Essential Guide to Research During Nuclear Medicine Residency

Why Research During Nuclear Medicine Residency Matters

Research during residency in nuclear medicine is more than an optional “extra.” It is increasingly central to shaping your career trajectory, strengthening your nuclear medicine match competitiveness if you are still applying, and opening doors to academic, leadership, and industry roles.

Nuclear medicine is fundamentally a technology- and data-driven specialty. New tracers, theranostics, AI-driven image analysis, and quantitative imaging tools are rapidly changing practice. Engaging in research during residency positions you to:

• Understand emerging diagnostic and therapeutic tools before they become mainstream
• Stand out for fellowships (e.g., PET/CT, theranostics, molecular imaging) and academic residency tracks
• Build relationships with mentors and collaborators at your institution and beyond
• Develop critical appraising and scientific communication skills that will serve you throughout your career

This guide focuses specifically on how to plan, execute, and leverage resident research projects in nuclear medicine. Whether you see yourself in community practice, hybrid academic/private roles, or a fully academic residency track, research can be tailored to support your goals.

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Understanding the Research Landscape in Nuclear Medicine

Nuclear medicine offers a wide array of research opportunities, from basic science to clinical trials and health services research. Knowing this landscape helps you identify where you best fit.

Major Research Domains in Nuclear Medicine

1. Radiopharmaceutical Development

   • Design and evaluation of new imaging and therapeutic tracers
   • Optimization of radiolabeling techniques and quality control
   • Pharmacokinetics, biodistribution, and dosimetry of novel agents
   • Examples:
     • Developing new PSMA ligands for prostate cancer
     • Evaluating new F-18–labeled amyloid tracers for neurodegenerative disease

2. Theranostics and Radionuclide Therapy

   • Clinical trials of targeted radioligand therapy: Lu-177 PSMA, Lu-177 DOTATATE, I-131, etc.
   • Dose-response relationships and individualized dosimetry
   • Toxicity profiles and long-term outcomes
   • Examples:
     • Comparing empiric vs dosimetry-guided I-131 therapy in thyroid cancer
     • Studying renal toxicity thresholds in Lu-177 DOTATATE patients

3. Quantitative and Functional Imaging

   • SUV-based metrics, parametric imaging, kinetic modeling
   • Standardization across scanners and centers
   • Using PET/CT and SPECT/CT metrics as biomarkers for prognosis and response
   • Examples:
     • Predicting immunotherapy response using baseline FDG PET heterogeneity
     • Harmonizing SUV measurements across PET scanners in a multi-site system

4. Artificial Intelligence and Image Analysis

   • Deep learning for lesion detection, segmentation, and quantification
   • Radiomics and machine learning models for prediction and classification
   • AI-assisted reading workflows and decision support
   • Examples:
     • CNN-based automatic segmentation of myocardial perfusion defects
     • Radiomics signatures predicting early response to RLT

5. Clinical Outcomes and Practice Improvement

   • Appropriateness criteria and utilization of nuclear medicine tests
   • Impact of imaging on management decisions and patient outcomes
   • Cost-effectiveness and value-based care studies
   • Examples:
     • Evaluating how often FDG PET/CT changes management in lymphoma
     • Reducing unnecessary bone scans through guideline-based ordering

6. Radiation Safety, Physics, and Quality

   • Dose optimization and reduction strategies
   • Shielding, workflow, and occupational exposure studies
   • Validation of new reconstruction algorithms and hardware (e.g., digital PET)
   • Examples:
     • Low-dose PET protocols and image quality thresholds
     • Impact of time-of-flight PET on small lesion detectability

Where Residents Fit In

Residents typically contribute most effectively to:

• Retrospective chart/imaging reviews (feasible with resident schedules)
• Quality improvement (QI) projects that can also be written up as research
• Secondary analyses of existing datasets or imaging registries
• Method development and pilot studies (especially with strong mentoring)
• Multi-disciplinary clinical projects, e.g., in oncology, cardiology, or neurology

You do not have to invent a new tracer to do meaningful research. Many highly cited papers come from carefully designed retrospective studies, practice improvement interventions, and translational collaborations.

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Getting Started: Laying the Foundation for Resident Research

Clarifying Your Goals Early

Even before you start your nuclear medicine residency (or at least in PGY-2/PGY-3), think through what you want research to do for you:

• Academic career focus

  • Aim for multiple projects, first-author manuscripts, and presentations
  • Seek out an academic residency track if your institution offers one
  • Consider more advanced methods (stats, programming, trial design)

• Clinically focused career with research literacy

  • Aim for 1–2 solid projects, ideally publishable
  • Focus on QI, clinical outcomes, or imaging utilization studies
  • Emphasize understanding literature, methods, and critical appraisal

Your goals will influence how much research you commit to and which mentors you seek.

Identifying Mentors and Research Homes

Strong mentorship is the most important factor in successful research during residency.

Look for:

• A primary nuclear medicine mentor

  • Actively publishes in an area you find interesting
  • Has a track record of working with residents or fellows
  • Will meet with you regularly and provide timely feedback

• Secondary mentors/collaborators in:

  • Oncology, cardiology, neurology, endocrinology (for clinical studies)
  • Medical physics, radiology, or engineering (for methods and imaging physics)
  • Biostatistics or epidemiology (for study design and analysis)

Best practices:

• Ask current residents who is “resident-friendly” and helps projects reach publication.
• Attend departmental research meetings and journal clubs to see which faculty are active.
• Start with a small conversation: “I’m interested in nuclear medicine research during residency. Are there ongoing projects where a resident could contribute meaningfully?”

Choosing the Right Project Type for Your Level

As a resident, feasibility is critical. Overly ambitious projects that require complex prospective recruitment or long follow-up are at high risk of stalling.

Common, achievable project types:

1. Retrospective Clinical Studies

   • Use existing PACS, EMR, RIS databases
   • Examples:
     • Impact of PSMA PET/CT on staging and management in prostate cancer
     • Prognostic value of FDG PET metabolic tumor volume in lymphoma

2. Imaging-Based Retrospective Analyses

   • Radiomics, image quantification, or segmentation studies
   • Works well if your institution has existing pipelines or collaborators

3. Quality Improvement → Research

   • E.g., reducing repeat nuclear cardiology scans due to suboptimal protocols
   • Before/after implementation of a new procedure or guideline

4. Case Series and Observational Reports

   • Small but instructive series of rare or emerging applications
   • E.g., unusual infections on FDG PET/CT, unusual Lu-177 toxicity patterns

5. Review Articles or Educational Papers

   • Narrative review: e.g., theranostics in neuroendocrine tumors
   • Pictorial essay: characteristic PET/CT findings in specific tumors

Begin with one manageable, high-probability-of-completion project before committing to multiple parallel efforts.

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Designing and Executing a Research Project During Residency

Step 1: Framing a Focused Research Question

Use a structured framework like PICO (Population, Intervention, Comparison, Outcome) or PECO (Population, Exposure, Comparison, Outcome) for observational studies.

Example – Clinical PET study:

• Population: Patients with newly diagnosed Hodgkin lymphoma
• Intervention/Exposure: Baseline FDG PET total metabolic tumor volume
• Comparison: Lower vs higher MTV groups (e.g., based on median or pre-set cutoffs)
• Outcome: Progression-free survival and overall survival at 2 years

A focused question helps determine:

• Inclusion/exclusion criteria
• Data fields to collect
• Appropriate statistical tests

Step 2: Checking Feasibility and Data Availability

Before writing anything for IRB, confirm:

• Sample size: How many eligible cases exist over a realistic time window?
• Data accessibility: Can you extract the necessary imaging and clinical variables from PACS and EMR without extraordinary effort?
• Time constraints: Can the project realistically be completed within 12–18 months (including analysis and manuscript preparation) given your rotations and call schedule?

Practical tip: Start with an “exploratory query”:

• Work with IT, a data analyst, or research coordinator to estimate numbers
• Ask senior residents or fellows how they handled similar datasets

Step 3: IRB and Regulatory Considerations

Most nuclear medicine resident research projects will fall into one of two categories:

• Retrospective chart/imaging review with minimal risk

  • Often qualifies for exempt or expedited IRB review
  • Usually involves waiver of informed consent

• Prospective observational or interventional studies

  • Greater complexity; usually requires full IRB review and potential consent
  • More time-consuming; consider carefully before committing as a junior resident

Key elements of an IRB submission:

• Research question and rationale
• Detailed methods and data elements
• Plans for de-identification and data security
• Risk assessment and mitigation strategies

Leverage templates:

• Many institutions have standardized IRB templates for retrospective imaging studies.
• Ask your mentor for a copy of a prior successful submission to model.

Step 4: Data Collection and Management

Efficient data handling is crucial to complete projects on time.

Best practices:

• Use secure, institutionally approved tools (e.g., REDCap, secure Excel on servers).
• Create a clear data dictionary (variable names, definitions, units).
• Pilot-test your data collection form on 5–10 cases to catch ambiguities.

Example data elements for a Lu-177 DOTATATE outcomes study:

• Demographics (age, sex)
• Tumor type and stage
• Dosimetry parameters (absorbed dose to kidney, liver, target lesions)
• Number of treatment cycles, cumulative activity
• Toxicities (hematologic, renal, hepatic)
• Response category (partial, stable, progressive)
• Survival and progression dates

Involve a statistician early to confirm:

• Which variables are essential
• How to handle continuous vs categorical variables
• Planned analyses (e.g., Cox regression, logistic regression, survival curves)

Step 5: Statistical Analysis and Interpretation

As a resident, you don’t need to become a full biostatistician, but you should:

• Understand basic concepts:

  • Descriptive statistics, p-values, confidence intervals
  • Survival analysis (Kaplan–Meier, log-rank test)
  • Multivariable regression basics

• Collaborate with professionals:

  • Many departments or universities provide biostatistical support
  • Acknowledge statisticians appropriately (authorship vs acknowledgment)

Interpretation is where clinical judgment meets data. Ask:

• Are observed differences clinically meaningful, not just statistically significant?
• Could there be confounding or bias (e.g., referral patterns, imaging indications)?
• How do results compare with published work in similar populations?

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Balancing Research With Clinical Training and the Nuclear Medicine Match

Time Management Strategies for Residents

Nuclear medicine residency can be busy, especially in combined programs (e.g., radiology + nuclear medicine) or during rotations with high call volume. Structured time management makes research possible.

Tactics that work:

1. Block Scheduling

   • Dedicate half-days or specific evenings for research tasks.
   • Treat these blocks as non-negotiable appointments with yourself.

2. Micro-Tasks

   • Break big goals (e.g., “write methods section”) into small, achievable chunks:
     • Draft inclusion/exclusion criteria
     • Outline data elements section
     • Write 3–4 sentences on study rationale

3. Use Slow Clinical Time

   • During off-peak hours, review articles or outline sections instead of passively browsing.
   • Keep a reading list in a reference manager (Zotero, EndNote, Mendeley).

4. Partner With Co-residents or Fellows

   • Share workload: one focuses on data extraction, another on initial drafting.
   • Co-authoring is normal; define roles early to avoid conflict.

Research and the Nuclear Medicine Match/Fellowship Applications

If you’re still in medical school applying to a nuclear medicine residency, or a resident applying to nuclear medicine or molecular imaging fellowships, research can:

• Demonstrate sustained interest in nuclear medicine
• Show analytical and scholarly ability
• Differentiate you from candidates with similar board scores and clerkship grades

Ways to make research visible:

• ERAS / CV:

  • List ongoing and completed projects under “Research Experience”
  • Include submitted manuscripts and accepted abstracts
  • Clarify your role (e.g., “first author,” “data analysis lead”)

• Personal statement:

  • Reference 1–2 key nuclear medicine or imaging research experiences
  • Reflect briefly on what the work taught you (e.g., about patient care, imaging value)

• Interviews:

  • Be prepared to explain your hypothesis, methods, findings, and limitations.
  • Avoid overstating your role: honesty is more impressive than inflated claims.

Programs with an academic residency track particularly value applicants who have shown commitment to scholarly work and can articulate future academic goals.

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Leveraging Resident Research for Long-Term Career Development

Building a Coherent Research Narrative

Even as a resident, you can begin to create a thematic focus. This doesn’t mean you must only work on one topic, but it helps if there’s at least some through-line.

Examples of early-career “micro-themes”:

• Theranostics in neuroendocrine and prostate cancer
• Quantitative PET in hematologic malignancies
• Cardiac nuclear imaging optimization and outcomes
• AI and radiomics in oncologic PET/CT

Over time, your CV tells a story:

• Multiple resident research projects →
• Fellowship involvement in more complex or multi-center work →
• Early faculty projects and possibly grant applications

Presenting and Publishing Your Work

Target 2–3 dissemination goals for each substantial project:

1. Local/Institutional Presentations

   • Departmental research day
   • Multidisciplinary tumor boards
   • Institutional trainee research symposia

2. Regional/National Conferences

   • Society of Nuclear Medicine and Molecular Imaging (SNMMI)
   • European Association of Nuclear Medicine (EANM) if applicable
   • RSNA, ASCO, ASTRO, ACC, AHA, depending on topic

3. Peer-Reviewed Publication

   • Start targeting an appropriate journal early (e.g., Journal of Nuclear Medicine, Clinical Nuclear Medicine, European Journal of Nuclear Medicine and Molecular Imaging).
   • Align structure and referencing style with the target journal’s guidelines before writing.

Basic manuscript structure:

• Introduction: What is known, what is unknown, and your study’s objective
• Methods: Design, population, imaging protocols, statistics
• Results: Focus on key findings, supported by tables/figures
• Discussion: Interpretation, comparison with prior studies, limitations, implications

Publishing during residency:

• Strengthens applications for fellowships and academic jobs
• Can support promotion criteria later if you pursue an academic residency track
• Builds confidence in scientific writing and peer review navigation

Transitioning to an Academic or Research-Heavy Career

If you’re leaning toward an academic path:

• Seek out research electives or protected research blocks during residency.
• Apply for fellowships at programs with strong nuclear medicine research output.
• Consider advanced training:
  • Master’s degree in clinical research, epidemiology, or biostatistics
  • Postdoctoral research fellowship (for those with heavy basic/translational interest)

During the latter half of residency:

• Start identifying grant opportunities for early-career investigators (e.g., society or foundation grants).
• Work with mentors to develop a 2–3 year post-residency research plan.

Even if you ultimately practice in a community setting, your resident research background will:

• Make you a more informed consumer of the literature
• Prepare you to lead or participate in multi-center trials or registries
• Support quality and innovation projects in your future practice

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Frequently Asked Questions (FAQ)

1. How many research projects should I realistically aim to complete during nuclear medicine residency?
Quality matters more than quantity. For most residents, 1–3 meaningful projects that reach presentation and/or publication is a strong track record. If you’re aiming for an intensive academic residency track or a highly research-focused career, you might engage in more projects, but it’s better to fully execute a smaller number of well-designed studies than to start many that never finish.

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2. Do I need prior research experience before starting nuclear medicine residency to be successful in resident research projects?
Prior research experience helps but is not mandatory. Many residents complete their first serious research projects during residency. What you need is:

• Willingness to learn basic methods
• A supportive mentor
• A feasible project and realistic timeline
  Your first project can be a retrospective review or a QI-driven study; as you gain skills, you can move to more complex designs.

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3. How can I balance board exam preparation, clinical responsibilities, and research during residency?
Use structured time management:

• Protect specific weekly blocks for research tasks
• Integrate reading for your project with exam prep (e.g., PET/CT literature relevant to both)
• Choose projects that align with the clinical content you are already seeing
  Discuss your plans with your program director; some programs can offer research electives or adjust schedules to support residents with active projects.

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4. Will doing research lock me into an academic career in nuclear medicine?
No. Research during residency keeps doors open, rather than closing them. It can:

• Make you a more competitive candidate for both academic and non-academic jobs
• Help you better interpret literature and adopt new technologies in practice
• Equip you to lead QI and practice improvement initiatives in community settings
  You can always choose later whether to pursue a heavily research-oriented path, a hybrid clinical-academic role, or a predominantly clinical career.

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Engaging in research during residency in nuclear medicine is one of the most effective ways to deepen your understanding of the field, contribute to patient care advances, and shape a flexible, future-proof career. With focused questions, good mentorship, and thoughtful planning, resident research projects can be both achievable and genuinely impactful.