UPDATE NUCLEAR MEDICINE in THAILAND Yuthana saengsuda Society of nuclear medicine of Thailand ( TSNM)

Thailand Populations of 67 millions 21 nuclear medicine sites Khon khaen Populations of 67 millions 21 nuclear medicine sites Active members 150-200 Physicians 75

Nuclear Medicine Site 5 Cancer center hospitals Chulabhorn institute National cancer center Lopburi cancer center Lampang cancer center Thanyaburi cancer center 4 Non-university based hospitals Sappasitthiprasong Hospital Korat Hospital Klang hospital Surasthanee hospital 2 Private hospitals Bumrungrad hospital Wattanosod hospital 10 University hospitals Chulalongkorn university hospital Siriraj hospital Ramathibodi hospital Chiang Mai university hospital Khon Kaen university hospital Rajavithi hospital Pramongkut hospital Prince of Songkla university hospital Vachira hospital Burapa university hospital

PET CENTER AND CYCLOTRON SITES 8 PET CENTERS: 6 centers in BKK ( 4 public, 2 private) 2 centers outside BKK (one in Chiengmai and one in Khonkaen ) 1 PEM CENTER Rajavithi hospital 3 Cyclotrons: Chulaporn Chiengmai university hospital Private hospital : BGH Upcoming : Two university hospitals Siriraj Khon Khaen

STATUS OF THERAPEUTIC NUCLEAR MEDICINE I-131 Hyperthyroid outpatient Rx I-131 Well-differentiated thyroid cancer in/outpatient Rx Sm-153 EDTMP Bone pain in/outpatient Rx I131-MIBG Rx Y-90 Microsphere for liver metastasis I-131 Rituximab in patient Rx for low grade lymphoma

Radionuclide therapy 2013 Hyperthyroidism 5760 cases Thyroid cancer RAI treatment 1936 cases MIBG treatment 34 cases Bone pain palliation 21 cases

Radiopharmaceuticals Two major sources Thailand Institute of Nuclear Technology (TINT) ( commercial part of office of atomic energy for peace in Thailand) daily supply for unit dose Tc-mm labeled , I-131, I-131 MIBG, Sm-153 EDTMP Ga 68 dotatate research , Tc-99m octeotride Global Medical Solution (GMS) : daily supply for unit dose Tc-99m lableled and I131 Clinical trials , IAEA projects Y-90 microsphere (SIRTEX), GMS Pharmaceutical companies: Sanofi for Thyrogen , upcoming Radium 223 from Bayer

National Guidelines for Thyroid Cancer Management ( upcoming 2014) Host : National cancer institute Scopes: Guidelines for screening, diagnosis and treatment of thyroid cancer by clinicians and NM team.

Residence Training in NM of Thailand Diploma of Thai board of NM Starting 1997 ,3 yrs training program Basic physics: Basic radiation physics , physics of NM, radiobiology NM knowledge: scintigraphy, nonimaging studies, RIA , radiopharmaceuticals , BMD , radionuclide therapy Skills and attitude in NM Knowledge of diagnostic radiology and radiation therapy Lecture, practice, conference, seminar , literature review, journal club, self learning , interesting case study, research

Resident Training Exam Research paper , defend for thesis Preliminary exam: radiation physics and radiation biology MCQ basic science and NM Short assay questions Oral examination

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