OVERVIEW

The course aims to provide specific skills related to the knowledge of the main radiopharmaceuticals used in Nuclear Medicine, either ready-to-use or prepared on-site, as well as the operations involved in the preparation/formulation of radiopharmaceuticals and the analytical techniques required for their quality control, in compliance with current regulations.Participants will be introduced to the Good Radiopharmacy Practice Guidelines for Nuclear Medicine (within the National context), the relevant regulatory framework, and the European Guidelines for the production, control, and handling of radiopharmaceuticals (including the Pharmacopoeia, Good Manufacturing Practice, and Scientific Guidelines on Radiopharmaceuticals issued by major institutions and scientific associations).Electrophoretic techniques for serum proteins and urine will be particularly emphasized and made available to students as one of the most commonly used techniques in laboratory activities.Immunoassay methods will also be covered, with the objective  of providing students with a foundational understanding of a widely used diagnostic technology.

AIMS AND CONTENT

LEARNING OUTCOMES

Know laboratory techniques of electrophoretic techniques of serum proteins and urine; production of radiopharmaceuticals through the use of a circular particle accelerator (cyclotron); production of the requested isotope, sending the material to the synthesis module, preparation of the radiopharmaceutical, execution of quality controls for the release of the radiopharmaceutical (injection for the execution of PET; The Immunometry Techniques course aims to describe the main technical methods used for the execution of immunometric tests both with manual methodology and with automatic instruments. The dilution techniques most used in the analysis laboratory are also illustrated.

Understanding Laboratory Techniques for Serum and Urine Protein Electrophoresis
The objective is to acquire knowledge of the laboratory techniques involved in electrophoretic analysis of serum and urine proteins.

The Course "Immunometric Techniques"
The Immunometric Techniques course aims to describe the main technical methods used to perform immunometric tests, both through manual procedures and with automated instruments.

In addition, the course covers the most commonly used dilution techniques in clinical analysis laboratories.

AIMS AND LEARNING OUTCOMES

Radiopharmaceutical and Ciclotrone

The educational offering will be enriched with elements concerning the process of acquiring radiopharmaceuticals in the hospital setting, along with guidance on how to optimize radiopharmaceutical production, manage the dosage for each individual radiopharmaceutical, or for the concurrent use of multiple radiopharmaceuticals, as commonly occurs in daily clinical practice.

Overall, the theoretical knowledge gained during the course will enable learners to understand the operations of a Radiopharmacy/Hot Lab in support of Conventional Nuclear Medicine, PET imaging, and Radiometabolic Therapy.

The primary goal of the course is to train qualified professionals who, through specific expertise, can be integrated into the field of Nuclear Medicine, understanding its operational dynamics and, potentially, being able to analyze and resolve issues related to the use of radiopharmaceuticals.

Electrophoretic Techniques

The objectives of this module are aimed at introducing students to the Electrophoresis and Specific Proteins sector, focusing on:

• Biological materials and sample collection

• Use of anticoagulants, sample handling, storage, and centrifugation

• Identification and labelling of biological specimens

Particular attention is given to the setup and execution of the electrophoresis session, covering:

• Principles and methods of electrophoresis

• Equipment and accessories (power supply, electrophoresis chamber, buffer, dye, densitometer)

• Electrophoretic run phases: sample application, migration, staining, detection

Students will learn the electrophoretic separation of proteins, including:

• Standard electrophoretic profile

• Protein fractions (albumin - α1 - α2 - β1 - β2 - γ)

• Specific proteins identifiable within the electrophoretic pattern

Additionally, the course covers Immunofixation Electrophoresis (IFE) on gel and the detection of Bence Jones proteins in gel-based systems.

Immunometry 

The module aims to provide students with a comprehensive understanding of the role of Laboratory Medicine as a clinical science that provides essential information throughout the clinical pathway. The course focuses on:

• Knowledge of major immunometric techniques for detecting antigens and antibodies

  • From non-labeled assays to those involving labeled tracers

  • Comparison between competitive and non-competitive assays

  • Common challenges in immunometric analysis

  • Definition and clinical relevance of biomarkers

• Understanding of the humoral and cell-mediated immune response, and the role of laboratory diagnostics in evaluating immunopathological processes

• Acquisition of basic concepts in tumor immunology, with emphasis on the role of cancer immunotherapy as a new frontier in the treatment of neoplastic diseases

• Familiarity with the types and roles of plasma proteins as indicators of organ function

  • Recognizing how changes in plasma protein levels can reveal various diseases and help monitor the progression of numerous pathological conditions

PREREQUISITES

Students are required to have met the prerequisites established by the Academic Regulations and outlined in the Manifesto degli studi.

TEACHING METHODS

Lectures will be delivered in the classroom with the projection of electronic teaching materials, which will be made available on Aula Web.

Students with documented Specific Learning Disorders (SLD) or special educational needs are required to contact the course instructor(s) and the designated SLD Representative at the Department before the start of classes, in order to agree on specific teaching arrangements and ensure the proper achievement of learning objectives and outcomes.

SYLLABUS/CONTENT

Radiopharmaceuticals and Cyclotron

• Main radiopharmaceuticals used in Nuclear Medicine, either ready-to-use or prepared on-site;

• Radiopharmaceutical preparation/formulation procedures and the analytical techniques required for quality control, in compliance with current regulations;

• Good Radiopharmacy Practice (GRP) for Nuclear Medicine (in the national context), with an overview of the relevant regulatory framework and European Guidelines for the production, control, and handling of radiopharmaceuticals (Pharmacopoeia, Good Manufacturing Practice, and Scientific Guidelines on Radiopharmaceuticals issued by major institutions and scientific associations);

• Understanding the operations of a Radiopharmacy/Hot Lab in support of Conventional Nuclear Medicine, PET imaging, and Radiometabolic Therapy.

Electrophoresis:

Electrophoresis and Specific Proteins
• Biological materials and collection
• Proteins: general characteristics, structure (overview), functions, determination methods
• Automated instrumentation used in the field (operation)
• Electrophoretic separation of serum proteins
• Standard electrophoretic profile
• Fractions (albumin - α1 - α2 - β1 - β2 - γ)
• Specific proteins detectable in the electrophoretic trace
• Gammopathies
• Immunofixation Electrophoresis (IFE): method principles, procedure, result interpretation
• Evaluation of normal and pathological patterns
• Urine Electrophoresis
• Detection of Bence Jones protein: procedure, result interpretation
• Immunosubtraction and interpretation of results

Electrophoretic Techniques
• Definition of electrophoresis: principle, equipment and accessories (power supply, electrophoretic chamber, buffer, stain, densitometer)
• Migration and influencing factors (voltage, frictional force, migration speed, electrophoretic mobility; sample; buffer solution; ionic strength; Joule effect; electroendosmosis)
• Execution methods: free or frontal phase; on sieving and non-sieving support or zonal
• Zonal electrophoresis of serum proteins on paper, cellulose acetate, agarose gel, and in capillaries
• Methods
• Interpretation of migration and capillary graphs
• Evaluation of normal and pathological profiles
• Comparative methods

Immunometry:

• Function of Laboratory Medicine: study of the clinical pathway through the characteristics and activities of different types of clinical laboratories

• Main immunometric techniques for the detection of antigens or antibodies, ranging from non-labeled tests to those using labeled substances; comparison between competitive and non-competitive tests; issues in immunometric analyses; definition of biomarker

• Humoral and cell-mediated immune responses and the role of laboratory medicine in the assessment of immunopathological processes

• Acquisition of key concepts in tumor immunology and the role of oncological immunotherapy as a new frontier in cancer treatment

• Role of plasma proteins as indicators of the functionality of various organs, where alterations can reveal numerous diseases and allow monitoring of the progression of many conditions

RECOMMENDED READING/BIBLIOGRAPHY

slides that will be uploaded to AulaWeb after the lessons

TEACHERS AND EXAM BOARD

Exam Board

MARIO PASSALACQUA (President)

ELISABETTA FRATERNALE

MADDALENA MASTROGIACOMO

MAURIZIO BRUSCHI (President and Coordinator of Integrated Course)

LESSONS

LESSONS START

I semester, II year

Class schedule

TECHNIQUES OF CLINICAL CHEMISTRY

EXAMS

EXAM DESCRIPTION

The exam will be oral.

During the exam, the university’s regulations concerning the assessment of students with certified Specific Learning Disorders (SLD) or other special educational needs will be respected.
These may include, for example: extra time for written exams or the use of concept maps, which must be submitted to the instructors for approval at least one week prior to the exam date.

ASSESSMENT METHODS

A basic understanding of the subject matter is required for the exam to be considered satisfactory (i.e., to pass).