{ "source": "Cooked Index — occupational AI risk register", "page": "https://cookedindex.com/jobs/nuclear-medicine-technologists/", "methodology": "https://cookedindex.com/methodology", "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.", "scored_at": "2026-08-11", "model": "claude-opus-5", "occupation": { "title": "Nuclear Medicine Technologists", "soc_code": "29-2033", "category": "Healthcare", "us_employment": 17080, "median_annual_wage": 101370 }, "verdict": "SAFE", "risk_resistance": 67, "contested": false, "near_boundary": true, "dimensions": { "task_resistance": 15, "embodiment": 17, "liability_shield": 13, "trust_premium": 11, "judgment_accountability": 11 }, "reasoning": { "task_resistance": "Drawing a Tc-99m elution from a generator, doing the moly breakthrough assay, quality-controlling the kit prep, then getting an 88-year-old with a hip fracture into position for a three-hour bone scan are all sequential manual tasks with no digital substitute — the 15 rather than 18 reflects that dose calculations, attenuation correction, decay math and camera QC trend logging are already software-driven and shrinking your paperwork.", "embodiment": "You work in a hot lab behind lead-glass syringe shields, palpate for veins, hoist patients onto narrow gantries, chase a stress-test patient down the hall to catch peak uptake, and clean up a spilled I-131 dose with a Geiger counter — an unpredictable physical environment where the only thing at a screen is the acquisition console.", "liability_shield": "Most states license nuclear medicine technologists by name and the NRC's 10 CFR 35 makes the authorized user's written directive your responsibility to execute correctly, so a wrong-patient or wrong-dose administration becomes a reportable medical event with your name in it; the 13 rather than 17 is because the authorized user physician signs the directive and owns the clinical decision.", "trust_premium": "Patients meet you once, for a scan someone else ordered and someone else reads, but that hour includes you explaining why you're injecting radioactive material, coaxing a claustrophobic patient to stay still, and asking a 40-year-old woman directly whether she could be pregnant — rapport that determines whether the study is diagnostic, without any ongoing relationship to protect the role.", "judgment_accountability": "Protocols are largely fixed by the ordering physician and departmental SOPs, but you decide in real time whether a bad injection means reinject or reschedule, whether motion artifact warrants a repeat before the tracer decays, and whether to add delayed views — real calls made alone at 6am with the radiologist not yet in, which is why this sits above procedural work but below the 14+ of people who own the diagnosis." }, "rationale": "The core of this job is physically compounding, calibrating and injecting radiopharmaceuticals, positioning anxious patients on PET/SPECT gantries, and troubleshooting a scanner mid-study — none of which current robotics can do in a busy hospital. AI is already strong at the image-reconstruction, artifact-flagging and dosimetry-calculation layers, and will absorb protocol paperwork and scheduling, but it cannot draw a dose, verify a patient's identity and pregnancy status, or answer to the NRC for a radiation incident. State licensure plus NMTCB/ARRT certification and radiation-safety accountability make the human legally load-bearing.", "outlook": "Employment stays small and roughly flat, with AI absorbing reconstruction and paperwork while techs shift toward therapeutic nuclear medicine and multi-modality PET/CT work.", "what_would_raise_it": { "levers": [ { "dimension": "liability_shield", "change": "State-level licensure closing the remaining gap: roughly a dozen states still do not license nuclear medicine technologists, and the SNMMI-TS-backed CARE/Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy Act (reintroduced repeatedly in Congress) would tie Medicare reimbursement to credentialed personnel. If enacted, or if the remaining unlicensed states adopt licensure, the named-and-liable human becomes federally load-bearing rather than employer policy.", "plausibility": "plausible", "would_add": 3 }, { "dimension": "liability_shield", "change": "An NRC rule change under 10 CFR 35 explicitly naming the authorized-user-delegated technologist as the accountable party for dose administration and written-directive verification when AI dose-calculation software is in the loop — i.e. requiring a human signature on any software-generated dose for Y-90, Lu-177 or I-131 therapy. Theranostics volume growth is already forcing NRC and Agreement State attention to this delegation chain.", "plausibility": "plausible", "would_add": 3 }, { "dimension": "judgment_accountability", "change": "Task-mix shift as theranostics displaces diagnostic-only work: Lu-177 PSMA/DOTATATE and I-131 therapy shift the technologist toward patient-specific dosimetry review, extravasation judgment, contamination response and release-criteria calls under NRC patient-release rules. This is a genuine two-tier job — routine bone scans and MUGAs are the low tier, therapy administration the judgment tier — and the tier ratio is already moving in centers adding radioligand therapy.", "plausibility": "already happening", "would_add": 3 }, { "dimension": "task_resistance", "change": "If AI absorbs reconstruction, artifact flagging, protocol selection and QC logging, the residual day is compounding, injection, difficult-patient positioning and mid-study troubleshooting — the fraction of the shift that is irreducibly manual rises even though total headcount need not. Watch for hot-lab and therapy-suite hours becoming the majority of the role in centers that deploy vendor AI reconstruction (GE, Siemens already shipping).", "plausibility": "already happening", "would_add": 2 }, { "dimension": "embodiment", "change": "Increase in on-site radiopharmacy compounding rather than unit-dose delivery — driven by short-half-life tracers (Ga-68 generators, F-18 in-house cyclotrons, Ac-225) where shipping is not viable. Each shift toward local compounding adds hands-in-a-hot-cell work that no deployed robot handles in a hospital hot lab.", "plausibility": "plausible", "would_add": 2 } ], "ceiling_note": "Trust premium has no plausible route: patients do not choose or pay for a named nuclear medicine technologist, and referral flows through the ordering physician and radiologist. The realistic ceiling is roughly the high 70s, driven almost entirely by licensure/NRC accountability and the theranostics task-mix shift — and the headcount risk is throughput consolidation (fewer techs per scanner as AI speeds reconstruction and scheduling), which this score does not capture." }, "adjudication": { "method": "two independent runs agreed on the verdict", "outcome": "corroborated", "run_totals": [ 67, 69 ], "run_verdicts": [ "SAFE", "SAFE" ] }, "employment_history": { "points": [ { "y": 2017, "emp": 18930, "wage": 75660 }, { "y": 2018, "emp": 18810, "wage": 76820 }, { "y": 2019, "emp": 18110, "wage": 77950 }, { "y": 2020, "emp": 17510, "wage": 79590 }, { "y": 2021, "emp": 17140, "wage": 78760 }, { "y": 2022, "emp": 16910, "wage": 85300 }, { "y": 2023, "emp": 16560, "wage": 92500 }, { "y": 2024, "emp": 16960, "wage": 97020 }, { "y": 2025, "emp": 17080, "wage": 101370 } ], "from": 2017, "to": 2025, "change_pct": -9.8, "comparable_from": 2019, "spans_soc_revision": true }, "pivots": [], "license": "https://cookedindex.com/terms" }