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21:59 CET
EU 3 - Improving radiation protection in medical imaging in low- and middle-income countries: past actions and future directions
EuroSafe Imaging Physics in Medical Imaging Radiographers
Friday, March 1, 16:00 - 17:30
Room: N
Type of session: EuroSafe Imaging Session
Topic: EuroSafe Imaging, Physics in Medical Imaging, Radiographers
Moderators: L. Donoso (Barcelona/ES), M. M. Rehani (Boston/US)

A-0657
16:00
Chairpersons' introduction (part 1)
L. Donoso; Barcelona/ES
Learning Objectives

1. To learn about the situation of medical imaging and radiation protection in low- and middle-income countries.
2. To understand the past challenges and possibly future ones in the area of radiation protection in medical imaging in low- and middle-income countries.
3. To learn about the activities of worldwide organisations to support low- and middle-income countries.

Abstract

The international professional societies have the mandate and responsibilities to extend outreach to low and middle-income (LMI) countries. In this respect, both the International Organization for Medical Physics (IOMP) and International Society of Radiology (ISR) join hands to assess and improve the situation of radiation protection in medical applications of radiation. This session involves important stakeholders like the International Atomic Energy Agency (IAEA), World Health Organization (WHO) and representative of an important region-Africa. The session will deliberate not only on actions taken, result achieved but also on a vision for the future. There have been important developments through IAEA in LMI countries with the support of WHO, IOMP and ISR such that reasonable information is available on radiation doses to patients in various imaging procedures dominantly in CT and interventional procedures and diagnostic reference levels (DRLs) are available from some of the LMI countries. There are few situations where patient doses are on higher side. However, the information comes largely from few major centres in each country (lacking in breadth), and depth of penetration of radiation protection actions is lacking. The session will identify actions that can be taken to improve the situation to cover the breadth and depth in LMI countries.

A-0658
16:03
Chairpersons' introduction (part 2)
M. M. Rehani; Boston/US
Learning Objectives

1. To learn about the situation of medical imaging and radiation protection in low- and middle-income countries.
2. To understand the past challenges and possibly future ones in the area of radiation protection in medical imaging in low- and middle-income countries.
3. To learn about the activities of worldwide organisations to support low- and middle-income countries.

Abstract

The international professional societies have the mandate and responsibilities to extend outreach to low and middle-income (LMI) countries. In this respect, both the International Organization for Medical Physics (IOMP) and International Society of Radiology (ISR) join hands to assess and improve the situation of radiation protection in medical applications of radiation. This session involves important stakeholders like the International Atomic Energy Agency (IAEA), World Health Organization (WHO) and representative of an important region-Africa. The session will deliberate not only on actions taken, result achieved but also on a vision for the future. There have been important developments through IAEA in LMI countries with the support of WHO, IOMP and ISR such that reasonable information is available on radiation doses to patients in various imaging procedures dominantly in CT and interventional procedures and diagnostic reference levels (DRLs) are available from some of the LMI countries. There are few situations where patient doses are on higher side. However, the information comes largely from few major centres in each country (lacking in breadth), and depth of penetration of radiation protection actions is lacking. The session will identify actions that can be taken to improve the situation to cover the breadth and depth in LMI countries.

A-0659
16:05
The International Society of Radiology’s (ISR) vision
G. Frija; Paris/FR
Learning Objectives

1. To learn about the ISR's radiation protection policy.
2. To appreciate actions which are currently developed.
3. To understand the challenges of low- and middle-income countries to improve radiation protection.

Abstract

Universal health coverage includes health promotion, preventive services, diagnostics, and medicines for communicable and non-communicable diseases. Regarding diagnostics, a global plan for imaging is needed, covering equipment, manpower, and regional governance. Quality and safety need to be addressed in each aspect. The Quality and Safety Alliance of the International Society of Radiology (ISRQSA) is working closely with the WHO and IAEA to improve radiation protection in low-, and middle-income countries (LMICs). It acts as a convener of radiation safety campaigns across the globe and encourages campaign creation in regions where none currently exist. Following the need for a multi-stakeholder approach to radiation protection, the ISRQSA seeks collaboration with related international organisations, including IOMP and ISRRT. The ISR recently defined its forthcoming work plan with the WHO, which will focus, among others, on the following areas: advocating the development of a global plan for equipment and manpower, also in LMICs; awareness raising and advocacy activities towards the implementation of the International Radiation Basic Safety Standards (BSS) and Bonn Call for Action; facilitating access to imaging referral guidelines and providing expertise to support implementation particularly in LMICs; fostering teamwork approaches and risk communication; and safety and quality in the medical use of non-ionizing radiation. In addition, the ISR is involved in the Lancet Oncology Commission on medical imaging and nuclear medicine with the aim of increasing global awareness of the importance of cancer imaging and improving access to imaging.

A-0660
16:20
Patient doses in large part of the LMI countries and way forward: The International Organization for Medical Physics' (IOMP) vision
M. M. Rehani; Boston/US
Learning Objectives

1. To learn about the current situation of patient doses in a large part of the world.
2. To appreciate the challenges and needs based on experience gained.
3. To understand the needs that will impact future actions.

Abstract

The radiation doses to patients in diagnostic imaging examinations and optimisation of dose with image quality is something akin to medical physicists. Medical physicists have published hundreds of papers covering data from more than 80 LMI countries. IOMP collated the data and information on patient doses pertains to computed tomography (CT) dominantly, but also for interventional procedures, mammography and other radiographic imaging. The patient dose information from Eastern European countries is more than other regions like Asia, Africa and Latin America, primarily because of Euratom. The past challenges pertained to crossing the threshold of dose assessment, shift from machine focus to patient focus, whereas future challenges pertain to creating focus on the protection of the individual patient. A large part of the data from LMI countries comes through the work of the IAEA. IOMP plays a role in creating agenda; organising training events; motivating professionals to work, produce results and publish them; disseminating the work; act as an expert for international organisations and provide leadership in creating and propagating outreach programs. Further, IOMP identifies the changing scenario and create a vision for professional colleagues with an emphasis on LMI countries. IOMP works with international organisations like IAEA and WHO and professional bodies.

A-0661
16:35
The International Atomic Energy Agency's (IAEA) approach
D. Gilley; Vienna/AT
Learning Objectives

1. To learn about regional challenges in radiation protection in healthcare.
2. To appreciate the efforts professionals are demonstrating in achieving progress in radiation protection in a resource-limited region with the help of the IAEA.
3. To understand the effects this has on the overall improvement of radiation protection of patients and workers.

Abstract

The International Atomic Energy Agency’s mission is to assist its Member States, in the context of social and economic goals, in planning for and using nuclear science and technology for various peaceful purposes and facilitates the transfer of such technology and knowledge in a sustainable manner to developing the Member States. Challenges in low and middle income have been identified, and the IAEA is achieving positive results in radiation protection with the support of local radiology professionals. The IAEA, through the radiation protection of the patient’s unit and technical cooperation, have seen improvements in patient safety activities at the local, national and regional levels. The success of these efforts would not be possible without the strong commitment of local radiology professions who support the IAEA goal of bringing the beneficial and safe uses of nuclear and radiology technology to all of society.

A-0662
16:50
The World Health Organization's (WHO) approach
M. d. R. Perez; Geneva/CH
Learning Objectives

1. To learn about WHO's views on the importance of safety and quality in medical imaging for globally advancing patient care.
2. To identify challenges and opportunities for enhancing radiation protection in medical imaging in low- and middle-income countries.
3. To understand the role and responsibilities of different stakeholders in strengthening radiation protection in health care.

Abstract

The UN Member States made a commitment towards 17 Sustainable Development Goals (SDGs) by 2030: the SDG #3 aspires to “ensure healthy lives and promote well-being for all at all ages”. Half the world lacks access to essential health services. Many countries have adopted national commitments to achieve universal health coverage (UHC), which means ensuring that all people have access to quality essential health services they need for their health and well-being without incurring financial hardship. This presents a unique opportunity for joining global efforts towards achieving UHC and, in this context, ensuring safety and quality in medical imaging services will be central to the success of these efforts. Indeed, both diagnostic radiology and image-guided interventions are linked to health promotion, preventive services, diagnosis, treatment, follow-up, rehabilitation and palliative care. A culture of radiation safety and quality can be embedded into policies, processes and institutions as the health care systems grow and develop as it is the case in low and middle-income countries. This represents at the same time a challenge and an opportunity and requires strong leadership, robust planning and strategic investment. This presentation will summarise WHO's views on the importance of safety and quality in medical imaging for globally advancing patient care, describe the roles and responsibilities of different stakeholders in strengthening radiation protection in health care and identify challenges and opportunities for enhancing radiation protection in medical imaging in low- and middle-income countries.

A-0663
17:05
Africa's vision to improve radiation protection
B. Mansouri; Algiers/DZ
Learning Objectives

1. To understand the African gaps and to identify the challenges with the existing opportunities.
2. To learn about the implementation of a safety culture in medical radiation protection in Africa and the support provided by international organisations, like IAEA and WHO, and professional societies, like ISR and ESR.
3. To learn about the Afrosafe campaign, in particular about the lessons from the past and the envisaged programme for the next three years 2019-2021.

Abstract

Radiation protection: Needs and challenges in Africa The burden from communicable and non-communicable diseases, including the socio-economic impact of these, has adversely affected development in Africa due to a poor or absent legislative and regulatory framework for radiation protection in many countries, an inadequate awareness of the radiology safety policies an insufficient awareness about radiation doses and the associated risks in the other health professions , an Inequitable distribution of radiation facilities, equipment and skilled personnel , and the financial and political constraints. The continent’s health care system faces big challenges to match health workforce supply and demand. Contemporary discussions in radiation protection entail a systematic articulation of the African health system as well as an explanation of how the professionals apprehend reality and interpret their experiences. To avoid to be left behind the progress and the international actions for safety is recommended, to provide an efficient response for a good medical practice, ensuring that the benefits outweigh risks in all radiological medical procedures using customized systems adapted to the heterogeneous African context The establishment and implementation of regulations to standardize with the development of policies, guidelines the practice of radiation is required and need to be adapted to the specific status of the health system in Africa. It is requested to all the stakeholders and the international organisations to develop national and regional action plan constructed from current discussions about conceptions in African thought and realities ensuring Africa’s patients the same quality and safety.

17:20
Panel discussion: What are the main obstacles for the safe use of imaging in low- and middle-income countries?
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