Module - Non-Imaging Radionuclide Tests

Work-based learning outcomes

  1. Perform and interpret measurements on equipment for non-imaging diagnostic tests, for example uncollimated gamma cameras, intra-operative gamma probes, uptake counters, gamma spectrometers, manual and automatic beta and gamma sample counters, and whole body counters This should include associated equipment such as balances, centrifuges and pipettes
  2. Ensure that all equipment used is calibrated and fit for purpose
  3. Advise on the acquisition and processing of data, including set-up and calibration of equipment
  4. Contribute to the analysis and clinical interpretation and reporting of results

Work-based Competencies

Learning outcome Title Knowledge
1 1

Make comprehensive quantitative performance measurements on non- imaging equipment

  • Equipment and its relationship to clinical purpose
  • The range of clinical conditions associated with the procedures carried out on the equipment
2 1

Plan and perform commissioning tests on beta and gamma counters and gamma spectrometers

  • Capability and specification of equipment and an understanding of it in relationship to clinical purpose
3 1,2

Critically review quality assurance programmes for the equipment used for non-imaging diagnostic tests

  • Relevant national legislation and associated guidance
  • Restrictions defined in local rules and other documentation
  • Existing quality system and an understanding of its relationship to legislation and any limitations of use
4 1,3

Instigate appropriate corrective action based on an evaluation of test results

  • Definition of key performance levels
  • Evidence for action levels and written procedures for the handling of problems
  • Local duty holders and their roles and responsibilities
5 3

Choose appropriate tissue – equivalent phantoms for quantitative in-vivo uptake measurements

  • Existing phantom material available and any limitations
  • Tests for suitability
6 2

Develop and critically evaluate the optimal acquisition and processing of data

  • Operation of a range of equipment
  • Impact on patient experience
7 2

Write standard operating procedures (SOPs) for non-imaging tests

  • Relevant guidance and legislation
  • The impact of SOPs on patient experience of non-imaging investigations
  • Implications for staff (control of substances hazardous to health (COSHH) considerations, radiation doses received, etc)
8 1,4

Participate in a range of non- imaging in-vivo and in-vitro tests

  • Theoretical clinical investigations for in-vivo and in-vitro tests
  • Stated local levels of supervision
  • Patient needs in relation to non-imaging tests
9 4

Generate results and assist in the interpretation of diagnostic tests, including the use of reference ranges

  • Standard procedures interpretation of results based on clinical details
  • Methods of reporting results
10 4

Explain the cause and effect of a range of artefacts, and of equipment performance limitations and patient- related factors on the interpretation of results

How significant these factors are to clinical results, how they are caused and how to minimise them

11 3

Advise on the clinical appropriateness of non-imaging diagnostic tests

  • Standard referral criteria
  • Any necessary patient preparation or continued behaviours during test period (eg dietary restrictions during test, drug preparation required, length of time since other specific investigations) that would otherwise affect the result
12 2

Perform clinical audit of non-imaging diagnostic nuclear medicine

  • IRMER and other legislation and guidance
  • Equipment replacement programmes and budgetary considerations

Work-based assessment

Complete 1 Case-Based Discussion(s)
Complete 1 of the following DOPS and/or OCEs
Type Title
DOPS Draw up injection under aseptic conditions (need not be for clinical use), and can be simulated radioactive material according to local procedures
DOPS Calculate activity required at certain time using decay tables and specific activity - include knowledge of local diagnostic reference level for activity and investigation
DOPS Process blood samples for counting in GFR test, RCM and PV - use of centrifuge, pipettes, sample tubes
DOPS Perform quality control procedures on intra- operative probe
DOPS Perform quality control procedures on sample counter.
DOPS Carry out counting and processing of SeHCAT patient or other non-imaging test - local procedures to be followed
DOPS Manual calculation to check result produced by spread-sheet for a non-imaging test
OCE Case study (with follow-up) of patient undergoing SeHCAT test - identify patient and IRMER roles; check patient preparation; explain procedure; give capsule according to local procedure;
OCE Case study (with follow-up) of patient undergoing (Red Cell Mass and Plasma Volume if possible) test - identify patient and IRMER roles; check patient preparation; explain procedure to patient; prepare radioactive injection(s) according to local procedure;
OCE Case study of patient undergoing Sentinel node procedure for breast / melanoma etc - identify patient and IRMER roles; explain procedure to patient;
OCE Discuss sentinel node procedures with theatre staff.
OCE Observe sentinel node procedures in theatre