Background
There are numerous nuclear medicine studies available to providers to help diagnose disease. As these techniques become more advanced and available there needs to be more robust familiarization among members of the healthcare team. In particular, reinforcing awareness of common and critical pitfalls in several frequently used studies can help mitigate risk by decreasing error at multiple levels.
Educational Goals / Teaching Points
Highlight common pitfalls in frequently ordered studies. Increase situational awareness for critical aspects of common nuclear medicine studies. Help minimize errors and improve study execution and interpretation quality. Target audience is radiologists, technologists, and ordering providers.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Patient preparation/guidance issues commonly impacting studies. Need for patient fasting/blood glucose thresholds. Recent iodinated contrast. Special patient population considerations (e.g., reduced particles for pregnant patients for V/Q scan). Laterality and artifact issues. Posterior imaging on renal scintigraphy, which could lead to confusion. Superimposed counts from other structures (e.g., free technetium in stomach or false-positive RBC study from nearby hematoma/varices). Error in study execution: incorrect ROI selection, patient positioning, or head movement significantly impacting result of DaT scan. Artifactual hot spots on V/Q study secondary to MAA aggregation in syringe. Imaging techniques: V/Q scan, HIDA scan, renal/RBC scintigraphy, 123I-Iofluplane SPECT, gastric emptying study.
Conclusion
Across the multitude of imaging modalities in nuclear medicine, positive steps can be taken to avoid common pitfalls in patient selection, preparation, image acquisition and interpretation. Doing so will bolster efficiency, safety, and help reinforce patient trust.
