Nuclear Medicine

Overview

Welcome to the Division of Nuclear Medicine at Duke University Hospital.

The division of nuclear medicine includes general nuclear medicine, nuclear cardiology, PET/CT, and the Duke Radiopharmacy. The division provides the clinical service for Duke University Hospital, Duke Raleigh Hospital, and the Durham VA Medical Center, including radionuclide diagnostic imaging studies in general nuclear medicine, PET/CT, and nuclear cardiology; laboratory based exams, such as quantitative glomerular filtration rate studies; and radionuclide therapy.

General nuclear medicine studies include a wide variety of adult and pediatric planar and SPECT/CT imaging, such as bone scans, renal scans, HIDA scans, ventilation/perfusion lung scans, parathyroid scans, MIBG scans, and pre-surgical sentinel lymph node scintigraphy.

The division is unique in providing cardiovascular stress testing and myocardial perfusion imaging within nuclear medicine with two cardiologists who oversee the Duke Nuclear Cardiology Program. There is a close working relationship with the Duke Internal Medicine division of cardiology that includes a joint laboratory in an off-site outpatient clinic. Cardiac PET/CT imaging is also available for myocardial perfusion imaging and for F-18 FDG metabolic imaging for evaluation of myocardial viability and cardiac sarcoidosis.

The PET/CT center is very active, providing diagnostic imaging service for patients with known or suspected illnesses, such as malignancy, dementia and infection, and for patients with intractable seizures. Available clinical PET radiopharmaceuticals include F-18 FDG and Ga-68 DOTATATE.

The division provides comprehensive therapeutic nuclear medicine service, working closely with the Duke Endocrinology service for I-131 therapy for hyperthyroidism and thyroid cancer, and the Duke Oncology service for Ra-223 Xofigo therapy for prostate cancer, Y-90 Zevalin therapy for lymphoma, I-131 MIBG and Lu-177 Lutathera therapies for neuroendocrine tumors, and, in collaboration with Duke interventional radiology, Y-90 microsphere therapy for hepatic malignancy. Instrumental to the various aspects of the therapeutic nuclear medicine program is Duke Radiation Safety office personnel, with whom there is also a close working relationship that provides physician consultation for clinical radiation safety issues.

The division is also very active in research; for example, the Nuclear Cardiology Program has one of the largest cardiovascular and nuclear cardiology databases from a single academic institution in the U.S.A., from which outcome research studies can be generated. There is also active research in instrumentation, often working closely with physicists in the nuclear medicine division for advances in PET/CT and SPECT/CT imaging.

The division is committed to teaching the multiple facets of nuclear medicine, including topics of clinical imaging techniques and image interpretation, radionuclide therapy, instrumentation, nuclear medicine physics and radiopharmacy to medical students, diagnostic radiology residents, nuclear medicine residents, nuclear radiology fellows, and pharmacy students. Teaching is done in an informal setting of daily image read out sessions and weekly case conferences by the nuclear medicine faculty and in a formal setting of weekly didactic lectures by physicians from the nuclear medicine faculty and from radiation safety, physicists, radiopharmacists and nuclear medicine technologists.

Residency and Fellowship

The Division of Nuclear Medicine at Duke University Hospital offers a one, two or three year ACGME accredited residency in Nuclear Medicine (length of required training determined by prior educational experience), which, after successful completion, provides eligibility for the American Board of Nuclear Medicine examination. Also offered for board eligible or board certified radiologists is a one year ACGME accredited fellowship in Nuclear Radiology which, after successful completion, provides eligibility for both the American Board of Radiology subspecialty examination (Nuclear Radiology CAQ) and the American Board of Nuclear Medicine examination. The training programs are designed to prepare the resident or fellow for a private practice or academic career in nuclear medicine.

The nuclear medicine / radiology training programs focus on all aspects of nuclear medicine in an active clinical service, including general nuclear medicine, PET/CT, nuclear cardiology and therapeutic nuclear medicine. The residents / fellows are exposed to a full spectrum of diagnostic imaging with state-of-the-art equipment, including routine nuclear medicine examinations and more challenging nuclear medicine studies, including correlative imaging with SPECT/CT. A wide range of diverse diagnostic studies is also performed in PET/CT, which includes exposure to new radiopharmaceuticals currently in clinical trials. Nuclear cardiology imaging and cardiac stress testing, in which participation is required for eligibility for the ABNM examination, are performed within the nuclear medicine section of radiology. The nuclear medicine service also offers comprehensive radionuclide therapies, in which trainees participate, including I-131, Ra-223 Xofigo, Y-90 Zevalin, I-131 MIBG, Y-90 microspheres and Lu-177 Lutathera.

The residents / fellows attend daily nuclear medicine faculty lectures or case presentations, while also participating both informally and formally in diagnostic radiology resident and medical student education. The residents / fellows also regularly present nuclear medicine didactic lectures and case studies, and are responsible for conducting monthly nuclear medicine journal club. Weekly multidisciplinary conferences and tumor boards are available for residents / fellows to attend.

The residents / fellows have protected academic time and actively participate in research; faculty guidance and assistance are provided for producing publications, scientific presentations and exhibits for nuclear medicine, radiology, oncology and cardiology. In addition to clinical research, basic science research with small animal micro-SPECT/CT and micro-PET/CT cameras are available for interested residents / fellows.

Program inquiries may be addressed to:
Michael W. Hanson, M.D.
Program Director, Nuclear Medicine Residency and Nuclear Radiology Fellowship Training Programs
P.O. Box 3949
Duke University Medical Center
Durham, North Carolina 27710
michael.hanson@dm.duke.edu
(919) 684-7245

Application inquiries should be made to:
Gloria Irving
Program Coordinator, Nuclear Medicine Residency and Nuclear Radiology Fellowship Training Programs
P.O. Box 3949
Duke University Medical Center
Durham, North Carolina 27710
gloria.irving@dm.duke.edu
(919) 684-7245 (office)
(919) 684-7135 (fax)