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International Atomic Energy Agency Department of Nuclear Sciences and Applications Division of Human Health IAEA activities to support Member States in Medical Imaging – Diagnostic Radiology H. Delis (Dosimetry and Medical Radiation Physics Section) IAEA International Atomic Energy Agency Presentation contents • Introduction of the IAEA / Human Health Division • IAEA activities to support medical imaging • Overview of MNE6004 project IAEA Introduction of the IAEA / Human Health Division IAEA International Atomic Energy Agency The IAEA is an independent organization within the United Nations serving as the global focal point for nuclear cooperation worldwide IAEA The IAEA works with its 167 Member States and multiple partners worldwide to promote safe, secure and peaceful use of nuclear technologies IAEA Three main areas of work: Safeguards and Verification Safety and Security Nuclear Sciences and Applications IAEA IAEA IAEA work in Human Health The mandate on human health arises from Article II of the IAEA's Statute: “the Agency shall accelerate and enlarge the contribution of atomic energy to health.” IAEA The role of the Division of Human Health is to strengthen the capabilities of MS to address the needs related to the prevention, diagnosis and treatment of health problems IAEA through the application of nuclear techniques Diagnostic uses of radiation 7000 6000 1988 26 % 2008 5000 4000 3000 122 % 130 % 2000 1000 0 Number of diagnostic procedures, million IAEA Collective dose, 1000 man Sv World population, million Medical Imaging - Diagnostic Radiology IAEA IAEA activities to support medical imaging DMRP IAEA International Atomic Energy Agency IAEA activities in medical imaging • • • • • • • • Definition of roles and responsibilities of Professionals Development of guidelines to support and standardize harmonization of training Development of guidelines to support clinical practice Quality assurance Dosimetry Safety Support to comprehensive clinical audits Dosimetry and calibration services (through IAEA DOL) Education and training activities ICTP courses Regional courses (through TC courses) Individual training (through TC fellowships) Education and training material (handbooks, Human Health campus) Webinars Research Coordinated research projects Doctoral coordinated research projects Technical Cooperation IAEA IAEA activities in medical imaging • • • • • • • • Definition of roles and responsibilities of Professionals Development of guidelines to support and standardize harmonization of training Development of guidelines to support clinical practice Quality assurance Dosimetry Safety Support to comprehensive clinical audits Dosimetry and calibration services (through IAEA DOL) Education and training activities ICTP courses Regional courses (through TC courses) Individual training (through TC fellowships) Education and training material (handbooks, Human Health campus) Webinars Research Coordinated research projects Doctoral coordinated research projects Technical Cooperation IAEA Responsibilities in the BSS IAEA CQMP roles & responsibilities Define appropriately and unequivocally the roles and responsibilities of a CQMP in specialties of medical physics related to the use of ionizing radiation, such as radiation therapy, nuclear medicine, and diagnostic and interventional radiology. Establish criteria that support the harmonization of education and clinical training worldwide, as well as to promote the recognition and professionalism of medical physics as a profession internationally. IAEA 16 IAEA activities in medical imaging • • • • • • • • Definition of roles and responsibilities of Professionals Development of guidelines to support and standardize harmonization of training Development of guidelines to support clinical practice Quality assurance Dosimetry Safety Support to comprehensive clinical audits Dosimetry and calibration services (through IAEA DOL) Education and training activities ICTP courses Regional courses (through TC courses) Individual training (through TC fellowships) Education and training material (handbooks, Human Health campus) Webinars Research Coordinated research projects Doctoral coordinated research projects Technical Cooperation IAEA Harmonization of training Guidelines for the establishment of a postgraduate academic education programme in medical physics. Guidelines for clinical training of medical physicists specialising in Diagnostic Radiology IAEA IAEA activities in medical imaging • • • • • • • • Definition of roles and responsibilities of Professionals Development of guidelines to support and standardize harmonization of training Development of guidelines to support clinical practice Quality assurance Dosimetry Safety Support to comprehensive clinical audits Dosimetry and calibration services (through IAEA DOL) Education and training activities ICTP courses Regional courses (through TC courses) Individual training (through TC fellowships) Education and training material (handbooks, Human Health campus) Webinars Research Coordinated research projects Doctoral coordinated research projects Technical Cooperation IAEA Development of guidelines (QA) IAEA Development of guidelines (dosimetry) IAEA Development of guidelines (safety) IAEA IAEA activities in medical imaging • • • • • • • • Definition of roles and responsibilities of Professionals Development of guidelines to support and standardize harmonization of training Development of guidelines to support clinical practice Quality assurance Dosimetry Safety Support to comprehensive clinical audits Dosimetry and calibration services (through IAEA DOL) Education and training activities ICTP courses Regional courses (through TC courses) Individual training (through TC fellowships) Education and training material (handbooks, Human Health campus) Webinars Research Coordinated research projects Doctoral coordinated research projects Technical Cooperation IAEA Comprehensive clinical audits Clinical audit is one of the key elements within the framework of quality assurance through the comprehensive and critical review of the practice in a medical radiation facility. • Development of guidance • Training of auditors • Development of training material • Function as the independent auditing body. IAEA IAEA activities in medical imaging • • • • • • • • Definition of roles and responsibilities of Professionals Development of guidelines to support and standardize harmonization of training Development of guidelines to support clinical practice Quality assurance Dosimetry Safety Support to comprehensive clinical audits Dosimetry and calibration services (through IAEA DOL) Education and training activities ICTP courses Regional courses (through TC courses) Individual training (through TC fellowships) Education and training material (handbooks, Human Health campus) Webinars Research Coordinated research projects Doctoral coordinated research projects Technical Cooperation IAEA IAEA Dosimetry Laboratory Dosimetry services R&D in dosimetry and radiation physics Fellows training (limited) IAEA/WHO SSDL Network • Dosimetry calibrations • Comparisons and audits of performance Dose Assurance Service • IAEA/WHO TLD network • Support to national audit networks • Support to QUATRO IAEA 2.2 The Agency's Dosimetry Laboratory 26 Dosimetry and calibration services Services Beams Calibration of ion chambers: RT, DR, RP levels X rays (10–300kV), 137 Cs, 60Co beams Calibration of well type ion chambers for LDR brachytherapy Comparison of RT level ion chamber calibrations for SSDLs TLD audits for RT for SSDLs and hospitals 137 Cs beams 60 Co beams 60 Co, h. e. X rays TLD audits for RP for SSDLs 137 Ref. irradiations of dosimeters for RT, RP X rays (40–300 kV), 137 Cs, 60Co beams IAEA Cs beams Training activities in medical imaging • • • • • • • • Definition of roles and responsibilities of Professionals Development of guidelines to support and standardize harmonization of training Development of guidelines to support clinical practice Quality assurance Dosimetry Safety Support to comprehensive clinical audits Dosimetry and calibration services (through IAEA DOL) Education and training activities ICTP courses Regional courses (through TC courses) Individual training (through TC fellowships) Education and training material (handbooks) Human Health campus - Webinars Research Coordinated research projects Doctoral coordinated research projects Technical Cooperation IAEA Training activities in medical imaging IAEA Training - ICTP courses For more than 50 years, the Abdus Salam International Centre for Theoretical Physics (ICTP) has been a driving force behind global efforts to advance scientific expertise in the developing world. The IAEA/ICTP joint courses are an effective method of organizing training events within the area of medical imaging (especially in medical physics) open to professionals from around the globe! IAEA Training - TC courses Regional Training Courses RTC on QA/QC and dosimetry in mammography. Algeria, May 22-26, 2016 – African Region - RAF6048 RTC on QA/QC in Diagnostic Radiology in a digital era. Slovenia, Oct. 3-7, 2016 (tent) – European Region - RER6032 National Training Courses Quality Assurance Audit for Diagnostic Radiology Improvement and Learning (QUAADRIL), Oct. 11-15, 2015 Wide beam CT and Cardiac Imaging: Physics & Clinical applications, Nov. 10-14, 2014 IAEA Training – Handbooks and slides IAEA Fundamentals of Atomic and Nuclear Physics Interactions of Radiation with Matter Fundamentals of Dosimetry Measures of Image Quality X ray Production Projection Radiography Receptors for Projection Radiography Fluoroscopic Imaging Systems Mammography Special Topics in Radiography Computed Tomography Physics of Ultrasound Ultrasound Imaging Physics of Magnetic Resonance Magnetic Resonance Imaging Digital Imaging Image Post Processing and Analysis Image Perception and Assessment Quality Management Radiation Biology Instrumentation for Dosimetry Patient Dosimetry Justification and Optimisation in Clinical Practice Radiation Protection Human Health Campus & Webinars The IAEA online information resource for health professionals working in nuclear medicine, radiation oncology, medical physics, and nutrition, providing insight into the different aspects of modern clinical practice. IAEA IAEA activities in medical imaging • • • • • • • • Definition of roles and responsibilities of Professionals Development of guidelines to support and standardize harmonization of training Development of guidelines to support clinical practice Quality assurance Dosimetry Safety Support to comprehensive clinical audits Dosimetry and calibration services (through IAEA DOL) Education and training activities ICTP courses Regional courses (through TC courses) Individual training (through TC fellowships) Education and training material (handbooks, Human Health campus) Webinars Research Coordinated research projects Doctoral coordinated research projects Technical Cooperation IAEA Coordinated research projects Coordinated Research Projects (CRPs) are designed to encourage the acquisition and dissemination of new knowledge from the use of nuclear technologies and isotopic techniques. E1.30.39 - Enhancing Capacity for Early Detection of Breast Cancer through Imaging [2011-2017] E2.40.20 - Evaluation and Optimization of Paediatric Imaging in Diagnostic Radiology and Nuclear Medicine [2015-2018] E2.40.19 - Advances in Medical Imaging Techniques (doctoral CRP) [2013-2017] IAEA IAEA activities in medical imaging • • • • • • • • Definition of roles and responsibilities of Professionals Development of guidelines to support and standardize harmonization of training Development of guidelines to support clinical practice Quality assurance Dosimetry Safety Support to comprehensive clinical audits Dosimetry and calibration services (through IAEA DOL) Education and training activities ICTP courses Regional courses (through TC courses) Individual training (through TC fellowships) Education and training material (handbooks, Human Health campus) Webinars Research Coordinated research projects Doctoral coordinated research projects Technical Cooperation IAEA Technical Cooperation Technical Cooperation (TC) Programme is the main mechanism through which the IAEA delivers services to its Member States to build, strengthen and maintain capacities. All Member States are eligible for support, although TC activities focus on the needs and priorities of low & middle income countries. IAEA Technical Cooperation • TC Programmes is based on requests from the Member States • TC programme is developed and managed jointly by the Member States and the IAEA Secretariat. IAEA Technical Cooperation Support mechanism different than “turnkey” solutions… IAEA Technical Cooperation • 125 countries/territories receive support from the IAEA • Per year ~ 3200 expert missions fielded ~ 1600 fellowships and scientific visits ~ 3200 participants in training courses ~ 190 training courses ~ 2500 Purchase Orders IAEA 40 Examples TC projects supported • MNE6004 - Upgrading the Quality Assurance and Quality • • • • Control Programme in Diagnostic Radiology for a National Breast Screening Programme ??????? - Establishing the Quality and Safety of Diagnostic Radiology Services ??????? - Upgrading Dose Management and Optimization in Computerized Tomography ??????? - Establishing a Telemedicine Programme at xxx Teaching Hospital ??????? - Developing National Capacity for Nuclear Applications in a Medical and Training Context for Sustainable Improvement of Human Health IAEA Overview of MNE6004 activities IAEA International Atomic Energy Agency MNE6004 activities Training: 12 fellows and scientific visitors ~ 10 months of training 1 training course (SLO) 9 participants 1 Workshop 1 PhD (medical physics) IAEA MNE6004 activities Experts and meetings: 3 project meetings (2 MNE, 1 AUT) 1 fact finding - project implementation 1 QA and acceptance testing 1 prone biopsy IAEA MNE6004 activities Procurements: Digital mammography / Tomosynthesis Stereotactic biopsy Unit QA set for mammography Advanced QA set for digital mammography Consumables for breast biopsy IAEA Sandra Steyskal (PMO) Programme Management Officer Harry Delis (TO) Medical Physicist (Diagnostic Radiology) Ravi Kashyap (TO) Diagnostic Radiologist / Nuclear Radiologist IAEA