MRTs instruct patients regarding preparation and ensure compliance prior to initiating procedures
- Standardized patient preparation is used for nuclear medicine procedures to achieve quality diagnostic results, improve accuracy and consistency of results and maintain patient safety.
- Failure to comply with the patient preparation may cause a delay in performance or a decrease in diagnostic quality of the procedure
- The patient preparation required depends on the procedure being performed and may vary by facility – examples of procedures may include, but are not limited to:
- Abstaining from caffeine (e.g., MPI)1,2
- Abstaining from strenuous exercise (e.g., 18F-FDG)3
- Discontinuing medications (e.g., 14C, Thyroid Uptake)4,5
- Increasing hydration (e.g., renal scan, bone scan)6
- Undergoing bowel preparation (e.g., 67Ga-citrate, 111In-Octreotide)7
- Administering antiemetics (e.g., 131I-NaI Therapy)8
- Administering thyroid blockade (e.g., 131I-MIBG, 131I-Tositumomab)9
- Restricting radiographic contrast for up to 3 weeks (e.g., thyroid uptake)4
- Restricting barium for 72 hours (e.g., abdominal images)
- Restricting other NM procedures within 48 hours (or longer), depending on the radiopharmaceutical6
- Consuming a light meal (e.g., might be required 2-4 hours prior for biliary, iodine therapy)
- MRTs are familiar with the specific set of requirements for each nuclear medicine procedure.
- Patients are more likely to comply when they have an understanding of the reasons for the instructions10,11.
- Instructions are given to the patient ahead of the procedure.
- Instructions are worded in clear and simple terms, and provide information on all aspects of the procedure, including:
- Pre-study preparations that need to be followed
- The importance and reasons why pre-study preparations are necessary
- Elements of the procedure
- MRTs answer patient questions related to preparation and the procedure at the time the instructions are given.
- Patients are provided the opportunity to clarify and ask further questions
- Patients are provided with a contact number in case questions arise
- MRTs interview patients to confirm compliance with pre-study preparation.
- In the event of non-compliance, the study may be delayed or rescheduled based on the advice of a supervising radiologist or nuclear medicine physician.
- If the lack of preparation isn’t critical (i.e., the loss of information won’t affect patient outcome), the procedure can be continued, despite the effect to the results
Juni JE, Waxman AD, Devous MD, et al. Procedure Guideline for Brain Perfusion SPECT Using 99mTc Radiopharmaceuticals 3.0. 2009. Available from: http://tech.snmjournals.org/content/37/3/191.full. [Accessed 7 Jan 2019]
Strauss HW, Miller D, Wittry MD, et al. Society of Nuclear Medicine Procedure Guideline for Myocardial Perfusion Imaging: version 3.3, approved June 14, 2008. Available from: http://snmmi.files.cms-plus.com/docs/Myocardial%20Perfusion%20Imaging%203.3.pdf. [Accessed 21 Dec 2018]
Boellaard R, Doherty MLO, Weber WA, et al. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Available at: http://www.eanm.org/publications/guidelines/gl_onco_fdgpet.pdf. Accessed March 22, 2013.
Balon HR, Silberstein EB, Meier DA, et al. Society of Nuclear Medicine Procedure Guideline for Thyroid Uptake Measurement: version 3.0, approved September 5, 2006. Available at: http://interactive.snm.org/docs/Thyroid%20Uptake%20Measure%20v3%200.pdf. Accessed March 22, 2013.
Balon HR, Roff E, Freitas JE, et al. Society of Nuclear Medicine Procedure Guideline for C-14 Urea Breath Test: version 3.0, approved June 23, 2001. Available at: http://interactive.snm.org/docs/pg_ch07_0403.pdf. Accessed October 17, 2013.
Taylor AT, Blaufox MD, Dubovsky EV, et al. Society of Nuclear Medicine Procedure Guideline for Diagnosis of Renovascular Hypertension: version 3.0, approved June 20, 2003. Available from: http://snmmi.files.cms-plus.com/docs/Renovascular_Hypertention.pdf. [Accessed 21 Dec 2018]
Schakett P. Nuclear Medicine Technology: Procedures and Quick Reference. 2nd ed. Baltimore, MD: Wolters Kluwer Lippincott Williams & Wilkins; 2009.
Silberstein EB, Alavi A, Balon HR, et al. The SNM Practice Guideline for Therapy of Thyroid Disease with 131I 3.0*. J Nucl Med 2012;53(10):1633-1651.
Giammarile F, Chiti A, Lassmann M, Brans B, Flux G. (European Association of Nuclear Medicine) EANM procedure guidelines for 131 I-meta-iodobenzylguanidine (131 I-mIBG) therapy. Eur J Nucl Med Mol Imag 2008;35:1039-1047.
Cameron LD, Leventhal H, Eds. The self-regulation of health and illness behaviour. London, UK: Routledge; 2003.
Greaves C, Senior V, Barnett J, Clark M, Pope J, Hinton P. Information to accompany patients undergoing nuclear medicine procedures. Available from: http://www.hse.gov.uk/research/rrpdf/rr416.pdf. [Accessed 22 March 2013]