Training of nuclear medicine technical staff by the Brazilian Society of Nuclear Medicine and Biology

Full text: Nuclear medicine was introduced in Brazil in 1949, at the University of Sao Paulo. Despite being a pioneer in South America and the existence of about 280 clinics of this medical specialty in the whole country serving around 185 million inhabitants, there is not any dedicated course forming its technical staff. Another shortcoming lies in the fact that there are not any basic requirements established for these professionals by an official medical or nuclear entity. As result, one can find persons ranging from university graduates (biomedics, radiology technologists, biologists, pharmacists, chemists, physicists, etc.) to secondary school graduates or radiology technicians working in nuclear medicine centres, preparing patients, labelling and injecting radiopharmaceuticals, obtaining images and processing studies. Due to the high heterogeneity of the technical staff and lack of a formal preparation, the Brazilian Society of Nuclear Medicine and Biology (SBBMN) organized during 2004 and 2005 short courses conducted in different regions of Brazil in order to supply organized basic knowledge and practice on: 1. Quality control of 99Mo-99mTc eluates and labelling and checking of dose calibrators 2. Fundamentals of radiation protection, area monitoring and decontamination 3. Quality control of scintillation cameras. Six courses were given during these two years in four cities in the South Eastern region and two in the North Eastern region. The first two topics were delivered during one weekend and the participants were presented with a lecture in the morning and, in the afternoon, a hands-on practice on the same subject. As QC of eluates and labelling and checking of dose calibrators were less practised in most clinics, this was the first time that the majority of the participants performed these activities. In one course, offered during a national congress, all three topics were included and the practical part was replaced by many examples from routine checkings, as well as extracted from the IAEA Quality Control Atlas. A total number of 200 people attended the courses, 145 of which were effectively working in nuclear medicine and related areas, and 55 were university students, mainly taking medical physics and biomedicine courses. About half of the active personnel were technicians in radiology (from a professionalized secondary school), 17% were either technologists in radiology or biomedics, 20% were biologists and pharmacists and 13% were physicists, chemists and engineers. The above numbers are coherent with the real scenario of the technical staff working in nuclear medicine clinics in Brazil, although the distributions are probably not the same in different regions and between large and small cities. Five courses with practical activities took place either in federal research institutions or in state universities. The lecturers (all volunteers) were experienced physicists, chemists and pharmacists from those institutions. Due to the practical part, a maximum number of participants was set in each course, depending on the installations of the hosting site. The participants paid a small fee for used materials and hand-outs. Teaching material [2-4] was made available in the Society's web site. Each course was evaluated and comments and suggestions were requested from the participants. The general opinion on the course was good or excellent. On the average, all topics contents were considered appropriate, except for a few experienced participants that classified them superficial. The majority suggested increasing the course length, so each topic could be made comprehensive, with more practices included. The more experienced professionals also proposed dividing the course in introductory and advanced parts, in order to suit better groups with different degrees of experience. The participants listed many topics as possible subjects for future courses. Most wanted topics include: clinical protocols, specifying frequent mistakes, care to be taken, etc.; kits labelling; QC/QA of cameras with practice; PET, PET/CT; radiation protection in 131I therapy and PET installations; theoretical basis in NM (physics, chemistry); image processing in clinical routines; ethics and good practice for NM technologists. From the results, comments and suggestions, it is possible to confirm the necessity of this type of courses, especially outside the large cities. As it is not feasible, in a short term basis, to create graduate courses of technology in nuclear medicine, the Society is planning to continue this activity in order to enhance and assure the quality of nuclear medicine technical human resources in Brazil. (author)