In nuclear medicine, radionuclides unstable atoms that emit radiation spontaneously are used to diagnose and treat disease. Radionuclides are purified and compounded like other drugs to form radiopharmaceuticals. Nuclear medicine technologists administer these radiopharmaceuticals to patients, then moniter the characteristics and functions of tissues or organs in which they localize. Abnormal areas show higher or lower concentrations of radioactivity than normal.
Nuclear medicine technologists operate cameras that detect and map the radioactive drug in the patient's body to create an image on photographic film. Radiologic technologists also operate diagnostic imaging equipment, but their equipment creates an image by projecting an x ray through the patient. (See the statement on radiologic technologists elsewhere in the Handbook.)
Nuclear medicine technologists explain test procedures to patients. They prepare a dosage of the radiopharmaceutical and administer it by mouth, injection, or other means. When preparing radiopharmaceuticals, technologists adhere to safety standards that keep the radiation dose to workers and patients as low as possible.
Technologists position patients and start a gamma scintillation camera, or scanner, which creates images of the distribution of a radiopharmaceutical as it passes through or localizes in the patient's body. Technologists produce the images on a computer screen or on film for a physician to interpret. Some nuclear medicine studies, such as cardiac function studies, are processed with the aid of a computer.
Nuclear medicine technologists also perform radioimmunoassay studies which assess the behavior of a radioactive substance inside the body. For example, technologists may add radioactive substances to blood or serum to determine levels of hormones or therapeutic drug content.
Technologists keep patient records and record the amount and type of radionuclides received, used, and disposed of.
Nuclear medicine technologists must adhere to radiation safety guidelines.
Nuclear medicine technologists generally work a 40-hour week. This may include evening or weekend hours in departments which operate on an extended schedule. Opportunities for part-time and shift work are also available. In addition, technologists in hospitals may be on-call duty on a rotational basis.
Because technologists are on their feet much of the day, and may lift or turn disabled patients, physical stamina is important.
Although there is potential for radiation exposure in this field, it is kept to a minimum by the use of shielded syringes, gloves, and other protective devices. Technologists also wear badges that measure radiation levels. Because of safety programs, however, badge measurements rarely exceed established safety levels.
Nuclear medicine technologists held about 12,000 jobs in 1992. About 9 out of 10 jobs were in hospitals. The rest were in physicians' offices and clinics, including imaging centers.
Nuclear medicine technology programs range in length from 1 to 4 years and lead to a certificate, associate degree, or bachelor's degree. Generally, certificate programs are offered in hospitals; associate programs in community colleges; and baccalaureate programs in 4 year-colleges and in universities. Courses cover physical sciences, the biological effects of radiation exposure, radiation protection and procedures, the use of radiopharmaceuticals, imaging techniques, and computer applications. Associate and bachelor's programs also cover liberal arts.
One-year certificate programs are for health professionals, especially radiologic technologists and ultrasound technologists wishing to specialize in nuclear medicine. They also attract medical technologists, registered nurses, and others who wish to change fields or specialize. Others interested in the nuclear medicine technology field have three options: a 2-year certificate program, a 2-year associate program, or a 4-year baccalaureate program.
The Committee on Allied Health Education and Accreditation (CAHEA) accredits most formal training programs in nuclear medicine technology. In 1992, there were 112 CAHEA-accredited programs.
All nuclear medicine technologists must meet the minimum Federal standards on the administration of radioactive drugs and the operation of radiation detection equipment. In addition, about half of all States require technologists to be licensed. Technologists also may obtain voluntary professional certification or registration. Registration or certification is available from the American Registry of Radiologic Technologists (ARRT) and from the Nuclear Medicine Technology Certification Board (NMTCB). Most employers prefer to hire certified or registered technologists.
Technologists may advance to supervisor, then to chief technologist, and to department administrator or director. (See statement on health services managers elsewhere in the Handbook.) Some technologists specialize in a clinical area such as nuclear cardiology or computer analysis or leave patient care to take positions in research laboratories. Some become instructors or directors in nuclear medicine technology programs, a step that usually requires a bachelor's degree or master's in nuclear medicine technology. Others leave the occupation to work as sales or training representatives for health equipment and radiopharmaceutical manufacturing firms, or as radiation safety officers in regulatory agencies or hospitals.
Employment of nuclear medicine technologists is expected to grow much faster than the average for all occupations through the year 2005. Substantial growth in the number of middle-aged and older persons will spur demand for diagnostic procedures, including nuclear medicine tests. Furthermore, technological innovations seem likely to increase the diagnostic uses of nuclear medicine. One example is the use of radiopharmaceuticals in combination with monoclonal antibodies to detect cancer at far earlier stages than is customary today, and without resorting to surgery. Another is the use of radionuclides to examine the heart's ability to pump blood. Wider use of positron emission tomography imaging to observe metabolic and biochemical changes for neurology, cardiology, and oncology procedures, will also spur demand for nuclear medicine technologists.
Cost considerations will affect the speed with which new applications of nuclear medicine grow. Some promising nuclear medicine procedures, such as positron emission tomography, are extremely costly, and hospitals contemplating them will have to consider equipment costs, reimbursement policies, and the number of potential users.
According to a University of Texas Medical Branch national survey of hospitals and medical centers, the median annual salary of nuclear medicine technologists, based on a 40 hour week and excluding shift or area differentials, was $32,843 in October 1992. The average minimum salary was $26,402 and the average maximum was $38,840.
Nuclear medical technologists operate sophisticated equipment to help physicians and other health practitioners diagnose and treat patients. So do radiologic technologists, diagnostic medical sonographers, cardiology technologists, electroencephalographic technologists, clinical laboratory technologists, perfusionists, and respiratory therapists.
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Reprinted with Permission of U. S. Department of Labor