Unlocking the potential of Control Charts for patient injected doses in Nuclear Medicine procedures

Purpose – To showcase the importance of Statistical Process Control (SPC) in detecting and
preventing errors in radiopharmaceutical dose dispensing in Nuclear Medicine imaging techniques, such as Positron Emission Tomography with Computed Tomography (PET/CT).
Design/methodology/approach – Retrospective analysis was conducted on anonymized data from 3003 patients who underwent [18F]fluoro-2-desoxy-D-glucose (2-[18F]FDG) PET/CT procedures between January 3, 2020, to December 30, 2021, at a Portuguese hospital. Control Charts were utilized to monitor the administered activity of 2-[18F]FDG between patients, and to monitor the 2- [18F]FDG PET/CT examination days.
Findings – Contrary to initial belief, the dose dispensing system is not the sole source of dose dispensing errors. Errors related to communication, as well as administering the dose to the patient before or after the scheduled time also contribute to this unwanted event. It was also found that the technologists sometimes request a dose to the system that is different than the recommended one, also resulting in dispensing errors. Through the control charts application, it was found that the process lacks capability to meet technical specifications.
Research limitations/implications – The findings of this study are limited as they are predicated on the research of a single case study.
Originality/value – SPC in Nuclear Medicine departments allows for an early detection of the dose dispensing errors, preventing its occurrence, and thus improving the dose dispensing process performance. To the best of our knowledge, no other study demonstrated how Control Charts can be a valuable tool in Nuclear Medicine Departments (much less in the dose preparation process).

Statistical Process Control, Control Charts, Positron emission tomography/computed tomography; Radiation protection.