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CI.J Produce Positron Emission Tomography/Computed Tomography (PET/CT) images for diagnostic purposes

Overview

This standard is concerned with the use of Positron Emission Tomography/Computed tomography (PET/CT) equipment and procedures to produce images for diagnostic purposes. It includes selecting the most appropriate scan protocol depending on the individual's condition and clinical history. 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 reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:
  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. the importance of obtaining valid consent in line with national and local guidelines
  7. clinical appropriateness of the examination request and the action to take when the request is not appropriate
  8. the gross surface and cross-sectional anatomy of the areas to be scanned
  9. the relevant physiology of the areas to be scanned
  10. the harmful effects of radiation to the human body and use of radiation protection equipment
  11. how to apply the principles of time, shielding and distance to reduce radiation exposure to staff
  12. the medical terminology relevant to the examination including abbreviations
  13. contra-indications to PET/CT scanning including the clinical implications of any allergies, pregnancy status, breastfeeding status and uncontrolled diabetes mellitus relevant to the examination
  14. how to measure and interpret blood sugar levels using a glucometer
  15. the aseptic techniques involving in intravenous cannulation
  16. the care and preparation of intravenous access routes for dose administration
  17. the requirements for administration of pharmaceuticals to reduce brown fat uptake in individuals less than 18 years of age
  18. the physiological uptake pathways for different PET tracers and the impact upon optimal image quality
  19. the physical, biological and effective half-life of different PET tracers and consequently the radiation protection aftercare advice for individuals and key people
  20. the calculation of administered radioactivity to an individual
  21. the calculation of residual radioactivity post injection of a PET tracer
  22. the common normal variants and their appearance on PET/CT images
  23. common pathologies of the areas to be scanned and their appearance on PET/CT images
  24. manifestations of individuals' physical and emotional status
  25. when additional images are required to aid diagnosis and to enhance the examination
  26. production, interactions and properties of x-rays, alpha, beta particles and gamma rays
  27. the physical processes involved in the production of PET/CT images, scanning techniques and protocols
  28. the ways in which PET/CT images can be captured, processed and permanently stored
  29. the physical principles of PET/CT scanning
  30. alternative imaging examinations that may be employed alongside PET/CT scanning
  31. the technical and diagnostic quality requirements of the image
  32. artefacts on images - their causes and avoidance strategies
  33. factors which influence the decision to repeat images or take additional PET/CT images
  34. the safe operation of the PET/CT scanner and accessories in use
  35. the use of quality assurance equipment, recording results and taking appropriate action
  36. equipment capabilities, limitations and routine maintenance including the quality control processes required by the operator
  37. the importance of timely equipment fault recognition and local procedures for reporting these
  38. how to adapt communication styles, ask questions, and listen carefully in ways which are appropriate to the needs of the individual
  39. methods of communicating difficult and complex information to individuals and key people
  40. the importance of providing individuals and key people with opportunities to ask questions and increase their understanding
  41. the importance of respecting individuals culture, privacy, dignity, wishes, beliefs and decisions
  42. the information that should be given to individuals before, during and on completion of the examination
  43. preparation of the environment, individual and equipment for PET/CT Scanning
  44. procedures relating to recording, collating and preparing appropriate information, documentation and images for transfer or storage according to local protocols
  45. how to keep full, accurate and clear records in line with organisational procedures

Performance Criteria

You must be able to do the following:
  1. apply standard precautions for infection 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 individual's 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 individual's privacy, dignity, beliefs and decisions
  11. 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
  12. confirm the status of key people before the examination and, where their presence is required, adhering to local guidelines
  13. clearly explain the procedure and possible outcomes, including risk, benefits and limitations
  14. check for any contraindications for the proposed procedure and take appropriate action in response to identified risks
  15. prepare the site for intravenous access
  16. obtain intravenous access using cannulation
  17. administer radioisotopes using the appropriate equipment
  18. enter the identification details of the individual into the PET/CT scanner or, if details have previously been entered, check them for accuracy
  19. accurately select all parameters required for the scan according to local scan protocols for the procedure, assess and any required modifications and take appropriate action
  20. position the individual 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:
    1. recognising the individual's need to retain their dignity and self-respect
    2. ensuring their comfort as far as possible
    3. preventing the appearance of artefacts
  21. check the room prior to making the exposure to ensure that only essential, protected persons remain with the individual, that all local protocols have been adhered to and take appropriate action if this does not occur
  22. commence the scan and monitor the individual's condition and compliance throughout the procedure and take action appropriate to their needs
  23. view the images on completion of the scan to ensure they are technically acceptable and suitable for diagnostic purposes
  24. create multi-planar reformats (MPR) from the relevant datasets as appropriate
  25. review images for clinical acceptability, take appropriate action, including further imaging if required
  26. monitor and record the individual's exposure to ionising radiation throughout the procedure according to local protocols
  27. observe the individual's condition and well-being at all times and take appropriate action
  28. 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
  29. provide the individual with information relating to the procedure and aftercare where necessary
  30. explain the process for obtaining results
  31. optimise, record, collate and prepare appropriate information, documentation and images for transfer or storage according to local protocols
  32. verify that the images have arrived/been stored according to local protocols
  33. recognise where help or advice is required and obtain this from appropriate sources

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB6 Assessment and treatment planning
CI.J Produce Positron Emission Tomography/Computed Tomography (PET/CT) images for diagnostic purposes
Final version approved January 2019 © copyright Skills For Health,
For competence management tools visit tools.skillsforhealth.org.uk