Enhancing patient safety and procedural quality in radiopharmacy: towards multidisciplinary collaboration between radiopharmacists and medical physicists

Purpose Ensuring patient and staff safety in nuclear medicine requires robust quality assurance and radiation protection systems. Radiopharmacists (RPhs) and medical physicists (MPs) play complementary roles. This study evaluates radiopharmacy practices across Spain and identifies areas for improved interdisciplinary collaboration. Methods A nationwide survey was conducted in 40 Spanish centres representing different types of Radiopharmacy Units. Fifty-two responses were collected from RPhs, MPs, technologists, and nuclear medicine physicians. The survey assesses workflows, activity verification, quality control (QC), staff organisation, and radiation protection practices. Interprofessional discrepancies within centres were also analysed. Results Most centres (78%) perform in-house radiopharmaceutical preparation. Staff organisation varies: 61% employ dedicated personnel, 39% share staff with Nuclear Medicine. Activity verification is performed in 75% of centres for gamma-emitting radiopharmaceuticals and 43% for PET, with inconsistent background subtraction. Only 50% cross-calibrate dose calibrators, and 45% apply geometry correction. Daily constancy tests are performed in 95% of centres, but advanced QC is implemented in fewer than 50%. Radiation protection practices are heterogeneous: over 20% do not use syringe shields, 55% do not wear lead aprons, and 12% do not use clamps. Interprofessional discrepancies are frequent, affecting 25 of 52 centre-dependent items. Conclusions Radiopharmacy practices in Spain show substantial heterogeneity in instrument verification, QC implementation, and radiation protection culture. Strengthening collaboration between RPhs and MPs, standardising procedures, and reinforcing a robust safety culture are essential to improve quality and safety in routine clinical practice.