Nuclear Medicine Training Research Articles

Investigation of patient release examination training in nuclear medicine using mixed reality

Investigation of patient release examination training in nuclear medicine using mixed reality

GPT-4 in Nuclear Medicine Education: Does It Outperform GPT-3.5?

The emergence of ChatGPT has challenged academic integrity in teaching institutions, including those providing nuclear medicine training. Although previous evaluations of ChatGPT have suggested a limited scope for academic writing, the March 2023 release of generative pretrained transformer (GPT)-4 promises enhanced capabilities that require evaluation. Methods: Examinations (final and calculation) and written assignments for nuclear medicine subjects were tested using GPT-3.5 and GPT-4. GPT-3.5 and GPT-4 responses were evaluated by Turnitin software for artificial intelligence scores, marked against standardized rubrics, and compared with the mean performance of student cohorts. Results: ChatGPT powered by GPT-3.5 performed poorly in calculation examinations (31.4%), compared with GPT-4 (59.1%). GPT-3.5 failed each of 3 written tasks (39.9%), whereas GPT-4 passed each task (56.3%). Conclusion: Although GPT-3.5 poses a minimal risk to academic integrity, its usefulness as a cheating tool can be significantly enhanced by GPT-4 but remains prone to hallucination and fabrication.

ChatGPT in Nuclear Medicine Education.

Academic integrity has been challenged by artificial intelligence algorithms in teaching institutions, including those providing nuclear medicine training. The GPT 3.5-powered ChatGPT chatbot released in late November 2022 has emerged as an immediate threat to academic and scientific writing. Methods: Both examinations and written assignments for nuclear medicine courses were tested using ChatGPT. Included was a mix of core theory subjects offered in the second and third years of the nuclear medicine science course. Long-answer-style questions (8 subjects) and calculation-style questions (2 subjects) were included for examinations. ChatGPT was also used to produce responses to authentic writing tasks (6 subjects). ChatGPT responses were evaluated by Turnitin plagiarism-detection software for similarity and artificial intelligence scores, scored against standardized rubrics, and compared with the mean performance of student cohorts. Results: ChatGPT powered by GPT 3.5 performed poorly in the 2 calculation examinations (overall, 31.7% compared with 67.3% for students), with particularly poor performance in complex-style questions. ChatGPT failed each of 6 written tasks (overall, 38.9% compared with 67.2% for students), with worsening performance corresponding to increasing writing and research expectations in the third year. In the 8 examinations, ChatGPT performed better than students for general or early subjects but poorly for advanced and specific subjects (overall, 51% compared with 57.4% for students). Conclusion: Although ChatGPT poses a risk to academic integrity, its usefulness as a cheating tool can be constrained by higher-order taxonomies. Unfortunately, the constraints to higher-order learning and skill development also undermine potential applications of ChatGPT for enhancing learning. There are several potential applications of ChatGPT for teaching nuclear medicine students.

American College of Radiology Paid Family/Medical Leave Policy: A Call to Action for the House of Medicine.

The American College of Radiology (ACR) passed a historic paid family/medical leave (PFML) resolution at its April 2022 meeting, resolving that "diagnostic radiology, interventional radiology, radiation oncology, medical physics, and nuclear medicine practices, departments and training programs strive to provide 12 weeks of paid family/medical leave in a 12-month period for its attending physicians, medical physicists, and members in training as needed." The purpose of this article is to share this policy beyond radiology so that it may serve as a call to action for other medical specialties. Such a PFML policy (1) supports physician well-being, which in turn supports patient care; (2) is widely needed across American medical specialties; and (3) should not take nearly a decade to achieve, as it did in radiology, especially given increasing physician burnout and the ongoing COVID-19 pandemic. Supported by information on the step-by-step approach used to achieve radiology-specific leave policies and considering current and normative policies at the national level, this article concludes by reviewing specific strategies that could be applied toward achieving a 12-week PFML policy for all medical specialties.

The integrated nuclear medicine and radiology residency program in the Netherlands: strengths and potential areas for improvement according to nuclear medicine physicians and radiologists

PurposeTo evaluate the Dutch integrated nuclear medicine and radiology residency program from the perspective of nuclear medicine physicians and radiologists.MethodsA survey was distributed among nuclear medicine physicians and radiologists in hospitals that participate in the Dutch integrated nuclear medicine and radiology training program.ResultsA total of 139 completed questionnaires were included. Nuclear medicine physicians (n = 36) assigned a mean score of 5.7 ± 2.0, and radiologists (n = 103) assigned a mean score of 6.5 ± 2.8 (on a 1–10 scale) to the success of the integrated training program in their hospital. On multiple regression, female gender of the survey participant (B = 2.22, P = 0.034), musculoskeletal radiology as subspecialty of the survey participant (B = 3.36, P = 0.032), and the survey participant’s expectancy of resident’s ability to handle workload after completion of residency were significantly associated with perceived success of the integrated training program (B = 1.16, P = 0.023). Perceived strengths of the integrated training program included broadening of expertise, a better preparation of future imaging specialists for hybrid imaging, increased efficiency in training residents, and increased efficiency in multidisciplinary meetings. Perceived weaknesses of the integrated training program included reduced exposure to nuclear medicine, less time for research and innovation, and concerns about its international recognition.ConclusionThis study provided insights into the experiences of nuclear medicine physicians and radiologists with the Dutch integrated nuclear medicine and radiology residency program, which may be helpful to improve the program and similar residency programs in other countries.

Initial Institutional Experience with 18F-Fluciclovine PET-CT in Biochemical Recurrence of Prostate Cancer.

18F-fluciclovine (fluciclovine) is an amino acid analog approved by the Food and Drug Administration for use as a radiotracer in positron emission tomography (PET) in men with biochemical recurrence of suspected prostate cancer. The purpose of this study was to investigate the initial institutional experience with 18F-fluciclovine in the evaluation of prostate cancer with biochemical recurrence. This study was a retrospective review of 135 patients who underwent 18F-fluciclovine PET-computed tomography (PET-CT) at a single institution from August 2018 through January 2020. Prognostic information, including prostate-specific level antigen (PSA) at the time of diagnosis, initial risk, initial Gleason score, and initial stage, was reviewed as well as the PSA level at the time of the scan. The images were reviewed by two radiologists with fellowship training in nuclear medicine and additional training to interpret the fluciclovine studies. A minority of studies were reviewed by a third fellowship-trained radiologist under the guidance of the two nuclear medicine-trained radiologists. In cases with abnormal radiopharmaceutical uptake in lymph nodes, the short-axis dimension of the lymph node or largest lymph node with abnormal uptake was noted. If CT or bone scan was performed within 4 months of the 18F-fluciclovine PET-CT, findings on the alternate imaging were compared with the results of the 18F-fluciclovine PET-CT. Our institutional positivity rate was 75.6%, with 64 (67.4%) patients with metastatic disease and 71 (52.6%) patients with local recurrence detected by fluciclovine. As expected, the rate of positive examinations increased with increasing PSA values measured at the time of imaging (P < 0.001). Of the 54 patients with nodal disease, 35 had nonpathologically enlarged lymph nodes measuring <1 cm in maximum short-axis dimension. In more than half of the patients in this study, with conventional imaging, fluciclovine either discovered otherwise undetectable metastatic disease or suggested the presence of local recurrence. Our single-institution experience with 18F-fluciclovine PET-CT has the largest number of patients to date in the literature and demonstrates the ability of fluciclovine to help guide clinical management in the detection of early recurrent disease.

Ausbildung in Nuklearmedizin und Zukunftsperspektiven.

Ausbildung in Nuklearmedizin und Zukunftsperspektiven.

The New Integrated Nuclear Medicine and Radiology Residency Program in The Netherlands: Why Do Residents Choose to Subspecialize in Nuclear Medicine and Why Not?

Our purpose was to explore the reasons that a resident chooses to enter the nuclear medicine subspecialty in the integrated nuclear medicine and radiology residency program in The Netherlands. Methods: A web questionnaire was developed and distributed among residents in the Dutch integrated nuclear medicine and radiology training program. Results: In total, 114 residents were included. The survey results revealed 4 categories of incentives to choose the nuclear medicine subspecialty: the expertise of nuclear medicine physicians and their quality of supervision in the training hospital; opportunities to do scientific research during and after residency; the diversity of pathologic conditions, radiotracers, examinations, and therapies in the training hospital; and the expectation that the role of hybrid imaging will increase in the future. The results also revealed 4 groups of disincentives to choose the nuclear medicine subspecialty: lack of collaboration and integration between nuclear medicine and radiology in some training hospitals; imbalance between nuclear medicine and radiology during the first 2.5 y of basic training during residency at the expense of nuclear medicine; uncertainty regarding the international recognition of nuclear medicine subspecialty training; and the uncertain future of nuclear medicine regarding the chances for employment and the ratio of nuclear medicine to radiology work activities. Conclusion: This study provided insight into residents' motives in pursuing or refraining from nuclear medicine subspecialization in an integrated nuclear medicine and radiology residency program. Medical imaging specialists in training hospitals and developers of curricula for nuclear medicine and radiology training should take these motives into account to ensure a sufficient outflow of newly graduated nuclear medicine specialists.

In Memoriam Grant Hieshima, MD: 1942–2019: Pioneer, Mentor, Visionary, Friend

Grant Hieshima, MD died unexpectedly on August 9, 2019, at the age of 77, while enjoying one of his lifelong passions, deep-sea fishing, with his son Michael at his side....

Efforts in the Formation and Development of Nuclear Medicine in Vietnam.

The foundations of nuclear medicine in Vietnam were established from 1970. Until now, after 48years of development, in Vietnam, we have some basic equipment including 31 SPECT, 4 SPECT/CT machines, 11 PET/CT scanners, five cyclotrons, and one nuclear reactor. Many nuclear medicine techniques in diagnosis and treatment have been routinely performed at provincial and central level health facilities such as tumor scintigraphy, thyroid scintigraphy, bone scintigraphy, kidney scintigraphy, cardiac scintigraphy, and radio-isotope therapy with I-131 and P-32. Selective internal radiation therapy with Y-90 microsphere and I-125 radioactive seed implantation has been also successfully applied in some big hospitals. However, there are still many difficulties for Vietnam as the lack of new widely used radioisotopes such as Ga-67, Cu-64, Samarium-153, and Lutetium-177 and the lack of nuclear medicine specialists. In the future, we are putting our efforts on the applications of new isotopes in diagnosis and treatment of cancers (theranostic) like Ga-68-DOTATATE, Lutetium-177-DOTATATE, Ga-68-PSMA, and Lutetium-177-PSMA, equipping modern nuclear medicine diagnostic tools, strengthening the human resources training in nuclear medicine. At the same time, we are trying our best to strengthen the cooperation with international nuclear medicine societies in over the world.

Radiologists and nuclear medicine physicians are looking forward to a cross-curricular training.

To obtain an overview of the attitudes toward interdisciplinary further education of residents and consultants in radiology and nuclear medicine and preferences regarding a future joint training curriculum in Switzerland. A 34-item questionnaire was sent electronically (SurveyMonkey online survey tool) to 1244 radiologists and nuclear physicians (residents and consultants) in Switzerland. The items asked about the motivation for further education in each other's specialty and preferences regarding a joint further education curriculum in radiology and nuclear medicine. Overall, 370 questionnaires were analyzed (370/1244, 30%). There were 280 (76%) board-certified physicians in either radiology (238/370, 64%) or nuclear medicine (42/370, 12%) and 65 (18%) residents (radiology 54/370, 15%; nuclear medicine 11/370, 3%). More than half of all residents (34/65, 52%) stated their conviction that a wide range of expertise in both disciplines could be fully guaranteed through adequate cross-curricular training. For responders already at a consultant level in radiology or nuclear medicine, the willingness to undergo further training in each other's specialty significantly increased with a shorter training period. The preferred option for a possible future joint training curriculum was a combination of a 5-year radiology training program with 2years of further training in nuclear medicine. Both residents and board-certified physicians in Switzerland are highly interested in a cross-curricular training curriculum in radiology and nuclear medicine. • A systematic survey was conducted to obtain information on interest in cross-curricular training in radiology and nuclear medicine and preferences regarding a future joint training curriculum. • More than half of radiology and nuclear medicine residents would be interested in further training in the other specialty. • There is a strong desire for a shorter training program when combining training in both radiology and nuclear medicine.

Regarding “Is 16 Months of Specialized Nuclear Medicine Training Enough for Best Patient Care?”

TO THE EDITOR: As the program director of the national nuclear medicine training program in Singapore (ex-British colony that just celebrated our 52nd anniversary of independence), I read with interest “Is 16 Months of Specialized Nuclear Medicine Training Enough for Best Patient Care?” I agree

Nuclear Medicine Training: What Now?

Although the multidisciplinary nature of nuclear medicine (NM) and clinical molecular imaging is a key strength of the specialty, the breadth of disciplines involved in the practice of NM creates challenges for education and training. The evolution of NM science and technology-and the practice of clinical molecular imaging and theranostics-has created a need for changes in the approach to specialty training. The broader U.S. community of imaging physicians has been slow to accept this change, in good part due to historical divides between the NM and nuclear radiology (NR) communities. In this Journal of Nuclear Medicine Hot Topics discussion, we review the historical pathways to training; discuss the training needs for the modern practice of NM, clinical molecular imaging, and radionuclide therapy; and suggest a path forward for an approach to training that matches the needs of the evolving clinical specialty.

Editorial introductions

Editorial introductions

Nuclear medicine training and practice in Turkey.

Nuclear medicine applications in Turkey started in the early 1950s, grew as an independent medical discipline and finally were recognized by the Ministry of Health in 1973. Later on, the professional organization of nuclear medicine physicians and other related professionals including radiopharmacists and technologists under the Turkish Society of Nuclear Medicine were established in 1975. Recently after completing more than a half century in Turkey, nuclear medicine has proved to be a strong and evolving medical field with more than 600 physicians serving for the changing needs of clinical practice throughout these years. This article describes past and present facts in this field and attempts to provide insights into the future which hopefully will be brighter than before.

Nuclear Medicine in the Philippines: A Glance at the Past, a Gaze at the Present, and a Glimpse of the Future.

While the introduction of radioactive tracers in the study of metabolic pathways has been well-documented in clinical thyroidology as early as 1924, the widespread utilization in other clinical specialties has been hampered by slow developments in radiation-detecting devices and in the production of appropriate radiopharmaceuticals, in addition to the morbid fear of radiation. In the Philippines, the first radioisotope laboratory was established in 1956. Ten years later, the Philippine Society of Nuclear Medicine was formed. Through the years, challenges were overcome, foundations were laid down, growth was encouraged, friendships with other organizations were built, adjustments were made, and rules were enforced. To date, there are approximately 58 nuclear medicine centers randomly distributed from north to south of the Philippines, 7 accredited nuclear medicine training institutions, 95 board-certified nuclear medicine physicians (a few of whom are also internationally recognized), and a regionally-indexed Philippine Journal of Nuclear Medicine. Qualifying examinations for technologists were also recently instated. International relations are constantly strengthened by sending trainees abroad and accepting foreign trainees here, as well as participating in conferences and other endeavors. While the cost of putting up nuclear medicine centers in the Philippines is still prohibitive, it should not pose too much of a constraint as there are foreign and local parties willing to help. With appropriate instrumentation, targeting radiopharmaceuticals and trained human resources, nuclear medicine can indeed contribute much to health care delivery.

Nuclear medicine training and practice in the UK.

Nuclear medicine training and practice in the UK.

Nuclear medicine training in the European Union: 2015 update.

Nuclear medicine training in the European Union: 2015 update.

Nuclear medicine training and practice in Italy.

Nuclear medicine training and practice in Italy.

Nuclear medicine technologist education and training in Europe: literature and web-based findings.

The education and training of a nuclear medicine technologist (NMT) is not homogeneous among European countries, which leads to different scope of practices and, therefore, different technical skills are assigned. The goal of this research was to characterize the education and training of NMT in Europe. This study was based on a literature research to characterize the education and training of NMT and support the historical evolution of this profession. It was divided into two different phases: the first phase included analysis of scientific articles and the second phase included research of curricula that allow health professionals to work as NMT in Europe. The majority of the countries [N=31 (89%)] offer the NMT curriculum integrated into the high education system and only in four (11%) countries the education is provided by professional schools. The duration in each education system is not equal, varying in professional schools (2-3 years) and high education level system (2-4 years), which means that different European Credit Transfer and Accumulation System, such as 240, 230, 222, 210 or 180 European Credit Transfer and Accumulation System, are attributed to the graduates. The professional title and scope of the practice of NMT are different in different countries in Europe. In most countries of Europe, nuclear medicine training is not specific and curriculum does not demonstrate the Nuclear Medicine competencies performed in clinical practice. The heterogeneity in education and training for NMT is an issue prevalent among European countries. For NMT professional development, there is a huge need to formalize and unify educational and training programmes in Europe.