Availability of oncological nuclear medicine in the regions of Slovakia

Full text: Nuclear medicine (NM) imaging technology, alone and in combination with other imaging modalities, provides clinically significant and useful information in the staging and treatment of the oncological diseases. The main objective of our study was to find out and present the situation vis-a-vis nuclear medicine facilities in the Central European country that soon becomes the new member of EU. For the purposes statistical data of WHO, Slovak Republic (SR) and nuclear medicine department (NMD) were evaluated for the period 1995-2001. Comparison with Czech Republic (CR) was done because of almost similar occurrence of the malignant diseases in these two republics that were a one country till separation in 1993. First nuclear medicine department in Czechoslovakia was established about 55 years ago. Comparing to CR the expenditures on health care per capita in SR is only 67% of CR. The number of gamma cameras, physicians and number of investigations are far from good standard of CR. The number NM departments are significantly low and growth of only 29% compared to CR is alarming. The one main reason is inadequate financial support to the health care and high debts of hospitals running nuclear medicine facilities. Providing radiology departments with new CT and MRI scanners is another reason of less nuclear medicine facilities. During the last five years, though the number of gamma cameras increased by 10%, but the number of investigations did not rise accordingly. Because of bad management of health care services in Slovakia, the latest facilities availability is greatly delayed. However, the exception is the installation of a new PET scanner in 2001. Of late, sentinel lymph node detection was started only with the help of IAEA. Data shows that most of the nuclear medicine centers are around the state capital. It is imperative to have sufficient diagnostic and therapeutic facilities in each region so as to make these available to patients living away from the central regional hospitals. The contribution of Nuclear Medicine facilities in oncological diagnostic work up in Slovak Republic, as per our analysis is concluded with following points: 1. Slovak Republic wishes to keep latest developments updated and hence a PET center is in service since 2001. However the number of investigations need to be increased by increasing the awareness of this facility, especially in oncology 2. There is only one specialized oncology department attached to a private hospital. The output of this department showed a good progress during the last few years. 3. Majority of nuclear medicine departments in state hospitals are stand still and show a decline in number of investigation. 4. Numbers of examinations per 100 000 inhabitants and other parameters are significantly lower than in Czech Republic. Availability of NM procedures is better in regions with more than one department. 5. The structure of NM examinations is not up to date, due to economical problems of the health care. (author)