Feature | February 26, 2013

Society of Nuclear Medicine and Molecular Imaging Identifies List of Commonly Used Tests to Question

Group aims to encourage physician and patient conversations by highlighting potentially unnecessary procedures in nuclear medicine, molecular imaging

Nuclear Imaging Choosing Wisely Five Questions Testing PET/SPECT Systems

February 26, 2013 — The Society of Nuclear Medicine and Molecular Imaging (SNMMI) released a list of specific tests that are commonly ordered — but not always necessary — in nuclear medicine and molecular imaging as part of the Choosing Wisely campaign, an initiative of the ABIM Foundation. The list identifies five targeted, evidence-based recommendations that can support conversations between patients and physicians about what care is really necessary and appropriate.

SNMMI’s list identified the following five recommendations; support points and references:

  1. Do not use PET/CT for cancer screening in healthy individuals.
  2. Do not perform routine annual stress testing after coronary artery revascularization.
  3. Do not use nuclear medicine thyroid scans to evaluate thyroid nodules in patients with normal thyroid gland function.
  4. Avoid using a computed tomography angiogram to diagnose pulmonary embolism in young women with a normal chest radiograph; consider a radionuclide lung study (“V/Q study”) instead.
  5. Do not use PET imaging in the evaluation of patients with dementia unless the patient has been assessed by a specialist in this field.


“All of us on the front lines of medical care know we have the opportunity to improve the care we deliver by engaging our patients in conversations about what tests are truly necessary and beneficial to their health. The recommendations released today for nuclear medicine and molecular imaging provide valuable information to help patients and physicians start important conversations about treatment options and make wise choices about their care,” said Gary Dillehay, M.D., SNMMI president-elect and chair of the SNMMI Choosing Wisely Taskforce.

To create its list, SNMMI convened a working group consisting of the SNMMI leadership, presidents of the SNMMI brain imaging, cardiovascular, general clinical nuclear medicine, nuclear oncology and pediatric councils, and several at-large members. The council presidents worked with their respective members to identify examples of nuclear medicine procedures that may not be used appropriately. Members who were not a part of the councils were encouraged to submit their suggestions by email. After a list was created, the working group determined the final “Five Things.”

SNMMI’s participation in the Choosing Wisely campaign is indicative of the society’s dedication to increasing understanding and sound practice of nuclear medicine and molecular imaging among the medical community and consumers. “By encouraging physicians and patients to discuss nuclear medicine and molecular imaging procedures, it is our hope that patients receive personalized, appropriate care,” said Dillehay.

The campaign is also reaching millions of consumers nationwide through a stable of consumer partners, led by Consumer Reports — the world’s largest independent product-testing organization — which has worked with the ABIM Foundation to distribute patient-friendly resources for consumers and physicians to engage in these important conversations.

Releasing lists along with SNMMI as part of the Choosing Wisely campaign are 16 other organizations representing more than 350,000 physicians, nurses, pathologists, radiologists and other health care professionals. All the lists released were developed by individual specialty societies after months of careful consideration and review. Using the most current evidence about management and treatment options within their specialty, the societies believe the recommendations can make a significant impact on patient care, safety and quality.

In April 2012, nine medical specialty societies each released lists as part of the Choosing Wisely campaign. To date more than 130 tests and procedures to question have been released as part of the campaign and the specialty societies are now undertaking considerable efforts to share the recommendations with their collective membership of more than 725,000 physicians.

For more information: www.snmmi.org/choosingwisely 

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