Quality Improvement Initiatives to Assess and Improve PET/CT Injection Infiltration Rates at Multiple Centers.

Area of Science:

• Nuclear Medicine
• Radiopharmacy
• Quality Improvement Science

Background:

• Radiotracer infiltration during PET/CT scans is a common issue, negatively impacting image quality, quantification, and patient management.
• Routine quality control and assurance for PET radiopharmaceutical administration have been lacking.
• There is a need for systematic methods to address and reduce infiltration rates.

Purpose of the Study:

• To quantify radiotracer infiltration rates in PET/CT injections.
• To identify factors associated with infiltration.
• To evaluate the effectiveness and sustainability of a quality improvement program in reducing infiltration rates across multiple centers.

Main Methods:

• A quality improvement methodology ('design, measure, analyze, improve, and control') was employed, incorporating novel technology.
• Technologists received education on quality injections.
• Baseline infiltration rates were measured, center-specific factors analyzed, and improvement plans implemented.
• Real-time feedback and ongoing monitoring were used to ensure sustained quality.

Main Results:

• Data from 5,541 injections across seven centers showed an aggregated baseline infiltration rate of 6.2%.
• Four centers implemented improvement plans, reducing their aggregated infiltration rate from 8.9% to 4.6% (P < 0.0001).
• Significant variations in infiltration rates were observed at both center and technologist levels (P < 0.0001 and P = 0.0020, respectively).

Conclusions:

• A quality improvement approach utilizing new technology can effectively measure infiltration, identify contributing factors, and implement interventions.
• This methodology improves and sustains the quality of radiotracer injections for PET/CT.
• Monitoring and enhancing radiotracer injection quality are crucial for accurate patient management guided by PET/CT imaging.