ACR-SNM Task Force on Nuclear Medicine Training: Report of the Task Force

Guiberteau, Milton J.; Graham, Michael M.

doi:10.1016/j.jacr.2011.03.009

Cited by 19 publications

(18 citation statements)

References 4 publications

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“…The task force made several recommendations on future training (12). Recommendations for the short-term horizon were to harmonize nuclear medicine residency and nuclear radiology fellowship program requirements, improve the robustness of nuclear medicine training in diagnostic radiology residencies, improve the robustness of diagnostic radiology training in nuclear medicine residencies, and encourage a 16-mo nuclear medicine pathway within diagnostic radiology residencies.…”

Section: Snmmi/abnm Recommendations For Combined Training In Diagnostmentioning

confidence: 99%

SNMMI/ABNM Joint Position Statement on Optimizing Training in Nuclear Medicine in the Era of Hybrid Imaging

et al. 2012

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It became a primary medical specialty board whose only sponsor was the SNMMI in 1985. Medical specialties are defined by their core knowledge, not by technologies, because technologies are constantly changing. Nuclear medicine is a primary medical specialty because its core knowledge (exploitation of the tracer principle to study biochemical, physiologic, and molecular processes in time and space) is unique. The ABNM defines nuclear medicine as "the medical specialty that uses the tracer principle, most often with radiopharmaceuticals, to evaluate molecular, metabolic, physiologic and pathologic conditions of the body for the purposes of diagnosis, therapy and research" (1). The ABNM has recently published a statement on nuclear medicine professional competency and scope of practice (2). Nuclear medicine training programs embrace the complete spectrum of the practice of nuclear medicine, including general diagnostic procedures, radionuclide therapies, and cardiac imaging with exercise or pharmacologic agents. Residency programs in nuclear medicine are robust and for the past 40 y have trained most of the nuclear medicine physicians in practice. In 2012-2013, there are 54 Accreditation Council for Graduate Medical Education (ACGME)-accredited nuclear medicine resident training programs, and there are currently 144 on-duty trainees (3,4). ABNM has issued 789 certificates from 2000 to 2012, and the number has remained stable since the early 1980s (Fig. 1).The ABR began offering its own certificate of competence in nuclear radiology in 1973. Nuclear radiology was established as a subset of nuclear medicine limited to nuclear diagnostic imaging. Fellowship programs in nuclear radiology have been created that lead to eligibility for subspecialty certification in nuclear radiology by the ABR. Physicians must have ABR certification in diagnostic radiology and have an additional year of fellowship training in nuclear radiology in one of the 19 ACGME-accredited nuclear radiology training programs. In 2012-2013, there are 18 onduty trainees (3,4). This training pathway includes a total of 16 mo in nuclear radiology: 4 mo during diagnostic radiology residency and 12 mo during a nuclear radiology fellowship. In 2011, the ABR created a second pathway for subspecialty certification in nuclear radiology consisting of 16 mo of training in nuclear radiology or nuclear medicine during 4 y of diagnostic radiology residency, of which 10 mo must be consecutive. A significant difference between nuclear medicine and nuclear radiology is the amount of training required for therapy with radiopharmaceuticals as described in a conjoint statement on credentialing and delineation of privileges for therapeutic procedures using radiopharmaceuticals (5). Hybrid Imaging and Molecular ImagingThe emergence of hybrid imaging in nuclear medicine has changed the scope of knowledge required for nuclear medicine physicians. Nuclear medicine physicians must now have a greater knowledge of 3-dimensional anatomy. In addition, molecular imaging is an evolv...

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Section: Snmmi/abnm Recommendations For Combined Training In Diagnostmentioning

confidence: 99%

SNMMI/ABNM Joint Position Statement on Optimizing Training in Nuclear Medicine in the Era of Hybrid Imaging

et al. 2012

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“…The SNM has 24 committees and approximately 300 volunteers. The 2009 survey of nuclear medicine program directors, with 22 responses, indicated that 40% of nuclear medicine physicians are in private practices (9,10). The SNM surveyed its membership in 2010 and received 4,063 responses (30% physicians and scientists and 57% technologists).…”

Section: Smentioning

confidence: 99%

Status of and Trends in Nuclear Medicine in the United States

Delbeke¹,

Segall²

2011

J Nucl Med

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Nuclear medicine in the United States has grown because of advances in technology, including hybrid imaging, the introduction of new radiopharmaceuticals for diagnosis and therapy, and the development of molecular imaging based on the tracer principle, which is not based on radioisotopes. Continued growth of the field will require cost-effectiveness data and evidence that nuclear medicine procedures affect patients' outcomes. Nuclear medicine physicians and radiologists will need more training in anatomic and molecular imaging. New educational models are being developed to ensure that future physicians will be adequately prepared.Key Words: nuclear medicine; statistics; status; trends J Nucl Med 2011; 52:24S-28S DOI: 10.2967/jnumed.110.085688Nucl ear medicine has a history of decades of strong growth, particularly in nuclear cardiology and PET/CT. In the United States, the number of nuclear medicine procedures has grown from approximately 14 million in 1999 to almost 20 million in 2005 (1). After 2005, however, it dropped to about 17 million. Most nuclear medicine procedures are performed in hospital-based settings, but the number performed in nonhospital settings has grown over time to one third of all nuclear medicine procedures in 2008.In the United States, the growth of nuclear medicine procedures is due primarily to nuclear cardiology, which has grown from about 7 million procedures in 1999 to about 11 million in 2005 (1). Nuclear cardiology represents more than 50% of the nuclear medicine procedures done in the United States but represents only 14% of those done in Europe. A study performed in 2007 investigated the worldwide use of nuclear cardiology (2). The study findings indicated that nuclear cardiology procedures were used most extensively in the United States, with 1,000 or more procedures performed per 100,000 people (Fig. 1).Bone scintigraphy is the next most common nuclear medicine procedure performed in the United States, but it represents only 17% of procedures (1). Bone scintigraphy represented 36% of procedures performed in Europe in 2008.The volume of PET procedures in the United States is approximately 1.5 million per year (3). Oncology accounts for more than 90% of the PET and PET/CT procedures performed, whereas cardiology and neurology account for about 4% each (3). According to the National Oncology PET Registry, about 84% of the slightly more than 1,600 PET facilities in the United States have PET/CT systems (4). The emergence of molecular imaging with new radiopharmaceuticals and new technologies is likely to result in continued growth in the coming decades.Efforts to control spiraling health care costs have resulted in decreased reimbursement for medical imaging and the need to provide evidence that patients' outcomes are improved by diagnostic tests and therapies. Radiology benefit managers have become gatekeepers for insurance plans, but without evidence to ensure the appropriate use of medical imaging, coverage decisions are frequently based on cost. Downward pressure on nuclear me...

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“…They have opened intersociety dialogues and have established working groups charged with defining future training needs and how best to implement them (24)(25)(26)(27). Also, the American Board of Nuclear Medicine has expanded the training requirements in cross-sectional imaging.…”

Section: Separate or Unified: Are We Ready?mentioning

confidence: 99%

“…The small pool of graduates is unlikely to meet the needs of nuclear medicine and, especially, of PET/ CT services, given the more than 1.7 million PET examinations performed in the United States each year. Moreover, employment opportunities for nuclear medicine graduates have remained limited, especially in private practice, despite an expressed need by potential employers for additional physicians in nuclear medicine and PET/CT (24). However, as a recent survey of nuclear medicine trainees indicates, only 75% of candidates found employment in their specialty within 6 mo of graduation.…”

Section: Separate or Unified: Are We Ready?mentioning

confidence: 99%

Nuclear Medicine at a Crossroads

Schelbert¹

2011

J Nucl Med

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The growth of molecular imaging heightens the promise of clinical nuclear medicine as a tool for individualization of patient care and for improvement of health-care outcomes. Together with greater use of integrated structure-function imaging, clinical nuclear medicine reaches beyond traditional specialty borders into diagnostic radiology and oncology. Yet, there are concerns about the future of nuclear medicine, including progressively declining reimbursement, the competitive advantages of diagnostic radiology, limited translation of research accomplishments to clinical diagnostic imaging and patient care, and an insufficient pool of incoming highly qualified nuclear medicine clinicians. Thus, nuclear medicine views itself as being at a critical crossroads. What will be important is for nuclear medicine to be positioned as the quintessential molecular imaging modality more centrally within medical imaging and for the integration of nuclear medicine with primary care specialties to be driven more by patient needs than by specialty needs. In this way, the full potential of nuclear medicine as an effective and efficient tool for improving patient outcomes can be realized. Theever-growi ng body of science in molecular imaging heightens the promise of clinical nuclear medicine as a tool for greater individualization of patient care and for improving health-care outcomes. Together with greater use of integrated structure-function imaging, clinical nuclear medicine reaches beyond traditional specialty borders into diagnostic radiology and oncology. Yet, there are concerns about the future of nuclear medicine, including progressively declining reimbursement, the competitive advantages of diagnostic radiology, limited translation of research accomplishments to clinical diagnostic imaging and patient care, and an insufficient pool of incoming highly qualified nuclear medicine clinicians. Thus, nuclear medicine views itself as being at a critical crossroads. NUCLEAR MEDICINE AND MOLECULAR IMAGING: GROWTH WITHOUT BOUNDARIESClinical nuclear medicine as the quintessential clinical molecular imaging specialty has experienced and continues to experience impressive growth. Imaging is no longer confined to diagnosis and risk stratification of disease but contributes to treatment strategies. This especially applies to oncology, in which PET/CT with 18 F-FDG, an indicator of global tumor vitality, has improved the accuracy with which tumors are detected and staged and with which tumor progression or regression in response to treatment is assessed. Other radiotracers complement the diagnostic arsenal; they enable visualization of tumor types that can escape detection by 18 F-FDG, such as liver, prostate, pancreas, and brain tumors. Radioisotopes that do not require on-site cyclotron production, such as 68 Ga, now used clinically in several European countries, promise to expand the clinical range of PET; peptides labeled with 68 Ga have proved effective for uncovering somatostatin receptorexpressing tumors.Other radiolabeled probes ...

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ACR-SNM Task Force on Nuclear Medicine Training: Report of the Task Force

Cited by 19 publications

References 4 publications

SNMMI/ABNM Joint Position Statement on Optimizing Training in Nuclear Medicine in the Era of Hybrid Imaging

SNMMI/ABNM Joint Position Statement on Optimizing Training in Nuclear Medicine in the Era of Hybrid Imaging

Status of and Trends in Nuclear Medicine in the United States

Nuclear Medicine at a Crossroads

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