Nuclear Medicine Technologists Research Articles

Occupational radiation dose among student radiographers, nuclear medicine technologists, and radiotherapists in an Australian university.

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.

Delivery Methods of Radiopharmaceuticals: Exploring Global Strategies to Minimize Occupational Radiation Exposure.

In the world of nuclear medicine, health care professionals face the challenge of safeguarding themselves and their patients from occupational radiation exposure. As the field experiences exponential growth, driven by the surge in approvals of radiopharmaceuticals for diagnostic and therapeutic applications, it becomes vital to delve into the delivery methods of radiopharmaceuticals. Health care professionals take precautions during radiopharmaceutical administration, including maintaining distance from radioactive sources, using shielding, limiting exposure time, and monitoring radiation levels with badges. Regular evaluations provide compliance with recommended exposure limits, yet concerns persist, especially regarding the cumulative radiation exposure from manual injections over time. Understanding the long-term effects of radiation exposure has spurred the development of cutting-edge medical device technologies, such as autoinjectors, designed to administer radiopharmaceuticals accurately while minimizing total radiation dose to health care professionals. The U.S. Pharmacopeia 825 regulation refers to these devices as "direct infusion systems." Nuclear medicine technologists commonly refer to them as "autoinjectors," whereas device manufacturers may use terms such as injection system, radiopharmaceutical injector, or infusion system. Despite variations in terminology, these devices hold a pivotal role in shaping the future of radiopharmaceutical delivery. In an era of escalating demand for PET procedures worldwide, skilled health care professionals ensure the safe and precise dosing of radiopharmaceuticals. This article explores the state-of-the-art medical devices in radiopharmaceutical delivery, spotlighting transformative medical devices currently revolutionizing the nuclear medicine landscape in the global market.

Occupational burnout in nuclear medicine technologists working in Australia and New Zealand - results of a multi-national survey.

Occupational burnout can be associated with negative feelings about the workplace and feeling that a person's efforts are of little consequence. Within a healthcare setting, occupational burnout can be attributed to a high workload or a non-supportive work environment. Higher levels of burnout are associated with increased absenteeism and turnover, increased medical errors and decreased patient care. The aim of this study was to investigate the levels of occupational burnout within nuclear medicine technologists (NMTs) working in Australia and New Zealand. An online questionnaire was distributed via QuestionPro. The questionnaire consisted of four sections, including the Professional Quality of Life Scale (ProQOL) Version 5 (2009) measuring compassion satisfaction, burnout and secondary traumatic stress in the workplace. For this study, only the burnout component of this scale is reported. There were 162 survey responses. Of the 18 New Zealand participants, 10 (56%) reported moderate levels of burnout. Of the 144 Australian participants, 114 (79%) reported moderate levels of burnout. No NMTs reported high levels of burnout. All states of Australia were represented in the survey, with Queensland, Western Australia and Victoria having the highest number of participants reporting moderate levels of burnout. This study revealed that more than half of New Zealand participants and three quarters of Australian participants reported moderate levels of burnout. It is imperative to address the wellbeing needs of NMTs working in Australia and New Zealand at an individual and organisational level to support NMTs to be more engaged in their work and help organisations retain staff.

Gender and Ethnicity Bias of Text-to-Image Generative Artificial Intelligence in Medical Imaging, Part 2: Analysis of DALL-E 3.

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.

Gender and Ethnicity Bias of Text-to-Image Generative Artificial Intelligence in Medical Imaging, Part 1: Preliminary Evaluation.

Generative artificial intelligence (AI) text-to-image production could reinforce or amplify gender and ethnicity biases. Several text-to-image generative AI tools are used for producing images that represent the medical imaging professions. White male stereotyping and masculine cultures can dissuade women and ethnically divergent people from being drawn into a profession. Methods: In March 2024, DALL-E 3, Firefly 2, Stable Diffusion 2.1, and Midjourney 5.2 were utilized to generate a series of individual and group images of medical imaging professionals: radiologist, nuclear medicine physician, radiographer, and nuclear medicine technologist. Multiple iterations of images were generated using a variety of prompts. Collectively, 184 images were produced for evaluation of 391 characters. All images were independently analyzed by 3 reviewers for apparent gender and skin tone. Results: Collectively (individual and group characters) (n = 391), 60.6% were male and 87.7% were of a light skin tone. DALL-E 3 (65.6%), Midjourney 5.2 (76.7%), and Stable Diffusion 2.1 (56.2%) had a statistically higher representation of men than Firefly 2 (42.9%) (P < 0.0001). With Firefly 2, 70.3% of characters had light skin tones, which was statistically lower (P < 0.0001) than for Stable Diffusion 2.1 (84.8%), Midjourney 5.2 (100%), and DALL-E 3 (94.8%). Overall, image quality metrics were average or better in 87.2% for DALL-E 3 and 86.2% for Midjourney 5.2, whereas 50.9% were inadequate or poor for Firefly 2 and 86.0% for Stable Diffusion 2.1. Conclusion: Generative AI text-to-image generation using DALL-E 3 via GPT-4 has the best overall quality compared with Firefly 2, Midjourney 5.2, and Stable Diffusion 2.1. Nonetheless, DALL-E 3 includes inherent biases associated with gender and ethnicity that demand more critical evaluation.

Comparison of sedation and general anesthesia protocols for 18F-FDG-PET/CT studies in dogs and cats: Musculoskeletal uptake and radiation dose to workers.

In veterinary medicine, PET/CT scans are generally performed with the patient under general anesthesia. The aim of this prospective crossover study was to compare the musculoskeletal uptake of 18F-FDG and radiation doses to workers during PET/CT studies of healthy dogs and cats between sedation and general anesthesia. Volume and maximal standard uptake values (SUVmax) values of abnormal 18F-FDG uptake in the skeletal musculature, presence of misregistration artifact, and radiation doses to workers for each PET/CT study were recorded. Sedation was associated with increased volume of 18F-FDG uptake in the musculature of the thoracic limbs (p=.01), cervical (p=.02), and thoracic (p=.03) spine. Increased volume and SUVmax of the musculature assessed altogether were associated with the lighter degree of sedation (p=.04 for both). A significant decrease in the odds of misregistration artifact was observed for anesthetized animals in comparison with sedated (OR: 0.0, 95% CI: 0.0-0.0, p=.01). Radiation doses to workers were significantly higher for sedation compared with general anesthesia (p=.01) and for the anesthesia technician compared with the nuclear medicine technologist (p=.01). Use of sedation for PET/CT studies in dogs and cats is feasible. However, it is associated with increased physiologic musculoskeletal uptake of 18F-FDG in the thoracic limbs, cervical, and thoracic spine, with increased frequency of misregistration artifact, and with increased radiation doses to workers. These limitations can be overcome by recognition of the uptake pattern and monitoring/rotation of the involved staff at institutions where a high caseload is expected.

So You Are a Clinical Instructor-Now What?

Many nuclear medicine technologists find themselves in the role of clinical instructor, often without much in the way of educational background. This article provides a few recommendations on how to get started in this role. After distinguishing between the roles of affiliate education supervisor and clinical instructor, the article discusses 2 basic tools: the clinical course learning outcomes and the student handbook. Expectations for students are reviewed. An important aspect of clinical instruction is the attitude of the instructor. Clinical instructors can motivate students or demotivate them, with this choice having a significant impact on the student's development. Overall, the desire and determination to be pleasant and helpful to students make the greatest difference in their development into nuclear medicine technologists.

Navigating a Transatlantic Career Shift: Guidance for U.S. Nuclear Medicine Technologists Looking to Relocate to the U.K.

Navigating a Transatlantic Career Shift: Guidance for U.S. Nuclear Medicine Technologists Looking to Relocate to the U.K.

Nuclear medicine technologists practice impacted by AI denoising applications in PET/CT images

PurposeArtificial intelligence (AI) in positron emission tomography/computed tomography (PET/CT) can be used to improve image quality when it is useful to reduce the injected activity or the acquisition time. Particular attention must be paid to ensure that users adopt this technological innovation when outcomes can be improved by its use. The aim of this study was to identify the aspects that need to be analysed and discussed to implement an AI denoising PET/CT algorithm in clinical practice, based on the representations of Nuclear Medicine Technologists (NMT) from Western-Switzerland, highlighting the barriers and facilitators associated. MethodsTwo focus groups were organised in June and September 2023, involving ten voluntary participants recruited from all types of medical imaging departments, forming a diverse sample of NMT. The interview guide followed the first stage of the revised model of Ottawa of Research Use. A content analysis was performed following the three-stage approach described by Wanlin. Ethics cleared the study. ResultsClinical practice, workload, knowledge and resources were de 4 themes identified as necessary to be thought before implementing an AI denoising PET/CT algorithm by ten NMT participants (aged 31–60), not familiar with this AI tool. The main barriers to implement this algorithm included workflow challenges, resistance from professionals and lack of education; while the main facilitators were explanations and the availability of support to ask questions such as a “local champion”. ConclusionTo implement a denoising algorithm in PET/CT, several aspects of clinical practice need to be thought to reduce the barriers to its implementation such as the procedures, the workload and the available resources. Participants emphasised also the importance of clear explanations, education, and support for successful implementation. Implications for practiceTo facilitate the implementation of AI tools in clinical practice, it is important to identify the barriers and propose strategies that can mitigate it.

A Four-Arm Randomized Clinical Trial of Topical Pain Control for Sentinel Node Radiotracer Injections in Patients with Breast Cancer.

Radioactive tracer injections for breast cancer sentinel lymph node mapping can be painful. In this randomized trial, we compared four approaches to topical pain control for radiotracer injections. Breast cancer patients were randomized (9 April 2021-8 May 2022) to receive the institutional standard of ice prior to injection (n=44), or one of three treatments: ice plus a vibrating distraction device (Buzzy®; n=39), 4% lidocaine patch (n=44), or 4% lidocaine patch plus ice plus Buzzy® (n=40). Patients completed the Wong-Baker FACES® pain score (primary outcome) and a satisfaction with pain control received scale (secondary). Nuclear medicine technologists (n=8) rated perceived pain control and ease of administration for each patient. At study conclusion, technologists rank-ordered treatments. Data were analyzed as intention-to-treat. Wilcoxon rank-sum tests were used to compare pain scores of control versus pooled treatment arms (primary) and then control to each treatment arm individually (secondary). There were no differences in pain scores between the control and treatment groups, both pooled and individually. Eighty-five percent of patients were 'satisfied/very satisfied' with treatment received, with no differences between groups. No differences in providers' perceptions of pain were observed, although providers perceived treatments involving Buzzy© more difficult to administer (p<0.001). Providers rated lidocaine patch as the easiest, with ice being second. In this randomized trial, no differences in patient-reported pain or satisfaction with treatment was observed between ice and other topical treatments. Providers found treatments using Buzzy® more difficult to administer. Given patient satisfaction and ease of administration, ice is a reasonable standard.

Experiences of Nuclear Medicine Technologists Working in PET/CT Facilities in Gauteng Province, South Africa.

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.

Gastric Emptying Studies in Pediatrics: A Cincinnati Children's Hospital Experience.

Gastric emptying studies are routinely performed in many nuclear medicine departments; however, there are many different techniques used to perform the procedure across the country. Creating consistency in clinical practice will aid gastroenterologists in diagnosing and treating illnesses associated with abnormalities related to gastric emptying. In 2017, Cincinnati Children's Hospital adopted adult standards for pediatric gastric emptying studies that included a standard meal along with imaging over the course of 4 h. Gastric emptying studies are the second-highest-volume examination performed in the nuclear medicine section at Cincinnati Children's Hospital. Accommodating this volume required changes in the scheduling template, scheduling questionnaire, and epic order sets, as well as identification of specific days and locations for gastric emptying studies. Both protocol standardization and workflow optimization are critically important in creating consistency in patient care. Gastric emptying can be evaluated with solid food, liquid food, or solid and liquid food simultaneously. The methodology of the study is initially determined by the ordering provider but may require special accommodations based on what the patient will tolerate. In coordination with the ordering and interpreting physicians, the nuclear medicine technologists at Cincinnati Children's Hospital have the decision-making ability to deviate from the provider's request as necessary, which helps expedite workflow and eliminates wasted time. Any deviation from the standardized protocol is documented by the nuclear medicine technologist and incorporated into the final report by the interpreting physician, as dietary information is meaningful to the ordering provider. Reference values associated with the standardized or modified protocol are also included in the final report.

An Evaluation of Gastric Emptying Scintigraphy Protocols in Health Care Institutions When Compared with the Society of Nuclear Medicine and Molecular Imaging Procedure Guidelines.

This study aimed to analyze the compliance of health care institutions with the Society of Nuclear Medicine and Molecular Imaging (SNMMI) procedure guidelines for gastric emptying scintigraphy (GES). Methods: A 19-question survey on demographics and the GES protocol was conducted using a Google form. The demographic questions covered position, number of technologists in the department, location, type of health care institution, and number of GES studies per month. The protocol questions included patient preparation, meal preparation, withholding of scheduled medications, radiopharmaceutical type, and radiopharmaceutical dose. The survey was sent to 7 nuclear medicine Facebook groups and a list of clinical affiliates provided by the Indiana University School of Medicine Nuclear Medicine Program. Descriptive statistics were compiled for most questions. A Fisher exact test with a significance level of 0.05 was used to compare the type of health care institution with compliance with the SNMMI GES protocol regarding radiolabeling time, meal preparation, and meal components, as well as to compare the type of health care institution with the number of GES studies performed per institution. Results: In total, 240 people responded to the survey. Most were nonsupervisory nuclear medicine technologists (72%) in nonacademic institutions (72%) and groups with 4 or more technologists (62%). Of the respondents, 72% followed the SNMMI guideline of adding the radiopharmaceutical before cooking, but only 37% followed the meal component guideline. There was no significant association between the type of institution or the number of GES studies and compliance with radiolabeling time or with meal preparation or components. Most respondents asked patients to withhold medications per SNMMI guidelines and used the recommended radiopharmaceutical (99mTc-sulfur colloid, 95%) at the recommended dose (18.5-37 MBq, 84%). Conclusion: Although most respondents followed most aspects of the SNMMI guidelines for GES, more than half did not use the recommended meal of liquid egg whites. Compliance did not vary between academic and nonacademic institutions or between groups performing a large or a small number of GES studies.

Organisational challenges to wellbeing in nuclear medicine technologists: Professionalism, burnout and pragmatic growth

IntroductionOccupational risk for burnout in nuclear medicine technologists globally, and particularly during disaster demands on the profession, is poorly researched. This idiographic study explored the lived experience of nuclear medicine technologists during COVID-19 in a regional city in Australia. MethodsData was collected from five participants using semi-structured interviews and transcribed and analysed according to the protocols of Interpretative Phenomenological Analysis (IPA). ResultsFour group experiential themes were identified: Systemic Contraindications, Professional Strengths and Limitations, Pragmatic Growth, and Covid Rollercoaster. For these participants a dichotomous health care system, impacted by COVID-19, risked career longevity and burnout. Through empathic connection with vulnerable patients, they redefined their priorities, re-engaged in supportive connections with colleagues, and sought new pathways. ConclusionMultiple workplace stressors compounded by COVID-19, risked mental wellbeing, in these participants. Nevertheless, these challenges provided opportunities for reflection around career trajectory and longevity precipitating personal growth, job satisfaction and work-life balance. Implications for practiceThis study provided a lens on the risk factors inherent for nuclear medicine technologists in Australia, exacerbated by the COVID-19 pandemic. Current, and disaster protective practices, to ensure wellbeing and prevent burnout risk are recommended for future research.

A Survey of Patient Experience During Molecular Breast Imaging.

Molecular breast imaging (MBI) is one of several options available to patients seeking supplemental screening due to mammographically dense breasts. Patient experience during MBI may influence willingness to undergo the test but has yet to be formally assessed. We aimed to assess patient comfort level during MBI, to compare MBI comfort with mammography comfort, to identify factors associated with MBI discomfort, and to evaluate patients' willingness to return for future MBI. Methods: A 10-question survey was sent by e-mail to patients undergoing MBI between August and December 2022 to obtain quantitative assessments and qualitative opinions about MBI. Results: Of 561 invited patients, 209 (37%) completed the survey and provided study consent. Their average age was 60.1 y (range, 40-81 y). Of the 209 responders, 202 (97%) were presenting for screening MBI, 195 (94%) had dense breasts, and 46 (22%) had a personal history of breast cancer. The average rating of MBI comfort was 2.9 (SD, 1.5; median, 3.0) on a 7-point scale (1 indicating extremely comfortable and 7 indicating extremely uncomfortable). The rating distribution was as follows: 140 (67%) comfortable (rating, 1-3); 24 (12%) neither comfortable nor uncomfortable (rating, 4); and 45 (22%) uncomfortable (rating, 5 or 6). No responders gave a 7 rating. The most frequently mentioned sources of discomfort included breast compression (n = 16), back or neck discomfort (n = 14), and maintaining position during the examination (n = 14). MBI comfort was associated with responder age (74% ≥55 y old were comfortable, versus 53% <55 y old [P = 0.003]) and history of MBI (71% with prior MBI were comfortable, versus 61% having a first MBI [P = 0.006]). Of 208 responders with a prior mammogram, 148 (71%) said MBI is more comfortable than mammography (a significant majority [P < 0.001]). Of 202 responders to the question of whether they were willing to return for a future MBI, 196 (97%) were willing. A notable factor in positive patient experience was interaction with the MBI nuclear medicine technologist. Conclusion: Most responders thought MBI to be a comfortable examination and more comfortable than mammography. Patient experience during MBI may be improved by ensuring back support and soliciting patient feedback at the time of positioning and throughout the examination. Methods under study to reduce imaging time may be most important for improving patient experience.

Evaluation of personal dose equivalents during positron emission tomography and computed tomography imaging

This study aimed to evaluate the annual occupational radiation exposure of technologists during PET/CT imaging in 2020 and 2021. Eleven nuclear medicine technologists were monitored at the PET/CT department. The personal dose equivalents (PDEs) for staff members, measured in terms of Hp (10) and Hp (0.07), were assessed annually, considering both deep and surface doses. PDEs were quantified using a thermoluminescent detector (LiF:Mg:Ti)). The average and range of PDEs and extremity doses (mSv) for the technologists were as follows: 4.5 (0.1–13.4) for Hp (10), 4.63 (0.1–13.9) for Hp (0.07), and 2.5 (0.2–17.5) for extremity, respectively. The results indicated that staff members are exposed to high-energy gamma rays while preparing radiopharmaceuticals, injections, and image acquisition. Therefore, proper handling of radiopharmaceuticals and patient management during the acquisition of parameters are crucial for maintaining the occupational dose within the defined limit.

Professional identity and role perception of Radiographers and Clinical Technologists in Nuclear Medicine – An exploratory qualitative study

IntroductionAn awareness of Professional Identity (PI), an individual's identity in relation to their professional group, and Role Perception (RP), an individual's view of their specific role, may enable safe and effective practice by providing an understanding of professional boundaries, behaviours and activities. This research aimed to explore and gain an understanding of the PI and RP of Radiographers and Clinical Technologists working as Nuclear Medicine Technologists (NMT's). Methods10 NMT's were recruited from a large National Health Service (NHS) Trust. Utilising the established methodology of Qualitative Description, data was obtained using semi-structured interviews and analysed using inductive thematic analysis. ResultsFour themes were identified: “Becoming the Unexpected” which detailed various training pathways; “Caring with Science” which described the NMT's role and defined their PI; “Same View, Different Lens” which portrayed how Radiographers and Clinical Technologists practise as team of NMT's; and “Confirmation of Professional Self” which presented how individuals view their professional status. ConclusionThe study showed that the NMT role is highly specialised, multi-faceted and patient-centred. Their professional status is based on the nature of their role and their university level education and training. They work together under the umbrella title of NMT with a dual professional identity of “provider of care” and “user of science and technology”. However, they may have an individual identity of Radiographer or Clinical Technologist that is determined by their training pathway. Implications for practiceThis research has provided valuable understanding of the PI and RP of NMT's. By highlighting the differences in the regulatory status of this workforce, an insight into the future implications in the context of national healthcare planning has been provided, highlighting potentially significant issues that may impact on the manner in which NMT's can practice.

Radiopharmaceutical administration practices-Are they best practice?

The nuclear medicine community has stated that they are using best practices to gain venous access and administer radiopharmaceuticals, and therefore do not contribute to extravasations. We tested this hypothesis qualitatively and quantitatively by evaluating four different perspectives of current radiopharmaceutical administration practices: (1) clinical observations of nuclear medicine technologists on the job, (2) quality improvement (QI) projects, (3) a high-level survey of current practices in 10 acute care hospitals, (4) intravenous (IV) access site data for 29,343 procedures. These four areas were compared to the gold standard of pharmaceutical administration techniques. From clinical observations of radiopharmaceutical administrations in adult populations, technologists extensively used 24-gauge peripheral intravenous catheters (PIVCs) and butterfly needles. They also performed direct puncture (straight stick). Technologists predominantly chose veins in areas of flexion (hand, wrist, and antecubital fossa), rather than forearm vessels for IV access placement; in many circumstances, antecubital fossa vessels are chosen first, often without prior assessment for other suitable vessels. For selecting the injection vein, technologists sometimes used infrared vein finders but primarily performed blind sticks. Review of QI projects suggested that smaller gauge needles were contributing factors to extravasations. Additionally, the review of surveys from 10 hospitals revealed an absence of formalized protocols, training, knowledge, and skills necessary to ensure the safety/patency of IV devices prior to the administration of radiopharmaceuticals. Finally, findings from a review of IV access data for 29,343 procedures supported the observations described above. We expect that nuclear medicine technologists have the best intentions when providing patient care, but many do not follow venous access best practices; they lack formal protocols, have not received the latest comprehensive training, and do not use the best placement tools and monitoring equipment. Thus, the presumption that most nuclear medicine technologists use best practices may not be accurate. In order to improve radiopharmaceutical administration and patient care, the nuclear medicine community should update technical standards to address the most recent peripheral IV access and administration best practices, provide technologists with vascular visualization tools and the proper training, develop and require annual vascular access competency, and provide active monitoring with center and patient-specific data to create ongoing feedback.

SNMMI Clinical Trials Network Research Series for Technologists: Imaging Contract Research Organizations, Nuclear Medicine Technologists, and the Role They Play in Medical Imaging Research.

Clinical imaging research is a fast-growing, complex, and integral part of drug and therapy discovery and development. Research sponsors rely on outside vendors to manage their trials and deliver results they hope will demonstrate the efficacy of their product. Specialized vendors known as imaging contract research organizations have teams of highly trained and specialized professionals who lend their expertise to all aspects of imaging research management, of which nuclear medicine technologists are key team members. This article is part of the Clinical Trials Network Research Series for Technologists and will help provide an overview of an imaging research study from initiation to data delivery and the roles that nuclear medicine technologists and other imaging professionals play.

'Growing your own' a case study of a collaborative training program in medical radiation science.

Two universities run a collaborative Medical Radiation Science program where students undertake study in Tasmania before transferring to a partner university in another state to complete their program. This study assessed rates and predictors of graduate radiographers, radiation therapists and nuclear medicine technologists (collectively classified as medical radiation practitioners according to AHPRA [https://www.medicalradiationpracticeboard.gov.au/About.aspx; ahpra.gov.au/registration/registers] contemporary classification) returning to Tasmania and rural locations to practice. A cross-sectional 22-item online survey including open-ended questions was administered via Facebook. Rates of graduates working in Tasmania and rural locations, work satisfaction, and program efficacy were assessed. Logistic regression was used to assess predictors of working in Tasmania and rural locations. 58 Facebook members from a total of 87 program graduates were invited to participate. Of these, 21 responded. Thirteen (62.0%) were currently working in Tasmania, of which the majority practised in regional (MMM2) areas. Most (90.5%) reported that they were happy at work, with all participants reporting the course prepared them well or very well for their first professional jobs. 71.4% stated that the provision of the first 2 years of the course in their home state influenced their decision to study medical radiation science. Being born in a rural region (MMM > 2) was a predictor for working in Tasmania (OR = 3.5) and rural locations (OR = 1.77). Males were twice as likely to work in Tasmania (OR = 2.3) and more rural locations (OR = 2.0). Collaboration is beneficial in producing professionals in regions with smaller enrolments limit the ability to grow their own graduates independently. Interuniversity collaborative models are recommended for other rural regions to meet local health workforce needs.