Barley's Technology as an occasion for structuring

It's been a while since my last post, so I thought I'd link to something related to my professional doctorate. As part of the literature review section, I came across an article which referred to something called the 'Barley's Technology effect'. Barley wrote a seminal article in 1986 related to the installation and structuring of two CT units in two different imaging departments.

Of particular interest to Barley was the different outcomes for each of the imaging departments, despite having similar organisational structures. Undertaking s subsequent search for other primary based research studies, looking at the effect of introducing technology within the workplace, has resulted in finding a number of articles by Stephen Barley. All the work by Barley relates to understanding the interactions of people within cultures / organisations, following the introduction of technology and / or the symbolic influences within the workplace. Barley's work is cited in numerous research papers and provides a very useful platform for the critical evaluation of work within this field.

SUV calculations and decision making abilities

From my time in clinical PET, I've noticed a variation in the calculations of Standard Update Values (SUV) between different manufacturers software platforms. I'm not sure why this occurs and perhaps it could be down to the use of different calculation algorithms being utilised.

Practitioners, physicists and consultants need to be aware however of the potential for variations in SUV calculations between different manufacturers. It would be interesting to conduct a validated comparison project between different vendors software to assess the potential variations in calculations.  This also highlights to me the need of ensuring practitioners have a strong understanding of quantification within nuclear medicine and in particular hybrid practice.  Ensuring the skills, training and education frameworks are in place is integral to the future of effective / innovative service provision.

Service Redesign in Nuclear Medicine

Developing new services in Nuclear Medicine requires careful planning and the advent of hybrid imaging technology has begun to open new avenues for nuclear medicine practitioners.

It is crucial that the nuclear medicine workforce continues to engage and work with other professions, such as cardiology, oncology and neurology to further promote the clinical value of nuclear medicine and further develop a multiprofessional approach to the whole imaging / treatment landscape.

Trying to convince financial managers to invest in a hybrid imaging system, whether it is to replace your aging gamma camera or as an additional system can be very difficult. Some centres have used the argument that the hybrid system could be used to support radiology workload (e.g. CT heads) and even conduct examinations involving the use of contrast agents. Phrases such as "one stop shop" imaging have begun to emerge where nuclear medicine departments attempt to increase their profile and workload and even perhaps justifying their new imaging system.

Having a hybrid imaging system does provide improved confidence / accuracy for clinicians and new opportunities for the nuclear medicine workforce. However, careful consideration is required to ensure the service redesign places Nuclear Medicine at the heart of the clinical provision.

patient support skills for hybrid imaging practitioners

During a weeks clinical attachment at a regional PET/CT centre in England, I began to realise the patient support skills that are required by nuclear medicine practitioners who work in PET/CT and SPECT/CT. Being able to identify the emotional levels within a patient during the first few moments of contact is crucial.

All practitioners working within an oncology environment learn to adjust their working parameters with each individual patient who requires care and treatment. Equipping nuclear medicine practitioners with patient support skills will ensure they fully appreciate and understand the patient's perspective / current state of mind and hopefully obtain optimal images. I have begun to explore the value of patient support training sessions for hybrid imaging practitioners and basic strategies that could be adopted.

We already use the Health Talk Online website within the programme of nuclear medicine education at the University of the West of England, Bristol and have begun including service users within certain modules. However, the inclusion of specific patient support sessions should further help nuclear medicine practitioners communicate with patients and provide a holistic clinical service.

Blending in Hybrid Imaging

Following some time at a clinical site recently, I noticed the knowledge and understanding required by practitioners in order to create fused image data sets in SPECT/CT and PET/CT. Having the correct amount of CT and PET or SPECT data can really highlight the presence of disease.

Image reviewing can be a subjective aspect of nuclear medicine and knowing how much "blending" is required comes from experience and an understanding of the modalities. This is particularly an issue when selective data sets are sent to PACS for reviewing by consultants.

The advent of "floating" licences has made it slightly easier to view fused hybrid data sets on remote systems, where the user has full access to imaging blending tools.

Hybrid Imaging Education

Other countries around the world seem to have a really good handle on hybrid imaging education. There is limited provision in the United Kingdom specifically for practitioners working in a hybrid imaging environment.

As part of my professional doctorate, I hope to evaluate the cultural changes brought about by the introduction of new technologies (such as SPECT/CT & PET/CT) and how traditional working relationships are being "shaped". Future workforce considerations are also required, as this is clearly an emerging aspect of clinical practice.

Hybrid Imaging in Nuclear Medicine: Changing times

I've created this blog to connect with other nuclear medicine practitioners and in particular the cultural changes that some departments are facing as a result of the introduction of hybrid imaging equipment. Hybrid imaging equipment in nuclear medicine currently includes SPECT/CT and PET/CT, however other integrated systems are on the horizon, such as PET/MRI.

The evolution of the hybrid imaging system is beginning to herald a new dawn in terms of providing greater diagnostic accuracy, which is undoubtedly beneficial to the patient.  However the role of the practitioner working in such environments is also changing.  This relates to how nuclear medicine practitioners work within a different physical environment, the uniforms they wear (see image below), the use of new 'language' (e.g. CTDi, topogram), emerging relationships with their peers and beyond (e.g. MDTs).