Medical Imaging Graduates' Knowledge About Infection Prevention and Control in Pharmaceutical Administration Including Contrast in CT and Radiopharmaceutical in Nuclear Medicine.

In 2015, the Society of Nuclear Medicine and Molecular Imaging Technologist Section (SNMMI-TS) launched a multiyear quality initiative to help prepare the technologist workforce for an evidence-based health-care delivery system that focuses on quality. To best implement the quality strategy, the SNMMI-TS first surveyed technologists to ascertain their perception of quality and current measurement of quality indicators. Methods: An internet survey was sent to 27,989 e-mail contacts. Questions related to demographic data, perceptions of quality, quality measurement, and opinions on the minimum level of education are discussed in this article. Results: A total of 4,007 (14.3%) responses were received. When asked to list 3 words or phrases that represent quality, there were a plethora of different responses. The top 3 responses were image quality, quality control, and technologist education or competency. Surveying patient satisfaction was the most common quality measure (80.9%), followed by evaluation of image quality (78.2%). Evaluation of image quality (90.3%) and equipment functionality (89.4%) were considered the most effective measures. Technologists' differentiation between quality, quality improvement, quality control, quality assurance, and quality assessment seemed ambiguous. Respondents were confident in their ability to assess and improve quality at their workplace (91.9%) and agreed their colleagues were committed to delivering quality work. Of note, 70.7% of respondents believed that quality is directly related to the technologist's level of education. Correspondingly, respondents felt there should be a minimum level of education (99.5%) and that certification or registry should be required (74.4%). Most respondents (59.6%) felt that a Bachelor's degree should be the minimum level of education, followed by an Associate's degree (40.4%). Conclusion: To best help nuclear medicine technologists provide quality care, the SNMMI-TS queried technologists to discern perceptions of quality in nuclear medicine. The results show that technologists believe image quality and quality control are the most important determinants. Most respondents felt that quality is directly related to the level of education of the technologist acquiring the scan. However, the responses obtained also demonstrated variation in perception of what represents quality. The SNMMI-TS can use the results of the study as a benchmark of current technologists' knowledge and performance of quality measures and target educational programs to improve the quality of nuclear medicine and molecular imaging.

Occupational radiation exposure in nuclear medicine technologists: A scoping review.

To become registered radiation worker as radiographer, nuclear medicine (NM) technologist, or radiotherapist in Australian health system, a 4-y bachelor's degree, or a 2-y master's degree in medical imaging (MI), NM, or radiation therapy (RT) approved by the Australian Health Practitioner Regulation Agency is required. During their supervised clinical practice period, it is crucial to monitor students' occupational radiation dose as their annual dose limit is 1mSvy-1 unlike regular occupational dose of 20mSvy-1. In this study, the distribution and trend of occupational dose among over 300 radiography, NM, and radiotherapy student practitioners per year in an Australian university are analyzed over a period of 10y (2013-22). The overall average annual effective dose was well below the dose limit set for the students. Among the three streams-MI, NM, and RT-NM students had the highest annual dose.

Nuclear medicine technologists (NMTs) are experts in the acquisition of myocardial perfusion (MP) images, in addition to the many other types of images acquired in nuclear medicine departments. NMTs are expected to ensure that images are of optimal quality in order to facilitate accurate interpretation by nuclear medicine physicians (NMPs). However, ensuring optimal image quality is a shared responsibility between NMTs and NMPs. The shared responsibilities have resulted in inconsistences in the assessment of MP image quality among NMTs in different departments. Little is known about the perceptions and experiences of NMTs on the assessment of MP image quality. Therefore, the focus of this research study was NMTs. The aim of this qualitative study was to explore and describe the perceptions and experiences of NMTs on the assessment of MP image quality. The research question was, "How do NMTs perform the responsibility of ensuring MP image quality?" Methods: The study followed a qualitative explorative approach using focus groups as a means of collecting data. Nineteen NMTs from 4 academic hospitals were purposefully selected to participate. A semistructured questionnaire was used to conduct the focus groups. The collected data were managed using a computer-aided qualitative data analysis software program to formulate codes, categories, and themes. Results: Two overarching themes emerged from the data: the management of MP images, and the resources required to support NMTs. NMTs differed in their management of MP images because of the prevailing circumstances in their respective departments. In addition, the results suggested that NMTs' level of involvement in the assessment of MP image quality was influenced by the availability of resources required for processing and assessing image quality. Conclusion: Despite the shared responsibility in the assessment of MP image quality with NMPs, NMTs considered themselves as playing a major role. However, resources to facilitate the assessment of image quality are considered necessary and should be available to support NMTs in submitting images of optimal quality for interpretation.

As the health care environment continues to change and morph into a system focusing on increased quality and evidence-based outcomes, nuclear medicine technologists must be reminded that they play a critical role in achieving high-quality, interpretable images used to drive patient care, treatment, and best possible outcomes. A survey performed by the Quality Committee of the Society of Nuclear Medicine and Molecular Imaging Technologist Section demonstrated that a clear knowledge gap exists among technologists regarding their understanding of quality, how it is measured, and how it should be achieved by all practicing technologists regardless of role and education level. Understanding of these areas within health care, in conjunction with the growing emphasis on evidence-based outcomes, quality measures, and patient satisfaction, will ultimately elevate the role of nuclear medicine technologists today and into the future. The nuclear medicine role now requires technologists to demonstrate patient assessment skills, practice safety procedures with regard to staff and patients, provide patient education and instruction, and provide physicians with information to assist with the interpretation and outcome of the study. In addition, the technologist must be able to evaluate images by performing technical analysis, knowing the demonstrated anatomy and pathophysiology, and assessing overall quality. Technologists must also be able to triage and understand the disease processes being evaluated and how nuclear medicine diagnostic studies may drive care and treatment. Therefore, it is imperative that nuclear medicine technologists understand their role in the achievement of a high-quality, interpretable study by applying quality principles and understanding and using imaging techniques beyond just basic protocols for every type of disease or system being imaged. This article focuses on quality considerations related to ventilation-perfusion imaging. It provides insight on appropriate imaging techniques and protocols, true imaging variants and tracer distributions versus artifacts that may result in a lower-quality or misinterpreted study, and the use of SPECT and SPECT/CT as an alternative providing a high-quality, interpretable study with better diagnostic accuracy and fewer nondiagnostic procedures than historical planar imaging.

Nuclear medicine (NM) is a rapidly developing field. In Portugal, no occupational study has been conducted yet that characterizes the professional profile of NM technologists (NMTs). We investigated the clinical tasks performed by NMTs in Portugal, analysing their practices with regard to radiation protection matters and their compliance with established international guidelines for best practice. A questionnaire targeted at NMTs was constructed and distributed among 105 NMTs working in Portugal (an estimated 88% of the NMT population in Portugal). Questions addressed the demographic profile, academic background and professional profile of NMTs, with emphasis on practices adopted in NM tasks and radiation protection. In all, 51.4% of the 105 NMTs responded. The majority (70.4%) of the NMTs studied were women, with an average age of 34.3 (± 10.4) years and 11.6 (± 10.6) years of professional experience. The reported NM tasks included radiopharmaceutical preparation (96.3%), PET (44.4%), intravenous administration (74.1%), administration with dose containers (97.7%) and administration with syringe shields (76.9%). The use of a protective lead apron was rare (2.7%). The average individual dose recorded was 3.8 (± 2.7%) mSv/year. NMTs in Portugal are generally young women with specialized academic education, consistent with the developments in NM technology and education in Portugal since the past decade. The majority of NMT activities are focused on conventional NM. The estimated annual average individual dose is below the established legal limit. However, radiation protection practices related to staff protection are not harmonized, revealing key aspects to be considered in future education and training.

The field of nuclear medicine and molecular imaging has grown tremendously over the past several years with the approval of new imaging agents, diagnostic radiopharmaceuticals, and radiopharmaceutical therapies. Clinical research continues to expand within nuclear medicine and molecular imaging departments. Working as a nuclear medicine technologist on a clinical trial or with investigational radiopharmaceuticals can be quite different from working in an approved-drug setting in the clinic. Nuclear medicine technologists involved in clinical trials can be at the front line of following rigorous trial requirements and ensuring good-quality data. The details of working in clinical research are often not taught in nuclear medicine technologist programs. As such, there is an emerging need for education about clinical research for both experienced and new nuclear medicine technologists, particularly for those working with investigational radiopharmaceuticals. This article is an introduction to the SNMMI Clinical Trials Network Research Series for Technologists. This series of articles aims to provide education on working in the context of a clinical trial within the nuclear medicine department. The following 7 topics will be addressed in the series: ethical issues in clinical research, application of good clinical practice to clinical research in medical imaging, contract research organizations with application in clinical imaging, a clinical research primer on the regulatory process for how and when radiopharmaceuticals can be used and the role of the institutional review board, use of imaging agents in therapeutic drug development and approval, imaging agent trials, and imaging agents with radiopharmaceutical therapies in clinical trials. Other topics may be added over the course of the development of the series.

This work investigates the applicability of using data from personal monitoring dosimeters to assess photon energies to which medical workers were exposed. Such determinations would be important for retrospective assessments of organ doses to be used in occupational radiation epidemiology studies, particularly in the absence of work history or other information regarding the energy of the radiation source. Monthly personal dose equivalents and filter ratios under two different metallic filters contained in the Luxel+® dosimeter were collected from Landauer, Inc. from 19 nuclear medicine (NM) technologists employed by three medical institutions, the institution A only performing traditional NM imaging (primarily using 99mTc) and institutions B and C also performing positron emission tomography (PET, using 18F). Calibration data of the Luxel+® dosimeter for various xray spectra were used to establish ranges of filter ratios from 1.1 to 1.6 for 99mTc and below 1.1 for 18F. Median filter ratios were 1.33 (Interquartile range (IQR), 0.15) for institution A, 1.08 (IQR, 0.16) for institution B, and 1.08 (IQR, 0.14) for institution C. The distributions of these filter ratios were statistically-significantly different between the institution A only performing traditional NM imaging and institutions B and C also performing PET imaging. In this proof-of-concept study, filter ratios from personal monitoring dosimeters were used to assess differences in photon energies to which NM technologists were exposed. Dosimeters from technologists only performing traditional NM procedures mostly showed Al/Cu filter ratios above 1.2, those likely performing only PET in a particular month had filter ratios below 1.1, and those which showed filter ratios between 1.1 and 1.2 likely came from technologists rotating between traditional NM and PET imaging in the same month. These results suggest that it is possible to distinguish technologists who only worked with higher-energy procedures versus those who only worked with other types of NM procedures.

Ionizing radiation used in diagnostic nuclear medicine procedures has the potential to have biologic effects on a fetus. Nuclear medicine technologists (NMTs) therefore have a responsibility to ensure that they question all patients of childbearing age about their pregnancy status before starting any procedure, to avoid unnecessary fetal irradiation. In Australia, there are no clearly defined practice guidelines to assist NMTs in determining whom to question or how to question their patients. Semistructured interviews were conducted with chief NMTs and staff NMTs in 8 nuclear medicine departments in Australia. Questions were based around 5 areas: regulations and policy, fetal radiation exposure, questioning of the patient, difficulties in determining pregnancy status, and the impact of the use of hybrid imaging. Audio files of the interviews were transcribed and coded. Topics were coded into 5 themes: policy and awareness of guidelines, questioning the patient, radiation knowledge, decisions and assumptions made by NMTs, and the use of pregnancy testing. There was a wide variation in practice between and within departments. NMTs demonstrated a lack of knowledge and awareness of the possible biologic effects of radiation. This study identified a need in Australia for nuclear medicine to arrive at a consensus approach to verifying a patient's pregnancy status so that NMTs can successfully question patients about their pregnancy status. Continuing education programs are also required to keep NMTs up to date in their knowledge.

Disparity among gender and ethnicity remains an issue across medicine and health science. Only 26%-35% of trainee radiologists are female, despite more than 50% of medical students' being female. Similar gender disparities are evident across the medical imaging professions. Generative artificial intelligence text-to-image production could reinforce or amplify gender biases. Methods: In March 2024, DALL-E 3 was utilized via GPT-4 to generate a series of individual and group images of medical imaging professionals: radiologist, nuclear medicine physician, radiographer, nuclear medicine technologist, medical physicist, radiopharmacist, and medical imaging nurse. Multiple iterations of images were generated using a variety of prompts. Collectively, 120 images were produced for evaluation of 524 characters. All images were independently analyzed by 3 expert reviewers from medical imaging professions for apparent gender and skin tone. Results: Collectively (individual and group images), 57.4% (n = 301) of medical imaging professionals were depicted as male, 42.4% (n = 222) as female, and 91.2% (n = 478) as having a light skin tone. The male gender representation was 65% for radiologists, 62% for nuclear medicine physicians, 52% for radiographers, 56% for nuclear medicine technologists, 62% for medical physicists, 53% for radiopharmacists, and 26% for medical imaging nurses. For all professions, this overrepresents men compared with women. There was no representation of persons with a disability. Conclusion: This evaluation reveals a significant overrepresentation of the male gender associated with generative artificial intelligence text-to-image production using DALL-E 3 across the medical imaging professions. Generated images have a disproportionately high representation of white men, which is not representative of the diversity of the medical imaging professions.

The aim of the study was to gain understanding of why nuclear medicine technologists (NMTs) leave and to compare workforce and service provision trends with diagnostic imaging professionals. A survey of all NMT professional body members in New South Wales, the Australian Capital Territory and Queensland was conducted. This paper reports on survey findings of those no longer working as a NMT. Analysis of 1996, 2001 and 2006 Australian Census data and Medicare statistics was made for NMTs, sonographers and radiographers. The five most influential reasons for leaving nuclear medicine were measured by survey. Census data measured workforce characteristics; size, sex, age. Medicare statistics measured national service provision. Primarily, limited career pathways and professional plateau influence retention of NMTs, with sonography a common career move. Nuclear medicine technologists are young (44.3% <30 years) compared with radiography (52.3% <40 years) or sonography (52.8% <40 years). From 2001 to 2006, service provision in nuclear medicine grew by 11.8% compared with 36% in ultrasound but the workforce size decreased by 4.9% whereas sonographers increased by 51.1%. Increasing the level of job control is the most likely factor in creating a positive change to the NMT job characteristics and improving retention.

The introduction of PET/CT requires staff training, redesign of patient workflow, new skills, problem-solving abilities, and adjustments to radiation protection protocols. When PET/CT was introduced in the U.K., nuclear medicine technologists (NMTs) encountered challenges in defining their roles and unfamiliarity with the new technology and the new working procedures. Since the introduction of PET/CT in South Africa, the experiences of NMTs with this hybrid imaging device have not yet been described. Therefore, the aim of this research study was to explore and describe the experiences of NMTs working in PET/CT facilities in Gauteng Province, South Africa. Methods: This study had a qualitative, exploratory, descriptive design and used a phenomenologic research approach. Semistructured interviews were conducted to collect data until data saturation was reached. A software program was used to manage the codes, categories, and themes. Nine NMTs participated in the study: 5 from public hospitals and 4 from private hospitals. Their age range of 27-58 y provided the ideal heterogeneity for sharing experiences in working in PET/CT facilities. Results: Two overarching themes emerged from the categories: the perspectives of NMTs working in PET/CT facilities and the PET/CT challenges encountered by NMTs. The results suggest that NMTs experience joy and fulfilment from working in PET/CT facilities and regard PET/CT as the future of nuclear medicine. However, NMTs also experience a gap in PET/CT training and are concerned about the high radiation exposure associated with PET/CT imaging and about the lack of psychologic support. Conclusion: Although the NMTs enjoy working in PET/CT, they desire additional clinical training and psychologic support. Since radiation exposure in PET/CT is higher than in general nuclear medicine, radiation monitoring is imperative to minimize exposure to NMTs and patients.

Objectives: To investigate radiation exposure among the staff of departments of nuclear medicine (NM) and diagnostic radiology (DR) during 2008 and 2009 and to compare the mean doses received with the limit of 20 mSv/year of the International Commission of Radiological Protection (ICRP). Materials and Methods: The whole-body dose or effective dose, i.e. Hp(10), and the skin dose, i.e. Hp(0.07), of the staff of departments of NM and DR in Kuwait for the period of 2008 and 2009 were taken from the national thermoluminescent dosimetry database. A total of 1,780 radiation workers, grouped as NM physicians, radiologists, NM technologists, and DR technologists, from 7 departments of NM and 12 departments of DR were included. The annual average Hp(10) and Hp(0.07) were calculated for each group and comparisons were made between the groups and the years. A two-sided Mann-Whitney test was carried out, at the p = 0.05 level, to compare the means. The mean Hp(10) was compared with the limits of the ICRP. Results: Of the 16 distributions of Hp(10) and Hp(0.07), 10 were normal, with a mean annual Hp (10) in 2008 of 1.06, 1.03, 1.07, and 1.05 mSv for NM physicians, radiologists, NM technologists, and DR technologists, respectively. The corresponding Hp(0.07) values for 2008 were 1.03, 1.00, 1.05, and 1.03 mSv, respectively. Small but significant (p < 0.001) reductions in Hp(10) and Hp(0.07) were observed in 2009 for NM technologists and DR technologists. In all other cases, no significant (p > 0.072) differences were found. Conclusion: The annual average Hp(10) was well below the limit of the ICRP.

Cross-use of technology between nuclear medicine and radiology technologists is expanding. The growth of PET/CT and the increasing use of intravenous contrast agents during these procedures bring the nuclear medicine technologist into direct contact with these agents and their associated complications. A basic understanding of the occurrence, risk factors, clinical features, and management of these procedures is of increasing importance to the nuclear medicine technologist. After reading this article, the technologist will be able to list the factors that increase the risk of contrast reactions; understand ways to minimize the occurrence of contrast reactions; and develop a plan to identify, treat, and manage the reactions effectively.

The purpose of this paper is to briefly explain report 160 of the National Council on Radiation Protection and Measurement and the significance of the report to medical imaging as a whole and nuclear medicine specifically. The implications of the findings of report 160 have had repercussions and will continue to affect all of ionizing radiation medical imaging. The nuclear medicine community should have an understanding of why and how report 160 is important. After reading this article, the nuclear medicine technologist will be familiar with the main focus of report 160, the significant change that has occurred since the 1980s in the ionizing radiation exposure of people in the United States, the primary background source of ionizing radiation in the United States, the primary medical exposure to ionizing radiation in the United States, trends in nuclear medicine procedures and patient exposure, and a comparison of population doses between 2006 and the early 1980s as outlined in report 160.