Developing guidance for the appropriate use of Computed Tomography within a hybrid imaging environment

The introduction of Computed Tomography (CT) within the nuclear medicine environment over the last decade has led to a dramatic increase in the number of hybrid imaging installations within the United Kingdom. Modern multislice Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET)/CT units now have the diagnostic capability to provide a high level of anatomical information and have redefined the physical environment required for this imaging modality. This alongside current financial pressures impacting on the NHS has begun to challenge traditional working practices and an increased emphasis is now being placed on the healthcare practitioner to provide high quality care, demonstrate greater clinical effectiveness, improve safe working practices and to continuously adapt their skills to meet with the changing needs of the patient. Initial research conducted by the authors in collaboration with existing clinical nuclear medicine practitioners has indicated variation in the optimal use of CT within a hybrid-imaging environment. It is a concern that this apparent position within the hybrid imaging community does not appear to be conducive with current government initiatives related to optimal service provision. These inconsistencies would therefore appear to highlight the need for the development of a competency based framework that would provide the practitioner with the opportunity to develop their own working practices and help promote the harmonised use of CT within the hybrid imaging environment