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The diagnosis and treatment of patients with cancer requires access to imaging to ensure accurate management decisions and optimal outcomes. Our global assessment of imaging and nuclear medicine resources identified substantial shortages in equipment and workforce, particularly in low-income and middle-income countries (LMICs). A microsimulation model of 11 cancers showed that the scale-up of imaging would avert 3·2% (2·46 million) of all 76·0 million deaths caused by the modelled cancers worldwide between 2020 and 2030, saving 54·92 million life-years. A comprehensive scale-up of imaging, treatment, and care quality would avert 9·55 million (12·5%) of all cancer deaths caused by the modelled cancers worldwide, saving 232·30 million life-years. Scale-up of imaging would cost US$6·84 billion in 2020-30 but yield lifetime productivity gains of $1·23 trillion worldwide, a net return of $179·19 per $1 invested. Combining the scale-up of imaging, treatment, and quality of care would provide a net benefit of $2·66 trillion and a net return of $12·43 per $1 invested. With the use of a conservative approach regarding human capital, the scale-up of imaging alone would provide a net benefit of $209·46 billion and net return of $31·61 per $1 invested. With comprehensive scale-up, the worldwide net benefit using the human capital approach is $340·42 billion and the return per dollar invested is $2·46. These improved health and economic outcomes hold true across all geographical regions. We propose actions and investments that would enhance access to imaging equipment, workforce capacity, digital technology, radiopharmaceuticals, and research and training programmes in LMICs, to produce massive health and economic benefits and reduce the burden of cancer globally., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Until recently, it has been challenging to engage Wall Street and large pharmaceutical companies in radiopharmaceutical opportunities. The modest economic prospects of most diagnostic radiopharmaceuticals have not attracted keen interest from the broader business community, despite the rapid advancement of diagnostic imaging capabilities and their increasingly crucial role in the therapeutic process. Similarly, compelling science supporting select radiopharmaceutical therapies in oncology has been overshadowed by the unique challenges posed by this class of drugs and historical commercial failures that serve as sobering reminders of risk. Fortunately, a few notable successes in the targeted radioligand therapeutic space are changing this dynamic, fueling a new flow of investor capital into these technologies and inciting increased merger and acquisition activity that has yielded significant value creation for investors. If the nuclear medicine industry is able to continue to effectively manage historical challenges, then there is significant opportunity for a new and promising wave of radioligand therapies to significantly change the oncology treatment paradigm and elevate the profile of the entire nuclear medicine sector., (© 2019 by the Society of Nuclear Medicine and Molecular Imaging.)

Objective: To investigate the correlation between the utilization of nuclear medicine diagnostic procedures and the mortality of women with breast cancer., Subjects and Methods: Based on the National Health Insurance Research Database (NHIRD), we studied female breast cancer patients in 2012 who underwent whole-body bone scan, lymphoscintigraphy, or fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) for possibly managing breast cancer metastases. The mortality of breast cancer was then followed up in 2017. Multiple linear regression analysis was applied to analyze the correlation between the use of any of these three nuclear medicine procedures and the mortality of breast cancer., Results: For patients with early-stage breast cancer, single lymphoscintigraphy was the most frequently performed nuclear medicine procedure, accounting for 36.4% of all three nuclear medicine procedures. For patients with late-stage breast cancer, single whole-body bone scan was the most frequently performed nuclear medicine procedure, accounting for 67.2% of all three nuclear medicine procedures. Mortality of breast cancer significantly increased with the prevalence of late-stage breast cancer (b=2.87, P=0.001) and significantly decreased in cases in which whole-body bone scan was used (b=-4.28, P=0.003)., Conclusion: The mortality of women with late-stage breast cancer was negatively related to the utilization of whole-body bone scan but not to the utilization of lymphoscintigraphy or the 18 F-FDG PET/CT scan. In women with early-stage breast cancer, no significant correlation existed between breast cancer mortality and the utilization of the above three nuclear medicine procedures.

The outcomes of a 2011 Medical Imaging & Technology Alliance (MITA) conference helped shape considerations about what might be the most appropriate pathways for the regulatory and payment considerations of new PET radiopharmaceuticals. As follow-up to that conference, MITA convened a second conference of stakeholders to advise payers on what might be acceptable endpoints for clinical trials to support the coverage of novel PET agents. The conference involved experts on imaging and clinical research, providers of PET services, as well as representatives of interested medical societies, the PET industry, and the regulatory and payer communities. The principal outcome of their deliberations was that it was unrealistic to expect trials of new PET radiopharmaceuticals to directly demonstrate a health benefit. Rather, intermediate outcomes, such as a positive change in patient management, would be more efficient and appropriate., (Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

The International Atomic Energy Agency's technical cooperation (TC) programme helps Member States in the developing world with limited infrastructure and human resource capacity to harness the potential of nuclear technologies in meeting socioeconomic development challenges. As a part of its human health TC initiatives, the Agency, through the TC mechanism, has the unique role of promoting nuclear medicine applications of fellowships, scientific visits, and training courses, via technology procurement, and in the past decade has contributed nearly $54 million through 180 projects in supporting technology procurement and human resource capacity development among Member States from the developing world (low- and middle-income countries). There has been a growing demand in nuclear medicine TC, particularly in Africa and ex-Soviet Union States where limited infrastructure presently exists, based on cancer and cardiovascular disease management projects. African Member States received the greatest allocation of TC funds in the past 10 years dedicated to building new or rehabilitating obsolete nuclear medicine infrastructure through procurement support of single-photon emission computed tomography machines. Agency support in Asia and Latin America has emphasized human resource capacity building, as Member States in these regions have already acquired positron emission tomography and hybrid modalities (positron emission tomography/computed tomography and single-photon emission computed tomography/computed tomography) in their health systems. The strengthening of national nuclear medicine capacities among Member States across different regions has enabled stronger regional cooperation among developing countries who through the Agency's support and within the framework of regional cooperative agreements are sharing expertise and fostering the sustainability and productive integration of nuclear medicine within their health systems., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Purpose: To provide a guideline curriculum covering theoretical and practical aspects of education and training for Medical Physicists in Nuclear Medicine within Europe., Material and Methods: National training programmes of Medical Physics, Radiation Physics and Nuclear Medicine physics from a range of European countries and from North America were reviewed and elements of best practice identified. An independent panel of experts was used to achieve consensus regarding the content of the curriculum., Results: Guidelines have been developed for the specialist theoretical knowledge and practical experience required to practice as a Medical Physicist in Nuclear Medicine in Europe. It is assumed that the precondition for the beginning of the training is a good initial degree in Medical Physics at master level (or equivalent). The Learning Outcomes are categorised using the Knowledge, Skill and Competence approach along the lines recommended by the European Qualifications Framework. The minimum level expected in each topic in the theoretical knowledge and practical experience sections is intended to bring trainees up to the requirements expected of a Medical Physicist entering the field of Nuclear Medicine., Conclusions: This new joint EANM/EFOMP European guideline curriculum is a further step to harmonise specialist training of Medical Physicists in Nuclear Medicine within Europe. It provides a common framework for national Medical Physics societies to develop or benchmark their own curricula. The responsibility for the implementation and accreditation of these standards and guidelines resides within national training and regulatory bodies., (Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.)

There has been a significant increase in cardiac radionuclide imaging over the past decade, leading to a corresponding increase in scrutiny from Federal and private health plans questioning the necessity of these tests. In response to efforts by third-party payers to limit all types of cardiovascular imaging studies, the American College of Cardiology Foundation, in conjunction with other professional societies, developed appropriate use criteria. The goal of this article is to explain how the criteria were created and define the 3 categories of indications: appropriate, inappropriate, and uncertain. Tips for using appropriate use criteria and tables, including a definition of several key terms technologists should be familiar with, will be provided. In addition, reimbursement, benchmark data, and practical considerations for implementation will be discussed. Finally, several tools to aid in calculating appropriateness are suggested. With a basic understanding, the appropriate use criteria are relatively easy to apply. It is important for facilities to begin to voluntarily incorporate them into their practice and document levels of appropriateness now as payers are developing 2 trends that are not favorable for nuclear cardiology: preauthorization and denial of payment for inappropriate studies.

The growth of molecular imaging heightens the promise of clinical nuclear medicine as a tool for individualization of patient care and for improvement of health-care outcomes. Together with greater use of integrated structure-function imaging, clinical nuclear medicine reaches beyond traditional specialty borders into diagnostic radiology and oncology. Yet, there are concerns about the future of nuclear medicine, including progressively declining reimbursement, the competitive advantages of diagnostic radiology, limited translation of research accomplishments to clinical diagnostic imaging and patient care, and an insufficient pool of incoming highly qualified nuclear medicine clinicians. Thus, nuclear medicine views itself as being at a critical crossroads. What will be important is for nuclear medicine to be positioned as the quintessential molecular imaging modality more centrally within medical imaging and for the integration of nuclear medicine with primary care specialties to be driven more by patient needs than by specialty needs. In this way, the full potential of nuclear medicine as an effective and efficient tool for improving patient outcomes can be realized.

Economic scale of radioisotopes (RI) in Japan is studied in the field of medicine, agriculture and a part of industry. (1) RI is used during medical examination with economic scale by 1.7M$ (million dollars) in 1997 and 0.4M$ in 2005. (2) Economic scale of RI utilization in agriculture is 4M$ for R&D, 127M$ for environmental protection and 1M$ for chronology. RI usage in agriculture is increased five times due to needs at environmental technology lasted after the Kyoto protocol. (3) Indirect economic scale of RI ((85)Kr, (147)Pm, (90)Cr) usage in paper fabrication field in Japan for 2006 is 8432M$.

Nuclear cardiology is well established in clinical diagnostic algorithms for many years. This is an update 2008 of the first common position paper of the German Association of Nuclear Medicine and the German Association of Cardiology, Heart and Circulation Research published in 2001 aiming at an overview of state-of-the-art scintigraphic methods.