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Efficacy, Education, Administration, Informatics

E3150. Keep Calm and Follow the Doctor’s Orders

Williams D,  Harnain C,  Gerard P. New York Medical College, Valhalla, NY

Address correspondence to D. Williams (

Background Information: Radiologic examinations require adequate patient preparation when a test is performed for diagnostic or therapeutic purposes. Although not limited to nuclear medicine studies in radiology, this is of particular importance when considering the mechanism of uptake of radiotracer material used in most nuclear medicine techniques, as naturally existing analogues of the radiotracers can inhibit uptake. Instructions issued to patients before a nuclear medicine test such as dietary, medical, or behavioral precautions, if not adhered to, may result in a suboptimal nuclear medicine examination and may significantly decrease the accuracy of the examination. Similarly, precautions must be taken for other imaging modalities such as radiography, fluoroscopic, nuclear medicine, CT, MRI, or ultrasound. The objective of this presentation is to assess the consequences of nonadherence to precautions established by the radiology department on patients before and after imaging examinations, and to determine methods to improve patient compliance with precautions in order to ensure imaging tests are carried out appropriately.

Educational Goals/Teaching Points: Our aim is to teach radiology residents about consequences of not following instructions for nuclear medicine, CT, and MRI examinations which can limit the sensitivity of an examination or even pose harm to the patient by delaying diagnosis and treatment, to train radiology residents to explain the appropriate instructions to patients to ensure they understand the precautions to be taken before an examination, and to educate radiology residents about the importance of radiation safety and highlight it as a key component in patient instructions.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: Patients may not comprehend the precautions and are therefore less inclined to comply. Reasons for the precautions may not be made explicitly clear to patients by the radiology department. Patients may have limitations such as language barriers, limited education, or preconceived notions about radiation or imaging that may preclude them from understanding the precautions.

Conclusion: It is critical for patients to understand and comply with precautions prior to undergoing any radiologic examination to ensure a safe and technically adequate study. Noncompliance with precautions may interfere with radiography, CT, MRI, ultrasound, fluoroscopic, or nuclear medicine study design may delay diagnosis and treatment and may ultimately result in patient dissatisfaction or pose risk to a patient’s well-being. It is the responsibility of the radiology department to ensure that patients have a clear understanding of and are capable of following instructions to minimize the chance of poor outcomes following any imaging study.