PET/CT hybrid imaging pioneers share dual-modality expertise

University Hospital Zurich is well known for its work in PET/CT. The hospital installed one of the world's first PET/CT systems in March 2001 and currently operates two PET/CT scanners. Now radiologists and nuclear medicine physicians from around the world are being offered the chance to improve their dual-modality reading skills at this pioneering institution.

Members of University Hospital Zurich's nuclear medicine department have been running short PET/CT courses since 2003. This latest initiative, launched in January, extends the level of certified competence that doctors will be able to reach.

"We have already had participants from the U.S., South Africa, Russia, Europe, and China," said Dr. Katrin Stumpe, a nuclear medicine physician at University Hospital Zurich and director of the new PET/CT training program. "From the beginning, most people have been interested in oncology, which is the main indication for PET/CT. But we also cover other subjects where PET/CT might be used, such as infection imaging, cardiology, and neurology."

PET/CT training at Zurich is aimed primarily at board-certified radiologists and nuclear medicine physicians. This is not exclusively the case, though.

"Physicians who are board-certified in other fields and permitted to perform nuclear medicine examinations in their home institutions-for example, internists who have extensive experience in this area-can also do our training program," Stumpe said.

Completion of the existing two-and-a-half-day PET/CT course at Zurich results in level I competency. Radiologists seeking to reach level II will need to report 150 PET/CT examinations independently, while nuclear medicine physicians must report 500 PET/CT examinations. Attainment of level III requires radiologists to report an additional 350 PET/CT examinations, and nuclear medicine physicians another 500.

These requirements take into account the extra time that nuclear medicine physicians will need to become familiar with cross-sectional CT images, according to Stumpe. They are also consistent with guidelines endorsed by several nuclear medicine organizations and published in the Journal of Nuclear Medicine.

Meeting these targets onsite may be easier said than done. Training program participants are expected to spend a minimum of four weeks at the University Hospital Zurich. In reality, doctors may struggle to spend any longer away from their home institution. It may be possible to report 150 PET/CT cases during this period but not the 500 required for nuclear medicine physicians.

Practitioners who can't reach the higher level of competency during their stay may soon be able to continue the certification process remotely, Stumpe said. A planned web-based scholarship system will allow doctors to report PET/CT cases from their home institution and then forward these to Zurich for a second opinion.

"We haven't started working with any web scholars yet, but we have had some interest in doing this," she said.