IAEA Activities in Nuclear Medicine Rodolfo Núñez Miller
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1 Activities in Nuclear Medicine Rodolfo Núñez Miller Nuclear Medicine and Diagnostic Imaging section Division of Human Health International Atomic Energy Agency, Vienna (Austria)
2 Outline 1. Who we are 2. How we work 3. Challenges 4. Outreach 5. Technical Cooperation Program
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4 "I am trying to change the widespread perception of the Agency as simply the world s nuclear watchdog because it does not do justice to our extensive activities in other areas, especially in nuclear energy, nuclear applications, and technical cooperation. Yukiya Amano Director General Scientific Forum 2010
5 International Atomic Energy Agency Is an independent intergovernmental, science and technologybased organization, in the United Nations family Serves as the global focal point for nuclear cooperation.
6 It was set up as the world's "Atoms for Peace" organization in 1957 within the United Nations family. The Agency works with its Member States and multiple partners worldwide to promote safe, secure and peaceful use of nuclear technologies. The atomic energy agency could be made responsible for the impounding, storage and protection of the contributed fissionable and other materials. The ingenuity of our scientists will provide special safe conditions under which such a bank of fissionable material can be made essentially immune to surprise seizure. The more important responsibility of this atomic energy agency would be to devise methods whereby this fissionable material would be allocated to serve the peaceful pursuits of mankind. Experts would be mobilized to apply atomic energy to the needs of agriculture, medicine and other peaceful activities. A special purpose would be to provide abundant electrical energy in the power-starved areas of the world. TO PROMOTE SAFE, SECURE AND PEACEFUL NUCLEAR TECHNOLOGIES. "Atoms for Peace" was the title of a speech delivered by U.S. President Dwight D. Eisenhower to the UN General Assembly in New York City on December 8, 1953.
7 162 Member States February, 2014 UN MS 2 Observer States
8 Mandate ARTICLE II: Objectives The Agency shall seek to accelerate and enlarge the contribution of atomic energy to peace, health and prosperity throughout the world.
9 INTERNATIONAL ATOMIC ENERGY AGENCY DIRECTOR GENERAL DEPT. MANAGEMENT DEPT. SAFEGUARDS DEPT. NUCLEAR ENERGY DEPT. NUCLEAR SAFETY DEPT. NUCLEAR SCIENCES and APPLICATIONS DEPT. TECHNICAL COOPERATION
10 What exactly does the do? Science & technology Assists MS in the context of social and economic goals, in planning for and using nuclear science and technology for various peaceful purposes, including the generation of electricity, human health, environment, water, food and agriculture, production of radioisotopes.
11 DIVISION OF HUMAN HEALTH (NAHU) Objective: to enhance the capabilities in Member States to address needs related to the prevention, diagnosis and treatment of health problems through the application of nuclear techniques: Division of Human Health May Mostafa Abdel Wahab Nuclear Medicine and Diagnostic Imaging (NMDI) Applied Radiation Biology and Radiotherapy (ARBR) Dosimetry and Medical Radiation Physics (DMRP) Nutritional and Heath Related Environmental Studies (NAHRES) Diana Paez Eduardo Rosenblatt Ahmed Meghzifene Najat Mokhtar
12 Nuclear Medicine and Diagnostic Imaging Section (NMDI) To enhance capabilities of Member States in Nuclear Medicine & Diagnostic Imaging through enhancing safety and quality of practice
13 Outline 1. Who we are 2. How we work 3. Challenges 4. Outreach 5. Technical Cooperation Program
14 Program tailored to the Needs of our Member States Needs of the MS Country Programme Frameworks (CPFs) s NUclear Medicine DAtaBase (NUMDAB). Maintain updated information regarding the status of nuclear medicine practice around the world. UN reports Global Action Plan for prevention and control of NCDs - WHO Advice from experts worldwide NUMDAB:
15 Outline 1. Who we are 2. How we work 3. Challenges 4. Outreach 5. Technical Cooperation Program
16 Lights and Shadows - Leonida Fremov
17 Lights Medical imaging technology has revolutionized health care over the past 30 years. Enables early diagnosis. Improves patient outcomes. Ranked by the New England Journal of Medicine as one of the top medical developments of the past millennium.
18 Shadows/Challenges Difficult to cope with training needs of the involved multidisciplinary team of professionals (physicians, medical physicists, radiographers, radiochemists). Lack of proper assessment of the impact of introducing novel high cost health technologies and their sustainability. High cost Equipment Increased health cost (If not appropriately used) Equitable access for all patients in all countries, not limited to wealthy individuals and countries Difficulty to comply the international standards in particular in LMIC due to the lack of adequate infrastructure, machinery, quality assurance culture, qualified human resources
19 Outline 1. Who we are 2. Program tailored for the Needs of our Member States 3. Challenges 4. Outreach 5. Technical Cooperation Program
20 Nuclear Medicine and Diagnostic Imaging Building the Road to support MS Mission: To enhance capabilities of Member States in Nuclear Medicine & Diagnostic Imaging through enhancing safety and quality of practice
21 Programmatic Activities: Focused on two Strategic Areas Diagnosis and therapy of noncommunicable diseases (NCDs) using nuclear techniques Educational resources for use of nuclear techniques in human health
22 Enhancing human health Four major mechanism of support Aim: Improve health through MNDI Service Quality Education Research
23 SECTION OF NMDI HOW WE WORK - SERVICE Well established function globally in providing technical guidance in the use of nuclear techniques
24 Section of NMDI How we work - Service Counselling in all stages of implementation
25 On-going efforts by - QUALITY Quality is essential for effective delivery of health care, Goal is to assist our MS to improve the quality of the services they provide, QUANUM project: means to help MS to implement QM systems Training professionals in QM Quality check-list Internal and external audits (EANM-EUMS) Audit missions to MS -advise them on how to improve the quality of practice always considering the safety. More than 20 audits in 17 countries 2013: revision and update
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27 Supporting Research Benefits of CRPs Way of bringing together researchers from both developing and industrialised countries to solve a problem of common interest. Participate in multinational research Improve routine clinical practice Provide answer to a relevant scientific question Our research aims to expand knowledge and apply this knowledge to health service
28 Current CRPs 1. Nuclear Cardiology: Nuclear Cardiology in CHF (Eco MPI synchronism Myocardial SPECT imaging and CTA in CAD 2. Oncology: FDG-PET in Paediatric Lymphoma Radiation Therapy planning based on PET/CT in NSCLC Sentinel lymph node in breast cancer, melanoma, H &N and pelvic cancers 3. Others: Enhancing capacity in early diagnosis and detection of Brest cancer through imaging Evaluation of SPECT-CT, PET-CT and MR in spine pathology (infection- inflammation) FDG - PET/CT in evaluation of MDR TB 4. Planned: Neurodegenerative diseases PET/CT in Solitary Pulmonary Nodule Gated SPECT in planning of ischemia guided PCI in STEMI patients
29 Enhancing Capacity Building Goal: to contribute to capacity building in NMDI through effective education and training programmes based on sound educational principles In order to develop competences in the professionals involved in the practice of NMDI through a lifelong learning process we organize. Seminars and workshops International, regional conferences (RTC, ) Teaching materials Technical and scientific publications Online trainings Education
30 Distance Assisted Training (DATOL) Online for Nuclear Medicine Professionals On-going for the last 15 years, mainly focus on the training of technologists. Three year competency-based online program that has >40 subjects delivered in 16 Modules, ~900 hours of study Two parts Part 1: basic science conventional nuclear medicine, Part 2: SPECT, PET, CT and Cyclotrons Certificate of achievement presented by professional societies, universities or hospitals (National recognition) trained technologists, + 25 countries
31 Cope with the training needs. Develop key competencies. Partnership with SNMMI - Lifelong learning program. 600 nuclear medicine physicians and radiologists in Member States worldwide. Review of CT and PET/CT Cases online
32 Goal: To support the MS with information for strengthening and improving the quality of practices through the use of CME Materials
33 Improving the learning experiences through elearning Development of interactive elearning modules Introduction of new interactive learning materials in the form of robust E-learning modules that enhance the self-directed learning experience. Has the potential to improve efficiency in education and expand educational opportunities in remote areas. A guide for hybrid imaging analysis CT lymph node schematic approach Head and Neck, Thorax, Abdomen and Pelvis
34 Aim is to support physicians in a structured manner
35 Human Health Campus is Mobile
36 Constantly updated New materials developed and selected at regular basis Partnerships with professional organizations
37 Nuclear Medicine and Diagnostic Imaging - Webinars Webinars, unlike webcasts, offer the opportunity of enhanced interaction with the learners facilitated through slide shows where the presenter guides and engages the audience using video and live streaming Monthly webinars in Spanish and English (French coming soon) In cooperation with mayor international organizations (SNMMI and ASNC) Series on: Nuclear cardiology and Computed Tomography Average of 300 participants per webinar worldwide
38 Conference and CME For the first time in an conference, participants were awarded with 24 CME credits by EACNME, as an objective evidence of the professional competency development to keep professionals up-to-date and improve the quality of clinical practice. CME for other educational initiatives Webinars Workshops The EACCME is an institution of the European Union of Medical Specialists (UEMS) IPET, 2007: 350 participants 69 MS IPET 2011: 370 participants 78 MS IMIC 2013: 240 participants, 70 MS IPET 2015: November 2015 Through an agreement between the European Union of Medical Specialists and the American Medical Association, physicians may convert EACCME credits to an equivalent number of AMA PRA Category 1 Credits
39 Scientific or Technical Publications Standard Operating Procedures for PET/CT - A practical approach for use in adult oncology Nuclear Cardiology: Guidance and Recommendations for Implementation in Developing Countries Practical Guidance on Peptide Receptor Radionuclide Therapy (PRRNT) in Neuroendocrine Tumours Appropriate use of FDG-PET for the Management of Cancer Patients Planning a Clinical PET Centre Quality Assurance for PET and PET/CT Systems A Guide to Clinical PET in Oncology: Improving Clinical Management of Cancer Patients Clinical Applications of SPECT/CT: New Hybrid Nuclear Medicine Imaging System The Role of PET/CT in Radiation Treatment Planning for Cancer Patient Treatment
40 Outline 1. Who we are 2. Program tailored for the Needs of our Member States 3. Challenges 4. Outreach 5. Technical Cooperation Program
41 The Technical Cooperation Program Technical Cooperation Program is aimed at technology transfer to MSs Biannual cycle Proposals sent by MS Evaluated by TC and technical divisions Projects in Human Health accounts for more than 25% of the total TC budget Total budget allocated to support NMDI projects worldwide exceeds 3.5 Mil USD/year
42 Technical Cooperation projects: Currently 60 national projects + 15 regional New concepts (16-17 cycle) deadline May 31 st, 2014
43 Focus on - Hybrid Modalities PET/CT and SPECT/CT PET/CT has become the standard of practice in cancer management in the last decade Supporting activities and projects focused on implementing PET/CT: 1/3 of Member States have at least one PET centre and many others are in the planning phase. From 2009 to 2014 : Thirty projects in MS (close to 40%) devoted to implementation of PET-CT From 2009 to 2014 : Seven projects in MS devoted to implementation of SPECT/CT In : First projects devoted to the establishing of a Diagnostic Radiology Centre in Afghanistan and Laos
44 Technical Cooperation activity Training (the last 50 years): Nearly 2300 fellowships/scientific visits awarded months (950 years) Close to 290 Regional/Interregional Training Courses (typically 5 days each) on different topics related to NM in the last 20 years in total 4758 participants
45 Technical Cooperation activity Procurement: Nearly 60 new SPECT cameras provided to MSs in the last 10 years Dose calibrators; Lead-shielded hoods; synthesis modules and treadmills among others. Generators and cold kits (LDCs)
46 Technical Cooperation Human Health Campus QUANUM CRPs Human Health DAT Online Trainings NUMDAB Publications Webinars
47 Thank you
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