EUROPE
Special Section: Building a better radiologist

With excitement building over the potential of fusion imaging techniques, the European Association of Nuclear Medicine (EANM) is considering creating a certificate to show proficiency in PET/CT.

Such a certificate could be granted upon completion of a one-week course, finishing with a multiple-choice test at the end, said Prof. Dr. Gustav von Schulthess, a member of the association committee considering the proposal. Courses could be held three times a year in various parts of Europe.

"We have good data showing the diagnostic accuracy, sensitivity, and specificity of PET go up considerably with PET/CT," he said.

But with the clinical advances have come educational challenges. Aside from on-the-job training and communication through medical journals, no clear path has emerged on how best to train physicians to take advantage of the technique. Large-scale training does not make sense when the installed base for hybrid scanners is still very small.

Von Schulthess compares PET/CT's adoption with the arrival of PET in the U.S. Once reimbursement was approved in late 1999, hundreds of PET scanners were sold. Suddenly, radiologists began reading what was often an unfamiliar modality, with many misdiagnoses.

"There were all these lesions you could see from head to toe and many false positives. The lack of education in this technique led to tremendous overreading of PET studies," he said.

Reimbursement in Europe is patchy and the installed base is low, but that could change in the future. As new techniques are developed, turf wars often erupt. A certificate could allow practitioners to prove their level of competence.

If the proposal for a PET/CT certificate is accepted by the EANM board, it will likely be sometime in 2003 before courses and certificates become available throughout Europe, von Schulthess said.