Annual Health Physics Meeting and SNM Training
By Ron Fraass, Executive Director
From July 11-18, 2004, I attended the Health Physics Society (HPS) Annual Meeting in Washington DC, met with the Executive Director (ED) of the Society of Nuclear Medicine (SNM), and attended Positron Emission Tomography (PET) Training for Physicians. The HPS provided complementary registration for our Chair, Chair elect, and me to attend their meeting and specifically to attend a special intersociety meeting on Monday July 12th. Following the close of the HPS meeting on Thursday, I met with Virginia Pappas, ED for SNM and two of her staff. Because SNM is interested is working with CRCPD on potential training areas, I was invited to stay in DC and attend their PET Physicians training on Saturday and Sunday.
The Intersociety Workshop included representatives from several of the professional radiation protection societies and included OAS as well as CRCPD on the state regulatory side. A major concern is the lack of programs, training, and educational opportunities for those entering the profession of Health Physics. The current, but not passed, Energy bill included a small amount for graduate training in HP topics. Most felt it was not enough. For CRCPD and OAS, a bigger concern is basic BS/BA education for our regulatory staff. It was agreed that these and other issues of mutual concern need to be addressed on an annual basis. AAPM will probably host the next meeting of this working group. The DC area is better for professional organization staff to attend. CRCPD can assist in getting the message out to state members, but we are not able to lobby Congress, as can some of the other organizations. HPS has both a 501(c)(6) and 501(c)(3) organization just for that purpose. 501(c)(6) organizations may lobby. CRCPD funding sources, mainly including government agencies, preclude lobbying efforts.
In discussions with the SNM staff, they are very interested in future work with CRCPD. They proposed providing some training either in conjunction with the annual meeting, regional meetings, or via electronic means. The special training for physicians was offered by two MDs who used previously taped presentations from other physicians. A slide would be shown, the taped comments played, and then the instructor would provide additional information. For example, the slide and comments might refer to a PET scan of a patient. The instructor would then highlight sections of the image, rotate it, orient it to a CT scan of the same patient, and show additional details not covered in the taped comments. It was an interesting method of presentation that permitted eight other physicians to “provide” training to the group. It is a method that we should consider. I thanked SNM for providing me the opportunity to attend the two days of training.
I am now a much more informed patient and clearly understand the power of PET when coupled with a quality CT either by software or hardware fusion. Future diagnostic procedures are apparently going to be approved for reimbursement including some dementia diagnostic tests for Alzheimer’s disease. The pictures of brain glucose activity were amazing. Much work is currently being done for breast cancer staging, lymphoma, and skin cancer. Nodules, as small as 3-5 mm in size that exhibit high glucose uptake may be imaged using PET.
Doses to patients and staff still need to be considered and balanced against the diagnostic power of the procedures. An article in the most recent Radiology Today indicates that CT exams are up a factor of 7x from a few years ago. With doses approaching 1 rem per study and the need to add the dose from Fluorine-18 if PET is combined with CT, we have a significant patient dose. Newer machines can do CT and PET scans much quicker, but dose reduction does not appear to be a major hardware research effort. I believe we have a lot of work to do together with the professional societies to reduce patient and staff dose while keeping such excellent diagnostic tools available.