abstract, we describe the following studies: DaTscan, thyroid I-123 scan, ventilation/perfusion scan, and HIDA scan.

Conclusion
By creating a comprehensive, quick-reference guide for first year residents being introduced to gamma nuclear imaging, we hope to improve the first year experience on the nuclear medicine rotation by presenting the basic concepts in a concise and accessible manner upon which further knowledge can be built.