Quality management systems are essential and should be maintained with the intent to continuously improve effectiveness and efficiency, enabling nuclear medicine to achieve the expectations of its quality policy, satisfy its customers and improve professionalism. The quality management (QM) audit methodology in nuclear medicine practice, introduced in this publication, is designed to be applied to a variety of economic circumstances. A key outcome is a culture of reviewing all processes of the clinical service for continuous improvement in nuclear medicine practice. Regular quality audits and assessments are vital for modern nuclear medicine services. More importantly, the entire QM and audit process has to be systematic, patient oriented and outcome based. The management of services should also take into account the diversity of nuclear medicine services around the world and multidisciplinary contributions. The latter include clinical, technical, radiopharmaceutical, medical physics and radiation safety procedures.

A quality health service, as defined by the World Health Organization, ‘is one which organizes resources in the most effective way to meet the health needs of those most in need, for prevention and care, safely, without waste and within higher level requirements’. As health care standards improve globally, providing an optimal service that meets international standards and public expectations requires effective quality management. The process of quality improvement aims at defining, measuring and setting quality standards, and overcoming the associated challenges that include rising costs and skills shortages. The objective of this publication is to provide a framework for quality management systems (QMSs) to be implemented, managed and sustained holistically in nuclear medicine departments. It builds upon the IAEA’s QUANUM program, which has successfully been implemented in more than 80 countries worldwide.

This comprehensive textbook provides a state of the art overview of the means by which quality in patient care is ensured within the field of nuclear medicine. Acknowledged experts in the field cover both management aspects, such as laws, standards, guidelines, patient safety, management instruments, and organisations, and specific issues, including radiation safety and equipment. Quality in Nuclear Medicine not only presents detailed information on the topics discussed but should also stimulate further discussion and offer an important tool to all professionals in the field of nuclear medicine and their stakeholders. Readers will find that the book provides a wealth of excellent guidance and reflects the pioneering role of nuclear medicine in advancing different aspects of quality within medicine.

Medical imaging is crucial in a variety of medical settings and at all levels of health care. In public health and preventive medicine as well as in both curative and palliative care, effective decisions depend on correct diagnoses. This edition addresses the most current needs and offers guidance on clinical practice, radiation safety and patient protection, human resource development and training required for the overall practice of nuclear medicine.

In the United States the performance of nuclear cardiology studies continues to increase. As an example, in 1998, 4,160,739 myocardial perfusion imaging st- ies were done. In 2001 this number increased to 5,679,258. The nonhospital performance of perfusion imaging increased over the same time period from 1,188,731 to 1,789,207 studies (Arlington Medical Resources data). In 1999, there were approximately 1300 nonhospital sites with nuclear imaging capabi- ties, of which 600 were in physician’s offices. By 2001, there were approximately 1700 nonhospital sites, of which 780 were in physician’s offices (from IMV, LTD: http://www.imvlimited.com/mid/). The growth of nuclear cardiology as an expanded outpatient laboratory ent- prise is readily apparent. In the United States, as well as in other parts of the world, this growth has been linked to the recognition of the ability of cardiologists to perform these studies. The certification examination in nuclear cardiology is now well established in the United States. Accreditation of laboratories is also well established. Over the years, some of the most frequent questions asked by our former trainees relate to practical issues involved in the establishment of a nuclear cardiology laboratory. In view of the growth of the field, this is certainly not surprising.

This publication presents a harmonized approach to quality assurance in the field of computed tomography applied to both diagnostics and therapy. It gives a careful analysis of the principles and specific instructions that can be used for a quality assurance programme for optimal performance and reduced patient dose in diagnostic radiology. In some cases, radiotherapy programmes are making a transition from 2-D to 3-D radiotherapy, a complex process which critically depends on accurate treatment planning. In this respect, the authors also provide detailed information about the elements needed for quality assurance testing, including those relating to accurate patient characterization as needed for radiotherapy treatment planning.

This publication contains information on the implementation of quality assurance and quality control programmes for measuring radioactivity relating to the practice of nuclear medicine, covering standards at both the end user (clinic) and secondary radioactivity standards laboratory levels. It is based on the QA principles in ISO/IEC 17025 which describes requirements that testing and calibration laboratories must meet to demonstrate that they have a quality system in place and are technically competent.

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

Clinically safe, effective and economic practices in the area of hospital radiopharmacy can strengthen the overall performance of nuclear medicine services. This guidance provides practical points at different levels of operation including staff training, facilities, radiopharmaceutical practices, record keeping and quality control. Therefore, it is an essential read for nuclear medicine physicians, radiologists, and radiopharmacists who take responsibility to ensure concordance with internationally recognized practices.

This manual provides a harmonized approach to quality assurance (QA) in the emerging area of digital mammography. It outlines the principles of, and specific instructions that can be used for, a QA programme for the optimal detection of early stage breast cancer within a digital environment. Intended for use by Member States that are now using digital mammography or that are assessing the implications of using digital mammography, it addresses major areas such as considerations concerning the transition from screen film to digital mammography, basic principles of QA, clinical image quality, quality control tests for radiographers, and quality control tests for medical physicists, including dosimetry assessment. Instructional materials to supplement the knowledge of professionals already working in the field of diagnostic radiology, as well as quality control worksheets, are also provided.