My first week in nuclear medicine was informative though a bit uneventful. After our orientation on Monday we received our ID’s, and we were basically let loose in the hospital to find our mentors. As with most hospital’s New York Presbyterian is a labyrinth of buildings with different names, corridors that have varying levels of access restrictions and elevators with limited access to different floors. I’m amazed that patients who sick or disabled are able to find their way around at all. Quick suggestion for NYP, more/any maps located on walls with “you are here” markers.

I eventually made my way to nuclear medicine where I met with my clinician mentor, Dr. Joseph Osborne. I was a little disappointed to find out that the project I was supposed to be working on had been recently cancelled due to lack of funding, but Dr. Osborne had several other options to discuss with me. We eventually settled on a PET imaging project that would require me to understand all components of nuclear medicine from compounding radiotracers in the radiopharmacy to image analysis of PET scans. Dr. Osborne took me on several tours of the facilities including a clinical and micro- PET scanners as well as the on-site cyclotron used to generate the more transient radionuclides like F¹⁸.

I also observed Dr.’s Ronan Killeen and Alain Ghanem while they were reading radiological report from a variety of patients using a variety of techniques including CT, MRI, PET, and gamma scan. What I found most interesting about this experience was learning about the different radiotracers and how they were modified to provide clinically relevant information. For instance, one gamma scan procedure I learned about was Indium-111 scintography, a procedure that involves isolating white blood cells from 40-60mL of a patient’s blood, non-specifically labeling them with the Indium isotope, and then injecting them back into the patient. Over the course of 48 hours, the radiolabeled neutrophils migrate to points of inflammation/infection and show up as gamma hotspots, allowing clinicians to identify infected regions. On one such scan, a patient appeared to have a hot spot on the lower portion of his leg. When a nurse was sent to investigate, it was found that the patient had a small scratch at that location, indicating the accuracy and sensitivity of this test.