Korea_Dr_Lee by liuqingyan

VIEWS: 8 PAGES: 62

									  Strategic Action for the Promotion of
Nuclear Medicine in Developing Countires




         Myung Chul Lee, M.D.
          (President, WFNMB)


       Department of Nuclear Medicine
       Seoul National University Hospital
                 Seoul, Korea
                  Radiology    Nuclear Medicine
•   Society            Big       Small
•   Members            Many      Small
•   Power             Strong     Weak
•   Competition         (-)        (+)
•   Challenges          (-)        (+)
•   Need of multi-      (-)        (+)
    disciplinary scientists
•   Regulation          (-)       (+)
•   Recognition       Good       Poor
•   Profit            Good       Poor
    Nuclear Medicine and PET
     (Complex Technology)

♣ Need more budget
♣ Need multiple, diverse tasks
♣ Need political support
♣ Need various system
♣ Need fusion or bridging of
  multidisciplines
♣ Need potential leadership
   Nuclear Medicine and PET
    (Complex Technology)

1) Need to maximize the functions of
   manpower, facility and system

2) Need to establish integrated cooperation
   and collaboration : government, related
   national or international organization,
   Institutes, societies
Heterogeneity
 Interconntinental
 Interregional
 International
 Interinstitutional
 Interdepartmental
        Number of Gamma Camera/Million
           Inhabitants (IAEA Report)
 Industrialized Countries    Developing Countries

North America 8940   33.0   Eastern Europe   605 2.2
Japan        2700    21.6   Latin America    953 2.1
Australia      300   16.0   West Asia        166 1.0
West Europe 3740     10.3   Asia             879 0.3
Others         500    3.8   Africa            86 0.2

Total        16240 17.7     Total            2689 0.7
   Myocardial Perfusion SPECT /
     Million Population / Year
                1995       1997     2002
USA            12000      15000    20000
Japan           1700       2750     3056
Korea            375        458     1192
UK               820       1120
Belgium         8000
Spain                      1100
Czech                               1500
Developing nations 50       70        90


                EU Optimum Range: 4000-5000
      Number of NM Studies
                         (Number/Million Pop)
           Nuclear
           Imaging   Heart      RIA

Japan       14,762   1,700   377,148
Korea        6,809     375   163,830
Thailand       328     NA      4,098
Philippines    551      50       NA
Indonesia       88     NA        NA
Bangladesh      23       3       NA
        NM Members (MD)
           (No / million pop)

Japan         24.0    Korea         3.3
Czech         20.0    China         3.1
Hungary       12.0    Thailand      0.7
Netherlands    6.3    Philippines   0.3
Yugoslavia     6.3    Other Asian <0.1
                      Countries
Bulgaria       4.7
                    Number/million population
           Institution     Camera    Members

USA           10.3         34.5       55.2
Japan          9.4          9.4       24.0
Korea          2.5           4.7       3.3
Netherlands    2.5          3.1        6.3
Hungary        4.7         10.0       10.6
Czech          4.7         11.7       28.5
Cyprus        7.1           8.6       28.6
Malta         5.0           5.0       27.5
Slovakia       2.0          4.4        8.0
Bulgaria      2.6           1.5        6.6
Serbia & Mont 1.9           2.3       5.4(14.0)
             Numbers/million population
             Institution   Camera   Members
Poland         0.5          1.3      2.1(5.2)
Lithuania      1.4           1.7      5.1
Turkey         0.9          1.7       5.4
Croatia        1.8          5.6      (22.2)
Bosnia         1.3           2.6      6.0
Macedonia       1.0         2.5      (12.0)
Ukraine         0.04         0.3      1.2
Azerbaijan      0.3          0.3      1.3
Estonia         1.3          2.6      4.0
Latvia          1.3          1.7      4.0
Romania         0.9          0.9      3.6
Changes in No of Institutes

               1991     2001
Japan         1,210   1,273
Korea          100     120
Thailand        14      19
Philippines     29      17
Indonesia       15      12
 Eastern Europe Countries
           (No/Million population)

 Country       Institute   Camera       Member
                „99 „03    „99 „03      „99 „03

Hungary        5.1 4.7     7.6   10.0   12.0 10.6
Czech          5.0 4.7     NA 11.7      20.0 28.5
Slovakia       3.0 2.0     4.4   4.4    NA    8.0
F.R.Yugoslavia 1.7   1.6   2.5   3.1    6.3   5.4
Bulgaria       3.3 2.6     1.9   1.5    4.7   6.6
Poland         2.6 0.5     2.9   1.3    NA    2.1 (5.2)
Romania        1.7 0.9     1.3   0.9    NA    3.6
              Number/million pop
Country       Institut. Camera   Member PET      GNP
                                        Center
USA           10.3    34.5       55.2   700      40000
Japan          9.4     9.4       24      60      30000
Korea          2.5     4.7        3.3    10       9000
Thailand       0.2     0.4        0.7     1       6000
Philippines    0.2     0.6        0.3     1       4000
Brazil         1.4     3.1        2.6     3       6500
Colombia       1.3     3.7        2.5     0       6200
Uruguay        1.8     3.1       15.8     0       6000
    Comparison between Developed
   Countries by Economical Status(I)

                                     (No/million pop)
GNP(US$)     Country    Institution Camera Members

             Netherlands   2.5      3.1       6.3
> 20000
             Japan         9.4      9.4      24.0

             Czech         5.0      NA       20.0
             Slovakia      3.0      4.4        NA
8000-11000
             Hungary       5.1      7.6      12.0
             Korea         2.5      4.7       3.3
   Comparison between Developing
  Countries by Economical Status(II)
                                        (No/million pop)
GNP(US$)Country         Institution Camera Members
          Poland             2.6      2.9       3.0
6000-7000                    0.2      0.4       0.7
          Thailand

          Bulgaria           3.3       1.9      4.7
          Russia             1.8       1.7      NA
3000-4500 Romania            1.7       1.3      3.6
          Philippines        0.2       0.6      0.3
          Indonesia         0.07       0.1     0.09

          Yugoslavia         1.7       2.5      6.3
          China              0.6       0.3      3.1
1000-2000 Pakistan, Vietnam
                            <0.1   0.1-0.3     <0.1
          Bangladesh, India
                                             Conclusion
     (Current Status of NM in Developing Countries)


       Different Economy, Geography, Culture

•   Lack of Awareness
•   Lack of Institutes
•   Very Poor Facility
•   Lack of Qualified Personnel
•   Unable to Attend International Meeting
•   Lack of Regional Cooperative Activity


       Heterogeneity in NM Practice and
              Scientific Activity
How to Solve?
: Need Support to Reduce Heterogeneity

      •   Need Cooperation
      •   Stimulate Scientific Activity
      •   Enhance Education
      •   Financial Support
      •   Increase of Awareness


     Role of International Organization
  (CJK, ARCCNM, AOFNMB, WFNMB, IAEA)
 Who are the responsible bodies?

• IAEA‟s statutory functions: “to encourage
  and assist research on, and development
  and practical application of, atomic energy
  for peaceful uses (Nuclear Medicine) and
  to foster the exchange of scientific and
  technical information”
• National Society of Nuclear Medicine
• Government
     Strategic Direction

• New way of thinking
• Rapid implementation and innovation
  for tangible benefit
• Strengthening capability
• Strengthening cooperation activity
• Encouraging to be self-reliance
               Strategic Action
   Awareness, Global Recognition
   Government Support
   Establishment related Functioning Infrastructure
   Database Collection and Information Networking
    : Global Networking Group
   Role of International Organization: IAEA, WHO etc.
   Regional Cooperative Activity: ARCCNM
   Facilitating the Function of WFNMB
   Political Alliance or Pressure Group
   Strong National Society of Nuclear Medicine
   Powerful Leadership
    Trends of In Vivo Studies
(x1000)
  500

 400

 300

 200

 100
    0
PET Application in Korea
 (X1000)

                                                  20.7



                                           12.5

                                     7.9
                               4.4
                   2.4   3.0
 1.0   1.2   1.8

 „95 „96 „97 „98 „99 „00 „01 „02 „03
                                                     SNUH
PET Installation in Korea

1994 – 2002
       8 PET Scanner in 7 PET Center
2003
       5 PET Scanner and 13 PET/ CT
       in 18 PET Centers

       13 PET + 13 PET/CT
 Number of In Vitro Studies
(x1,000,000)

   12
   10
    8
    6
    4
    2
    0 „82 „85 „88 „91 „94 „97 „00 „02 „03
Scientific Activity in SNM from Korea

                                                  7.0%(96)
                                      6.3% 6.3%6.3%
                                  5.6%




                          2.9% 2.9%


   0.7%0.7%0.6%    1.0%
               0.5%
    Most Contributing Factors for Recent
       Development of NM in Korea

 National economy
 Promotion of SPECT and PET technology
 Government support
 Research activity by young members
 Korean Board of NM : Independent Dept.
 International cooperation
 Powerful national society
 Strong leaders
 Related infrastructure
                                           SNUH
    Awareness, Global Recognition

•   Education
•   Newsletter, homepage
•   Mass communication
•   Scientific communication
        :Interdepartmental conference

    Active participation for nongovernmental
    organization‟s activity

    Global Networking
    Government Support
National Society
Political Alliance (Pressure Group): lobby

Continuing consultation and interaction
 through requesting (national grant project
 or infrastructure), stressing, appreciating,
 encouraging, taking note, convincing,
 recognizing, recalling, emphasizing,
 reiterating
Balanced promotion of non-power nuclear
 application
 3 Stages of Cooperation
       (Rule of 3)



1st Stage   2nd Stage   3rd Stage
Negative    Breakeven   Positive
  3yr          3yr        3yr
 Dr. Maisey‟s Analysis of Factors
 Determining PET Development
in European Countries (EANM,2002)


No relation with
       Population
       Cancer incidence
       Imaging investigation
       Health expenditure
       National economy
         Dr. Maisey‟s Suggestion
               (EANM 2002)

 Government control (Political)
 Reimbursement and Health care system
 Clinical / Cost effectiveness
 Training
 Pressure groups
Related National Infrastructures
•   National Atomic Energy Research Institutes
•   National Radioisotope Association
•   National PET Association
•   National Advanced Radiation Technology
    Research Center
•   National Institute of Radiological and Medical
    Sciences (KIRAMS)
•   National Radiation Emergency Medical Care
    Center
•   Radiation Health Research Institute
•   Radiation Medicine Research Center
    (University)
•   Legal body such as foundation
•   Related Societies
    …………
            Infrastructure
• KCNN, KCNC, …..
• KRIA (Korean RI Association)
• KAERI (Korea Atomic Energy Research Institute)
• KIRAMS (Korea Institute of
           Radiological and Medical Sciences)
• Regional Cyclotron Center
• Advanced Radiation Technology Research Center
• Korea PET Association
• Radiation Health Research Institute
           Related Societies
• National Nuclear Society
• National Societies of Internal Medicine, Radiology,
  Radiation Oncology, Cardiology, Neurology…..
• National Association of Radiation Protection
• National Society of Radiation Biosciences
• National Society of Biomedical Engineering
• National Society of Molecular Imaging
• National Society of Human Brain Mapping
• National Council of Nuclear Neurology
• National Council of Nuclear Cardiology
    ……….
           PET Promotion
 Education (SNM PET Learning Center)
 Publicity for Awareness
 Steering Committee
 Training
 PET related scientific occasion(Symposium)
 Cooperation with Government, Administrator,
  Related Society, Research Institute
 Establishment of PET or Cyclotron
  Association( ICP     AMI, EANM PET Institute)
 Regional Cyclotron Center
Planning
and          Korea PET Association
Advisory
Committee
                Executive Committee


                5 Task Force Groups
                  (Chairman, Members)




Regional    Health    Science and   Clinical   Education
Cyclotron   Related   Technology    PET        And
Center      Policy    Policy        Center     Publicity
Strengthening National Society of
        Nuclear Medicine

• Strengthening the effectiveness and
  improving efficiency
• Multiple functioning and integrated
  structure
• Integrated or three dimensional approach
• International initiatives
• Evaluation and restructuring
• Powerful leader
3 Major Determining Factors

  1) Powerful Leader

  2) Excellent Staff, Officers,
    Advisory Groups

  3) System, Structure, Organization
  Aiming of Restructuring

       Not Competitive
        No splitting

       Synergistic,
        Maximize function


Need cooperation, collaboration,
         coordination
 Korean Society of Nuclear Medicine

• President, President-Elect, Chairman
• 10-15 Board of Directors, Advisory
  Members, Council Members
• Multiple committees: publication,
  financing, scientific, planning, insurance,
  education, training and board certification,
  information, cooperation etc….
• Multiple task groups
• Affiliated Councils (Korean Councils of
  Nuclear Cardiology and Neurology)
• Regional Chapters
• Permanent office
Multiple Tasks and Activities
• Annual Scientific Meeting (March and
  November)
• Monthly Seminar
• Winter Meeting (Workshop)
• Continuing Education Programme
• Regional Chapter Meeting
• Study Groups (bilateral or multicenter)
• Special symposium or lecture courses
• Annual Meeting of each Korean
  Councils
       ……….
    Nuclear Medicine
     - Complex Technology -

               Policy
               Issues

                              Scientific
Practice                      Research
                               Activity

    Inspiration (Spirit)
    Aspiration (Passion , Enthusiasm)
    Perspiration (Endeavor)

Sustained, Consistent, Systematic Activities
• Appendix
                                 (Number/Million Pop)
                            Cameras
              Institution   (%SPECT)    Members

Japan            9.4         9.4 (78)       24

Korea            2.5         4.7 (45)       3.3

China            0.6         0.3 (76)       3.1

Thailand         0.2         0.4 (33)       0.7
                              0.14
Indonesia        0.07                      0.09
                             0.6 (30)
Philippines      0.2                        0.3

USA              10.3         34.5         55.2
          Main Policy Issues
• Radiobiology for optimal regulation
• Regulations on clinical use of new
  radiopharmaceuticals
• Technology to overcome competing
  modalities
• Health economics and insurance policy
• Status of education, infrastructure and
  nuclear medicine practice


             Global Network
        Global Networking Group
 Chairman : Dr. Chonh-Soon Kim (RHRI, Korea)
 Vice Chairman : Dr. Dong Soo Lee (SNU, Korea)
                    Dr. Jae Min Jeong (SNU, Korea)
 Objectives
  - To effectively administer the policy issues of the
   WFNMB by conducting systematic reviews
  - To manage the activities of the task-force groups
  - To develop successful policies and programs
    utilizing data and research collected by the task-
    force groups through ICC and WFNMB

-To preserve and enhance information and knowledge through
networking for future expansion in the application of nuclear
medicine
                Strengthening Cooperation
                                  Activity
- Domestic Cooperation :
   Related Ministries, Research institutes, Organizations, RI
   Association, Related Societies
- Strengthening International Organizations;
    IAEA, WHO, WFNMB
- International Associations:
   SNM, EANM, AOFNMB, ALASBIMN, AANM, ARCCNM, CJK
   (CSNM, JSNM, KSNM) (KRIA, JRIA, CRIA)
- Cooperation of Enterprises :
   Action of Industrial Corporate
          (Domestic and Global Office)
                    IAEA               WFNMB

Organization   Governmental       Non - Governmental

Structure      Bureaucratic,      Voluntary, Autonomous

               Non-Flexible       Flexible


Budget         Member State       Contributing companies

Concerns       Political issues   Scientific issues
               Project-based
         IAEA/WFNMB
          (Joint Relationship)



Complimentary role

Organization of Functioning Body

Regular Bilateral Meeting
     Possible IAEA Collaboration
• Special Session by IAEA during 2006 World
  Congress
• Conducting surveys for database coordination
  concerning political issues
• Encourage political support through
  government route
• Initiating regional cooperative organization in
  developing countries
• Establishment of regional school of nuclear
  medicine
• Promotion of PET and cyclotron technology
ARCCNM
(Asian Regional Cooperative
Council for Nuclear Medicine)
- A Fit Model of New Horizon -



                       www.arccnm.org
                    Current Situation of
                  Related Organizations
AOFNMB (Asia & Oceania Federation of Nuclear
Medicine and Biology)
- To be held every 4 years : Host Nation - China (2004)
- Geographically and culturally heterogeneous
- Two big continents (Middle Asia, Oceania)

CJK Conference
- China, Japan, Korea
- To be held every 2 years (June 2-3, 2002, Dalian, China)

IAEA
- No regular continuous scientific meeting
Asian School of Nuclear Medicine
                         (ASNM)

Administration : ARCCNM or AOFNMB
Dean of ASNM 20 ~ 30 Faculty Members
Participants: Specialized NM physician,
student,residents
Curriculum: ASNM Seminars 2 ~ 4 days in topics
several comprehensive ASNM Course for 1~2
weeks
ESNM: Fit Model
Regional Cooperative Council
        for Nuclear Medicine
   Asia : ARCCNM
          - Far East Chapter
          - South East Chapter
          - South Chapters
   Africa
          - Sub-Sahara RCCNM
          - North African RCCNM
   Eastern Europe: (ERCCNM)
   Arab RCCNM (Middle East)
   Central Asian RCCNM
        WFNMB 2006
 (The 9th Congress of the World Federation
      of Nuclear Medicine & Biology)
             (www.wfnmb.org)

SEOUL, KOREA October 22~27, 2006
Main Venue

     The Largest
     Conference
     Facilities in Asia

     Innovative Multi-
     Lingual Simultaneous
     Translation
     World-class Audio-
     visual Equipment
   Congress Organizing Committee
                    : Executive Members

   Chairman                                    Honorary
                      Advisory Committee
                                           Advisory Members

 3 Vice Chairmen    * (Japan, China)


Secretary General

                                           Fund-Raising
                          Treasurer
                                            Committee

                       Global Networking
                            Group

                         Technologist
                       Section Committee
Special Consideration for Developing
             Countries
• Exemption or discount for registration fee
  for young investigators by awards
• Reasonably cheap priced accommodation
• Continuing education program
• Review lectures for various scientific
  sessions
• Providing database and guidelines for the
  promotion
• Cooperation with developed countries for
  training, publication and collaboration
                              Main Activity
Successful 9th World Congress
: International Scientific Committee

Facilitating the Role of WFNMB
: International Coordinating Committee
: Advisory Council
: Global Networking Group
  (Multiple Task Force Teams)
: World Journal of Nuclear Medicine
: World Radiopharmaceutical Therapy Council
Global Harmonization and New
Horizon of Nuclear Medicine

Seoul

								
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