Nuclear cardiology technologists: the MVPs of our nuclear cardiology programs

Dennis A. Calnon, MD, MASNC

A successful nuclear cardiology program requires teamwork. All members of the team have important roles. This includes schedulers, receptionists, stress laboratory nurses and exercise physiologists, nuclear cardiology technologists, interpreting physicians, and cardiac imaging laboratory administrators. However, nuclear cardiology technologists stand out as the MVPs of our nuclear cardiology programs. It is incumbent on us to ensure they know how much we value them and to provide tangible evidence of our support.

Why technologists are our MVPs

Nuclear cardiology technologists have always been key to the success of our nuclear cardiology programs. As imaging protocols and equipment have advanced, the roles of nuclear cardiology technologists have expanded substantially. In 2022, a “one size fits all” imaging protocol is not adequate to provide state-of-the-art patient care. Nuclear cardiology technologists make important contributions to determining the most appropriate imaging modality for the individual patient (e.g., SPECT myocardial perfusion imaging vs. PET myocardial perfusion imaging), the proper imaging protocol (e.g., stress-first vs. rest-first), the feasibility of imaging the patient in multiple positions to assist in attenuation compensation, and whether image quality is adequate or if repeat image acquisition is necessary. In some nuclear cardiology programs, nuclear technologists also play a major role in deciding whether stress-first images are adequate to obviate the need for resting images.

In many laboratories, one or more of the nuclear cardiology technologists has primary responsibility for completing the extensive documentation requirements to achieve and maintain laboratory accreditation. This additional work is often completed simultaneously with the demands of direct patient care, with little to no dedicated administrative time provided to complete the accreditation documentation requirements.

Nuclear cardiology technologists are also asked to incorporate new protocols and equipment. In my nuclear cardiology program, we have asked our nuclear technologists to adapt to the use of modern high-sensitivity SPECT cameras facilitating two-position imaging, utilize a stress-first SPECT imaging protocol in appropriate patients, and incorporate PET/CT imaging with myocardial blood flow assessment. We are currently asking our technologists to acquire dynamic SPECT images for myocardial blood flow assessment and to incorporate formal coronary artery calcium scores (CACS) as part of our SPECT and PET imaging protocols for patients without previously documented coronary artery disease.

In Ohio, nuclear cardiology technologists are not currently permitted to acquire diagnostic CT images required for CACS, though in many laboratories nuclear cardiology technologists are directly responsible for acquiring the CACS images. We anticipate hybrid imaging with coronary artery atherosclerosis assessment will continue to expand, and more demands will be placed on nuclear cardiology technologists to achieve the additional certification required to perform CACS.

The quality of the product produced by the nuclear cardiology laboratory depends on the skill, expertise, and diligence of the nuclear cardiology technologists. This in turn can add significant mental and emotional stress on our nuclear cardiology technologists.

COVID-19 imposed new challenges

All the demands and responsibilities placed on nuclear cardiology technologists are occurring at a time when they are still reeling from the impact of the COVID-19 pandemic on their work and personal lives. Nuclear cardiology technologists have been on the frontlines of patient care throughout the COVID-19 pandemic. They have delivered high-quality patient care while wearing personal protective equipment, including gowns, N-95 masks, and protective eyewear. During the early stages of the pandemic, before the availability of effective COVID-19 treatments or vaccines, our nuclear cardiology technologists provided compassionate patient care despite their own concerns regarding the possibility of acquiring COVID-19 infection at the workplace and transmitting the virus to their families.

Despite this enormous stress and pressure, nuclear cardiology technologists around the world have risen to the task. They quickly adapted to new requirements and made it possible for our teams to continue providing high-quality, state-of-the-art patient care. Physicians who interpret nuclear cardiology studies owe our nuclear cardiology technologists sincere gratitude for all that they have done and continue to do.

Showing our appreciation

What more can (and should) nuclear cardiologists and nuclear cardiology laboratory administrators do to express our appreciation for the extraordinary efforts of our nuclear cardiology technologists? Here are a few ideas:

1. Our laboratory budgets should include financial support to allow our nuclear cardiology technologists to become members of ASNC. For just $80 per year, ASNC technologist members receive unlimited online access to the Journal of Nuclear Cardiology and the guidelines and standards that are crucial for them to stay current in our field. As ASNC members, our technologists will also enjoy discounts on ASNC programs, including the Annual Scientific Session and Exhibition and the upcoming “Nuclear Imaging in Women and Special Populations” (https://www.asnc.org/meetings).

2. We should recognize that our nuclear cardiology technologists need networking experiences to grow their careers and expand their friendships. We should provide them with time and opportunities to participate in networking with their peers in other areas of the country and world. ASNC membership is a bridge to making such connections, through ASNC programs and events specifically designed for (and by) nuclear cardiology technologists. There are numerous examples of ASNC programs with value for nuclear cardiology technologists; however, I recommend two programs: The “SPECT Virtual Reading Room” series and “Tech Talks: How to Sharpen Your Nuclear Cardiology Skills” (https://www.asnc.org/meetings). A “Cardiac PET Workshop for Technologists” is also being planned this year to educate our technologists who are performing (or will soon be performing) cardiac PET.

3. We can deliver a vote of confidence to our nuclear cardiology technologists by encouraging them to become involved in ASNC committees. Here they can provide input regarding important decisions that will impact the field of nuclear cardiology. Technologists are included on the Board of Directors, Cardiovascular PET Committee, Health Policy Committee, Hybrid Imaging Task Force, International Advisory Panel, Leadership Development Program Committee, Membership Relations Committee, Registry Oversight Committee, and the Technologist Advisory Panel.

4. We must all make a point of letting our nuclear cardiology technologists know that we recognize their tremendous efforts. One excellent way is by urging your technologists to apply for the FASNC (Fellow of ASNC) designation. The FASNC designation is a signal to our peers and patients that we are committed to excellence in nuclear cardiology imaging. When you tell your technologists that they deserve to be considered FASNC members of ASNC, you are complimenting their expertise and their dedication to the field of nuclear cardiology.

To nuclear cardiology technologists who are reading this President’s Message, I want you to know that ASNC appreciates you and we value your membership and your engagement in the Society. Each of you makes ASNC stronger by participating in educational programs and committees, and by joining the conversations on social media. Are you taking advantage of all the membership benefits to which you are entitled? Here’s an overview:

1. Educational programs designed by, and specifically created for, nuclear cardiology technologists to help you to incorporate new protocols and equipment in your laboratory

2. A social community where you can get to know nuclear cardiology technologists from around the world and share your successes, questions, and concerns

3. A voice on health policy and regulatory matters that impact your practice – for example, ASNC is working to remove barriers that currently prevent nuclear medicine technologists from performing CACS and other forms of hybrid imaging

4. Opportunities to join the ASNC Board of Directors and other ASNC committees, which will allow you to provide meaningful input into important decisions that will impact the field of nuclear cardiology in the future

Next steps

In addition to the suggestions above, I recommend that each of us prioritize the following action items:

• If you are a nuclear cardiology technologist, join ASNC right now and ensure you take advantage of all the benefits of membership.

• If you are a nuclear cardiologist or a nuclear cardiology laboratory administrator, first, encourage your nuclear cardiology technologists to join ASNC and offer financial assistance to cover their membership dues. Second, invite one or more of your nuclear cardiology technologists to join you at ASNC2022 in Orlando in September. This would be an excellent way to provide them with a much-needed break from the stresses of patient care, provide opportunities for networking with other technologists, and make your nuclear cardiology technologists feel valued and appreciated.

We literally could not provide modern state-of-the-art nuclear cardiology imaging without the expertise and dedication of our nuclear cardiology technologists. They are the MVPs of our nuclear cardiology programs. Let's show our appreciation for their hard work and give them the financial and emotional support they deserve.