Module - Radionuclide Imaging


Work-based learning outcomes


  1. Perform and interpret measurements on imaging equipment, including gamma cameras, Single-photon emission computed tomography (SPECT/CT) scanners and Positron emission tomography (PET)/ Computed Tomography (CT) scanners, advising on the acceptability of their clinical use in a range of contexts
  2. Advise on the acquisition and processing of clinical planar, SPECT and PET images
  3. Analyse images to extract quantitative information and increase diagnostic utility
  4. Contribute to the clinical interpretation and reporting of images

Work-based Competencies


Learning outcome Title Knowledge
1 1

Perform planar gamma camera commissioning tests and participate in the commissioning tests of Single-photon emission computed tomography (SPECT)/ Computed Tomography (CT) and Positron emission tomography (PET)/ (CT) scanners

  • Correct and safe operation of imaging equipment
  • Factors that affect dose and image quality in the context of intended use
  • The benefits to patient treatment and care of performing commissioning tests
  • Individual types and components of instrumentation
  • Standards applicable to radionuclide imaging equipment, including National Electrical Manufacturers Association (NEMA), national standards and manufacturer’s guidance
  • Current guidelines and legislative requirements for imaging equipment testing
  • Analysis of performance trends
  • Performance criteria, including remedial and suspension levels, for a broad range of imaging equipment
  • Likely causes of degradation of image quality and timescale over which common defect types progress
  • Awareness of escalation pathway for corrective action (eg first-line action, when to contact manufacturer)
  • Principles of quality assurance and equipment quality control, including the key performance parameters for testing
  • The range of suitable tests to carry out on equipment to establish safe, consistent and expected operation
  • Errors and statistical analyses
  • The performance and limitations of test procedures
  • Appropriate specifications for different clinical requirements
  • Appropriate level of accuracy and precision for a range of tests
2 1

Make comprehensive quantitative routine performance measurements on imaging equipment

  • Correct and safe operation of imaging equipment
  • Factors that affect dose and image quality in the context of intended use
  • The benefits to patient treatment and care of performing commissioning tests
  • Individual types and components of instrumentation
  • Standards applicable to radionuclide imaging equipment, including National Electrical Manufacturers Association (NEMA), national standards and manufacturer’s guidance
  • Current guidelines and legislative requirements for imaging equipment testing
  • Analysis of performance trends
  • Performance criteria, including remedial and suspension levels, for a broad range of imaging equipment
  • Likely causes of degradation of image quality and timescale over which common defect types progress
  • Awareness of escalation pathway for corrective action (eg first-line action, when to contact manufacturer)
  • Principles of quality assurance and equipment quality control, including the key performance parameters for testing
  • The range of suitable tests to carry out on equipment to establish safe, consistent and expected operation
  • Errors and statistical analyses
  • The performance and limitations of test procedures
  • Appropriate specifications for different clinical requirements
  • Appropriate level of accuracy and precision for a range of tests
3 1

Critically review quality assurance programmes for radionuclide imaging

  • Correct and safe operation of imaging equipment
  • Factors that affect dose and image quality in the context of intended use
  • The benefits to patient treatment and care of performing commissioning tests
  • Individual types and components of instrumentation
  • Standards applicable to radionuclide imaging equipment, including National Electrical Manufacturers Association (NEMA), national standards and manufacturer’s guidance
  • Current guidelines and legislative requirements for imaging equipment testing
  • Analysis of performance trends
  • Performance criteria, including remedial and suspension levels, for a broad range of imaging equipment
  • Likely causes of degradation of image quality and timescale over which common defect types progress
  • Awareness of escalation pathway for corrective action (eg first-line action, when to contact manufacturer)
  • Principles of quality assurance and equipment quality control, including the key performance parameters for testing
  • The range of suitable tests to carry out on equipment to establish safe, consistent and expected operation
  • Errors and statistical analyses
  • The performance and limitations of test procedures
  • Appropriate specifications for different clinical requirements
  • Appropriate level of accuracy and precision for a range of tests
4 1

Instigate corrective action based on an evaluation of quality control results

  • Correct and safe operation of imaging equipment
  • Factors that affect dose and image quality in the context of intended use
  • The benefits to patient treatment and care of performing commissioning tests
  • Individual types and components of instrumentation
  • Standards applicable to radionuclide imaging equipment, including National Electrical Manufacturers Association (NEMA), national standards and manufacturer’s guidance
  • Current guidelines and legislative requirements for imaging equipment testing
  • Analysis of performance trends
  • Performance criteria, including remedial and suspension levels, for a broad range of imaging equipment
  • Likely causes of degradation of image quality and timescale over which common defect types progress
  • Awareness of escalation pathway for corrective action (eg first-line action, when to contact manufacturer)
  • Principles of quality assurance and equipment quality control, including the key performance parameters for testing
  • The range of suitable tests to carry out on equipment to establish safe, consistent and expected operation
  • Errors and statistical analyses
  • The performance and limitations of test procedures
  • Appropriate specifications for different clinical requirements
  • Appropriate level of accuracy and precision for a range of tests
5 1,4

Understand the wider clinical situation relevant to patients presenting to the modality

  • The wider clinical indications for a broad range of standardradionuclide  imaging procedures
  • The patient experience, expectations and needs associated with the modality, including patient information Alternative/complementary modalities
6 2,3,4

Develop and evaluate protocols for the optimal acquisition, processing and display of clinical images

  • Consequences of the selection of acquisition parameters (eg matrix size, collimator, dynamic phasing, etc)
  • The techniques and applications inherent in standard image processing and types of errors that may result
7 2

Write standard operating procedures for radionuclide imaging

  • The range of radiopharmaceuticals, radioactivity administered and radiation dose in relation to clinical studies, including patient preparation and imaging parameters
8 3

Use sophisticated image analysis software to extract quantitative information and enhance diagnostic utility

  • Full range of methods to accurately extract quantitative data, eg ROI analysis and various background subtraction methods
  • Attenuation correction
  • Scatter correction
9 3

Modify and develop image acquisition and analysis software

  • Specific application software or programming language
10 3

Explain the cause and effect of a range of artefacts and of equipment performance limitations on the interpretation of clinical images

  • Performance characteristics on a range of imaging equipment
  • Normal appearances of a range of diagnostic images
11 2

Participate in the clinical audit of radionuclide imaging in nuclear medicine

  • Ethical and governance regulations and guidance
  • Risks associated with the procedure

Work-based assessment


Complete 2 Case-Based Discussion(s)
Complete 1 of the following DOPS and/or OCEs
Type Title
DOPS Prepare a phantom for SPECT QC
DOPS Perform monthly QC on gamma camera according to Departmental procedures
DOPS Process a renogram
DOPS Perform a SPECT or SPECT/CT reconstruction
OCE Explain an imaging procedure to a patient
OCE Explain breast-feeding details to a patient with regard to the test they are undergoing.
OCE Discuss an imaging procedure with a member of the nursing staff.
OCE Discuss the result of an imaging procedure with the reporting clinician
OCE Present a clinical audit to colleagues