The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientifc 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-proft 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, nonproft,
scientifc association whose purpose is to promote communication, research, development, and applications in the feld of
magnetic resonance in medicine and biology and other related topics and to develop and provide channels and facilities for
continuing education in the feld.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 defne 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 ffth 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 efective use of diagnostic nuclear medicine imaging and magnetic resonance imaging requires
specifc training, skills, and techniques, as described in each document. Reproduction or modifcation 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 infexible 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 specifc 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 difering from
the guidelines, standing alone, is below the standard of care. To the contrary, a conscientious practitioner may responsibly
adopt a course of action diferent 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 efective and safe medical care. The sole purpose of
these guidelines is to assist practitioners in achieving this objective.