Euro-American discussion document on entry and advanced level practice in nuclear medicine

The European Association of Nuclear Medicine Technologist Committee (EANMTC) and the Society of Nuclear Medicine Technologist Section (SNMTS) meet biannually to consider matters of mutual importance. These meetings are held during the SNM and EANM annual conferences. For several years, within these meetings, EANMTC and SNMTS have considered the value of having a Euro-American initiative in defining entry-level and advanced practice competencies for nuclear medicine radiographers (NMRs) and nuclear medicine technologists (NMTs). In June 2009, during the SNM annual conference in Toronto, it was agreed that a Euro-American working party would be established to consider advanced practice. It was recognized that any consideration of a definition for advanced practice would be predicated on an understanding or definition of entry-level practice. As a result, both types of practice would have to be considered. This discussion document outlines some of the background issues associated with advanced practice generally and specifically within nuclear medicine. The primary purpose of this document is to stimulate debate, on a Euro-American level, about the perceived value of advanced practice for NMRs and NMTs within nuclear medicine and to develop an internationally accepted list of entry-level competencies and scope of practice for NMRs and NMTs within nuclear medicine

Basics for nuclear medicine image reconstruction

Introduction and evolution of digital imaging proved to be a great tool for clinical and experimental medicine, changing the pathway in which patients are diagnosed and progress of therapy is monitored. The demand for diagnostic imaging procedures is constantly increasing, and sophisticated procedures, like Nuclear medicine (NM) and positron emission tomography (PET)-computed tomography (CT), are now state of the art in most of the developed countries. Nuclear medicine professionals benefitted in their practices, together with the evolutions of scanners and development of radiotracers, with the improvement of computational ability of systems devoted to image reconstruction. In this chapter, we will explore the basic of NM image reconstruction in an effort to describe the processes that arise from the detection of radiation emitted to the creation of clinically effective pictorial representation. The first part will analyze the physical and technological principles of image formation in planar NM imaging, including dynamic and whole body. It will describe image quality parameters, matrix size, interpolation and impact of computational processing capability evolution on image reconstruction. The second part will consider tomographic image reconstruction, discussing the role of sinograms and the most common processing algorithms, discussing also the impact of enhanced computational ability of modern systems on data analysis. It will start explaining analytical reconstruction and its role in single photon emission computed tomography (SPECT) systems and early PET detectors. It will then cover different logarithmic filters used to improve image quality. The chapter will also consider the evolution from filtered back-projection to the modern algorithms for iterative reconstruction including also specific PET-CT reconstruction. The chapter will offer to nuclear medicine professional the basics of the topic and instrument to facilitate the understanding of more specific NM and PET-CT techniques and reconstructions, described in other part of the book

Technologist approach to global dose optimization

Nuclear medicine technologists are specialized health professionals who cover a wide range of tasks from clinical routine (including image acquisition and processing, radiopharmaceutical dispensing and administration, patient care, and radioprotection tasks) to leading clinical research in the field of nuclear medicine. As a fundamental concern in all radiation sciences applied to medicine, protection of individuals against the harmful effects of ionizing radiation must be constantly revised and applied by the professionals involved in medical exposures. The acknowledgment that nuclear medicine technologists play a prominent role in patient management and several procedural steps, both in diagnostic and in therapeutic nuclear medicine applications, carries the duty to be trained and knowledgeable on the topic of radiation protection and dose optimization. An overview on selected topics related to dose optimization is presented in this article, reflecting the similarities and particularities of dose reduction-related principles, initiatives, and practicalities from a global perspective

Resistance training increases glucose uptake and transport in rat skeletal muscle

The purpose of these guidelines is to assist physicians in recommending, performing, interpreting and reporting the results of FDG PET/CT for oncological imaging of adult patients. PET is a quantitative imaging technique and therefore requires a common quality control (QC)/quality assurance (QA) procedure to maintain the accuracy and precision of quantitation. Repeatability and reproducibility are two essential requirements for any quantitative measurement and/or imaging biomarker. Repeatability relates to the uncertainty in obtaining the same result in the same patient when he or she is examined more than once on the same system. However, imaging biomarkers should also have adequate reproducibility, i.e. the ability to yield the same result in the same patient when that patient would have been examined on different systems and at different imaging sites. Adequate repeatability and reproducibility are essential for the clinical management of patients and the use of FDG PET/CT within multicentre trials. A common standardized imaging procedure will help promote the appropriate use of FDG PET/CT imaging and increase the value of publications and, therefore, their contribution to evidence-based medicine. Moreover, consistency in numerical values between platforms and institutes that acquire the data will potentially enhance the role of semiquantitative and quantitative image interpretation. Precision and accuracy are additionally important as FDG PET/CT is used to evaluate tumour response as well as for diagnosis, prognosis and staging. Therefore both the previous and these new guidelines specifically aim to achieve standardized uptake value harmonization in multicentre settings

FDG PET/CT:EANM procedure guidelines for tumour imaging: version 2.0

The purpose of these guidelines is to assist physicians in recommending, performing, interpreting and reporting the results of FDG PET/CT for oncological imaging of adult patients. PET is a quantitative imaging technique and therefore requires a common quality control (QC)/quality assurance (QA) procedure to maintain the accuracy and precision of quantitation. Repeatability and reproducibility are two essential requirements for any quantitative measurement and/or imaging biomarker. Repeatability relates to the uncertainty in obtaining the same result in the same patient when he or she is examined more than once on the same system. However, imaging biomarkers should also have adequate reproducibility, i.e. the ability to yield the same result in the same patient when that patient is examined on different systems and at different imaging sites. Adequate repeatability and reproducibility are essential for the clinical management of patients and the use of FDG PET/CT within multicentre trials. A common standardised imaging procedure will help promote the appropriate use of FDG PET/CT imaging and increase the value of publications and, therefore, their contribution to evidence-based medicine. Moreover, consistency in numerical values between platforms and institutes that acquire the data will potentially enhance the role of semiquantitative and quantitative image interpretation. Precision and accuracy are additionally important as FDG PET/CT is used to evaluate tumour response as well as for diagnosis, prognosis and staging. Therefore both the previous and these new guidelines specifically aim to achieve standardised uptake value harmonisation in multicentre settings