Impact of hybrid imaging on patient management

The use of a hybrid imaging technique such as SPECT/CT or PET/CT may bring advantages to the overall patient management that may have not been initially forcasted.  From working alongside clinical nuclear medicine practitioners, there is a degree of 'incidental findings' that may occur within a hybrid imaging procedures.  Questions that immediately come to mind in this situation:

1) What are the ethics and clinical protocol/s associated with this sort of situation?
2) How are nuclear medicine practitioners trained to spot the incidental findings?
3) Can autonomous practice be adopted by practitioners, to enable them to fully utilise the diagnostic capabilities of hybrid imaging (e.g. Intravenous Contrast injection)?


There is also the matter of reporting the resultant images and ensuring the data sets acquired match highlight any additional information.