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what is nuclear medicine?

Nuclear Medicine is a medical and imaging specialty in which radiopharmaceuticals (molecules tagged with a radioactive marker) are administered to patients either for diagnosis or treatment of diseases. Once administered for diagnosis either by injection, orally or by inhalation, the patient is placed in a dedicated hybrid camera (SPECT/CT or PET/CT), which captures radiation emitted from the body to generate images of the radiopharmaceutical distribution. From these images alterations in biological processes can be identified and diseases diagnosed or monitored during treatment.  Numerous FDA-approved commercially available radiopharmaceuticals are used to image a variety of processes, including but not limited to tumor metabolism, bone turnover, cardiac perfusion, brain function, pulmonary perfusion and ventilation, and endocrine functions.

The two main technologies used to generate these images are SPECT/CT and PET/CT which combine a functional imaging tool (SPECT or PET) with an anatomic imaging tool CT (Computed Tomography). The combination of both imaging scanners allows for a more thorough assessment of disease and therefore unique diagnostic capabilities unmatched by any other imaging equipment.

The other aspect of nuclear medicine consists of therapies in which radioactive molecules are administered for treatment of a variety of diseases such as hyperthyroidism, thyroid cancer, liver cancers, prostate cancer metastases to bone, neuroendocrine tumors and certain lymphomas. Lu-177 PSMA for treatment of metastatic prostate cancer is currently awaiting FDA approval for use in the United States.

Over 100 different imaging and therapeutic protocols are in place at UW Medicine to care for patients. The UW Division of Nuclear Medicine continues to innovate and develop novel imaging protocols in response to unmet clinical needs and new medical advances.

Strengths of our UW nuclear medicine division include:

  1. Unique technical capabilities in PET/CT and SPECT/CT scanners. A PET/MRI scanner is scheduled to be installed in 2023.
  2. Dual-trained technologists capable of performing both functional (PET, SPECT) and anatomic scans (CT).
  3. Extensive clinical experience of nuclear medicine faculty in answering complex medical management questions using hybrid imaging.
  4. A much broader range of services offered than at any other nuclear medicine facility in the region. Our division ranks among the very best in the nation with continued clinical growth and diversification. This is underscored by the fact that top equipment manufacturers look to us and to our nuclear medicine faculty (physics and clinical) for input regarding the future of the discipline.
  5. A proven track record of clinical service excellence.

Overview

The University of Washington division of Nuclear Medicine offers a one- or two-year non-ACGME accredited PET/CT Fellowship program with emphasis on cancer imaging.

Our division is a part of the Department of Radiology within the School of Medicine and has a long tradition of excellence in PET imaging, PET/CT physics and PET radiopharmaceutical development.

Since its inception in July 2006, the PET/CT Fellowship program was designed as a one-year program of clinical training. Teaching encompasses all clinical applications of PET imaging for cancer, neurologic disorders, and cardiac disease.

A second year of advanced PET/CT Fellowship is optional for those seeking additional training in hybrid imaging (PET/CT and SPECT/CT). Second year fellowship training availability is contingent on good training performance during the first fellowship year.

Our PET/CT fellowship program allows Nuclear Medicine specialists to gain extensive specialty training in hybrid imaging (PET/CT and SPECT/CT imaging), an area of imaging that has rapidly expanded over the past few years. The UW Division of Nuclear Medicine has been a leader in developing these areas of imaging for which there is a real deficit of trained providers. The training consists of interpretation of the more complex PET/CT and now SPECT/CT scans, development and review of clinical protocols, and selection of protocols for patients. All activities are under the supervision of expert faculty members. This fellowship program also consists of one-on-one instruction by faculty and attendance at state-of-the-art lectures designed to teach hybrid imaging. Research opportunities are also provided. Fellowship responsibilities also include teaching basic nuclear medicine and PET imaging to nuclear medicine residents, diagnostic radiology residents, and medical students rotating on the nuclear medicine service.

The optional second year fellowship training is for those wishing to continue to advance their knowledge base by interpreting more complex imaging cases. This advanced hybrid imaging fellowship position emphasizes either PET/CT or SPECT/CT training across oncologic, neurologic and cardiac applications.

PET/CT fellows are based primarily at the University of Washington Medical Center (UWMC) – Montlake. Scans from our affiliated teaching hospitals are read from UWMC-Montlake. These include the University of Washington Medical Center – Montlake (UWMC-M), University of Washington Medical Center – Northwest (UWMC-NW), Harborview Medical Center (HMC), and Fred Hutch Cancer Center (FHCC).

Each hospital nuclear medicine service has state-of-the-art gamma cameras with single-photon emission computed tomography/CT (SPECT/CT). State-of-the-art PET/CT cameras are deployed at UWMC-Montlake and FHCC.

 Multiple research opportunities are available to fellows.

Fellows meeting eligibility requirements may be considered as acting instructors – provisional in the Department of Radiology.

Mission Statement

Our mission statement echoes that of the University of Washington School of Medicine (UWSOM) which is dedicated to improving the general health and well-being of the public. We are committed to training PET/CT fellows to improve the health of the public by the practice of advanced Nuclear Medicine in particular the use of hybrid imaging techniques (PET/CT and SPECT/CT). In addition to clinical excellence our trainees are supported in their scholarly activities to advance medical knowledge and contribute to the scientific literature. The PET/CT fellowship program and Nuclear Medicine services at the University of Washington Medical Center and affiliated sites support a significant amount of uncompensated care for underserved populations in alignment with the overall mission of the UW School of Medicine.

Program Aims

We train PET/CT fellows in the practice of advanced Nuclear Medicine and apply hybrid imaging techniques (PET/CT and SPECT/CT) to diagnose diseases using radionuclides. Fellows receive instruction and experience that allows for gradual independence as they progress through their training. At graduation fellows have advanced competency to practice general and advanced nuclear medicine independently. Our graduates have been able to transition to academic positions of service throughout the country. Many have become educational leaders for future generations of physicians as well as contributing to research within the field of Nuclear Medicine.

 

Facilities and Equipment

PET/CT fellows are based primarily at the University of Washington Medical Center – Montlake (UWMC-ML). Scans from our affiliated teaching hospitals are read from UWMC-ML. These include the University of Washington Medical Center – Montlake (UWMC-ML), University of Washington Medical Center – Northwest (UWMC-NW), Harborview Medical Center (HMC), and Fred Hutch Cancer Center (FHCC).

Nuclear medicine service at each hospital has state-of-the-art gamma cameras with single-photon emission computed tomography/CT (SPECT/CT). State-of-the-art PET/CT cameras are deployed at UWMC-Montlake and FHCC.

Research Opportunities

PET/CT fellows have the opportunity to engage in research projects under the guidance of section faculty members during the academic year. These projects are expected to result in at least one scientific or educational paper in a peer-reviewed journal. Multiple research opportunities are available.

Research Facilities

UWMC-ML has a well-equipped animal laboratory, excellent facilities for radiochemical and radiopharmaceutical research, and a large instrumentation development and imaging research laboratory. There is a cyclotron at UWMC-ML and a radioisotope production facility used for the positron emission tomography (PET) program.

Specific research programs in nuclear medicine include radionuclide evaluation of cardiovascular disease, radio-pharmaceutical development, PET studies of tumor biology, radiolabeled monoclonal antibody imaging and therapy of hematologic tumors, brain imaging, biokinetic modeling, and software design.

Imaging Research Lab

An active nuclear medicine physics group has been at the forefront of developing cutting-edge technology. Research projects include camera detector design, camera electronics, image reconstruction algorithms, and image quality assessment.

How to apply

Our Nuclear Medicine PET/CT Fellowship program is recruiting for the 2028-2029 academic year and beyond.

Applicants to the one-year PET/CT Fellowship must have successfully completed:

1) a residency program in nuclear medicine, or

2) a diagnostic radiology residency training program, or

3) a combined Nuclear Medicine/Diagnostic Radiology program (qualifying for ABR and ABNM certifications), or

4) will be accepted as part of the ABR Alternate Pathway program.

A second year of PET/CT fellowship focusing on advanced hybrid imaging (PET/CT and SPECT/CT) may be offered to qualified applicants. Applicants for a second year of fellowship must have successfully completed the one-year University of Washington PET/CT Fellowship. Eligibility is at the discretion of the fellowship program director.

All candidates should have passed USMLE Step 3 prior to joining our program.

To apply, please send supporting documentation requested to nmadmin@uw.edu.

Requested documentation:

For All Candidates

  • Current Curriculum Vitae (CV) (should include training history and relevant work experience with dates, publications and professional presentations, leadership and volunteer experience)
  • A brief Personal Statement, addressing your interest in nuclear medicine and your career goals/plans (one page preferred, include name, date and signature). Please include date you are interested in starting training.
  • USMLE scores (Copies of results for Steps 1, 2-CK and 3)
  • Copy of medical school transcripts
  • Copy of Dean’s Letter from Medical School
  • Medical School Diploma (official copy with notarized translation if not in English)
  • Documentation of PGY 1 year (as applicable)
  • Documentation of completion of residency program (as applicable)
  • Board Certification(s) (as applicable)
  • Three reference letters, dated and signed on department letterhead:
    • One (1) from the director of your current residency/fellowship program
    • One (1) from a radiologist familiar with your work
    • One (1) from any physician that you worked with and has observed you professionally

For International Candidates (including Canada)

Submit above required documentation plus:

  • OET exam (in lieu of USMLE Step 2- Clinical Skills (CS) exam)
  • ECFMG Certificate (For applicants with Medical Degrees issued outside the United States/Canada)

Please do not send a photograph as part of the application process.

Please have professional references send original letters of recommendation emailed to  nmadmin@uw.edu. Letters of recommendations should be addressed to the UW Nuclear Medicine PET/CT program director:

Hubert Vesselle, Ph.D., M.D.

Professor of Radiology
Director of Nuclear Medicine PET/CT Fellowship Program
University of Washington Medical Center
1959 N.E. Pacific St., Box 357233
Seattle, WA 98195-7223

If you need further assistance, please contact NM administration at: nmadmin@uw.edu

The University of Washington is committed to fostering an inclusive, respectful and welcoming community for all. As an equal opportunity employer, the University considers applicants for employment without regard to race, color, creed, religion, national origin, citizenship, sex, pregnancy, age, marital status, sexual orientation, gender identity or expression, genetic information, disability, or veteran status consistent with UW Executive Order No. 81.

We recruit trainees on the basis of merit. All candidates are considered without bias towards race, gender, sexual orientation, religion, or disability. Our training adheres to the UW GME expectation of diversity and inclusion. All residents are treated respectfully and without bias during their training to facilitate progress and retention.