How this list was created

The 5 recommendations reported were defined by 5 Task Groups of our Association. Each Task Group evaluated a nuclear medicine practice, commonly performed in Italy, with relevant data and clinical evidence to consider its use as inappropriate, because of lack of important benefits to the patients or approaching overtreatment. The impact of these inappropriate practices on cost management is not relevant as the number of Nuclear Medicine procedures commonly performed is far less than that of all Diagnostic Imaging tests. Nevertheless inappropriate exam prescription may critically affect waiting lists causing a low adherence in timing to treatment planning standard (e.g. 18F-FDG PET in preoperative staging, treatment response evaluation after chemotherapy etc.). Even though Nuclear Cardiology procedures, a real core-business activity of the Nuclear Medicine Departments, are not included in the recommendations, we suggest that these procedures should be carefully monitored in order to avoid inappropriateness and to focus on specific disease issues and functional timing which is crucial for patient workup while adhering to appropriateness criteria. As an example, it is still a major concern that many interventional procedures are performed in the absence of a clearcut documentation of ischemia but only by nears of anatomical data: this is obviously the exemplification where “doing best” would be much better than “doing less”.