Imaging and Diagnostic Nuclear Medicine —
Training activity: 6

Details

Perform basic image analysis

Type

Entrustable training activity (ETA)

Evidence requirements

Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion. ​

Reflection at multiple timepoints on the trainee learning journey for this activity.

Considerations

• Image filtering
• ROI analysis
• Time activity curves
• Renogram analysis

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

• What does success look like?
  • What is your understanding of what constitutes successful basic image analysis, and how will you ensure you can accurately identify anatomical landmarks, assess image quality, and recognise normal versus abnormal patterns?
  • Have you discussed this particular analysis task with your training officer to gain a clarity of understanding regarding the clinical context and the specific level of detail required?
• What is your prior experience of this activity?
  • Thinking about your prior experience —such as those involving image reconstruction or acquisition parameters—how familiar are you with the basic functions of the analysis software?
  • What possible challenges do you anticipate—such as poor image quality, artefacts, or unfamiliar pathology—and how have you planned to handle these if they arise during the analysis?
  • Do you clearly recognise the scope of your own practice, specifically knowing exactly when you must seek advice or help from a supervisor or reporting clinician to confirm your observations?
  • How do you feel about embarking on this training activity?
• What do you anticipate you will learn from the experience?
  • What specific skills do you want to develop through this activity, such as improving your ability to navigate complex datasets or apply appropriate display settings?
  • What specific insights do you hope to gain regarding the variability of normal anatomy or how different acquisition parameters impact final image appearance?
• What additional considerations do you need to make?
  • Have you consulted actions for improvement identified from your previous experiences, such as points you noted for yourself while observing image reporting sessions?
  • Have you reviewed all important information before starting, including the patient’s history, the referral reason, the radiopharmaceutical used, and the standard viewing protocols for this image type?

In action

• Are you noticing anything surprising or different from what you anticipate during the process of performing basic image analysis?
  • Are you encountering situations such as:
    • The image quality is poorer than expected, making analysis difficult
    • Identifying the correct anatomical landmarks or regions of interest (ROIs) is challenging
    • The software behaves unexpectedly when trying to draw ROIs or perform measurements
    • A measurement yields a value that seems clinically improbable
    • An artefact is present in the image that complicates the analysis
    • There is difficulty accessing or loading the necessary image data
  • How does this experience compare with previous experiences of similar activities?
• How is any unexpected development being resolved as you progress during the activity?
  • How are you working within your scope of practice?
  • Are you successfully managing the situation within your authority, or do you need support because it is beyond your current scope (for example, escalating the case due to poor image quality or questionable results)?
  • What are you learning in this moment as a result of any unexpected development? For example, are you learning a specific technique for drawing ROIs in a difficult area, how to identify a particular artefact, or the protocol for escalating cases with questionable image quality?
• How is this impacting your actions? For example, are you responding to the situation appropriately?
  • Are you adapting or changing your approach to the procedure? Is it affecting your ability to undertake the activity independently?
  • Consider the steps you are taking in the moment, such as:
    • Are you pausing the analysis?
    • Are you reviewing the original request or patient information for context?
    • Are you attempting the analysis on a different workstation or using a different method?
    • Are you consulting departmental standard operating procedures (SOPs) for the specific analysis?
    • Are you seeking advice from a supervisor or colleague?
    • Are you documenting the issue and your attempt to resolve it?
  • How are you feeling in this moment? For example, are you finding it difficult to adapt? Is it affecting your confidence? Are you feeling positive you can reach a successful conclusion?

On action

• Begin by summarising the key points of the experience of performing basic image analysis.
  • Describe the specific steps you undertook using the software to analyse the images.
  • Consider specific events, actions, or interactions that felt important during the activity, including your own feelings during the experience. For example, how did you feel when the image quality made analysis difficult or drawing ROIs was challenging?
  • Include any ‘reflect-in-action’ moments, where you adapted to the situation as it unfolded. Recall anything that felt surprising or different from what you anticipated during the analysis process, and how you reacted to that unexpected development in the moment.
• Identify what learning you can take from this experience. For example, what did you learn about assessing image quality, identifying and managing artefacts, accurately defining anatomical regions for analysis, or using specific software tools for measurement?
  • What strengths did you demonstrate during the activity? Were there specific skills or knowledge (e.g., anatomical interpretation, software navigation) you applied effectively?
  • What skills and/or knowledge gaps were evident? Was there anything about image interpretation, ROI definition, or specific analysis tools you were unsure about or struggled with?
  • Compare this experience against previous engagement with similar activities (if any). Have any previously identified actions for development related to basic image analysis been achieved? Has your practice in this area improved?
  • Identify any challenges you experienced (beyond unexpected events already noted) and how you reacted to these. Did these challenges affect your ability to deal with the situation independently? Were you able to overcome the challenges?
  • Identify anything significant about the activity. Did you need to seek advice or clarification from a supervisor or colleague regarding image features, analysis techniques, or ambiguous findings? Or did you need to escalate something (e.g., poor image quality impacting analysis) to ensure you were working within your scope of practice?
  • Acknowledge any changes in your own feelings now that you are looking back on the experience. Do you feel more confident in performing basic image analysis tasks?
• Identify the actions you will now take to support the assimilation of what you have learnt.
  • What will you do differently next time you perform basic image analysis? Will you change your approach to image assessment, ROI drawing, or documentation?
  • Has anything changed in terms of what you would do if you were faced with a similar situation again, particularly regarding handling unexpected developments like challenging anatomy or image artefacts?
  • Do you need to practise any aspect of the activity further? Are there specific image analysis techniques or software features you want to develop further, drawing upon this experience?

Beyond action

• Have you revisited your previous reflections for this specific activity (performing basic image analysis)?
  • When reviewing these past reflections, what actions for improvement did you previously identify you would need to take to improve your practice related to using image analysis software, identifying key features, applying basic quantitative or qualitative techniques, or documenting your analysis steps?
  • Have you completed these previously identified actions? If not, what are the barriers? If so, how did completing them impact your subsequent performance of this activity? Are you ready to demonstrate this new learning confidently and consistently when performing this task?
  • Have you engaged in professional storytelling or discussed your experiences of basic image analysis with peers, near peers, or colleagues? Has discussing these experiences with others changed your view or understanding of image analysis pitfalls, variations, or clinical relevance?
• Considering your cumulative experiences and reflections on this activity, how will the learning you have gained support you in preparing for relevant observed ‘in-person’ assessments for the module?
  • How has your practice related to performing basic image analysis developed and evolved over time across multiple instances of undertaking this training activity?
  • Can you identify specific examples of improvement or increased confidence in interpreting images or applying standard analysis methods?
  • Based on your experiences, how has your ability to recognise when something related to image analysis is beyond your scope of practice improved?
  • Do you have a clearer understanding of when and from whom (e.g., supervisor, clinical scientist, radiologist) you need to seek advice or clarification regarding complex cases or novel analysis methods?

Relevant learning outcomes

#	Outcome
# 3	Outcome Use appropriate software to extract quantitative and qualitative information from nuclear medicine images and combine images from different modalities.