Impact of COVID-19 on nuclear medicine in the UK.

PURPOSE: COVID-19 brought about unprecedented challenges to healthcare, with nuclear medicine (NM) being no exception. The British Nuclear Medicine Society (BNMS) COVID-19 survey assessed the impact of the first wave of pandemic on NM services in the UK. With COVID-19 resurge compounded by seasonal winter pressures, we reflect and share lessons learnt from the first wave of pandemic to guide future strategy. METHODS: A questionnaire consisting of 34 questions was sent out to all BNMS members over 2 weeks in May 2020, to evaluate the impact of 'lockdown'. RESULTS: One hundred thirty-eight members (92 sites) from a multidisciplinary background responded. There was a 65% reduction across all services; 97.6% of respondents reported some reduction in diagnostic procedures and 71.3% reduction in therapies; 85% worked with a reduced workforce. The North East of England, Greater London and South East and Wessex were most affected by staff absences. The North East reported the highest number of COVID-19 positive staff; London reported the greatest lack of testing. The reported time required to clear the backlog was 1-12 months. Seventy-one percent of participants used BNMS COVID-19 guidance. CONCLUSION: The first wave caused a major disruption of NM service delivery and impacted on the workforce. The departmental strategies should tailor services to evolving local and regional differences in prevalence of COVID-19. A blanket shutdown of services with a 'one size fits all' strategy would likely have a severe impact on future delivery of NM and health services in general. Timely testing of staff and patients remains of paramount importance.

Preparation and use of 131I magic gel as a dosimeter for targeted radionuclide therapy.

Clinical interest in targeted radiotherapy is increasing, but accurate dosimetry studies are difficult to achieve. The aim of this study was to investigate the preparation and use of a "normoxic" polymer gel (with a tissue-equivalent density), known as MAGIC gel, and magnetic resonance imaging (MRI) for nonsealed source dosimetry. MAGIC gel samples were mixed with deionized water (MAGIC95) or a solution of 131I (131I-MAGIC95). By measuring the radioinduced variations of R2 values (relaxivity) of irradiated gels, we analyzed the response of MAGIC95 and MAGIC samples to external photon beam or 131I irradiation (131I-MAGIC95). MRI showed that a homogeneous dose distribution from 131I can be achieved if the MAGIC gel, at a temperature of approximately 35 degrees C, is mixed in 131I solution and the resulting mixture shaken gently for 30 minutes. It is important that the vials are completely filled, as residual air reduces polymerization and causes spontaneous polymerization stripes. Responses of MAGIC95 or MAGIC gels to external photon beam irradiation are similar. The variations of R2 values for 131I-MAGIC95 gel depend on the absorbed dose and not on the duration of the irradiation being reproducible from one batch of gel to another. MAGIC gel responses to 131I or external beam irradiation (EBI) are different. Our preliminary results suggest that radiolabeled "normoxic" polymer can be easily and safely produced. Radiolabeled MAGIC gel may, therefore, be suitable for the creation of phantoms dedicated to nonsealed source dosimetry.