NMTCB CNMT study guide
NMTCB CNMT, administered by NMTCB (Nuclear Medicine Technology Certification Board), is mapped here as 5 topic areas; the heaviest are D5 — Clinical Procedures (40%), D3 — Pharmaceutical & Radiopharmaceutical Agents (25%) and D4 — Instrumentation Operation & QC (15%).
About this course: Study nuclear medicine physics, safety, radiopharmacy, instrumentation and clinical procedures. This focused 51-question bank provides practice, not a computer-adaptive exam simulation.
NMTCB CNMT at a glance
- Questions
- 90
- Time allowed
- approximately 1 hour 55 minutes
- Passing standard
- scaled score of 375 on a 200–500 scale = pass
- Format
- Computer Adaptive Test (CAT): each examinee answers 90 items (unscored pretest items seamlessly embedded)
- Standard / edition
- NMTCB Annual Report 2024, printed page 5, Scaled Score Information
- Administered by
- NMTCB (Nuclear Medicine Technology Certification Board)
Source: NMTCB Annual Report 2024, printed page 5, Scaled Score Information, NMTCB (Nuclear Medicine Technology Certification Board). Confirm current details with the exam owner before you book.
Topic areas and weights
| Topic area | Weight | Concepts | Guide |
|---|---|---|---|
| D1 — Radiation Physics & Detection | 7% | 2 | Section below |
| D2 — Radiation Safety & Regulations | 13% | 6 | Section below |
| D3 — Pharmaceutical & Radiopharmaceutical Agents | 25% | 11 | Section below |
| D4 — Instrumentation Operation & QC | 15% | 6 | Section below |
| D5 — Clinical Procedures | 40% | 15 | Section below |
Study plan in this course
- Decay Modes & Half-Life Math — 3 cards · free
- Detection, Windows & Counting Statistics — 3 cards · free
- NRC Dose Limits & ALARA — 3 cards · free
- Contamination, Transport, Written Directives & Waste — 4 cards · full course
- The Mo-99/Tc-99m Generator & Its QC — 4 cards · full course
- Cardiac, Bone & Renal Agents — 3 cards · full course
- Lung, Liver, Endocrine, Brain & Therapy Agents — 5 cards · full course
- Dose Calibrator & Gamma Camera QC — 3 cards · full course
- SPECT, PET & Non-Imaging Detectors — 3 cards · full course
- Cardiac Procedures — MPI & MUGA — 3 cards · full course
- Bone & Lung Procedures — 3 cards · full course
- Renal, Hepatobiliary & GI Procedures — 3 cards · full course
- Thyroid Uptake & Endocrine Therapy — 3 cards · full course
- Brain, Infection & Oncology Imaging — 3 cards · full course
- Theranostics, Patient Care & Artifacts — 4 cards · full course
D1 — Radiation Physics & Detection
D1 — Radiation Physics & Detection carries 7% of the NMTCB CNMT blueprint used in this course, the 5th-largest of its 5 weighted areas. It spans 2 concepts. The course teaches it in 2 study units: Decay Modes & Half-Life Math and Detection, Windows & Counting Statistics.
What D1 — Radiation Physics & Detection covers
- Decay & Half-life — IAEA Tc-99m radioisotope series + StatPearls Mo99/Tc99m
- Detection & Statistics — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
Common mistakes in D1 — Radiation Physics & Detection
- 'Tc-99m and Tc-99 are the same' — isomeric transition, different states
- 'PET uses a collimator' — PET uses coincidence detection, no collimator
Key terms for D1 — Radiation Physics & Detection
photopeak · effective half-life
How D1 — Radiation Physics & Detection connects to other areas
- Detection & Statistics links to PET — D4 — Instrumentation Operation & QC
Official references for D1 — Radiation Physics & Detection
- IAEA Tc-99m radioisotope series + StatPearls Mo99/Tc99m
- Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
In the app this area comes with 6 memory cards and 7 module-quiz questions and is part of the free starting modules.
D2 — Radiation Safety & Regulations
D2 — Radiation Safety & Regulations carries 13% of the NMTCB CNMT blueprint used in this course, the 4th-largest of its 5 weighted areas. It spans 6 concepts. The course teaches it in 2 study units: NRC Dose Limits & ALARA and Contamination, Transport, Written Directives & Waste.
What D2 — Radiation Safety & Regulations covers
- Dose Limits — NRC 10 CFR 20 + 10 CFR 35
- ALARA & Shielding — NRC 10 CFR 20 + 10 CFR 35
- Contamination & Surveys — NRC 10 CFR 20 + 10 CFR 35
- Transport & Receipt — NRC 10 CFR 20 + 10 CFR 35
- Written Directives — NRC 10 CFR 20 + 10 CFR 35
- Handling & Waste — NRC 10 CFR 20 + 10 CFR 35
Common mistakes in D2 — Radiation Safety & Regulations
- 'shield beta with lead' — use low-Z plastic first to avoid bremsstrahlung
- 'the tech decides the therapy dose' — the authorized user's written directive governs; a deviation is a medical event
Key terms for D2 — Radiation Safety & Regulations
written directive · medical event
How D2 — Radiation Safety & Regulations connects to other areas
- Contamination & Surveys links to Counting & Survey — D4 — Instrumentation Operation & QC
- Written Directives links to Endocrine Therapy — D5 — Clinical Procedures
Official references for D2 — Radiation Safety & Regulations
- NRC 10 CFR 20 + 10 CFR: 35
In the app this area comes with 7 memory cards and 7 module-quiz questions and is part of the free starting modules.
D3 — Pharmaceutical & Radiopharmaceutical Agents
D3 — Pharmaceutical & Radiopharmaceutical Agents carries 25% of the NMTCB CNMT blueprint used in this course, the second-largest of its 5 weighted areas. It spans 11 concepts. The course teaches it in 3 study units: The Mo-99/Tc-99m Generator & Its QC, Cardiac, Bone & Renal Agents and Lung, Liver, Endocrine, Brain & Therapy Agents.
What D3 — Pharmaceutical & Radiopharmaceutical Agents covers
- Generator — IAEA Tc-99m radioisotope series + StatPearls Mo99/Tc99m
- Generator QC — IAEA Tc-99m radioisotope series + StatPearls Mo99/Tc99m
- Labeling & Impurities — IAEA Tc-99m radioisotope series + StatPearls Mo99/Tc99m
- Cardiac — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Bone — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Renal — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Lung — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Hepatic — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Endocrine — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Brain/Infection/GI — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Therapy & PET — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
Common mistakes in D3 — Pharmaceutical & Radiopharmaceutical Agents
- 'sulfur colloid and HIDA are interchangeable liver agents' — colloid = RES, HIDA = biliary
- 'free pertechnetate goes to the liver' — free goes to stomach/thyroid; hydrolyzed-reduced Tc goes to liver
Key terms for D3 — Pharmaceutical & Radiopharmaceutical Agents
moly breakthrough · pertechnetate (TcO4-)
How D3 — Pharmaceutical & Radiopharmaceutical Agents connects to other areas
- Renal links to Renal — D5 — Clinical Procedures
- Hepatic links to Hepatobiliary — D5 — Clinical Procedures
- Brain/Infection/GI links to Infection — D5 — Clinical Procedures
- Therapy & PET links to Oncology PET — D5 — Clinical Procedures
- Labeling & Impurities links to Hybrid & Artifacts — D5 — Clinical Procedures
Official references for D3 — Pharmaceutical & Radiopharmaceutical Agents
- IAEA Tc-99m radioisotope series + StatPearls Mo99/Tc99m
- Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
In the app this area comes with 12 memory cards and 12 module-quiz questions in the full course.
D4 — Instrumentation Operation & QC
D4 — Instrumentation Operation & QC carries 15% of the NMTCB CNMT blueprint used in this course, the third-largest of its 5 weighted areas. It spans 6 concepts. The course teaches it in 2 study units: Dose Calibrator & Gamma Camera QC and SPECT, PET & Non-Imaging Detectors.
What D4 — Instrumentation Operation & QC covers
- Dose Calibrator — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Gamma Camera — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Camera QC — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- SPECT — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- PET — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Counting & Survey — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
Common mistakes in D4 — Instrumentation Operation & QC
- 'linearity is a daily check' — constancy is daily, linearity is quarterly
- 'PET needs a collimator like SPECT' — coincidence detection replaces the collimator
Key terms for D4 — Instrumentation Operation & QC
photopeak window
How D4 — Instrumentation Operation & QC connects to other areas
- PET links to Detection & Statistics — D1 — Radiation Physics & Detection
- Counting & Survey links to Contamination & Surveys — D2 — Radiation Safety & Regulations
Official references for D4 — Instrumentation Operation & QC
- Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
In the app this area comes with 6 memory cards and 6 module-quiz questions in the full course.
D5 — Clinical Procedures
D5 — Clinical Procedures carries 40% of the NMTCB CNMT blueprint used in this course, the largest of its 5 weighted areas. It spans 15 concepts. The course teaches it in 6 study units: Cardiac Procedures — MPI & MUGA, Bone & Lung Procedures, Renal, Hepatobiliary & GI Procedures, Thyroid Uptake & Endocrine Therapy, Brain, Infection & Oncology Imaging and Theranostics, Patient Care & Artifacts.
What D5 — Clinical Procedures covers
- Cardiac — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Skeletal — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Pulmonary — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Renal — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Hepatobiliary — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- GI — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Endocrine — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Endocrine Therapy — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Neuro — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Infection — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Oncology PET — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Theranostics — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Patient Care — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Pediatrics — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
- Hybrid & Artifacts — Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
Common mistakes in D5 — Clinical Procedures
- 'dobutamine is a vasodilator' — dobutamine is an inotrope; regadenoson/adenosine/dipyridamole are vasodilators
- 'renal obstruction can't be distinguished from dilation' — Lasix separates them
Key terms for D5 — Clinical Procedures
V/Q mismatch · gated SPECT
How D5 — Clinical Procedures connects to other areas
- Renal links to Renal — D3 — Pharmaceutical & Radiopharmaceutical Agents
- Hepatobiliary links to Hepatic — D3 — Pharmaceutical & Radiopharmaceutical Agents
- Endocrine Therapy links to Written Directives — D2 — Radiation Safety & Regulations
- Infection links to Brain/Infection/GI — D3 — Pharmaceutical & Radiopharmaceutical Agents
- Oncology PET links to Therapy & PET — D3 — Pharmaceutical & Radiopharmaceutical Agents
- Hybrid & Artifacts links to Labeling & Impurities — D3 — Pharmaceutical & Radiopharmaceutical Agents
Official references for D5 — Clinical Procedures
- Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines
In the app this area comes with 19 memory cards and 19 module-quiz questions in the full course.
Details that change — checked against official sources
- NMTCB CNMT scores are reported on a 200–500 scale, with 375 as the passing score, for examinations since January 1, 2018. — NMTCB Annual Report 2024: Scaled Score Information, checked 2026-10-09
Official references
- NMTCB Annual Report 2024: Scaled Score Information
- NRC 10 CFR 20 + 10 CFR: 35
- NMTCB exam matrix + Computer Adaptive Test pages, nmtcb.org
- arrt.org nuclear-medicine content specs + ARRT Annual Exam Report: 2025
- IAEA Tc-99m radioisotope series + StatPearls Mo99/Tc99m
- Christian & Waterstram-Rich 'Nuclear Medicine and PET/CT Technology and Techniques' + SNMMI procedure guidelines