Abstract
Sustainable nuclear medicine practice tends to focus on "greener" practices. A holistic framework requires a multi-dimensional approach that considers the entire nuclear medicine pipeline beyond "green" initiatives and through a global lens. There is a paucity of nuclear medicine sustainability literature although documented sustainability strategies in radiology provide transferability. For nuclear medicine practice, there are a number of interconnected sustainability domains. While AI may provide solutions for improved sustainability through workflow efficiencies, cost reductions, and decreased carbon footprint, there are a number of other easy to implement strategies for waste reduction, energy consumption reduction, and improved efficiencies. Carbon offsets represent a potential strategy to create carbon neutrality of nuclear medicine services and represent a commitment to planetary health and global "net zero by 2030" sustainability targets.