Starting the Conversation: What Brought You Here

• Tell me briefly why your team is exploring new nuclear medicine imaging equipment now Options: Replace aging scanner, Add PET/CT capacity for oncology, Improve detector sensitivity/resolution, Reduce scan times and increase throughput, Regulatory or safety requirement, Other
• Describe your current imaging fleet, including modality mix (SPECT, SPECT/CT, PET/CT) and typical system age
• How many dedicated nuclear medicine studies does your department perform per week on average Options: Less than 50, 50-100, 101-200, 201-400, More than 400
• Estimate peak daily patient throughput separately for PET/CT and for SPECT studies
• Who in your leadership and which committees must authorize capital spend and clinical acceptance Options: Nuclear medicine director, Radiology chair, Cardiology service line leader, Capital planning committee, Hospital CFO/finance, Other
• When do you aim to have replacement equipment or added capacity operational Options: Within 30 days, Within 60 days, This quarter, Within 6 months, Next fiscal year

Where the Current Imaging Pathway Breaks Down

• If your imaging capacity and image quality stayed the same for the next 12 months, which clinical or financial outcome would force you to change course
• Describe the top three clinical use cases under the most pressure today, for example cardiac perfusion, oncologic staging, neurology, or theranostics Options: Cardiac SPECT perfusion, Oncology PET/CT staging, Neurology PET, Bone and skeletal imaging, Theranostic planning and dosimetry, Other
• How long are typical patient wait times from referral to scan for PET/CT and for SPECT in your center Options: Same day, 1-7 days, 8-14 days, 15-30 days, More than 30 days
• What specific image quality or sensitivity failures have caused repeat scans, downstream referrals, or delayed diagnoses in the past year
• Share a recent example where staffing or throughput forced a protocol change or affected patient care, and what the consequence was
• Which single operational failure, equipment downtime, radiotracer supply interruption, or chronic staffing gap, would make you pause a purchase today Options: Equipment downtime, Radiotracer supply risk, Technologist shortage, Lack of physicist support, Network/PACS integration risk, Other

Clinical Workflows and Patient Volume Realities

• Would your clinicians accept shorter scan times if it reduced diagnostic confidence for low-count studies, and where is their tolerance threshold Options: Yes, up to 20% loss in confidence, Yes, up to 10% loss, No, diagnostic confidence is priority, Undecided, needs discussion
• List the nuclear medicine protocols your team runs regularly and mark which are high volume versus specialized Options: Cardiac perfusion SPECT, Cardiac PET perfusion, FDG PET/CT oncology, Amyloid PET, Bone scans, Theranostic dosimetry, Other
• Who currently owns technology validation, physicist acceptance, and clinical acceptance testing in your department Options: Medical physicist, Nuclear medicine director, Radiology operations manager, External medical physics vendor, Other
• Where in the patient flow are technologist bottlenecks most frequent, for example prep, injection, positioning, reconstruction, or reporting Options: Patient prep and registration, Injection and dose handling, Positioning and setup, Image reconstruction and processing, Reporting and post-processing, Multiple areas
• Approximately how often do you run attenuation correction CTs or motion correction workflows, and do those add measurable time per case Options: Always, and add significant time, Often, and add moderate time, Sometimes, minimal added time, Rarely or never
• If a new system reduced average scan time by 40% but required new reconstruction settings and a two-week clinical validation, what would stop you from approving a pilot

Operational Constraints That Will Make or Break the Project

• Identify any physical, technical, or regulatory constraint at your site that could prevent installation within your target window
• Confirm whether room dimensions, shielding certification, measured power capacity, and network/PACS/RIS endpoints are already documented for the intended installation room Options: All documented and available, Partially documented, some items missing, Not documented yet, Unsure
• Do you have a named owner for PACS/RIS integration, and is an API or DICOM endpoint already provisioned Options: Named owner and endpoints ready, Named owner, endpoints pending, No named owner yet, Integration will require external vendor
• Estimate typical lead times for shielding work, electrical upgrades, and institutional radiation safety approvals at your site Options: Less than 2 weeks, 2-6 weeks, 1-3 months, More than 3 months
• Name the internal teams or external vendors who will be responsible for shielding, electrical, and IT work during installation
• Suppose shielding verification fails or the room lacks required power, do you have a mitigation plan that preserves your desired timeline Options: Yes, alternate room available, Yes, electrical upgrades planned, No mitigation plan, Unsure

What Else Are You Considering? (Alternatives and Internal Options)

• List the other vendors, incumbent systems, or non-purchase approaches you are actively evaluating instead of buying new equipment Options: Replace with same vendor, Upgrade detectors on existing systems, Extend maintenance contracts, Use regional imaging partners, Build internal engineering solution, Other vendors
• Which currently installed systems would you prefer to keep if upgrades could deliver the needed sensitivity or throughput Options: Keep SPECT and upgrade detectors, Keep PET/CT and add software only, Replace older units only, Prefer full replacement, Undecided
• Would an internal capital reallocation or extended maintenance on existing scanners be acceptable if it closed the performance gap Options: Yes, if cost savings are clear, Maybe, depends on timeline, No, need new capacity now
• Tell me about any pilot programs, internal proof-of-concept scans, or engineering projects proposed to avoid an external purchase
• Assuming you remain with your incumbent, what specific performance or cost changes would have to occur in the next 12 months to keep you from replacing equipment
• Name the specific pilot or demo outcome that would make signing a purchase order realistic within your fiscal quarter Options: Meet sensitivity target, Achieve throughput target, Pass physicist acceptance with margin, Vendor guarantees on uptime, Other

Acceptance Criteria and Success Signals

• Imagine we delivered improved sensitivity and throughput, what measurable change would convince you the system meets clinical expectations
• Select the top metrics your team will use for clinical acceptance and ongoing success monitoring Options: Lesion detectability (clinical reads), System sensitivity (counts), Average scan time per protocol, Daily throughput (studies/day), Repeat scan rate, Quantitative accuracy (SUV), Radiation dose reduction, Technologist time per case
• Provide the target values or thresholds for the metrics you selected and the timeframe you expect to reach them after go-live
• Identify who will sign off on physicist acceptance testing, radiation safety approval, and clinical validation scans Options: Medical physicist, Nuclear medicine director, Radiation safety officer, Clinical lead physician, Procurement representative
• Where will you run validation scans and which patient cohorts or phantoms will you use for clinical validation Options: Inpatient cohort, Outpatient cohort, Specific oncologic protocols, Cardiac cohort, Phantom-only validation, Combination
• Suppose the system misses one critical metric at acceptance, what is your threshold for corrective action versus rejecting delivery Options: Allow remediation and retest, Partial acceptance with penalties, Reject and delay go-live, Escalate to procurement/legal

Decision Ownership, Timeline, and Next Steps

• Point to the single decision, blocker, or governance step that will determine whether this purchase happens this fiscal year
• Choose your target procurement window Options: Next 30 days, Next 60 days, This quarter, Next fiscal year, Undecided
• Give the total budget range your capital committee has allocated or is willing to consider for hardware, installation, and initial service Options: Under $500k, $500k–$1M, $1M–$2M, $2M–$5M, More than $5M
• Provide the names and roles of the people who must be involved in final commercial and legal review, and who will own contract routing
• Are there procurement blackout dates, fiscal close windows, or committee cycles we should avoid when scheduling demos or pilots Options: Yes, provide dates, No restrictions, Unsure
• Assuming a pilot meets acceptance and your committee signs off, what is the single fastest path to a signed contract, internal routing, delegated authority, or accelerated committee review Options: Internal delegated authority, Expedited committee review, Standard committee process, Requires CFO signature

• Solution Experience: Clinical Scenarios Walkthrough

• Confirm the current state and its cost
• You confirm the demonstrated oncology and cardiac workflows reduce per-patient acquisition time enough to meet your throughput target.
• Deliver a site-specific throughput and sensitivity comparison using the provided exam mix and target daily volumes.
• Oncology PET scenario, diagnosis to reporting
• You confirm that the integration approach removes the manual reconstruction and PACS transfer steps that cause delays and rework.
• Provide typical weekly exam volumes by modality, peak-hour scheduling, and current average scan times for representative oncology and cardiac protocols.
• Cardiac SPECT scenario, stress-through-rest workflow
• Produce a draft list of acceptance test criteria and minimal integration endpoints required for final sign-off.
• You agree on the concrete evidence and tests required to recommend procurement to your committee.
• Schedule a physicist and lead technologist workshop to review acceptance testing and technologist workflow changes.
• Integration and technologist workflow proof
• Validate alignment with your stated needs
• Agree remaining evidence and next decision steps

• Solution Experience: Clinical Scenarios Walkthrough
• Solution Experience Deck
• Solution Brief

• meeting
• slides
• document

• Equipment Delivery and On-Site Installation
• Radiation Shielding Supply and Installation
• Electrical and HVAC Hookup for Scanner
• Physicist Acceptance Testing and Certification
• Technologist Hands-On Operating Training
• Physician Clinical Interpretation Training
• Detector Replacement and Retrofit Service
• Install and Calibrate Low-Dose CT Attenuation
• Deploy Iterative Reconstruction and Motion Correction
• PACS and RIS Integration and DICOM Configuration
• Radiopharmaceutical Dose Calibration and QC Tools
• PET Radiopharmaceutical Delivery Infrastructure Installation
• Service, Remote Monitoring, and Preventive Maintenance
• Spare Parts and Consumables Kit Provisioning
• Capital Financing and Incentive Qualification Package

Equipment Delivery and On-Site Installation

• Provide the exact delivery address, unloading dock location, and maximum truck access dimensions.
• Which access constraints must we plan for inside the facility (elevator interior dimensions in cm, corridor width, door clearances, floor load capacity in kg/m2)?
• List any required permits or contractor badges our delivery team must obtain before arrival.
• Who is your site receiving coordinator for shipment scheduling and crate handling (name, role, contact)?
• When do you prefer delivery to occur relative to the installation window (weekdays, nights, weekend), and are there curfew restrictions? Options: Weekdays 8am-5pm, Evenings 5pm-11pm, Weekends, Flexible / To be scheduled

Radiation Shielding Supply and Installation

• Confirm whether you will provide an existing shielding plan or require a site-specific shielding design from us for the isotopes in use (e.g., 99mTc, F-18, Lu-177). Options: You will provide shielding plan, We should provide shielding design, Unknown / need assessment
• Specify required shielding materials and minimum thicknesses per your local regulator for primary and secondary barriers (lead mm, high-density concrete cm).
• Which areas require additional shielding verification (control room, adjacent exam rooms, corridor) and do you have prior survey reports to reference? Options: Control room, Adjacent exams, Corridor, No prior reports
• Identify whether fixed door shielding or movable lead door inserts are preferred for the scanner room entry and give dimensions of the door opening. Options: Fixed door shielding, Movable insert, Not applicable
• Provide the target completion date for shielding so it aligns with equipment installation.

Electrical and HVAC Hookup for Scanner

• Upload or describe your single-line electrical diagram (SLD) and state available dedicated circuit capacity (voltage, phase, amps).
• Specify required electrical deliverables you expect us to provide versus facility scope (dedicated panel, generator transfer switch, UPS, isolation transformer). Options: We provide all, You provide all, Split responsibilities - specify
• State HVAC tolerances and heat rejection requirements for the room (maximum delta T, required chilled water capacity, redundancy N+1).
• Who is the facility mechanical or electrical contractor we should coordinate with (name, company, contact)?
• When can a utilities verification visit be scheduled to validate power, grounding, and HVAC prior to delivery?

Physicist Acceptance Testing and Certification

• Name the licensed medical physicist or QA vendor who will accept the system and provide credential and contact details.
• Select the acceptance standards you require for final sign-off (select all that apply): NEMA NU-2 for PET, NEMA NU for SPECT, local radiation safety regulator, ACR accreditation criteria, or in-house thresholds. Options: NEMA NU-2 (PET), NEMA for SPECT, Local regulator, ACR accreditation, In-house thresholds
• What specific measurable acceptance criteria must the physicist report demonstrate for spatial resolution (mm), sensitivity (cps/MBq), uniformity (%), CT Hounsfield unit accuracy, and PET/CT co-registration (mm)?
• Identify who will be responsible for shipping and setup of acceptance phantoms and whether you will provide institutional phantoms for baseline measurements. Options: You provide phantoms, We provide phantoms, Shared / to be determined

Technologist Hands-On Operating Training

• How many technologists require hands-on operation training and which shifts must be covered (day, evening, night)? Options: 1-3, 4-6, 7-10, 10+
• List the specific procedures and QC tasks to include: cardiac stress-rest workflows, dynamic PET protocols, CT attenuation correction checks, daily phantom QA.
• Do you require competency assessments with operator sign-off checklists at completion of training? Options: Yes, No
• Which PACS and modality worklist steps should be part of the training (DICOM modality worklist scheduling, automatic routing, query/retrieve examples)?
• When do you prefer initial on-site hands-on training relative to physicist acceptance testing (before, during, after)? Options: Before acceptance testing, During acceptance testing, After acceptance testing

Physician Clinical Interpretation Training

• How many physicians require interpretation training and which subspecialties (nuclear cardiology, oncology PET/CT, neurology)?
• Which clinical case mix should be used for training: cardiac perfusion stress/rest, whole-body FDG PET oncology staging, PSMA PET, or brain perfusion studies? Options: Cardiac perfusion, Whole-body oncologic PET, PSMA PET, Brain perfusion, Mixed
• Confirm whether you require case-based benchmarking of interpretation accuracy against your existing reports and structured reporting templates. Options: Yes, No
• Which reporting fields or structured report templates must be exported to your RIS as part of training (e.g., perfusion scores, SUV metrics, staging templates)?
• Provide example de-identified DICOM studies we can use for live interpretation exercises if available.

Detector Replacement and Retrofit Service

• Specify the existing camera model, chassis serial number, and any legacy accessories included in the retrofit scope.
• Which retrofit tasks will require scanner downtime and what maximum acceptable downtime window do you have (hours/days)? Options: <4 hours, 4-8 hours, 1 day, More than 1 day
• Identify whether legacy cabling, power, or network interfaces will be reused or need replacement during the retrofit. Options: Reuse existing, Replace all, Partial - specify
• Describe any site access or LOTO (lockout/tagout) procedures and onsite contractor constraints that affect retrofit work.
• Estimate required lead time for ordering detector modules and schedule availability for on-site retrofit work.

Install and Calibrate Low-Dose CT Attenuation

• Which CT kVp and mA ranges are required for your attenuation correction workflows and low-dose protocols (list clinical targets)?
• Specify CT acceptance metrics you require for HU accuracy, slice thickness, and CT-to-PET registration prior to clinical use.
• What are the pass/fail acceptance criteria and evidence you will accept for CT attenuation calibration (phantom reports, HU tolerance, registration error mm)?
• Who will perform CT radiation dose documentation and supply local dose reference levels (DRLs) for our protocol tuning?
• When should CT calibration and low-dose protocol tuning be scheduled relative to PET detector acceptance? Options: Before PET acceptance, During PET acceptance, After PET acceptance

Deploy Iterative Reconstruction and Motion Correction

• Which reconstruction kernels and iterative algorithm presets do you require for cardiac, oncology, and brain protocols (list by exam type)?
• Specify target reconstruction latency (time from raw data to first reconstructed image) acceptable for your clinical workflow. Options: <30s, <60s, <2 minutes, No strict requirement
• Identify motion correction strategies needed (gating, data-driven motion correction, respiratory correction) and which exams require them. Options: ECG gating, Respiratory gating, Data-driven, None
• Describe any local image processing constraints such as GPU availability, on-prem compute limits, or cloud usage restrictions.
• Who will approve final algorithm parameter sets for clinical release and should we include a limited POC recon comparison report? Options: Your lead physician, Your physicist, Joint sign-off

PACS and RIS Integration and DICOM Configuration

• Provide the PACS and RIS vendor names, AE titles, IP addresses, and port numbers for DICOM association and HL7 routing.
• Which DICOM services must be validated during integration (C-STORE, C-FIND/Move, Modality Worklist, Structured Reports) and which require logging evidence? Options: C-STORE, C-FIND/Move, Modality Worklist, Structured Reports
• What is the acceptable first-image-load latency over your WAN/VPN for remote reading workstations (target seconds)? Options: <5s, <10s, <30s, No SLA
• What test cases or sample DICOM studies will you provide to validate routing, accession mapping, and report reconciliation with your RIS?
• What defines successful integration evidence for you (DICOM test log, HL7 ADT accession match rate, first-image-load timing)?

Radiopharmaceutical Dose Calibration and QC Tools

• Which dose calibrator models and calibration standards (NIST-traceable) are in scope and do you require new instrument provisioning? Options: You will provide calibrators, We should supply calibrators, Hybrid
• Specify required QC test frequencies and tolerances for dose calibrator linearity, accuracy, and constancy.
• Identify which radiopharmaceuticals and typical administered activities (MBq or mCi) will be used for system commissioning and routine QC.
• Describe whether you need automated dose recording interfacing to your electronic medical record or radiopharmacy system. Options: Yes - integrate, No - manual record, Partial
• Who will own day-to-day QC execution and logs (technologist, physicist, radiopharmacy) and provide access for audits? Options: Technologist, Physicist, Radiopharmacy, Shared

PET Radiopharmaceutical Delivery Infrastructure Installation

• Specify the radiopharmaceutical types to be delivered onsite (FDG, PSMA, DOTATATE, Lu-177) and anticipated weekly vial volumes.
• Which delivery interfaces are needed: shielded delivery locker, refrigerated storage, lead-lined hood, or direct pharmacy handoff? Options: Shielded locker, Refrigerated storage, Lead hood, Direct handoff
• Identify required service connections for delivery infrastructure (compressed air, chilled water, dedicated drain) and who will provide them.
• Who will handle licensing and local transport paperwork for incoming radioisotopes and do you require our assistance to qualify carriers? Options: You handle licensing, We assist, We handle fully
• When are deliveries expected to start relative to installation and do you require an inventory kickoff training session? Options: Before clinical go-live, At go-live, After go-live

Service, Remote Monitoring, and Preventive Maintenance

• Select the service coverage model you prefer: remote monitoring plus annual preventive maintenance, 24x7 service contract, or pay-per-call. Options: Remote + annual PM, 24x7 contract, Pay-per-call

• Purchase Agreement & Order Confirmation
• Master Services Agreement (MSA)
• Statement of Work (SOW)
• Service Level Agreement (SLA) / Maintenance Agreement
• Delivery & Installation Schedule
• Site Acceptance Test Protocol (SAT) / Acceptance Criteria
• Payment Schedule & Invoice Terms
• Equipment Warranty & Repair Terms
• Change Order Agreement
• HIPAA Business Associate Addendum (BAA) (conditional)
• Radiation Safety & Licensing Addendum

• Go-live Health Check (weeks 1-4)
• First Outcomes Measurement (weeks 4-10)
• 90-day Performance Review and Safety Audit (around day 90)
• Quarterly Operational Review (ongoing)

• Record and distribute clinical image samples used in the spot-check along with any recommended acquisition or reconstruction parameter changes.
• Validate whether 90-day metrics meet the Solution Scope targets or identify which metrics remain off-target and why.
• Confirm there are no unresolved safety or compliance items preventing routine clinical operations.
• Document closure evidence for remediations or set firm deadlines for remaining items with deliverables.
• Publish the 90-day performance and safety audit summary with metric comparisons to Solution Scope targets and required follow-ups.
• If any metric remains off-target, define a corrective project plan with milestones and expected metric improvement by the next review.
• Reconfirm targets and ownership
• Ensure the incident queue is actively managed with realistic closure dates and owners for remaining items.
• Recent period metrics and trend analysis
• Maintain or improve key operational metrics throughput and PACS transfer success rate toward Solution Scope targets.
• Agree a prioritized backlog of non-critical enhancements to be reviewed each quarter.
• Deliver the quarterly metrics report with trend lines and a summary of actions taken since the previous review.
• Add agreed enhancement requests to the shared backlog with priority level and target review quarter.
• Schedule targeted training refresh sessions for any technologists flagged during proficiency review.
• Confirm all critical deployment tasks are complete or have committed resolution dates and owners.
• Verify early adoption signals show no safety or connectivity blockers to routine use.
• Establish the incumbent decommission status and next steps if decommissioning is not complete.
• Publish the go-live health summary with outstanding issues and owners within 48 hours.
• Schedule any required follow-up site visits or remote fixes and record expected completion dates.
• If the incumbent is still active, produce a decommission checklist including data archival confirmation and contract actions.
• Present first-period metric data
• Establish whether the key metrics average scan time per study and study transfer success rate to PACS are progressing toward Solution Scope targets and identify deviations.
• Agree a prioritized remediation plan with clear tasks and completion dates to bring metrics into target ranges.
• Confirm the timeline for resolving outstanding items before the 90-day performance review.
• Deliver a root-cause report for each off-target metric including proposed fixes and estimated impact on the metric.
• Schedule focused technologist training sessions addressing identified workflow gaps and document attendance.
• Implement and validate any necessary PACS/DICOM configuration changes and confirm study transfer success rates post-change.
• 90-day performance dashboard
• Deployment and system health validation
• Outstanding incident and remediation burn-down
• Clinical image quality spot-check
• Root-cause analysis for metric gaps
• Operational adoption review
• Enhancement request triage
• Early adoption and usage signals
• Radiation safety and compliance review
• Agree corrective actions and timeline
• Training and staffing check
• Close or extend remediation items
• Open issues and immediate remediation
• Incumbent system wind-down check