Presentations
- Evaluation of bone mineral density
- Gastroenteropancreatic and lung neuroendocrine tumours
- Hyperparathyroidism
- Pheochromocytoma / Paraganglioma
- Thyroid carcinoma, differentiated and non-differentiated
- Thyrotoxicosis for evaluation
Conditions
- Adrenal hypersecretory syndromes
- Graves disease
- Hyperparathyroidism
- MEN and other genetic conditions associated with poly-endocrinopathies
- Metabolic bone disease
- Neuroendocrine tumour hypersecretory syndromes
- Nodular thyroid disease
- Osteoporosis / Osteopaenia
- Subacute thyroiditis
PCH
- Child and adolescent conditions:
- bone mineral density
- hyperthyroidism
- thyroid malignancy
- Neonatal conditions:
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
No presentations / conditions listed
PCH
- Congenital hyperinsulinism
- Genetic disorders associated with endocrinopathies
- Hyperparathyroidism
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Endocrine anatomy, embryological origin, and physiology
- Adrenal glands:
- discuss the approach to an adrenal mass on CT, the diagnostic work-up of an adrenal lesion, and hypercortisolism
- understand hormone production and secretion of the adrenal glands, with particular attention to phaeochromocytomas and paraganglionomas
- Bone mineral density:
- therapies to improve bone health.
- calculate whether a significant interval change has occurred
- different BMD reference ranges
- dual energy X-ray absorptiometry (DXA) in the evaluation of bone mineral density and practical applications
- report DXA in accordance with the ANZBMS standards including absolute fracture risk
- Trabecular bone score
- technical limitations, artefacts, and common anatomical variants that may alter scan interpretation
- Parathyroids:
- discuss the difference between primary, secondary, and tertiary hyperparathyroidism, and the role of imaging in each of these settings
- understand physiology of PTH and regulation of secretion
- understand that the embryological origin of parathyroid tissue can help with localisation
- Pathophysiology of:
- adrenal hypersecretory syndromes
- hypo- and hyper-functioning thyroid nodules:
- correlate findings with relevant imaging
- indications for fine needle aspiration biopsy of thyroid nodules
- natural history of thyroid nodules, and the relationship of thyroid nodules to thyroid cancer
- primary, secondary, and tertiary hyperparathyroidism
- Thyroid gland:
- embryology and gross anatomy
- physiology of the thyroid gland and the hypothalamic–pituitary axis
- the mechanism of uptake of iodine / pertechnetate in thyroid tissue and how this may be affected during thyroid disease
- thyroid physiology in normal and pathological states, with respect to scintigraphic appearance
PCH
- Embryology and how it impacts on organ development
- Paediatric bone development and the impact on bone mineral density:
- bone densitometry in childhood skeletal dysplasias
- effect of childhood disease on bone growth and development
- reporting criteria for bone densitometry in childhood and adolescence
Investigations
- Functional imaging for neuroendocrine tumours:
- MIBG, labelled with I-123 or I-131
- PET radiotracers, such as Ga68 DOTATATE, F18 F- DOPA
- tektrotide (Tc-99m HYNIC-TOC)
- Parathyroid scintigraphy:
- imaging protocols for combined thyroid and parathyroid scintigraphy, including:
- choice of collimator
- correlative thyroid scintigraphy
- delayed imaging
- image subtraction techniques
- imaging of the mediastinum
- oblique imaging
- role of contrast CT and US in parathyroid imaging
- typical patterns of parathyroid adenomas / hyperplasia in the neck and in ectopic locations
- use of FCH PET in parathyroid imaging
- use of SPECT and SPECT / CT
- Tc-99m sestamibi imaging of the parathyroids
- DXA scanning
- ANZBMS reporting guidelines
- Frameworks for report fracture risk
- Thyroid imaging:
- RAI and imaging for hyperthyroidism and malignancy
- scintigraphy using I-123, SPECT / CT, and technetium, along with the ability to explain when to use them
- the role of PET / CT imaging with FDG and other PET radiotracers
- the role of ultrasound imaging and imaging guided biopsy in evaluation and diagnosis of thyroid pathology
Procedures
- Patient preparation needed prior to:
- mark thyroid nodule(s) so the nodule(s) can be clearly identified and related to radiological findings
- MIBG imaging
- parathyroid scintigraphy
- thyroid scintigraphy
- treatment of benign thyroid disease
PCH
- DXA
- Thyroid imaging
- Parathyroid scintigraphy
- F-18 F-DOPA PET / CT for congenital hyperinsulinism
- Functional imaging for neuroendocrine tumours
- Patient demographics, including geographic location, socioeconomic status, ethnicity, and cultural background, and the considerations when managing and following up these patients, such as travel from rural to metropolitan areas
- Radiation protection, patient safety
- Radioisotope decay and patient proximity to therapy / examination
PCH
- Administration of radioisotopes to children, and the impact on the family and child
