Current practice in determining pregnancy status prior to diagnostic Introduction This survey has been designed to provide information regarding current practice in Nuclear medicine on determining the pregnancy status of patient's prior to diagnostic imaging. This survey forms part of the PhD studies of Daphne James, from The University of Newcastle. The survey should take approximately 10 mins to complete. At the completion of the survey you will be redirected to a web page where, if you wish, you can enter your name & email address to enter the draw for one of five $100 Westfield vouchers. This information is kept separate to your survey responses to maintain anonymity.

Participant Information 1. What is your gender? fe c Male fe c Female

2. What is your profession? c Physician fe c Physicist fe c Senior physicist fe c PDY Nuclear Medicine Scientist fe c Nuclear Medicine Scientist fe c Senior Nuclear Medicine Scientist fe c Chief Nuclear Medicine Scientist fe

3. How many years of experience do you have in your current profession? fe c 0-2 years fe c 3-5 years fe c 6-10 years fe c 11-15 years fe c 16+ years

4. What type of practice are you employed in? fe c Public fe c Private

JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY • Vol. 41 • No. 3 • September 2013

James et al.

Current practice in determining pregnancy status prior to diagnostic 5. Where do you practice? c NSW e f c ACT e f c VIC e f c QLD e f c SA e f c WA e f c NT e f c TAS e f c NZ e f

6. Did you obtain your University qualifications in Australia? c Yes e f c No e f

7. If Yes to Question 6, at which University? c University of Sydney fe c University of Newcastle fe c University of South Australia fe c Charles Sturt University fe fe c RMIT c Monash University fe c Other (please specify) fe

8. If No to question 6, In which country did you obtain your University qualifications?

Policy and Regulations 9. Does the department you work in have a written policy regarding how to determine the pregnancy status of female patients prior to diagnostic imaging procedures? c Yes e f c No e f fe c Unsure

JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY • Vol. 41 • No. 3 • September 2013

James et al.

Current practice in determining pregnancy status prior to diagnostic 10. If Yes to question 9, when did you last read it? fe c < 1 week fe c < 1 month fe c < 6 months fe c < 1 year fe c > 1 year

11. Are you aware of any government regulations regarding how to determine the pregnancy status of female patients prior to diagnostic imaging procedures? c Yes e f c No e f

12. If yes to question 11, briefly state what the regulations state regarding how to determine the pregnancy status of female patients prior to diagnostic imaging procedures. 5 6

13. Have you read the sections in the following government regulations regarding how to determine the pregnancy status of female patients prior to diagnostic imaging procedures? Yes

No

ARPANSA 14.2

j k l m n

j k l m n

ICRP 84: Pregnancy and

j l m

j l m

Medical Radiation

Current Practice

JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY • Vol. 41 • No. 3 • September 2013

James et al.

Current practice in determining pregnancy status prior to diagnostic 14. Please indicate the minimum age of patient that you routinely question about their pregnancy status. c 10 years e f c 11 years e f c 12 years e f c 13 years e f c 14 years e f c 15 years e f c 16 years e f c 17 years e f c 18 years e f c Depends on how mature the patient appears e f Other (please specify)

15. What is the rationale for this age? 5 6

16. Please indicate the maximum age of patient that you routinely question about their pregnancy status. c 40 years e f c 45 years e f c 50 years e f c 55 years e f c 60 years e f Other (please specify)

17. What is the rationale for this age? 5 6

JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY • Vol. 41 • No. 3 • September 2013

James et al.

Current practice in determining pregnancy status prior to diagnostic 18. Which method do you use to determine the pregnancy status of female patients prior to diagnostic imaging procedures? c Verbal question e f c Verbal + signature e f c Written form e f Other (please specify)

19. If you use verbal questioning, do you routinely ask the patient any questions regarding: c Last menstrual period (LMP) e f c Contraceptive Use e f c Menopause/Hysterectomy e f

20. If you use a written form, does it ask the patient any questions regarding: c Last menstrual period (LMP) e f c Contraceptive Use e f c Menopause/Hysterectomy e f

21. Do you use pregnancy tests in your department? c Yes e f c No e f

22. If yes to question 21, how often are they used? c Routinely e f c Occasionally e f

23. If yes to question 21, what type of pregnancy tests are used in your department? c Urine e f c Serum e f

24. If yes to question 21, in which circumstance are they used? 5 6

JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY • Vol. 41 • No. 3 • September 2013

James et al.

Current practice in determining pregnancy status prior to diagnostic 25. Please rank the following diagnostic procedures from 1-8, with 1 having the most risk to a foetus from exposure to ionising radiation and 8 having the lowest risk. Bone scan Thyroid scan

1

2

k l m n j

k l m n j

l m j

3

l m j

4

j k l m n l m j

5

k l m n j l m j

j k l m n

6

j k l m n

7

8

k l m n j

j k l m n

l m j

l m j

l m j

l m j

V/Q Lung scan

k l m n j

k l m n j

k l m n j

k l m n j

k l m n j

k l m n j

k l m n j

k l m n j

Renal Perfusion scan

j l m

j l m

l m j

j l m

l m j

l m j

l m j

l m j

Gated Heart Pool scan Sestamibi Myocardial

k l m n j j l m

k l m n j

k l m n j

l m j

l m j

k l m n j

k l m n j

k l m n j

k l m n j

k l m n j

l m j

l m j

l m j

l m j

l m j

Perfusion scan Bone scan with

j k l m n

k l m n j

k l m n j

k l m n j

k l m n j

k l m n j

k l m n j

k l m n j

j l m

l m j

l m j

l m j

l m j

l m j

l m j

l m j

SPECT/CT of lumbar spine 18F-FDG PET/CT

Scenarios 26. Briefly describe how you would question the patient in the following scenario: Young teenager accompanied by a parent 5 6

27. Briefly describe how you would question the patient in the following scenario: Unconscious or heavily sedated patient 5 6

28. Briefly describe how you would question the patient in the following scenario: Patient with a cultural or language barrier 5 6

29. Briefly describe how you would question the patient in the following scenario: Patient with a mental disability 5 6

JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY • Vol. 41 • No. 3 • September 2013

James et al.

Current practice in determining pregnancy status prior to diagnostic 30. Is there anything you would like to add about the verification of pregnant patients prior to diagnostic nuclear medicine imaging? 5 6

Thank you Thank you for completing this survey. You will now be directed to a link to enter your name & email address to enter the draw for one of five $100 Westfield vouchers.

JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY • Vol. 41 • No. 3 • September 2013

James et al.