CME 11 Session – EANM’13

(1)
Pitfalls in Nuclear Medicine

Educational objectives:
  1. Define pitfalls and understand the concept of error in nuclear medicine; how to define and apply standard operating procedures (SOP); knowledge of Total Quality Management (TQM) as a "new" attitude in daily work; how to apply a PDCA (plan, do, check, act) cycle
  2. Review common and important sources of technical problems in Nuclear Medicine, including examples from Gamma camera, SPECT/CT, PET/CT and intraoperative probe work. Learn good practice to follow in order to avoid such problems
  3. Understand how technical aspects or imaging, pathology and the drugs taken by a patient may alter the appearances of nuclear medicine and PET images
Summary:
This interactive CME session is directed primarily towards nuclear physicians, radiopharmacists, radiochemists, physicists and technologists. Starting from the definitions of pitfall and error in medicine, all the major radiochemical and radiopharmaceutical issues that have to be checked before the radiocompound’s administration to the patient will be discussed. The choice of examination and precise procedures for the subject are discussed, including any medical issues, such as contraindications and interferences. Problems connected with Radiology Information Systems, Systems of picture archiving and medical billing software will be also analysed. Solutions will be identified through a TQM (total quality management) approach and the application of quality controls, regarding both the radiopharmaceutical’s preparation and its release. At the end of this first part, the application of a PDCA cycle system in the routine work to improve the “before the scan” SOP (Standard Operating Procedure) will be shown. In the second lecture, common and important sources of technical problems in Nuclear Medicine, including examples from Gamma camera, SPECT/CT, PET/CT and intraoperative probe work will be discussed. This will include issues in the data acquisition, image processing and study analysis. There will be a debate of good practice to follow in order to avoid such problems. In the 3rd and final lecture, unusual images will be presented, obtained after ensuring a correct radiopharmaceutical and the physics is right and therefore depending on the patient themselves. The causes may be technical, due to pathology changing the way a radiopharmaceutical is handled or interaction with drugs. A good knowledge of these pitfalls is needed for accurate interpretation. The CME’s panel aims to give to nuclear physicians elements of knowledge able to avoid and/or interpret pitfalls that may arise during all the steps preceding the clinical diagnosis. Non-medical professionals may be interested both for a better knowledge of their specific arguments and for an improvement of the interactive dialogue between all the parties involved in the final common goal: a correct diagnosis.

Key Words:
Pitfalls, Quality Control, SOP (Standard Operating Procedure), TQM (Total Quality Management), Technical Artefacts, Drug Interaction

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