2019 WINTER EDITION ISSUE 27
49 Annual Scientific Meeting Highlights Dr. Berry Allen, 2019 Lowenthal Lecturer
2019 WINTER EDITION ISSUE 27
Contents From the President
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Introduction to the Winter Edition
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Branch News
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Special Interest Group News
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49th Annual Scientific Meeting Highlights • ASM Award Winners Abstract
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Special Feature • Who? What? Where? A snapshot of Nuclear Medicine Research Presentations from recent ANZSNM conferences in Australia and New Zealand.
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Articles • User Insights into the Australian 99Mo crisis of 2018 • Publish or Perish
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Education and Continuing Professional Development (CPD) • Case Studies • What’s That?
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Calendar of Events Design & Production
Ester Gomez, Creative Director Enovate Studio ester@enovatestudio.com www.enovatestudio.com
Disclaimer
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Editorial
Events & Advertising Enquiries
Rajeev Chandra, General Manager PO Box 6178, Vermont South, VIC 3133 1300 330 402 (03) 8677 2970 secretariat@anzsnm.org.au
marketing@anzsnm.org.au
Submissions secretariat@anzsnm.org.au
The views expressed in any signed article in the journal do not necessarily represent those of the Society. The individual rights of all authors are acknowledged. © 2019 The Australian and New Zealand Society of Nuclear Medicine. Copyright is transferred to the Australian and New Zealand Society of Nuclear Medicine once an article/paper has been published in the ANZSNM Gamma Gazette (except where it is reprinted from another publication).
From the President
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he 49th ANZSNM Annual Scientific Meeting ‘Precision Nuclear Medicine’ in Adelaide was a fantastic success. The scientific program was engaging and highlighted the current areas of growth and potential in Nuclear Medicine and the feedback received from participants reinforced this. We are very grateful to our invited speakers who all provided excellent talks, and enthusiastically participated in the full range of conference activities. The theme of the Conference Awards dinner of 1969 was a celebration of our 50th Anniversary, and, in amongst the bright colours and festivities we were also able to reflect on our 50 years during a historical photograph slideshow compiled by Debra Huddleston, our Society Archivist. Congratulations go to our awards winners, some of whose presentations are featured in this issue of Gamma Gazette. Congratulations also to our Pioneer Lecturer Dr Geoff Currie and Lowenthal Lecturer Dr Berry Allen. Finally, congratulations are again due to the Convenors (Gabby Cehic, Prab Takhar and Dominic Mensforth), the Adelaide organising committee and to Plevin and Associates, our conference organisers. I recently attended the SNMMI annual scientific meeting in Anaheim, California where there was an impressive Australian contribution, both in the scientific sessions and in the submitted abstracts. The quality of Nuclear Medicine in Australia is exceptionally high, and in international meetings, reference is frequently made to Australian research projects, papers and people. Our collaborative clinical trials and the activities of ARTnet are also increasingly highlighted internationally and I participated in a number of meetings in which these were areas of discussion and opportunity. We continue to have a close relationship with both SNMMI and EANM (the US and European bodies). In Anaheim, in conjunction with the AANMS, we had meetings with both organisations to discuss opportunities, collaboration and the future of Nuclear Medicine. Whilst there, on behalf of ANZSNM, I formally signed a Memorandum of Understanding with the EANM, which will enhance educational opportunities, support joint activities for the promotion of Nuclear Medicine, and will explore synergies in research activities. The Society’s International Relations Committee provides a key link between Australian and New Zealand nuclear medicine, and a number of international societies and initiatives, including the World Federation, AOFNMB, IAEA, EANM and SNMMI. We will continue to keep you updated with these initiatives. These activities highlight many positives however there are also significant challenges. In particular, Nuclear Medicine in Australia is currently facing a number of challenges with regard to radiopharmaceutical supply, increasing cost and the regulatory environment. “We continue to advocate with regard to these important issues, and
recognise the impact on both Nuclear Medicine practices and on clinical care.”
Shortly a survey will be sent to Society members regarding membership activities. In addition, there have been discussions regarding the potential for a closer relationship between ANZSNM and AANMS, and your views are explored within the survey. I encourage you to make your views known and complete the survey when available. At our Annual General Meeting in Adelaide, I outlined the current strategic priorities for your Society. These priorities include representation, education and professional impact. Through these priorities we aim to strengthen our profession. I outline these again and I extend my thanks to all members for contributing to the Society, as your engagement is essential to ensuring these outcomes are achieved. • Representation: Advocate for our profession in a manner that is inclusive, collaborative, broad and forward-thinking, taking into account all stakeholders and the community we serve • Education: Continue to serve the Nuclear Medicine profession and provide our members opportunity to keep their learning and thinking current through our ongoing promotion of research and support of education, professional standards and ethics, including with our international peers. • Professional impact: Assist our membership base personally to be a key and growing part of 21st century healthcare through leadership, mentoring and networking opportunities that the ANZSNM and its history and membership diversity provides Please stay connected within the profession and your Society through your active participation and through the website, which we continue to improve and keep updated. Best Wishes
Roslyn Francis, President
2019 Winter Edition
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Special Interest Group News International Relations Committee Update
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trainees (physicians, scientists, he ANZSNM technologists) from Asian International countries in Nuclear Medicine Relations Departments in Australia Committee (IRC) has through IAEA sponsored been involved in a positions. number of initiatives The Lancet Oncology involving SNMMI, EANM, IAEA and WHO Our president, Associate Professor Roslyn Francis and Professor Commission on Medical Imaging and Nuclear Medicine over the last 3-4 months. Wim Oyen, president of EANM signing a Memorandum of is continuing to develop a Meetings were held Understanding to formalize the cooperation between the two position paper on Global with the SNMMI and organisations, earlier in July. standards for imaging in cancer EANM leadership at the SNMMI conference patients, and ANZSNM is represented in this project through the IRC. Meetings in Anaheim, where discussions on exchange of were held at the ASCO and SNMMI conferences, with teaching and training materials, clinical trials (ARTnet) further meetings planned for ASTRO and RSNA. linkages, and workforce issues occurred. There is great This Commission will ultimately make interest in continuing the close interactions between ANZSNM, SNMMI and EANM. Members of the IRC recommendations on workforce, equipment and levels of imaging necessary for optimal cancer care in developed also attended the Asia-Oceania Congress of Nuclear and developing countries. Medicine and Biology (AOCNMB) in Shanghai in May, and attended meetings where teaching and training programs involving IAEA and ANZSNM sites were Prof. Andrew Scott, IRC Chair discussed. There is ongoing interest in placement of
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2019 Winter Edition
50th Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine 24th – 26th April 2020 Sydney, Australia
www.anzsnmconference.com/ANZSNM2020
@anzsnm2020 ANZSNM 2020 on Facebook:
On behalf of the Australian and New Zealand Society of Nuclear Medicine (ANZSNM) and New Zealand Society of Nuclear Medicine, which will be held in Sydney, from the 24th – 26th April 2020. The theme of the
past (2020 hindsight) and a strategic look forward (2020 vision). The main program will be supported by pre-conference learning, big data and their role in precision medicine (Intelligent Imaging Summit 2020) on 24 April. Mark ANZSNM 2020 in your diary. Please refer to the Conference website for more
See you in Sydney in April 2020!
ANZSNM 2020 Conference Manager Plevin and Associates Pty Ltd Tel +61 8 8379 8222 | anzsnm2020@plevin.com.au
SAVE THE DATE
OCTOBER
ACT Branch Capital Forum
19 October 2019
The East Hotel, 69 Canberra Av Kingston ACT 2604 10am - 3pm
(includes tea/coffee/lunch/afternoon tea) BOOKINGS OPENING SOON WWW.ANZSNM.ORG.AU
Articles
USER INSIGHTS INTO THE AUSTRALIAN 99 MO CRISIS OF 2018
Foreword by Dale Bailey
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he disruption to the supply of ANSTO’s GenTech generators in June 2018, caused by a mechanical failure of the production facility, persisted into 2019 until full local generator production supply was restored. During this time, the Australian Nuclear Medicine community worked with ANSTO, GMS and, importantly, each other to maximise the amount of 99mTc available for our patients. The major professional organisations – ANZSNM, AANMS and RAINS – all had input into the allocation and distribution of the precious resources that were available at various times. Tribute must be paid to our commercial partners at GMS and on the production and logistics sides at ANSTO as individual interests were put to one side to get us through the crisis. Nevertheless, some sites experienced numerous days without 99mTc supply, while others (mostly in the metropolitan areas) hardly noticed any impact. Behind the scenes, generators were being redirected to areas where other supplies had failed with very short notice. When I look back at it now, over the six or more months and the umpteen teleconferences between the various organisations on the “Working Group”, it was a monumental effort.
Geoffrey M Currie1,2 Dale Bailey3,4 1
Faculty of Science, Charles Sturt University
Rural Alliance in Nuclear Scintigraphy (RAINS)
2
Department of Nuclear Medicine, Royal North Shore Hospital
3
Australian and New Zealand Society of Nuclear Medicine (ANZSNM)
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Correspondence: Geoff Currie Faculty of Science Locked Bag 588, Charles Sturt University, Wagga Wagga, 2678 Australia Telephone: 02 69332822 Facsimile: 02 69332588 Email: gcurrie@csu.edu.au
But the impact could not be totally eliminated. Soon after the situation started to return to normal, a few of us felt that we should try and get a snapshot of how various practices and individuals were impacted before the memories fade with time and while the “pain” remained acute. Therefore, we put together a small survey to capture this. Geoff Currie and I have gone through the responses received and tried to dissect out the impact, which are contained in the following article. Dale Bailey, July 2019
ABSTRACT BACKGROUND
On 16 June 2018 ANSTO experienced a mechanical failure on the GenTech (99Mo/99mTc generator) production line that produced a 7 month period of sustained supply shortages in Australia; longer in New Zealand and South East Asia.
METHOD
A joint internal quality assurance initiative of the ANZSNM and RAINS saw survey invitations sent to the membership of each organisation. The timing of the survey coincided with the planned return to full domestic production of 99 Mo/99mTc generators; affording an opportune time to reflect on the preceding period of crisis.
RESULTS
Fifty nine practices responded, representing approximately 20% of the number of sites in Australia. Reduced activity days were reported in 96% of these departments with 80% of departments reporting cancellation of patients, 60% rescheduling patient studies and 80% of departments reporting negative impacts on patients. There were 54% of departments reporting dissatisfaction with communication about the crisis from suppliers and 41% dissatisfied with supply reliability. The results demonstrate strong negative themes around impact on staff, impact on patients, impact on patient numbers and impact on departments financially.
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2019 Winter Edition
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Education & CPD Case Study F-FDG PET/CT Guided Biopsy
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Authors: Peter Garcia1 & Shane Hynard1 – 1 Department of Nuclear Medicine & Specialised PET Services Queensland, Royal Brisbane and Women’s Hospital
CASE HISTORY The patient was diagnosed with a vulvar squamous cell carcinoma (SCC) in 2016, treated with surgery and chemoradiotherapy. In 2018, a biopsy confirmed suspected recurrence within bilateral inguinal nodes, the patient then underwent a bilateral inguinal node dissection in April of 2018, followed by further chemoradiotherapy. A follow-up ultrasound of the groin demonstrated a left inguinal node that was suspicious for further recurrence. An 18F-FDG PET/CT scan was subsequently performed in December 2018 (Figure 1), which showed moderately intense FDG uptake throughout the lower to mid vaginal canal which was suspicious for malignant tumour infiltration. Additionally, moderately intense FDG avidity in the left inguinofemoral node, consistent with residual nodal metastasis was visualised. The patient was booked for a total pelvic exenteration and abdominoperineal resection, despite concern over the FDG avid lymph node. While an ultrasound guided biopsy was performed in an attempt to determine the inguinal node involvement, the results showed no lymphoid tissue, only necrotic fat tissue was identified. Prior to the surgery, the interventional radiologist approached Nuclear Medicine to determine whether an 18 F-FDG PET/CT guided biopsy was feasible. PROCEDURE The patient was given an intravenous injection 270MBq of 18F-FDG and imaging from vertex to proximal thighs commenced after a 60-minute uptake period. Imaging showed a similar result to the previous PET/CT scan in December 2018 and the decision to go ahead with the biopsy was made. A two-minute single bed PET/CT acquisition was performed to localise the left inguinal node (Figure 2); followed by several single axial CT scans of 1.2mm giving 6 slices of 0.2mm per scan as the biopsy needle was advanced towards the inguinal node (Figure 3). Whilst advancing the needle, the Radiologist felt some unusual resistance. When the Radiologist believed the biopsy needle was positioned correctly, a second single bed two-minute PET/CT was performed to confirm the needle position.
Figure 1 – 18F-FDG PET/CT December 2018
Figure 2 - Single bed PET/CT acquisition for localisation, prior to needle insertion
Figure 3 - Axial CT demonstrating biopsy needle
2019 Winter Edition
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EVENTS CALENDAR TSIG Annual Day Symposium 24 August 2019
The Esplanade Hotel, Fremantle, Perth
ACTA International Clinical Trials Conference 2-5 October 2019
CPD Points
Sydney International Convention Centre, Darling Harbour
QLD Branch Meeting 27 August 2019
EANM’19 Annual Congress 12-16 October 2019
Translational Research Institute (TRI) building 37 Kent St, Woolloongabba, QLD CPD Points
2019 NZIMRT - NZ Branch of ANZSNM Joint Conference 30 Aug - 1 Sep 2019 Energy Events Centre, Rotorua, New Zealand CPD Points* * 7 points Friday & Saturday / 3 points Sunday
Barcelona, Spain
ACT Branch Capital Forum 19 October 2019
The East Hotel, 69 Canberra Ave, Kingston ACT 2604 CPD Points
ANZSNM NSW Branch Meeting 2 November 2019 Mercure Sydney Hotel, 818-820 George Street, Chippendale CPD Points
15th Hunter Technologist Group Meeting 7 September 2019 Crowne Plaza Resort, Pokolbin, Hunter Valley
QLD Branch Meeting (Radpharm Award) 4 November 2019
Go to www. anzsznm.org.au for venue details
CPD Points
CPD Points
SA Branch Meeting 11 September 2019
WA Branch Meeting 19 November 2019
Benson Radiology, Lvl 3, Adelaide Day Surgery, 18 North Terrace.
Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA
CPD Points
CPD Points
WA Branch Meeting 18 September 2019
SA Branch ANZSNMT AGM Dinner & Radpharm Award 20 November 2019
Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA, 6150
Go to www. anzsznm.org.au for venue details CPD Points
CPD Points
VIC/TAS Branch Masterclass and Radpharm Award 2020 21 September 2019 RACV Club Melbourne
SA Branch Meeting 27 November 2019 Go to www. anzsznm.org.au for venue details CPD Points
CPD Points
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