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Artificial intelligence (AI) is coming into the field of nuclear medicine, and it is likely here to stay. As a society, EANM can and must play a central role in the use of AI in nuclear medicine. In this position paper, the EANM explains the preconditions for the implementation of AI in NM and takes position. [ABSTRACT FROM AUTHOR]

Executive Summary: The EC Directive 2013/59/Euratom states in article 56 that exposures of target volumes in nuclear medicine treatments shall be individually planned and their delivery appropriately verified. The Directive also mentions that medical physics experts should always be appropriately involved in those treatments. Although it is obvious that, in nuclear medicine practice, every nuclear medicine physician and physicist should follow national rules and legislation, the EANM considered it necessary to provide guidance on how to interpret the Directive statements for nuclear medicine treatments. For this purpose, the EANM proposes to distinguish three levels in compliance to the optimization principle in the directive, inspired by the indication of levels in prescribing, recording and reporting of absorbed doses after radiotherapy defined by the International Commission on Radiation Units and Measurements (ICRU): Most nuclear medicine treatments currently applied in Europe are standardized. The minimum requirement for those treatments is ICRU level 1 ("activity-based prescription and patient-averaged dosimetry"), which is defined by administering the activity within 10% of the intended activity, typically according to the package insert or to the respective EANM guidelines, followed by verification of the therapy delivery, if applicable. Non-standardized treatments are essentially those in developmental phase or approved radiopharmaceuticals being used off-label with significantly (> 25% more than in the label) higher activities. These treatments should comply with ICRU level 2 ("activity-based prescription and patient-specific dosimetry"), which implies recording and reporting of the absorbed dose to organs at risk and optionally the absorbed dose to treatment regions. The EANM strongly encourages to foster research that eventually leads to treatment planning according to ICRU level 3 ("dosimetry-guided patient-specific prescription and verification"), whenever possible and relevant. Evidence for superiority of therapy prescription on basis of patient-specific dosimetry has not been obtained. However, the authors believe that a better understanding of therapy dosimetry, i.e. how much and where the energy is delivered, and radiobiology, i.e. radiation-related processes in tissues, are keys to the long-term improvement of our treatments. [ABSTRACT FROM AUTHOR]

The authors comment on the position paper entitled "White paper of the European Association of the Nuclear Medicine (EANM) and the European Society of Radiology (ESR) on multimodality imaging" published in the August 2007 issue. They examine the position paper's justifications for a new definition of the contours of nuclear medicine in Europe. They also consider the white paper's propositions of the re-definition of nuclear medicine, which they believe is unnecessary.

Aim: We performed a systematic survey to assess the existing gaps in Europe in multidisciplinary education for integration of radioligand therapy (RLT) into cancer care and to obtain detailed information on the current limitations and key contents relevant. Methods: A high-quality questionnaire, with emphasis on survey scales, formulation, and validity of the different items, was designed. An expert validation process was undertaken. The survey was circulated among medical specialties involved in cancer treatment, universities, and nursing organizations. Questionnaires (156) were distributed, and 95 responses received. Results: Sevety-eight percent of medical societies indicated that training in RLT was very important and 12% important. Eighty-eight percent indicated that their specialty training program included RLT. Twenty-six percent were satisfied with the existing structure of training in RLTs. Ninety-four percent indicated that the existing training is based on theory and hands-on experience. Main identified limitations were lack of centers ready to train and of personnel available for teaching. Sixty-five percent indicated that national programs could be expanded. Fifty percent of consulted universities indicated partial or scarce presence of RLT contents in their teaching programs. In 26% of the cases, the students do not have the chance to visit a RLT facility. A large majority of the universities are interested in further expansion of RLT contents in their curriculums. Nursing organizations almost never (44.4%) or occasionally (33.3%) include RLT contents in the education of nurses and technologists. Hands-on experience is almost never (38%) and sometimes (38%) offered. However, 67% of centers indicated high interest in expanding RLT contents. Conclusion: Centers involved recognize the importance of the training and indicate a need for inclusion of additional clinical content, imaging analysis, and interpretation as well as extended hands-on training. A concerted effort to adapt current programs and a shift towards multidisciplinary training programs is necessary for proper education in RLT in Europe. [ABSTRACT FROM AUTHOR]

Purpose: Coronavirus disease-19 (COVID-19) pandemic is challenging the availability of hospital resources worldwide. The Young Group of the Italian Association of Nuclear Medicine (AIMN) developed the first international survey to evaluate the impact of COVID-19 in nuclear medicine (NM). The aim of this study was to perform a preliminary report of the ongoing survey. Methods: A questionnaire of thirty questions was prepared for all NM professionals addressing three main issues: (1) new scheduling praxes for NM diagnostic and therapeutic procedures, (2) assistance of patients with diagnosed or suspected COVID-19, and (3) prevention of COVID-19 spreading in the departments. An invitation to the survey was sent to the corresponding authors of NM scientific papers indexed in SCOPUS in 2019. Personal data were analysed per individual responder. Organisation data were evaluated per single department. Results: Two-hundred and ninety-six individual responders from 220 departments were evaluated. Most of the responders were from Europe (199/296, 67%). Approximately, all departments already changed their scheduling praxes due to the pandemic (213/220, 97%). In most departments, scheduled diagnostic and therapeutic procedures were allowed but quantitatively reduced (112/220, 51%). A significant reduction of diagnostic and therapeutic procedures (more than 20%) affected 198/220 (90%) and 158/220 (72%) departments, respectively. Incidental COVID-19 signs in NM exams occurred in 106/220 departments (48%). Few departments were closed or shifted to assist patients with COVID-19 (36/220, 16%). Most of the responders thought that pandemic would not permanently change the work of NM departments in the future (189/296, 64%). Conclusions: According to this preliminary report of the first international survey, COVID-19 heavily impacted NM departments and professionals. New praxes for NM procedures, assistance, and prevention of COVID-19 have been applied during the pandemic. [ABSTRACT FROM AUTHOR]

We performed a bibliometric search covering a 1-year period to evaluate the number and the scientific “weight” of nuclear medicine papers published from European as compared with other countries. The scientific impact of our discipline was evaluated according to the impact factor of each publication, and we also aimed to identify those countries and topics that are making the principal contributions to the development of our discipline. To this end, a search on MEDLINE (PubMed) was run to find all peer-reviewed articles published between April 2002 and May 2003, using isotope definitions as search terms. A total of 3,292 publications were identified. Of these, 650 were of no nuclear medicine interest, 229 were reviews and 82 had no country specified. In absolute numbers, Europe leads research in nuclear medicine (939 papers, 38.9%) followed by the USA (608 papers, 25.2%). Among European countries, Germany is the nation that is currently making the greatest contribution to the scientific production of nuclear medicine in Europe. Articles concerning the use of nuclear medicine in oncology account for more than one-quarter of all published nuclear medicine papers. [ABSTRACT FROM AUTHOR]

A personal narrative is presented which explores the authors' experience as members of the Fellowship Committee of European Board of Nuclear Medicine tasked with implementing remote examination during the COVID-19 pandemic.

The article offers news about the European Association of Nuclear Medicine (EANM). The EANM Springer Prizes 2008 have been awarded to three papers, including "Myocardial perfusion scintigraphy: the evidence." The 21st annual congress of the EANM was held at the Munich International Congress Center in Germany on October 11-15, 2008. The 4th International Meeting of the Hellenic Society of Nuclear Medicine was held on November 7-9, 2008 in Greece.

The Annual Congress of the European Association of Nuclear Medicine took place in Copenhagen on October 13–17, 2007. The event is the major scientific and professional effort in the field of nuclear medicine in Europe. The most important developments in the fields of instrumentation, radionuclide production, radiochemistry, radiotherapy, as well as the clinical imaging fields of neurology, cardiology, oncology, and general sciences were reported. This paper emphasizes the major findings and trends at this important gathering. This review is, however, only a brief summary of the large amount of data discussed. [ABSTRACT FROM AUTHOR]

The article offers news briefs related to medicine in Europe. The European Association of Nuclear Medicine (EANM) Spinger prizes 2007 Awardees include D. J. Kwekkeboom, Gabriele Pöpperl and Maya Diaminovich. The EANM 20th annual congress in Denmark from October 13-17, 2007 was attended by 4,567 members and 93 exhibitors. A partnership made between EANM and European Cooperation in Scientific and Technical research (COST) to promote nuclear medicine in the country.

This paper provides an overview of the curricula of undergraduate training in nuclear medicine in 77 European medical departments and, for comparison, in nine departments outside Europe. The data show a high level of variation in the number of hours (0–62) devoted to nuclear medicine in the different departments. In most cases this teaching is integrated into one of the radiology or clinical modules, and in some cases also into training in clinical physiology. The paper discusses the differences in the particular approaches to nuclear medicine teaching. [ABSTRACT FROM AUTHOR]

Improvements in software and hardware have enabled the integration of dual imaging modalities into hybrid systems, which allow combined acquisition of the different data sets. Integration of positron emission tomography (PET) and computed tomography (CT) scanners into PET/CT systems has shown improvement in the management of patients with cancer over stand-alone acquired CT and PET images. Hybrid cardiac imaging either with single photon emission computed tomography (SPECT) or PET combined with CT depicts cardiac and vascular anatomical abnormalities and their physiologic consequences in a single setting and appears to offer superior information compared with either stand-alone or side-by-side interpretation of the data sets in patients with known or suspected coronary artery disease (CAD). Hybrid systems are also advantageous for the patient because of the single short dual data acquisition. However, hybrid cardiac imaging has also generated controversy with regard to which patients should undergo such integrated examination for clinical effectiveness and minimization of costs and radiation dose, and if software-based fusion of images obtained separately would be a useful alternative. The European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC) in this paper want to present a position statement of the institutions on the current roles of SPECT/CT and PET/CT hybrid cardiac imaging in patients with known or suspected CAD. [ABSTRACT FROM AUTHOR]

The article reflects on the European way of communicating science. It is said that publication of the potential benefits versus risks and costs posed by novel medical technologies is nowadays necessary across Europe. It is also said that with escalating costs, funding sources play a role in what is investigated. At the same time, authors may foresee direct or indirect financial benefit from their research.

Multimodality imaging represents an area of rapid growth with important professional implication for both nuclear medicine physicians and radiologists throughout Europe. As a preliminary step for future action aimed at improving the quality and accessibility of PET/SPECT/CT multimodality imaging practice in Europe, the European Association of Nuclear Medicine (EANM) and the European Society of Radiology (ESR) performed a survey among the individual membership of both societies to obtain information on the status of multimodality imaging in their facilities and their future visions on training for combined modalities. A questionnaire was forwarded to all individual members of the EANM and ESR. The main subject matter of the questionnaire related to: (1) study performance, current procedures, current equipment including its supervisory personnel at respondents’ individual facilities and (2) vision of future practice, performance and the potential for combined interdisciplinary viewing and training for future professionals. The reporting and the billing procedures of multimodality imaging studies are very heterogeneous in European countries. The majority of the members of both societies believe that the proportion of PET/CT conducted as a full diagnostic CT with contrast enhancement will increase over time. As expected, 18F-FDG is the most commonly used PET tracer for clinical applications. The large majority of respondents were in favour of an interdisciplinary training programme being developed on a European level together by the EANM and the ESR and the respective sections of the European Union of Medical Specialists. The results of this survey show that there is wide heterogeneity in the current practice of multimodality imaging in Europe. This situation may limit the full potential and integration of multimodality imaging within the clinical arena. There is a strong desire within both specialties for the development of interdisciplinary training to address some of these issues. [ABSTRACT FROM AUTHOR]

The article presents the developments in the European Association of Nuclear Medicine (EANM) and news on related fields. The closing ceremony of the annual meeting of EANM in Istanbul on October 19, 2005 involved the handing over of the EANM banner from Hatice Durak, Istanbul congress president 2005, to Georgios Limouris, Athens congress president 2006 that is marked with humor from both parties. Other news include EANM Springer Prizes 2005 Awardees and Kuwait Foundation for the Advancement of Sciences (KFAS), an Arabian Nobel Prize awardee professor Osama Sabri.

The article announces several awards given by the European Association of Nuclear Medicine (EANM) for 2013 to several published papers including "PET imaging with a [68-Ga]gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions" as the Best Clinical Paper.

The authors reflect on the collaborative use of positron emission tomography/computed tomography (PET/CT) conducting diagnostic examinations in children in Europe. They argue that the combined use of PET/CT improves diagnostic accuracy compared with PET alone or side by side comparison of PET and CT images basing on several papers published. They cite two studies proving the efficacy of PET/CT for determining suspected or known malignancies in children.

Presents news concerning nuclear medicine in Europe as of December 2002. Role of nuclear medicine in clinical decision making in cardiology; Conference on nuclear medicine and biology; Seminar of the European School of Nuclear Medicine.

The article focuses on the continuing medical education (CME) and continuing professional development (CPD) to ensure the competence of physicians and fitness to practice in Europe Union (EU) countries. It looks at the interplay among society, economy and technology and the rapid migration of patients and doctors within the countries which are reshaping medical practice. Moreover, the EU of Medical Specialists (UEMS) has focused on CME-CPD as cornerstone of quality assurance in medical care.

The article offers news briefs related to nuclear medicine in Europe. Gerhard W. Goerres, Gabriela Kramer-Marek and Yi Li were awardees of the 2009 European Association of Nuclear Medicine (EANM) Springer Prizes. The European School of Nuclear Medicine (ESNM) seminar on radiopharmacy and nuclear cardiology which was held in Opatija, Croatia was participated about seven countries. Ilse Zolle, pharmacologist at Austria-based Department of Nuclear Medicine, died on April 8, 2009.

The article focuses on the efforts of various medical organizations in advancing the growth of multimodality imaging in Europe. As the world of medicine progresses, imaging with single photon emission computed tomography (SPECT) or positron emission tomography (PET) or other means experiences very rapid growth. Many medical organizations discussed ways to advance multimodality imaging in medicine and acknowledged that nuclear medicine and clinical radiology are two separate medical specialties.

Single-center experiences have shown that myocardial meta-iodobenzylguanidine ( mIBG) uptake has prognostic value in heart failure (HF) patients. To verify these observations using a rigorous clinical trial methodology, a retrospective review and prospective quantitative reanalysis was performed on a series of cardiac 123I- mIBG scans acquired during a 10-year period at six centers in Europe. 123I- mIBG scans obtained on 290 HF patients [(262 with left ventricular ejection fraction (LVEF) < 50%)] from 1993 to 2002 were reanalyzed using a standardized methodology to determine the heart-to-mediastinum ratio (H/M) on delayed planar images. All image results were verified by three independent reviewers. Major cardiac events [MCEs; cardiac death, cardiac transplant, potentially fatal arrhythmia (including implantable cardioverter-defibrillator discharge)] during 24-month follow-up were confirmed by an adjudication committee. MCEs occurred in 67 patients (26%): mean H/M ratio was 1.51 ± 0.30 for the MCE group and 1.97 ± 0.54 for the non-MCE group ( p < 0.001). Two-year event-free survival using an optimum H/M ratio threshold of 1.75 was 62% for H/M ratio less than 1.75, 95% for H/M ratio greater than or equal to 1.75 ( p < 0.0001). Logistic regression showed H/M ratio and LVEF as the only significant predictors of MCE. Using the lower and upper H/M quartiles of 1.45 and 2.17 as high- and very low-risk thresholds, 2-year event-free survival rates were 52% and 98%, respectively. Among patients with LVEF ≤ 35% and H/M ≥ 1.75 ( n = 73), there were nine MCEs because of progressive HF and only one because of an arrhythmia. Application of a clinical trial methodology via the retrospective reanalysis of 123I- mIBG images confirms the previously reported prognostic value of this method in HF patients, including potential identification of a quantitative threshold for low risk for cardiac mortality and potentially fatal ventricular arrhythmias. [ABSTRACT FROM AUTHOR]

The article provides information on the content of the European Board Certificate in Nuclear Medicine (NM) 2008 in Europe. The primary purpose of the said certificate is to prove that the knowledge and skills of a candidate in NM fulfill the European standards. Information regarding the requirements on how to obtain Certificate of Fellowship, venue, types and languages used in the examination, application form, registration fee, refund policy and important dates are also presented.

The article reports that the European Board Certificate of Nuclear Medicine (EBNM) proves that the candidate's knowledge and ability in Nuclear Medicine satisfy European standards. To be awarded a Certificate of Fellowship of the EBNM it is necessary to fulfill certain prerequisites. Candidates may enroll for and take the written exam of multiple-choice questions after they have completed the training requirements necessary for their specialist qualification by their national body. The multiple-choice questions and the oral examination have to be taken in English. In case of difficulties with oral expression in this language, candidates are allowed to ask for the presence, at the oral examination, of an additional examiner familiar with the candidate's language.

Presents a letter to the editor of the "European Journal of Nuclear Medicine and Molecular Imaging," commenting on the paper by Piotr Lass and Justyna Scheffler on the undergraduate teaching of nuclear medicine in European universities.

Focuses on the controversy over the need for more nuclear cardiologists in Europe in 2003. Issues raised in the controversy; Usage rate of myocardial perfusion imaging in Europe; Comparison of European myocardial usage with that of the U.S. and Great Britain; Advantages associated with the British system of assessing health-care needs; Requirements for a nuclear cardiologist.

The article offers information on the 21st meeting of the Hellenic Society of Nuclear Medicine in Thessaloniki, Greece and the May Day celebration in Vienna, Austria is presented. The Hellenic Society meeting is noted to have discussed the role of nuclear medicine in the treatment of prostate cancer and thyroid cancer. While, the May Day celebration is a traditional day off in Europe with some nuclear physicians taking the Fellows of the European Board of Nuclear Medicine (FEBNM) examination.

Editorial. Features the "European Journal of Nuclear Medicine." Contents of the periodical; History of the periodical.

Profiles Peter Ell, editor of the European Journal of Nuclear Medicine and Molecular Imaging. Career history; Achievements; Job responsibilities.

This paper updates the information on the prevalence of the disorders induced by iodine deficiency (IDD) in Europe. Thirty-two European countries were still affected by mild to severe iodine deficiency in the late 1990s. The most severely affected countries were in Eastern Europe, including Central Asia, but Western Europe was also still affected. National surveys recently conducted in 11 of these countries show that, with the exception of the Netherlands, none has yet reached a state of iodine sufficiency, though very significant improvement in the situation has been evidenced in many of them, e.g. Poland, Bulgaria and Macedonia. The consequences of persisting iodine deficiency are goitre, hyperavidity of the thyroid for iodide (which increases the risk of thyroid irradiation in the event of a nuclear accident) and subclinical hypothyroidism during pregnancy and early infant (with a concomitant risk of minor brain damage and irreversible impairment of the neuropsychointellectual development of offspring). Access to iodised salt at the household level in European countries affected by IDD increased from 5%-10% in 1990 to 28% in 1999. This constitutes encouraging progress. However, in terms of access of iodine-deficient countries to iodised salt, Europe remains the worst region in the world, as shown by the fact that the mean figure worldwide in 1999 was 68%. In Latin America it even reached 90%. Salt iodisation has to be further implemented in Europe. Until that goal is achieved, iodine supplementation in those groups most sensitive to the effects of iodine deficiency (pregnant and lactating women and young infants) will have to be considered in the most severely affected areas. [ABSTRACT FROM AUTHOR]

Comments on the training of nuclear medicine technologists in European countries. Curriculum of nuclear medicine training of technologists; Total curriculum of hours; Harnomization of training.

In this article, the author presents his views on whether standardisation and harmonisation increases the credibility of nuclear medicine procedures. The author says that procedural guidelines published by professional associations in this field or the local societies in European countries are an important milestone to provide a basic framework. Also, standardisation and harmonisation will increase the credibility of nuclear medicine procedures.

Presents the 2001 multiple choice questionnaire of the European Board of Nuclear Medicine. Field codes of multiple choice questions; Presentation of sample questions; Publication of further examples from previous year.

Presents the 2002 Certificate of Fellowship of the European Board of Nuclear Medicine (EBNM). Requirements of the Certificate of Fellowship awardee; Relevant information for applicant; Presentation of the application form.

The author reflects on the guideline of the European Society of Nuclear Medicine (EANM) for Investigational Medicinal Product Dossier (IMPD) preparation. He mentions the essence of radiopharmaceuticals in nuclear medicine and their application in therapy and diagnosis. An overview of their legislation in the continent is also presented.

Explains that the European Board Certificate in Nuclear Medicine proves that the candidate's knowledge and ability in Nuclear Medicine satisfy European standards. Venue of the examination on September 4-8, 2004; Oral and written examinations; Language; Applications to be sent with curriculum vitae including detailed listing of all institutions where training took place; Registration fee; Refund policy; Important dates.

Presents information on the Certificate of Fellowship of the European Board of Nuclear Medicine in 2004. Venue; Examination; Registration fee; Contact information.