Running head: nuclear cardiology imaging
Nuclear cardiology imaging
The technologist’s role in achieving safe and the highest quality, nuclear cardiology images is essential in accurate patient diagnosis. Assuring patient safety is very important when performing these tests. With the ongoing advancement in nuclear cardiology we must be aware of the necessary patient preparations prior to the study, and adjusting the test to their needs while also obtaining meaningful information for the physician. Firstly, patient safety is key in providing quality care for the patient and assuring the patient feels comfortable to carry out with the study, so that as much information as possible can be captured. With the drastic increase in patient awareness regarding radiation exposure, explaining the procedure appropriately and flowing the necessary protocols regarding different patient weights and dosing should also be considered when evaluating a patient. In addition, transparent communication between the patient, technologist and referring physician is crucial before performing the test to assure that proper imaging protocol is followed. For instance, if the patient is smaller they should consider following the one-day stress/rest test protocol, where as those patients whom are much larger and heavier should go for the two-day protocol so enough counts are obtained and image quality might turn out better with their body type. However, depending on the patients history and age such as if they are much older and have a pretty high chance of coronary artery disease (CAD) or a history of left ventricle (LV) dysfunction, then a one-day stress test may not typically be recommended due to the relatively low stress dose, image artifacts are more likely to appear. These artifacts are also bound to lead to misinterpretation or make it more difficult to interpret especially in these patients where this test is more meaningful (DePuey, 2012).
Another key point that helps technologists provide high quality patient care and safety while performing cardiac imaging is being familiar with the equipment and camera systems that are used for the study. Familiarity with the equipment used is beneficial in getting patients in and out faster and helpful when needing to adjust to camera to get the heart centered in the correct field of view, along with deciding whether supine and prone images need to be taken, or just supine. Being knowledgeable with regards to the camera systems is important when providing the referring physician with the images, as well as assuring there is enough information obtained in order to accurately interpret the image results. It is important to review the protocol book established by the hospital in order to assure you are following the detailed procedures correctly to receive the most valuable high quality image for interpretation. Furthermore, when the images are being interpreted, results must be communicated in a clear, timely fashion in case any high-risk findings are present, the referring physician should be quickly notified. Reporting explicit conclusions is critical for an easy interpretation from the referring physician and in return, a more accurate patient diagnosis (Douglas, 2006). It is also important for technologists to clearly indicate specific and significant findings to aid the ordering physician in patient diagnosis. Lastly, carrying out high-quality images leads to greater improvement in decision making and overall patient care.
All in all, in order for technologists to achieve safe and high-quality cardiac images, personal dosimeters must be worn correctly and ALARA (as-low-as-reasonably-achievable) principles must be practiced at all times. Patient satisfaction is also a key aspect while imaging patients. As a technologist, respecting the patient and being empathetic is necessary when looking to gain patient satisfaction and making patient care a top priority. Overall, effective and efficient communication, quality patient care, and gaining knowledge on the systems used to perform the study will lead technologists in achieving safe and high-quality nuclear cardiology images.
DePuey, G. & Mahmarian, J. (2012). Patient-centered imaging. ASNC Preferred Practice Statement. Journal of Nuclear Cardiology.
Douglas, P,. et al. (2006). Achieving Quality in Cardiovascular Imaging. Journal of the American College of Cardiology. 48 (10). 2141-2151. Doi:10.1016/j.jacc.2006.06.076