Opportunities for Error in Diagnostic Nuclear Medicine
| Procedure stage | Opportunities for error | Staff involved |
|---|---|---|
| Scheduling | Single vs. multiple-day procedures; procedures with delay between injection and imaging | Scheduler/referring physician |
| Screening | Scan appropriateness, medication interference, pregnancy/breastfeeding | Nuclear medicine physician |
| Patient preparation | Medications (prescribed and over counter), NPO status, hydration, caffeine avoidance, oral contrast agent (barium), intravenous contrast agent (iodinated) | Scheduler/technologist |
| Radiopharmaceutical administration | Correct radiopharmaceutical, amount, route, and timing | Technologist |
| Special techniques | Stress testing, injections in other departments (e.g., surgery) | Technologist/stress test personnel/other physician |
| Image acquisition | Collimator; energy window; matrix size; acquisition type (e.g., static vs. dynamic); planar vs. SPECT, SPECT/CT, or PET/CT; positioning; technical quality | Technologist |
| Image processing and display | Region-of-interest placement, image summation, filtering, reference database comparison, archiving | Technologist |
| Interpretation and reporting | Misdiagnoses, missed pathology, incomplete reporting, delayed reporting | Nuclear medicine physician |
NPO = nothing by mouth.