Nuclear medicine has a key role to play and should be a major element in healthcare systems, but substantial costs and a lack of skilled practitioners often pose a challenge to ensure wide application in countries, particularly in the developing world. Private-public partnerships and the integration of equipment purchase and maintenance in broader health plans are crucial to mobilize resources and ensure the sustainability of these services. The IAEA is in a unique position to help countries build partnerships and use these technologies safely and securely. These were the main conclusions of this year’s Scientific Forum.
In two days, several high-level speakers, including King Letsie III of Lesotho, the ministers from Cameroon and Russia and over 40 dignitaries and experts, joined IAEA Director General Yukiya Amano to discuss the role of nuclear techniques in the diagnosis, treatment and prevention of diseases, especially the major killers of our time: non-communicable diseases (NCDs).
This article summarizes the takeaways from the five thematic sessions. Highlights from the opening session can be found here, and individual presentations here.
In session 1, Preventing Disease through Better Nutrition, speakers looked at the crucial role of diet in the prevention of diseases. “Investing in nutrition is a mandate for the future. If we fail to do that we will compromise human and social development for at least one generation,” said Ricardo Uauy, Professor at the Institute of Nutrition at the University of Chile. Presentations focused on the use of isotopic techniques to look at body composition and metabolic activities to support actions to tackle conditions such as undernutrition and obesity.
In session 2, Looking beyond the Visible: New Frontiers in Diagnostic Techniques, the key role of nuclear medicine for early-stage disease detection was highlighted, particularly as countries look to address the growing burden of non-communicable diseases such as cancer. The cost of PET scans is only about 1.5% of total cancer care, and such precise technologies are crucial for best treatment outcome, offering physicians the best chance to manage their patients correctly, said Homer Macapinlac, Distinguished Professor of the University of Texas MD Anderson Cancer Center. The crucial part these technologies play in helping to diagnose infectious and neurological diseases was also discussed.
The various challenges countries face in ensuring the safe use of nuclear medicine was examined in session 3, Addressing Implementation Challenges in Countries. A major topic was health expenditures and budgets, and discussions centred on ways to help governments mobilize resources effectively, such as through the support of technology transfer and also through training to build expertise. The audience had the opportunity to enjoy an interactive session with Neerja Bhatla, Professor from the All India Institute of Medical Sciences, who demonstrated the cancer staging app – a tool to facilitate optimal patient management in a practical and user-friendly way.
“Approximately almost 50% of cancer patients worldwide will need to receive radiotherapy treatment,” said Julie Wetter of the Groote Schuur Hospital and University of Cape Town. Session 4, Radiotherapy: Saving and Improving Quality of Life of Cancer Patients through New Approaches, looked at the future of this life-saving treatment option, including personalized treatment and the latest technological innovations to improve patient care, such as proton and carbon ion beam therapy. In addition, Professor Mack Roach from the University of California in San Francisco emphasized that an understanding of the role of these technologies requires robust data from well-designed clinical research studies.
It is estimated that 10 million people undergo diagnostic and therapeutic procedures involving medical radiation every day, and the need to ensure best treatment outcome for patients and the protection of medical personnel was discussed in session 5, Ensuring Quality and Safety. Issues such as the need for peer reviews, clinical audits and quantification of performance were explored. The session also reviewed requirements for quality and safety in applying nuclear medicine, and the challenges that countries may face in implementing these, as well as examples of successful IAEA projects to assist in this respect
The Forum concluded with a session on the future of nuclear techniques in medicine. The audience heard differing perspectives, from both physicians and policy makers.
Mr Amano, who confirmed that health will remain a priority in his forthcoming term, emphasized that the IAEA’s key role in support of health, particularly in fighting NCDs, needs to be better recognized. He mentioned that, in light of budget constraints that many countries face, private-public partnership could provide a way to increase the availability of equipment.. The importance of government support and the recognition of the vital role of nuclear medicine and radiotherapy in health care, especially cancer, was particularly highlighted by the panel during the closing discussion. Policy- and lawmakers were urged to place human health at the top of their list of priorities.
Referring to his own experience of visiting hospitals around the world, Mr Amano stressed that actions that lead to more equipment and training were required at the ground level, and more political support to ensure the sustainability of technical assistance projects are needed at the national level. Panellists highlighted the importance of partnerships between governments, non-governmental organizations, professional societies, international organizations and the private sector in order to fund equipment, gain access to nuclear medicine and radiotherapy procedures, and ensure a qualified workforce of health professionals in this area. All this must be done within a quality assurance framework to ensure safety and accurate delivery of therapy.
