Project Planning Meeting RAS/6/029 Shanghai,China th April, 2007

Greetings from Bangladesh… Lutfun Nisa, MBBS, MPhil National Coordinator Institute of Nuclear Medicine & Ultrasound, Dhaka Bangladesh

Distance Assisted Training (DAT) Programme for Nuclear Medicine Technologists The Project

Project Genesis… June, 1994 July, 1999 The project came into existence Bangladesh’s participation in the project was committed in the Project Advisory Board Meeting in Shanghai, China

Project Genesis: November,1999 Project manager and coordinator visited Bangladesh Inclusion of Bangladesh in the project was confirmed Beginning of the programme in Bangladesh Other participating countries were China, India, Indonesia, Korea, Malaysia, Sri Lanka, Thailand and Pakistan

DAT Programme in Bangladesh ( ) Project Coordinator: Ms. Kamila A. Quadir Place: Institute of Nuclear Medicine & Ultrasound, Dhaka Project Code: RAS/6/029 Start date: November, 1999 Completion date: July, 2002

Project Objectives To provide individual trainees (technicians) with a basic practical understanding of Nuclear Medicine methods and techniques To help them comprehend the reasons behind the international standard protocols, procedures and best practices

Project Participants Entity IAEA Advisory board members Project manager Coordinator Course developers Role Project administration Progress review and direction Managing the entire project Coordinating with all the country coordinators Developing all the modules, assignments and workbooks

Project Participants Personnely Country Coordinator Hospitals/NM Centre Supervisors Trainers Trainees Role Ensuring pace and completion of the full cycle of the entire programme in the country Usually the Center head, help trainees to cope with the assignments and workbooks Physicists, Radiopharmacists and Physician Learn protocols, procedures and international best practices

The Course (Phase - 1) ModuleBasic ScienceClinical 1Basic Physics, Radiation Safety 1, Radiopharmacy 1 2Radiation Safety 2, Radiopharmacy 2, Quality Control, Instrumentation 1, Dose Calibrator, Scintillation Counter Endocrinology 1, Thyroid Uptake 3Instrumentation 2, Rectilinear Scanner, Gamma Camera, Imaging Techniques, Computers 1 Endocrinology 2, Thyroid Imaging Gastrointestinal, Liver/Spleen Imaging 3 4Instrumentation 3, Gamma Camera QC, Film Processing Endocrinology 3, 131 I Therapy for Hyperthyroidism, Pulmonary Ventilation and Perfusion 4 5Computers 2 SkeletalRadionuclide Brain Imaging (planar) 5 6Renal, Differential, Gastrointestinal, Dynamic flows 7Cardiovascular, Gated Blood Pool First Pass, Hot Spot

The Course (Phase - 2) ModuleBasic ScienceClinical 8Understanding SPECT (1), SPECT Theory, Quality Assurance, Image Reconstruction Brain SPECT General SPECT 9Understanding SPECT (2), Advanced SPECT Topics, Introduction to PET Myocardial Perfusion SPECT 10Radiopharmaceuticals for Infection and Tumour Infection and Tumour Imaging, General Anatomy and Physiology, Special Paediatric Studies 11Behavioral ScienceIn-Vivo Non-imaging Blood Volume and Urea Breath Test, CSF-Cerebral Spinal Fluid, Shunt Patency 12Introduction to Literature Review Total duration: 2 years with average Study rate of 3-4 hours a week

Teaching and Assessment Methodology Tutorials Practical demonstrations Workshops Assignment20% Workbook30% Final Assessment50% Teaching Assessment

The DAT Program in Dhaka Inception: November 1999 Number of Students: 15 Number of Supervisors: 6 Number of Centers: 6 INMU (6) CNMU, Dhaka (2) Mitford (1) Chittagong (2) Rajshahi (2) Mymensingh (2)

Internal Resource Persons Dr. Lutfun Nisa PMO, INMU, Dhaka Dr. Harunor Rashid PSO CNMU, Dhaka Dr. Raihan Hussain, SMO, CNMU, Mitford, Dhaka Dr. Sadia Sutana, SMO, INMU, Dhaka Dr. Nurun Nahar, SMO, INMU, Dhaka Dr. Fatema Sultanahaque, SMO, INMU Dr. Jasmin Ara Haque, SMO, INMU, Dhaka Ms. Kamila Afroj, SSO, INMU, Dhaka Md. Israque Hossain Ansari, SSO, INMU, Dhaka Md. Nurul Islam, SSO, INMU, Dhaka Md.Zahangir Alom, S.O, INMU, Dhaka

Westmead Hospital, Sydney, Australia Prof. Brian F. Hutton Ms. Heather Patterson Ms. Fiona Batty Australian Youth Ambassadors Ms. Katrina Neville Ms. Lisa Halversion External Resource Persons

Major Events 1 st Phase Mid - Course Workshop 1 st Phase Evaluation and Assessment Workshop 2 nd Phase Mid-Course Workshop Final Assessment Workshop

Objective: Cover 1 st phase, Module 1-7 Exchange students’ views and ideas Understand and identify problems in any specific areas Duration: 5 days ( August 13 – 17, 2000) Assisted by: Dhaka based Physicists/Physicians/ Pharmacist and an Australian Youth Ambassador First Phase: Mid - Course Workshop

First Phase: Evaluation and Assessment Workshop Duration: 4 days (February 25 – 28, 2001) Conducted by : Prof. Brian F. Hutton and Ms. Fiona Batty Objective: Determine level of understanding of material Review workbooks and assess progress, understanding and identify problems Address solutions to problem areas with tutorials and suggestions for alternatives Meet the supervisors and assess their problems Introduce assessment techniques for trainees and local assessors

Second Phase: Mid-Course Workshop Duration: 5 days (September 2- 6, 2001) Assisted by: Dhaka based Physicists/Physicians and an Australian Youth Ambassador Objective: -Cover 2 nd phase, the basics of SPECT imaging system -Provide better access to instrument

Final Assessment Workshop Duration: 5 days (July 6 – 12, 2002) Assisted by: IAEA expert and Local Assessor Objective: -Training the local assessor -Final assessment, checking workbook completion and practical capabilities -Conduct two closed book examinations

Trainee Output Number of initial participants: 15 Participant withdrawal: 2 Participants for final assessment: 13

Performance of the Participants StatusPercent Trainees completing Phase % Trainees Completing Phase % Workbook completion by completing trainees > 80% Assignment completion by completing trainees 100% 5 trainees appeared in the on-line challenge examination under the University of Sydney and passed their first international level examination

Programme Revival and Sustenance Suitable institutes to manage DAT programme National Steering Committee National Programme Coordinator Identification of participating Nuclear Medicine Centres

Suitable Institute in Bangladesh Institute of Nuclear Medicine & Ultrasound,Dhaka

Credentials of the Institute Infrastructure for providing training in nuclear medicine Previous experience in successfully running the DAT programme Recent expansion of facilities Long time experience in conducting academic courses

Major Equipment at INMU Equipment SPECT Dual Head Camera 2 SPECT Single Head Camera 2 General Gamma Camera 2 Poly Scanner 1 Dedicated gamma camera 1 Number 02 01

National Steering Committee National Programme Coordinator Directors of all the participating centres Representative from BAEC

National Programme Coordinator

Participants in Future Programmes Lot of interest in the DAT programme Suitable technologists will be selected from the nuclear medicine centres in the country

Bangladesh Population: 132 million Number of Nuclear Medicine Institutes/ Centres: 14 under BAEC 2 in the Private Sector Number of Technologists: ~120 Number of Gamma Cameras 2 8 (13 with SPECT): BAEC 2 with SPECT: Private Sector

SPECT-CT in Pipeline Sylhet Nuclear Medicne Centre Rajshahi Nuclear Medicine Cntre Chittagong Nuclear Medicine Centre Mitford Nuclear Medicine Centre

PET-CT Project Government of Bangladesh has approved the project One PET-CT with Cyclotron will be acquired for INMU

Conclusion The previous programme was found very effective Very conspicuous improvement in understanding and skill of the trainees Big demand for such training from aspirant technologists The training should be made an ongoing and continuous event