Guidelines for the Nuclear Medicine Technologist
Nuclear Cardiology uses small amounts of radioactive pharmaceuticals to obtain information about the heart. With this technology, the nuclear cardiologist may assess the heart muscle. Modern imaging techniques provide qualitative and quantitative information with little risk or discomfort to the patient. All nuclear cardiology imaging procedures may be done on an outpatient basis.
Nuclear cardiology imaging procedures are performed under the supervision of cardiologists. Nuclear cardiology testing facilities may be located in hospitals, clinics, or private offices. Such a facility must have a materials license from the federal government, or in the case of agreement states, a state radiation control agency. A materials license is issued after a thorough evaluation of the facility and documented proof of the physician’s training.
Nuclear cardiology imaging today consists of complex and highly technologically demanding studies. The role of the technologist has never been greater in a field in which excellence in science and patient care is essential. The nuclear medicine technologist can provide quality nuclear cardiology services only by having a global understanding of all the issues that impact the field of nuclear cardiology. To optimize the clinical impact of nuclear cardiology procedures in patients with coronary syndromes, the technologist must consistently produce optimal image quality. To accomplish this, the technologist must adhere to basic nuclear cardiology principles and practices.
The Nuclear Medicine Technologist working in nuclear cardiology must:
- Understand cardiac anatomy and physiology
- Understand the appropriate performance of exercise tolerance or pharmacological stress testing
- Demonstrate the correct application of patient monitoring techniques during exercise or pharmacological stress testing
- Maintain current basic life support certification
- Implement quality control procedures to confirm optimal performance of imaging systems, monitoring equipment, radiopharmacy, gating equipment, infusion pumps
- Demonstrate appropriate selection of acquisition and processing parameters
- Create image displays for the interpreting and referring physician to review
- Understand the performance of functional imaging procedures
- Understand the process of effective patient management
To sustain a high level of professionalism, knowledge, and skill, nuclear cardiology technologists must actively participate in professional growth through continuing education programs. By having a membership in professional organizations including the Society of Nuclear Medicine, your regional Technologist Chapter and the American Society of Nuclear Cardiology (ASNC), the technologist is afforded the opportunity to maintain skill levels. This can be accomplished by reading journals, interacting with peers, and availing oneself of guidelines- written by experts in the field- to produce optimal nuclear cardiology procedures.
As nuclear medicine technologists, you play a critical role in providing information to the physician for total patient management. It helps to have a global understanding of the many issues that impact the field. The success of your technology is based on the quality of your studies and your understanding of nuclear cardiology as a vital diagnostic and prognostic tool.
In addition to the core requirements noted in the Society of Nuclear Medicine’s Curriculum Guide for Nuclear Medicine Technologists, the American Society of Nuclear Cardiology Technologist Committee has made several recommendations (J Nucl Cardiol, 1997). This committee recommends that the technologist who actively practices in the field of nuclear cardiology should have a minimum of 8 weeks of specialized, hands-on training and experience of nuclear cardiology procedures in the following areas:
Acquisition, including equilibrium radionuclide angiography, eg, first-pass radionuclide angiography and perfusion (SPECT and planar) with optional training in first-pass shunt detection and cardiac infarct avid imaging
Processing, including quality assurance and computer processing and reconstruction
Instrumentation, planar and SPECT technology
– Planar imaging, including acquisition and processing
– SPECT and ECG-gated imaging, including acquisition, reconstruction, image processing, technical artifacts, SPECT gamma camera system, PET, and ancillary instrumentation and equipment
– Myocardial perfusion agents
– 99m-Tc-labeled red blood cell imaging
– Myocardial infarct avid imaging
Anatomy and physiology
Basic ECG skills
Stress testing methods
– Physical (bicycle)
– Physical (treadmill)
– CPR, including cardioversion/ defibrillation
– Laboratory values (serum enzymes, serum electrolytes)
– Cardiovascular drugs
– Cardiac revascularization
– Nonnuclear cardiovascular evaluation
Additional nuclear cardiology guidelines are written by experts in the field and are available on the Web sites of the Society of Nuclear Medicine
(www.snmmi.org) and the American Society of Nuclear Cardiology (www.asnc.org).