RT Journal Article
SR Electronic
T1 Quality Improvement Initiatives to Assess and Improve PET/CT Injection Infiltration Rates at Multiple Centers
JF Journal of Nuclear Medicine Technology
JO J. Nucl. Med. Technol.
FD Society of Nuclear Medicine
SP 326
OP 331
DO 10.2967/jnmt.119.228098
VO 47
IS 4
A1 Terence Z. Wong
A1 Thad Benefield
A1 Shane Masters
A1 Jackson W. Kiser
A1 James Crowley
A1 Dustin Osborne
A1 Osama Mawlawi
A1 James Barnwell
A1 Pawan Gupta
A1 Akiva Mintz
A1 Kelley A. Ryan
A1 Steven R. Perrin
A1 Ronald K. Lattanze
A1 David W. Townsend
YR 2019
UL http://tech.snmjournals.org/content/47/4/326.abstract
AB PET/CT radiotracer infiltration is not uncommon and is often outside the imaging field of view. Infiltration can negatively affect image quality, image quantification, and patient management. Until recently, there has not been a simple way to routinely practice PET radiopharmaceutical administration quality control and quality assurance. Our objectives were to quantify infiltration rates, determine associative factors for infiltration, and assess whether rates could be reduced at multiple centers and then sustained. Methods: A “design, measure, analyze, improve, and control” quality improvement methodology requiring novel technology was used to try to improve PET/CT injection quality. Teams were educated on the importance of quality injections. Baseline infiltration rates were measured, center-specific associative factors were analyzed, team meetings were held, improvement plans were established and executed, and rates remeasured. To ensure that injection-quality gains were retained, real-time feedback and ongoing monitoring were used. Sustainability was assessed. Results: Seven centers and 56 technologists provided data on 5,541 injections. The centers’ aggregated baseline infiltration rate was 6.2% (range, 2%–16%). On the basis of their specific associative factors, 4 centers developed improvement plans and reduced their aggregated infiltration rate from 8.9% to 4.6% (P < 0.0001). Ongoing injection monitoring showed sustainability. Significant variation was found in center- and technologist-level infiltration rates (P < 0.0001 and P = 0.0020, respectively). Conclusion: A quality improvement approach with new technology can help centers measure infiltration rates, determine associative factors, implement interventions, and improve and sustain injection quality. Because PET/CT images help guide patient management, the monitoring and improvement of radiotracer injection quality are important.