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Malta Upgrades Radiotherapy Services, Following IAEA Support


With the CT machine physically installed at the Centre, in March and April 2021, SAMOC staff began the process of setting protocols and calibrating the system according to OEM specifications, to ensure a fully-functional, patient-ready scanner. (Photo: SAMOC)

Cancer patients in Malta now have access to improved cancer treatment thanks to a new computed tomography (CT) scanner installed late last year at the country’s Sir Anthony Mamo Oncology Centre (SAMOC). Several hundred have already undergone therapy planning on the scanner, which will replace an ageing, 10-year-old machine. It was installed following years of IAEA support and guidance and put into operation following IAEA-organized virtual and on-site training on how to operate the new equipment safely and effectively.

“So far, we have planned the therapy of approximately 820 patients with the new scanner, and our team has gained valuable experience in advanced diagnostic imaging techniques, made possible by the new scanner, across the entire human body,” said Dorothy Anne Aquilina, the Medical Physics Coordinator of SAMOC.

The new machine is expected to improve image quality and treatment outcomes for the around 70 per cent of the Centre’s 1200 annual cancer patients who require radiotherapy. It will also broaden access to modern, safe, effective and precise treatment and diagnosis.

Improved images, enhanced treatment

Computed tomography scans are one of the most important advances in medical imaging over the past 50 years. They extend the clinical benefits of traditional X-ray imaging to produce detailed pictures of internal organs, allowing healthcare professionals to locate tumours and blood clots, to detect internal injuries, and to better plan therapy and procedures, among other applications.

“CT scanners are indispensable in modern medicine, providing 3D, cross-sectional views of the human body including soft and hard tissues, normal organs and various pathologies,” said Daniel Berger, a Radiotherapy Medical Physicist at the IAEA.  “In oncology, CT scanners are essential equipment in the diagnosis and staging of malignancy, but also in facilitating radiotherapy treatment planning.”

Malta, with a population of 500,000, has almost 2000 new cancer patients annually, increasing 5 per cent per year. Breast, colon and prostate cancer are the most common.

The Oncology Centre is home to Malta’s only CT scanner. While the old machine has enabled the Centre to apply a number of clinically-valuable imaging techniques, newer technologies offer improved quality and better positional accuracy, resulting in lower radiation doses needed from medical imaging, improving patient outcomes and reducing risks.

One advanced technique now possible thanks to the use of the new scanner is stereotactic radiotherapy, which allows very high doses of radiotherapy to be delivered to small target sites, with extremely low doses to surrounding tissues. “This can be beneficial in two situations,” said Kamal Akbarov, an IAEA Radiation Oncologist. “First, a standard dose can be delivered with a lower risk of long-term side effects: this is of particular benefit in the treatment of children, who have a long life ahead of them. And second, patients with very resistant tumours may be treated with higher radiotherapy doses, without any additional side effects.”

Training in stereotactic radiotherapy is currently under way at the Centre, and expert missions will be organized through the IAEA’s technical cooperation programme, with plans to introduce brachytherapy to SAMOC in 2022 and 2023.

SAMOC staff are executing a long list of acceptance tests, designed to assess the imaging performance, mechanical accuracy and safety of the scanner. (Photo: SAMOC)

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