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 

Related Content

PET/CT Tracer Identifies Vulnerable Lesions in Non-Small Cell Lung Cancer Patients

Example of a patient with an upper left lung NSCLC: A: FDG; B: FDG PET/CT; C: Planning radiotherapy based on FDG (66Gy) with BTVm (GTV), CTV and PTV; D: PET FMISO E: FMISO PET/CT; F: boost based on the FMISO PET (76Gy) with BTVh (biological hypoxic target volume) and PTV boost. Credit: QuantIF – LITIS EA 4108 – FR CNRS 3638, Henri Becquerel Cancer Center, Rouen, France

News | PET-CT | July 14, 2017
July 14, 2017 — Fluorine-18 (18F)-fluoromisonidazole (FMISO) is a positron emission tomography (PET)...
Novel PET Tracer Detects Small Blood Clots

PET images (MIP 0-60 min) of three Cynomolgus monkeys. Strong signals are detected at the sites where inserted catheters had roughened surfaces. Almost no other background signal is visible. Only accumulation in the gallbladder becomes visible at the bottom of the image. Credit: Piramal Imaging GmbH, Berlin Germany.

News | PET Imaging | July 07, 2017
July 7, 2017 — Blood clots in veins a
Sponsored Content | Videos | Clinical Decision Support | June 29, 2017
Rami Doukky, M.D., system chair, Division of Cardiology, professor of medicine, Cook County Health and Hospitals Syst
Dual-Agent PET/MR With Time of Flight Detects More Cancer

Tc-99m MDP bone scan (left) is negative for osseous lesions. NaF/FDG PET/MRI (right and second slide) confirms absence of bone metastases, but shows liver metastases. Image courtesy of Stanford University.

News | PET-MRI | June 20, 2017
Simultaneous injections of the radiopharmaceuticals fluorine-18 fluorodeoxyglucose (18F-FDG) and 18F-sodium fluoride (...
Combined Optical and Molecular Imaging Could Guide Breast-Conserving Surgery

WLE specimen from a patient with a grade 3, ER-/HER2-, no special type (NST) carcinoma. (A) Cerenkov image; (B) Grey-scale photographic image overlaid with Cerenkov signal. An increased signal from the tumor is visible (white arrows); mean radiance is 871 ± 131 photons/s/cm2/sr, mean TBR is 3.22. Both surgeons measured the posterior margin (outlined in blue) as 2 mm (small arrow); a cavity shaving would have been performed if the image had been available intraoperatively. The medial margin (outlined in green) measured >5 mm by both surgeons. Pathology ink prevented assessing the lateral margin; a phosphorescent signal is visible (open arrows). (C) Specimen radiography image. The absence of one surgical clip to mark the anterior margin, and the odd position of the superior margin clip (white arrow) prevented reliable margin assessment. (D) Combined histopathology image from two adjacent pathology slides on which the posterior margin (bottom of image) and part of the primary tumor are visible (open arrows). The distance from the posterior margin measured 3 mm microscopically (double arrow). The medial margin is > 5 mm (not present in image). Credit: A. D. Purushotham, M.D., King’s College London, UK

News | Nuclear Imaging | June 20, 2017
June 20, 2017 — Breast-conserving surgery (BCS) is the primary treatment for early-stage...
A 77-year-old male with recurrent lymph node and pulmonary metastases detected by Ga-68 PSMA PET/CT but not by conventional imaging

A 77-year-old male with recurrent lymph node and pulmonary metastases detected by Ga-68 PSMA PET/CT but not by conventional imaging. Graphic courtesy of the Department of Nuclear Medicine, Royal North Shore Hospital, Sydney

News | Prostate Cancer | June 15, 2017
An estimated one in seven American men will be affected by prostate cancer in their lifetime. Prostate-specific...
Dual-labeled PSMA-inhibitors for the diagnosis and therapy of prostate cancer

IMAGE OF THE YEAR: Dual-labeled PSMA-inhibitors for the diagnosis and therapy of prostate cancer. Technology of dual-labeled PSMA-inhibitors for PET/CT imaging and fluorescence-guided intraoperative identification of metastases. This work might help to establish a new treatment regimen for more precise and sensitive pre-, intra- and post-therapeutic detection of prostate cancer.

Credit: Courtesy of A. Baranski, M. Schäfer, U. Bauder-Wüst, M. Roscher, J. Schmidt, E. Stenau, L. Maier-Hein, M. Eder, K. Kopka, German Cancer Research Center, Heidelberg, Germany; T. Simpfendörfer, B. Hadaschik, U. Haberkorn, Heidelberg University Hospital, Heidelberg, Germany; PET-image: Afshar-Oromieh et al., EJNMMI 2013; 40(4); STED-image: J. Matthias, German Cancer Research Center.

This study was supported by the VIP+ fund, Federal Ministry of Education & Research (BMBF), Germany.

Scientific Paper 531: “Preclinical evaluation of dual-labeled PSMA-inhibitors for the diagnosis and therapy of prostate cancer.” A. Baranski, M. Schäfer, U. Bauder-Wüst, M. Roscher, J. Schmidt, E. Stenau, L. Maier-Hein, M. Eder, K. Kopka, German Cancer Research Center (DKFZ), Heidelberg, Germany; T. Simpfendörfer, B.  Hadaschik, U. Haberkorn, University Hospital, Heidelberg, Germany. Presented at SNMMI’s 64th Annual Meeting, June 10-14, 2017, Denver, Colo.

News | Prostate Cancer | June 15, 2017
In the battle against metastatic prostate cancer, the removal of lymph node metastases using image-guided surgery may...
Axial fused 89Zr-5B1 antibody PET/CT image demonstrates focus of uptake in the liver (arrow). Focus of uptake correlates with increased liver metastasis seen on diagnostic CT (red arrow) performed 2 weeks prior

Axial fused 89Zr-5B1 antibody PET/CT image demonstrates focus of uptake in the liver (arrow). Focus of uptake correlates with increased liver metastasis seen on diagnostic CT (red arrow) performed 2 weeks prior. Image courtesy of Christian Lohrmann, Jason Lewis, Wolfgang Weber, Memorial Sloan Kettering Cancer Center; MabVax Therapeutics

News | PET-CT | June 14, 2017
Pancreatic cancer is associated with bleak five-year survival rates and limited treatment options, but new research is...

While subject No. 1 (left) was judged as positive for both the neuronal injury and the amyloid load biomarker, both Alzheimer's disease biomarkers were negative in subject No. 2 (right). Image courtesy of Henryk Barthel et al., University Hospital Leipzig, Leipzig, Germany

News | PET Imaging | June 14, 2017
More people die of Alzheimer's disease than prostate and breast cancer combined. Identifying the disease before major...
Overlay Init