Veit-Haibach Patrick, Ahlström Håkan, Boellaard Ronald, Delgado Bolton Roberto C, Hesse Swen, Hope Thomas, Huellner Martin W, Iagaru Andrei, Johnson Geoffrey B, Kjaer Andreas, Law Ian, Metser Ur, Quick Harald H, Sattler Bernhard, Umutlu Lale, Zaharchuk Greg, Herrmann Ken
Joint Department Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, Toronto General Hospital, 1 PMB-275, 585 University Avenue, Toronto, Ontario, M5G 2N2, Canada.
Joint Department of Medical Imaging, University of Toronto, Toronto, Canada.
Eur J Nucl Med Mol Imaging. 2023 Oct;50(12):3513-3537. doi: 10.1007/s00259-023-06406-x. Epub 2023 Aug 25.
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and professional organization founded in 1954 to promote the science, technology, and practical application of nuclear medicine. The European Association of Nuclear Medicine (EANM) is a professional non-profit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. The merged International Society for Magnetic Resonance in Medicine (ISMRM) is an international, nonprofit, scientific association whose purpose is to promote communication, research, development, and applications in the field of magnetic resonance in medicine and biology and other related topics and to develop and provide channels and facilities for continuing education in the field.The ISMRM was founded in 1994 through the merger of the Society of Magnetic Resonance in Medicine and the Society of Magnetic Resonance Imaging. SNMMI, ISMRM, and EANM members are physicians, technologists, and scientists specializing in the research and practice of nuclear medicine and/or magnetic resonance imaging. The SNMMI, ISMRM, and EANM will periodically define new guidelines for nuclear medicine practice to help advance the science of nuclear medicine and/or magnetic resonance imaging and to improve the quality of service to patients throughout the world. Existing practice guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each practice guideline, representing a policy statement by the SNMMI/EANM/ISMRM, has undergone a thorough consensus process in which it has been subjected to extensive review. The SNMMI, ISMRM, and EANM recognize that the safe and effective use of diagnostic nuclear medicine imaging and magnetic resonance imaging requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guideline by those entities not providing these services is not authorized. These guidelines are an educational tool designed to assist practitioners in providing appropriate care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, the SNMMI, the ISMRM, and the EANM caution against the use of these guidelines in litigation in which the clinical decisions of a practitioner are called into question. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by the physician or medical physicist in light of all the circumstances presented. Thus, there is no implication that an approach differing from the guidelines, standing alone, is below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the guidelines. The practice of medicine includes both the art and the science of the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment. Therefore, it should be recognized that adherence to these guidelines will not ensure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care. The sole purpose of these guidelines is to assist practitioners in achieving this objective.
核医学与分子影像学会(SNMMI)是一个成立于1954年的国际科学和专业组织,旨在促进核医学的科学、技术及实际应用。欧洲核医学协会(EANM)是一个专业的非营利性医学协会,它促进了全球范围内在核医学领域追求临床和研究卓越的个人之间的交流。EANM成立于1985年。合并后的国际医学磁共振学会(ISMRM)是一个国际非营利性科学协会,其宗旨是促进医学和生物学领域磁共振及其他相关主题的交流、研究、开发和应用,并为该领域的继续教育开发和提供渠道及设施。ISMRM于1994年通过医学磁共振学会和磁共振成像学会的合并而成立。SNMMI、ISMRM和EANM的成员包括专门从事核医学和/或磁共振成像研究与实践的医生、技术人员和科学家。SNMMI、ISMRM和EANM将定期为核医学实践制定新的指南,以帮助推动核医学和/或磁共振成像科学的发展,并提高全球范围内对患者的服务质量。现有实践指南将在其五周年或如有必要更早的时候进行审查,以便酌情修订或更新。每一项实践指南,作为SNMMI/EANM/ISMRM的政策声明,都经历了一个全面的共识过程,在此过程中它受到了广泛的审查。SNMMI、ISMRM和EANM认识到,如每份文件所述,安全有效地使用诊断性核医学成像和磁共振成像需要特定的培训、技能和技术。未提供这些服务的实体无权复制或修改已发布的实践指南。这些指南是一种教育工具,旨在帮助从业者为患者提供适当的护理。它们不是僵化的实践规则或要求,也无意,也不应被用于确立护理的法律标准。出于这些原因以及下文所述的原因,SNMMI、ISMRM和EANM告诫不要在对从业者的临床决策提出质疑的诉讼中使用这些指南。关于任何特定程序或行动方案是否恰当的最终判断必须由医生或医学物理学家根据所呈现的所有情况做出。因此,并不意味着与指南不同的方法本身低于护理标准。相反,当从业者合理判断患者的病情、可用资源的限制或指南发布后知识或技术的进步表明需要采取不同的行动方案时,尽责的从业者可能会负责任地采取与指南中规定的不同的行动方案。医学实践包括疾病预防、诊断、缓解和治疗的艺术与科学。人类病情的多样性和复杂性使得不可能总是做出最恰当的诊断或确定地预测对治疗的特定反应。因此,应该认识到遵循这些指南并不能确保准确的诊断或成功的结果。所能期望的只是从业者将根据当前知识、可用资源和患者需求采取合理的行动方案,以提供有效和安全的医疗护理。这些指南的唯一目的是帮助从业者实现这一目标。