Produce positron emission tomography/magnetic resonance images (pet/mri) for diagnostic purposes

SFHCI.K SFHCI.K This standard is concerned with the use of Positron Emission Tomography/ Magnetic Resonance imaging (PET/MRI) equipment and procedures to produce images for diagnostic purposes. Key people are those involved in the individual's care and others involved in provision of services. Users of this standard will need to ensure that practice

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1. apply standard precautions for infection prevention and control and

   other appropriate health and safety measures

2. ensure all necessary preparations have been made by the individual

   and staff before starting the procedure

3. check and prepare the equipment required for the examination

4. ensure the environment is conducive to maintaining the privacy and

   dignity of the individual

5. check the identification details before commencing the procedure in

   accordance with local policies and procedures

6. introduce yourself and other members of staff present during the

   examination

7. communicate with the individual / key people to facilitate their

   understanding of and co-operation with the examination

8. establish the individuals capacity to understand the procedure with

   the help of key people if necessary

9. obtain valid consent for the procedure in accordance with national

   and local guidelines

10. respect the individuals privacy, dignity, beliefs and decisions

11. clearly explain the procedure and possible outcomes, including risk,

    benefits and limitations

12. check for Magnetic Resonance imaging safety by use of the

    department Magnetic Resonance imaging safety check list which will

    include checking for the presence of ferro-metallic objects/prostheses

    and implanted medical devices

13. take appropriate action if any of these are found to be present

14. check for any contraindications for the proposed procedure and

    take appropriate action in response to identified risks

15. examine previous relevant images and clinical information, where

    available, to ensure that the correct procedure and techniques are

    employed

16. assess the individuals clinical and physical condition prior to the

    start of the examination with a view to proceeding

17. check individuals of child-bearing potential for pregnancy or

    possible pregnancy and breast-feeding status, if appropriate to the

    examination, and take action in accordance with local protocols

18. prepare the site for intravenous access

19. obtain intravenous access using cannulation

20. administer radioisotopes using the appropriate equipment

21. administer gadolinium using the appropriate equipment

22. confirm the MRI safety status of key people before the examination

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    and, where their presence is required, adhering to local guidelines

23. enter the identification details of the individual into the Magnetic

    Resonance scanner or, if details have previously been entered, check

    them for accuracy

24. select all sequences required for the scan according to local

    protocols for the procedure, assess and any required modifications and

    take appropriate action

25. position the individual, provide any hearing protection and adjust

    their clothing according to the protocols for the examination to be

    performed in a manner which allows an optimal outcome to be achieved

    while:

    25.1 ensuring their comfort as far as possible

    25.2 preventing the appearance of artefacts

26. correctly and safely position appropriate Radio Frequency (RF)

    coils, cables and monitoring equipment

27. check the room prior to taking the scan to ensure that only essential

    protected persons remain and that all local rules have been adhered to,

    taking appropriate action where necessary

28. commence the scan and monitor the individuals condition and

    compliance throughout the procedure and take action appropriate to

    their needs

29. view the images on completion of the scan to ensure they are

    technically acceptable and suitable for diagnostic purposes

30. create multi-planar reformats (MPR) from the relevant datasets as

    appropriate

31. review images for clinical acceptability, take appropriate action,

    including further imaging if required

32. provide the individual with information relating to the procedure and

    aftercare where necessary

33. explain the process for obtaining results

34. following the preliminary imaging examination, inform the

    appropriate person if an abnormality is observed on the image which is

    likely to require further investigation or treatment

35. optimise, record, collate and prepare appropriate documentation

    and images for transfer or storage according to local protocols

36. verify that the images have arrived/been stored according to local

    protocols

37. recognise where help or advice is required and obtain this from

    appropriate sources

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1. legal, organisational and policy requirements relevant to your role,

   the role of others in your organisation and the activities being

   carried out

2. the relevant national and local standards, guidelines, policies and

   procedures that are available and how and when they should be

   accessed

3. the importance of respecting individuals culture, privacy, dignity,

   wishes, beliefs and decisions

4. the limitations of your own knowledge and experience and the

   importance of operating within your scope of practice

5. the roles and responsibilities of other team members

6. clinical appropriateness of the examination request and the action

   to take when the request is not appropriate

7. the gross, surface and cross-sectional anatomy of the areas to be

   scanned

8. the medical terminology relevant to the examination, including

   abbreviations

9. the relevant physiology of the areas to be scanned

10. the common normal variants and their appearance on Magnetic

    Resonance images

11. common pathologies of the areas to be scanned and their

    appearance on Magnetic Resonance images

12. manifestations of individuals physical and emotional status

13. contra-indications to Magnetic Resonance scanning, including

    absolute and relative

14. contra-indications to PET/MRI scanning including the clinical

    implications of any allergies, pregnancy status, breastfeeding

    status and uncontrolled diabetes mellitus relevant to the

    examination

15. contraindications to MRI contrast agents including the clinical

    implications of any allergy relevant to the examination

16. the importance of assessing for presence of ferro-metallic

    objects/prostheses and implanted medical devices and the

    appropriate action to take if these are identified

17. when additional images are required to aid diagnosis and to

    enhance the examination

18. how to adapt communication styles, ask questions, and listen

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    carefully in ways which are appropriate for the needs of the

    individual

19. methods of communicating difficult and complex information to

    individuals and key people

20. the importance of providing individuals and key people with

    opportunities to ask questions and increase their understanding

21. the information that should be given to individuals before, during

    and on completion of the examination

22. the harmful effects of radiation to the human body and use of

    radiation protection equipment

23. how to apply the principles of time, shielding and distance to

    reduce radiation exposure to staff

24. the medical terminology relevant to the examination including

    abbreviations

25. how to measure and interpret blood sugar levels using a

    glucometer

26. the aseptic techniques involving in intravenous cannulation

27. the care and preparation of intravenous access routes for dose

    administration

28. the requirements for administration of pharmaceuticals to reduce

    brown fat uptake in individuals less than 18 years old

29. the physiological uptake pathways and half-life for different PET

    tracers and the impact upon optimal image quality

30. the physical, biological and effective half-life of different PET

    tracers and consequently the radiation protection aftercare advice

    for individuals and key people

31. the calculation of administered radioactivity to an individual

32. the calculation of residual radioactivity post injection of a PET

    tracer

33. controlled access areas and safety requirements in the MRI

    environment in line with current MRI safety guidelines

34. the physical principles of Magnetic Resonance scanning,

    techniques and protocols

35. production, interactions and properties of gamma rays.

36. the technical and diagnostic quality requirements of the image

37. artefacts on images - their causes and avoidance strategies

38. factors which influence the decision to repeat images or take

    additional images

39. alternative imaging examinations

40. the safe operation of the Magnetic Resonance scanner and

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    accessories in use

41. the safe use of quality assurance equipment, recording results

    and taking appropriate action

42. how to deal with spillages and the action to take if spillages occur

    in line with national MRI safety guidance

43. equipment capabilities, limitations and routine maintenance

    including the quality control processes required by the operator

44. the importance of timely equipment fault recognition and local

    procedures for reporting these

45. procedures for preparation of the individual, environment and

    equipment for Magnetic Resonance scanning

46. procedures relating to recording, collating and preparing

    appropriate documentation and images for transfer or storage

    according to local protocols

47. how to keep full, accurate and clear records in line with

    organisational procedures

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This standard links with the following dimension within the NHS

Knowledge and Skills Framework (October 2004):

Dimension: HWB6 Assessment and treatment planning

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