Staffing levels will reflect the aims of the unit. If the intention is to have a stand-alone scanner with no on-site cyclotron and chemistry facilities, then, assuming a throughput of ~800 patients per annum, the department will need a minimum of two technologists. Two are needed to ensure that there will always be cover for annual leave and sickness and also to share the radiation dose. This number of staff assumes that there will be some additional scientific and clerical support staff. However, with a scanner plus cyclotron and chemistry facilities, the annual patient throughput is likely to increase due to greater availability of radiopharmaceuti-cals for clinical studies and, possibly, research work. Assuming an annual workload of ~1200 patients, there would need to be at least three technologists with a corresponding increase in support staff. Provision of [18F]-FDG for 8:00 am injection, allowing scanning to start at 9:00 am, requires cyclotron and chemistry staff to begin work very early. This has obvious revenue consequences as it will necessitate out-of-hours or enhanced payment and may make recruitment difficult. For this reason it is possible that in many centers the [18F]-FDG will not be available for injection much before 9:30-10:00 am, with the first scan not starting until nearly 11:00 am. To maximize the resources available it will probably be necessary to extend the working day into the early evening by working a split shift system. Once the PET technologists have been selected, consideration must be given to how they will be trained. There is little point sending a technologist who is going to be working in a clinical PET center to train in a center that undertakes research work only. The two units will operate in very different ways with different priorities, and are likely to be using a different range of tracers. To gain an in-depth working knowledge of clinical PET, technologists should spend at least four and preferably eight weeks at their "training" center. The amount of training required will depend on the existing knowledge of the technologist. It must be remembered that in order to function successfully in a PET unit, the technologist should be experienced in patient care, handling of unsealed sources, intravenous cannulation, and administration of radiopharmaceuti-cals as well as the acquisition and subsequent reconstruction of the data.
A good basic understanding of physics and computing will also help, particularly when it comes to troubleshooting problems. CT training is also likely to be an advantage as time goes on and there are several short courses available that will provide a good grounding in basic CT. If the work is likely to include full diagnostic CT, there are staffing implications with regards to state registration and the operation of CT scanners which cannot be ignored.
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