The British nuclear medicine research strategy - the framework.

The British Nuclear Medicine Society (BNMS) has developed a Research Strategy framework led by the Research Champions of the BNMS and overseen by the BNMS Research and Innovation Committee. The objectives of the Research Strategy are to improve translation of cutting-edge nuclear medicine research from bench to bedside, the implementation of state-of-the-art multimodality technologies and to enhance multicentre radionuclide research in the UK. It strives to involve patients and the public in radionuclide research and to contribute to and work with the multi-professional national and international organisations involved in research with an ultimate aim to improve nuclear medicine services, and patients' outcomes and care.

Evidence of expert clinical practice among nuclear medicine non-medical staff: a scoping review.

OBJECTIVE: This scoping review concerns expertclinical practice (ECP) by nuclear medicine practitioners (NMP), encompassing radiographers, technologists and nurses. ECP is typically demonstrated by clinical skills with higher levels of autonomy and responsibility traditionally fulfilled by physicians. The Advanced Clinical Practice (ACP) framework by Health Education England (2017) specifies ECP as one aspect of advanced role progression. This scoping review aims to identify and categorise the extent and type of the existing NMP ECP evidence to support the establishment of Nuclear Medicine ACP. METHODS: PubMed, Cumulative Index to Nursing and Allied Health Literature, and Ovid Medline were searched for peer-reviewed literature published between 2001 and 2021 using extended and advanced practice as key terms alongside nuclear medicine and each NMP profession. Due to the sparsity of results, conference abstracts from prominent international societies were also searched. Studies were independently reviewed and graded for inclusion by four NMP. RESULTS: Of the 36 studies that met the inclusion criteria, 80.6% were conference abstracts and 66.7% were single-centres studies. Commonly reported NM ECP activities included image interpretation, cardiac stressing and therapies. Less reported activities include ordering complementary diagnostic procedures, invasive procedures and physical examinations. The United Kingdom presented itself at the forefront of NMP ECP publications. CONCLUSION: This study demonstrates evidence of NMP ECP across a variety of clinical roles. The dominance of conference abstracts highlights NMP ECP as an emerging area of role extension and a potential preference for information dissemination by NMP. Greater research into specific NMP ECP activities is required particularly studies of greater sample size and robusticity.

Hepatic and splenic 18 F-FDG blood clearance rates (Ki) in hepatic steatosis and diabetes mellitus.

AIM: The study aim was to investigate the relationships of blood glucose level (BGL) with hepatic and splenic blood FDG clearances (Ki) in patients with diabetes mellitus (DM) and/or hepatic steatosis (HS). METHODS: This was a retrospective study of 238 patients, including 92 with type 2 DM (DM2) and 11 with type 1 DM (DM1), having routine whole body FDG PET/CT. Patients with lymphoma were excluded. Patients were divided into the following groups: HS-DM-, HS-DM2+, HS+DM-, HS+DM2+ and 2 DM1 groups (hypoglycaemic and hyperglycaemic). ROI were placed over liver and spleen for measurement of SUVmax , and left ventricular cavity (LV) for measurement of SUVmean . Tissue SUVmax was divided by LV SUVmean . This division, giving Z, eliminates bias from the whole body metric used to calculate SUV and renders SUVmax a closer surrogate of Ki. HS was diagnosed when hepatic unenhanced CT was ≤40 HU. RESULTS: In all patients, individual hepatic Z and individual splenic Z correlated significantly with individual BGL. Highest mean hepatic Z and highest mean BGL were recorded in HS+ DM2+ group and lowest in hypoglycaemic DM1 group. Patients with DM1 and hyperglycaemia showed low hepatic Z in relation to BGL. Hepatic and splenic Z correlated inversely with CT density in patients without DM but not in those with DM2. CONCLUSION: As BGL increases, hepatocyte glucokinase is up-regulated. This includes patients with HS and DM2 but not DM1. We speculate that in HS and DM2, up-regulation results from insulin resistance and hyperinsulinaemia. The data also support a hepato-splenic metabolic axis.