Multimodality imaging in Europe: a survey by the European Association of Nuclear Medicine (EANM) and the European Society of Radiology (ESR)

Abstract

Purpose

Multimodality imaging represents an area of rapid growth with important professional implication for both nuclear medicine physicians and radiologists throughout Europe. As a preliminary step for future action aimed at improving the quality and accessibility of PET/SPECT/CT multimodality imaging practice in Europe, the European Association of Nuclear Medicine (EANM) and the European Society of Radiology (ESR) performed a survey among the individual membership of both societies to obtain information on the status of multimodality imaging in their facilities and their future visions on training for combined modalities.

Methods

A questionnaire was forwarded to all individual members of the EANM and ESR. The main subject matter of the questionnaire related to: (1) study performance, current procedures, current equipment including its supervisory personnel at respondents’ individual facilities and (2) vision of future practice, performance and the potential for combined interdisciplinary viewing and training for future professionals.

Results

The reporting and the billing procedures of multimodality imaging studies are very heterogeneous in European countries. The majority of the members of both societies believe that the proportion of PET/CT conducted as a full diagnostic CT with contrast enhancement will increase over time. As expected, ¹⁸F-FDG is the most commonly used PET tracer for clinical applications. The large majority of respondents were in favour of an interdisciplinary training programme being developed on a European level together by the EANM and the ESR and the respective sections of the European Union of Medical Specialists.

Conclusion

The results of this survey show that there is wide heterogeneity in the current practice of multimodality imaging in Europe. This situation may limit the full potential and integration of multimodality imaging within the clinical arena. There is a strong desire within both specialties for the development of interdisciplinary training to address some of these issues.

Appendix: survey questions

• 1. In your facility, PET/CT results are reported by

  • PET by a nuclear medicine physician and CT by a radiologist

  • A nuclear medicine physician

  • A radiologist

  • A dual specialist

  • Other

• 2. In your facility, PET/CT results are billed by

  • PET by a nuclear medicine physician and CT by a radiologist

  • A nuclear medicine physician

  • A radiologist

  • A dual specialist

  • Other

• 3. How often is the CT part of PET/CT conducted as a full diagnostic CT± contrast enhancement in your facility?

  • Never

  • <20%

  • 20–40%

  • 40–60%

  • 60–80%

  • >80%

• 4. Do you think that the proportion of diagnostic CT± contrast enhancement will

  • Increase

  • Remain the same

  • Decrease

• 5. Does your facility undertake PET or PET/CT in the following indications?

  • Oncology

  • Neurology

  • Infection/inflammation

  • Cardiology

  • Others

• 6. Which of the following radiopharmaceuticals are in clinical use in your country?

  • ¹⁸F-FDG

  • ¹⁸F-Dopa

  • ¹⁸F-Fluorocholine

  • ¹⁸F-FET

  • ¹⁸F-FLT

  • Other ¹⁸F

  • Any ¹¹C

  • ⁸²Rb

  • ¹⁵O-Water

  • Others

• 7. Would you be in favour of an interdisciplinary training programme being developed on a European level together by the EANM and the ESR and the respective UEMS sections?

  • Yes

    • (a) Adjusted period of training

    • (b) Integrated training programme

  • No