[Impact of COVID-19 on Nuclear Medicine Procedures in Germany 2020 - Results of a National Survey]. / Auswirkungen von COVID-19 auf nuklearmedizinische Untersuchungen und Therapien im Verlauf von 2020 ­ Ergebnisse einer nationalen Umfrage.

INTRODUCTION: The COVID-19 pandemic imposed an unimaginable challenge to the healthcare systems worldwide. This online survey captured the impact of the COVID-19 pandemic on nuclear medicine services in Germany comparing 2020 to 2019. MATERIALS AND METHODS: A web-based questionnaire was developed to record the 2020 numbers of nuclear medicine procedures and, in particular, the change compared with 2019. The changes in nuclear medicine diagnostics and therapy were queried, as well as the extent to which "Coronavirus SARS-CoV-2" recommendations provided by the DGN were implemented. RESULTS: 91 complete responses were recorded and evaluated. This corresponds to about 20 % of all German nuclear medicine facilities. Nuclear medicine diagnostic tests showed a decrease in scintigraphies for thyroid (15.9 %), bone (8.8 %), lung (7.6 %), sentinel lymph nodes (5.5 %), and myocardium (1.4 %) with small increases in PET/CT examinations (1.2 %) compared with 2019. Among nuclear medicine therapies, reductions were highest for benign indications (benign thyroid 13.3 %, RSO 7.7 %), while changes from 2019 were less pronounced for malignant indications (PRRT: + 2.2 %, PSMA: + 7.4 %, SIRT: -5.9 %, and RJT for thyroid carcinoma -2.4 %). The DGN recommendations for action were fully or partially applied in 90 %. CONCLUSIONS: The initial significant reduction in nuclear medicine procedures in the first three weeks of the COVID-19 pandemic did not continue, but there was no compensation of the previously not performed services. The decrease in diagnostics and therapy procedures of benign diseases was particularly severe.

How COVID-19 pandemic affected cancer progression: Three different scenarios evidenced by PET imaging.

COVID-19 pandemic is having a strong impact on healthcare providers around the world, by refocusing and reducing non-essential medical activities. Nuclear medicine departments among others, have been reorganizing and reprioritizing diagnostic and theragnostic procedures. This reorganizing had a negative impact on the supply of positron emission tomography (PET) services to oncologic patients, whose health was affected. We herein present the PET findings in three different cancer scenarios in which disease course was dramatically affected by the COVID-19 outbreak.

COVID-19 en la biopsia selectiva de ganglio centinela: el invitado inesperado / COVID-19 on selective sentinel node biopsy: the unexpected guest

OBJETIVO: Describir las medidas adoptadas dentro del plan de contingencia del COVID-19 respecto a la biopsia selectiva de ganglio centinela (BSGC) y analizar su impacto sobre la actividad asistencial. METODOLOGÍA: Estudio cualitativo, descriptivo y retrospectivo de BSGC realizadas durante el período del 14/03 al 11/05 de 2020. Análisis de las medidas tomadas para minimizar las probabilidades de contagio y resultados de PCR de pacientes y personal. Comparativa de casos con los realizados en el mismo período de 2019. Actividad diaria de linfogammagrafía y de cirugía radioguiada (CRG) por indicación médica. Cálculo numérico y porcentual de CRG por hospital y recursos humanos diarios de medicina nuclear requeridos. RESULTADOS: Se realizaron 42 intervenciones con BSGC, un 31,1% menos que en 2019. La indicación médica de cáncer de mama experimentó el mayor descenso de actividad (n=18, 41,9%). Del total de CRG, Hospital Clínic realizó el 45,2%, Hospital Maternitat el 31,0%, Hospital Plató el 16,7% y Hospital Sant Joan de Déu el 7,1% restante. En relación con los recursos humanos, la planificación inicial se cumplió en un 77% de los días. El total de los controles PCR a pacientes (n=42) y personal de CRG (n=9) dio resultado negativo. CONCLUSIONES: El COVID-19 influyó negativamente en la actividad asistencial de la BSGC del Hospital Clínic, pero fue compensado por una planificación acertada, basada en el análisis previo de los procesos del procedimiento, que permitió adaptar los recursos de material y personal a las circunstancias cambiantes, otorgándole una flexibilidad que posibilitó el cumplimiento de la programación establecida

OBJECTIVE: To describe the measures taken within the COVID-19 contingency plan concerning sentinel lymph node biopsy (SNB) procedures and to assess their impact on healthcare activity. METHODOLOGY: Qualitative, descriptive and retrospective study of SNB procedures conducted during the lockdown period of COVID-19 (14/03 to 11/05 2020). Analysis of measures taken to minimise the chances of contagion and PCR outcomes of patients and staff. Comparison with SNB procedures conducted in the same time interval in 2019. Daily activity of lymphoscintigraphy and radioguided surgery (RGS) by medical indication. Numerical and percentage calculation of RGS by hospital and daily requirements for human resources in nuclear medicine. RESULTS: Forty-two SNB were performed, representing 31.1% less than those conducted in the same period in 2019. The medical indication of breast cancer showed the greatest activity decrease (n=18, 41.9%). RGS was performed in 45.2% of patients in Hospital Clínic, 31.0% in Maternitat, 16.7% in Plató and 7.1% in Sant Joan de Déu Hospital. Concerning the human resources required, the initial planning was accomplished in 77% of the days (24/31). All the PCR samples from patients (n=42) and RGS staff (n=9) were negative for COVID-19. CONCLUSIONS: COVID-19 negatively influenced the healthcare activity of SNB in Hospital Clínic, but was compensated by adequate planning, based on prior analysis of the procedure's processes, which allowed adaptation of material and personnel resources to the changing circumstances. This allowed flexibility, which in turn enabled compliance with the established schedule

An IAEA survey of radiotherapy practice including quality assurance extent and depth.

Background: The IAEA recommends a quality assurance program in radiotherapy to ensure safe and effective treatments. In this study, radiotherapy departments were surveyed on their current practice including the extent and depth of quality assurance activities.Methods: Radiotherapy departments were voluntarily surveyed in three stages, firstly, in basic facility information, secondly, in quality assurance activities and treatment techniques, and thirdly, in a snapshot of quality assurance, departmental and treatment activities.Results: The IAEA received completed surveys from 381 radiotherapy departments throughout the world with 100 radiotherapy departments completing all three surveys. Dominant patterns were found in linac-based radiotherapy with access to treatment planning systems for 3D-CRT and 3D imaging. Staffing levels for major staff groups were on average in the range recommended by the IAEA. The modal patient workload per EBRT unit was as expected in the range of 21-30 patients per day, however significant instances of high workload (more than 50 patients per day per treatment unit) were reported. Staffing levels were found to correlate with amount of treatment equipment and patient workload. In a self-assessment of quality assurance performance, most radiotherapy departments reported that they would perform at least 60% of the quality assurance activities itemized in the second survey, with particular strength in equipment quality control. In a snapshot survey of quality assurance performance, again equipment quality control practice was well developed, particularly for the treatment equipment.Conclusions: The IAEA surveys provide a snapshot of current radiotherapy practice including quality assurance activities.

Factors associated with appointment non-attendance at a medical imaging department in regional Australia: a retrospective cohort analysis.

INTRODUCTION: Appointment non-attendance contributes added cost to the healthcare sector through wasted resource allocations. Medical imaging departments commonly schedule appointments for most modalities; however, no study has quantified patient attendance rates in the Australian regional setting. This is despite evidence that regional, rural and remote Australians tend to demonstrate poorer health than metropolitan counterparts. This study aims to identify the factors that influence appointment non-attendance at a teaching hospital in regional Australia. METHODS: Categories restricted to age, gender, indigenous status, distance from investigation site, referral source and imaging modality were collected for all appointments (N = 13,458) referred to the medical imaging department in 2015. The likelihood of each of these factors correlating with a patient not attending a scheduled appointment was calculated using the chi-squared analysis and binary logistic regression. RESULTS: Gender, indigenous status as well as specific imaging modalities, referral sources and age categories were significantly associated with non-attendance. Overall, male patients were 1.57 (P < 0.001) times more likely to miss a scheduled appointment than female patients. Patients who identified as Aboriginal and Torres Strait Islander were 2.66 (P < 0.001) times more likely to miss a scheduled appointment than patients who did not identify as Aboriginal and Torres Strait Islander. CONCLUSIONS: Several key factors appear to affect medical imaging appointment non-attendance. Key factors include indigenous status, gender, image modality, referral source and age. Further improvement is required to better meet the needs of underrepresented patient demographics.

A new era for Nuclear Medicine neuroimaging in Spain: Where do we start from in Spain? / Nuevos tiempos para la neuroimagen de Medicina Nuclear en España: ¿de dónde partimos?

OBJECTIVE: To determine the status of neuroimaging studies of Nuclear Medicine in Spain during 2013 and first quarter of 2014, in order to define the activities of the neuroimaging group of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). MATERIAL AND METHODS: A questionnaire of 14 questions was designed, divided into 3 parts: characteristics of the departments (equipment and professionals involved); type of scans and clinical indications; and evaluation methods. The questionnaire was sent to 166 Nuclear Medicine departments. RESULTS: A total of 54 departments distributed among all regions completed the questionnaire. Most departments performed between 300 and 800 neuroimaging examinations per year, representing more than 25 scans per month. The average pieces of equipment were three; half of the departments had a PET/CT scanner and SPECT/CT equipment. Scans performed more frequently were brain SPECT with 123I-FP-CIT, followed by brain perfusion SPECT and PET with 18F-FDG. The most frequent clinical indications were cognitive impairment followed by movement disorders. For evaluation of the images most sites used only visual assessment, and for the quantitative assessment the most used was quantification by region of interest. CONCLUSIONS: These results reflect the clinical activity of 2013 and first quarter of 2014. The main indications of the studies were cognitive impairment and movement disorders. Variability in the evaluation of the studies is among the challenges that will be faced in the coming years.

A work observation study of nuclear medicine technologists: interruptions, resilience and implications for patient safety.

BACKGROUND: Errors by nuclear medicine technologists during the preparation of radiopharmaceuticals or at other times can cause patient harm and may reflect the impact of interruptions, busy work environments and deficient systems or processes. We aimed to: (a) characterise the rate and nature of interruptions technologists experience and (b) identify strategies that support safety. METHODS: We performed 100 hours of observation of 11 technologists at a major public hospital and measured the proportions of time spent in eight categories of work tasks, location of task, interruption rate and type and multitasking (tasks conducted in parallel). We catalogued specific safety-oriented strategies used by technologists. RESULTS: Technologists completed 5227 tasks and experienced 569 interruptions (mean, 4.5 times per hour; 95% CI 4.1 to 4.9). The highest interruption rate occurred when technologists were in transit between rooms (10.3 per hour (95% CI 8.3 to 12.5)). Interruptions during radiopharmaceutical preparation occurred a mean of 4.4 times per hour (95% CI 3.3 to 5.6). Most (n=426) tasks were interrupted once only and all tasks were resumed after interruption. Multitasking occurred 16.6% of the time. At least some interruptions were initiated by other technologists to convey important information and/or to render assistance. Technologists employed a variety of verbal and non-verbal strategies in all work areas (notably in the hot-lab) to minimise the impact of interruptions and optimise the safe conduct of procedures. Although most were due to individual choices, some strategies reflected overt or subliminal departmental policy. CONCLUSIONS: Some interruptions appear beneficial. Technologists' self-initiated strategies to support safe work practices appear to be an important element in supporting a resilient work environment in nuclear medicine.

Biopsia selectiva de ganglio centinela en el melanoma. Resultados de encuesta en servicios de medicina nuclear de España / Selective biopsy of sentinel node in melanoma. Survey results of nuclear medicine services in Spain

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Estimation of the collective ionizing dose in the Portuguese population for the years 2011 and 2012, due to nuclear medicine exams.

OBJECTIVES: In 2009-2010 a Portuguese consortium was created to implement the methodologies proposed by the Dose Datamed II (DDM2) project, aiming to collect data from diagnostic X-ray and nuclear medicine (NM) procedures, in order to determine the most frequently prescribed exams and the associated ionizing radiation doses for the Portuguese population. The current study is the continuation of this work, although it focuses only on NM exams for the years 2011 and 2012. MATERIAL AND METHODS: The annual frequency of each of the 28 selected NM exams and the average administered activity per procedure was obtained by means of a nationwide survey sent to the 35 NM centres in Portugal. RESULTS: The results show a reduction of the number of cardiac exams performed in the last two years compared with 2010, leading to a reduction of the annual average effective dose of Portuguese population due to NM exams from 0.08 mSv ± 0.017 mSv/caput to 0.059 ± 0.011 mSv/caput in 2011 and 0.054 ± 0.011 mSv/caput in 2012. Portuguese total annual average collective effective dose due to medical procedures was estimated to be 625.6 ± 110.9 manSv in 2011 and 565.1 ± 117.3 manSv in 2012, a reduction in comparison with 2010 (840.3 ± 183.8 manSv). CONCLUSIONS: The most frequent exams and the ones that contributed the most for total population dose were the cardiac and bone exams, although a decrease observed in 2011 and in 2012 was verified. The authors intend to perform this study periodically to identify trends in the annual Portuguese average effective dose and to help to raise awareness about the potential dose optimization.

Development of a new software for comprehensive management and traceability of hospital radiopharmacies.

A database software application for comprehensive management and traceability of hospital radiopharmacies has been developed and implemented. This software is a customizable shareware called Radiolab, which provides an immediate and complete traceability of all preparations, controls and radiopharmaceuticals, as well as a great help in the management of reports, orders, stock and radioactive waste. Available by now in five languages (English, Spanish, French, Portuguese and Italian) this software and its manual can be downloaded from the Internet at www.radiopharmacy.net.

Radiation dose to nuclear medicine technicians per unit activity of administrated 99mTc at four Norwegian hospitals.

Nuclear medicine technicians work daily with radioactive isotopes, and therefore receive a certain amount of radiation dose. The aim of this study was to assess the radiation dose, during various tasks, to the technicians at four nuclear medicine departments and to investigate to what extent there are differences between the departments and possible reasons for such. Measurements were made at nuclear medicine departments at four Norwegian hospitals. Doses to the technicians were measured with an educational direct dosimeter-instrument worn outside the lead apron during work at hot-lab, administrating the injection and image acquisition. Calculated annual collective and individual doses were compared with data from personal dosimetry. A value of ∼1 nSv MBq(-1) seems to be representative for modern Norwegian nuclear medicine departments. In departments with upgraded hot-labs, the largest dose contribution is received during image acquisition.

[Nuclear Medicine in Germany. Key data from official statistics]. / Nuklearmedizin in Deutschland. Kennzahlen aus offiziellen Statistiken.

AIM: To explain the spectrum and number of in-vivo nuclear medicine examinations and therapies based on official statistics about out-patient and in-patient care. Trends in time of the frequency and spectrum of procedures as well as data on the health care structure for nuclear medicine in Germany should be collected. METHODS: Data from the Gesundheitsberichterstattung des Bundes, from the frequency statistics of the statutory health insurance for out-patients and from the Bundesärztekammer were used. Customized queries were performed to analyse temporal changes. RESULTS: Nuclear medicine physicians are more frequently consulted by out-patients over the last years (2008: 2024498; 2009: 2164664) and the number of colleagues in private practice increased. For in-patients, the frequency of conventional nuclear medicine procedures (mainly for brain, lymphatic system, lung and heart) increased since 2008 after a decline in previous years (2009: 323515; +4.6%) and the number of PET(/CT) examinations continued to rise (2009: 25123; +18%), even if changes in OPS keys may hamper comparisons. Nearly 600 gamma cameras and 76 PET(/CT) scanners were installed in hospitals in 2008. Nuclear medicine procedures are increasingly performed as cross sectional imaging like SPECT(/CT) and PET(/CT). With the supply shortfall with 99Mo, the frequency of thyroid scans with 123I iodine increased as well as the use of 18F PET as a substitute for conventional bone scans. The number of radionuclide therapies, in particular non-thyroid treatments, increased since the mid-nineties and stabilized at nearly 50000 cases per year with shorter lengths of stay. CONCLUSION: The details of the present analysis may help to understand the positive evolution of key numbers for nuclear medicine.

[Analysis of the number of patients needed to treat by coronary revascularisation in relation to the presence of myocardial viability in gated SPECT images: a prospective cohort study from a nuclear cardiology unit]. / Análisis del número de pacientes que es necesario tratar mediante revascularización coronaria en relación con la presencia de viabilidad miocárdica en las imágenes de la gated-SPECT: estudio de cohorte prospectivo desde una unidad de cardiología nuclear.

OBJECTIVE: To evaluate the number of patients needed to treat (NNT) to assess the magnitude of benefit of coronary revascularisation (CR) in patients with ischaemic cardiomyopathy (IC) in relation to the presence or absence of myocardial viability in myocardial perfusion gated-SPECT (single photon emission computed tomography) images. METHOD: We studied 198 consecutive patients with IC using rest gated-SPECT with technetium-based agents. The cardiac mortality was analysed in four groups: viable with CR (n = 50), viable with medical treatment (MT) (n = 90), non-viable with CR (n = 18), and non-viable with medical treatment (n = 40). RESULTS: During 2.3 +/- 1.2 years of follow-up, the cardiac mortality rate in patients with scintigraphic viability criteria undergoing revascularisation was 5.9/100 patients/year and 12.9/100 patients/year in those who received medical treatment. In patients without viability who underwent revascularisation, the cardiac mortality rate was 6.2/100 patients/year and in those who received MT it was 1.9/100 patients/year. In patients with myocardial viability the NNT was 4, while in patients without myocardial viability, the NNT was 24. CONCLUSIONS: In patients with scintigraphic viability criteria, the NNT to obtain one survival with CR was 6 times lower with respect to patients without viability, with lower cost and mortality.

[Study of physician satisfaction as a quality criterion in Nuclear Medicine]. / Estudio de satisfacción de facultativos como criterio de calidad en Medicina Nuclear.

OBJECTIVE: To determine the perception and satisfaction level of referring physicians requesting scans as final users of the Nuclear Medicine Department. MATERIAL AND METHODS: A self-administered questionnaire was designed; it was composed of 10 closed questions (5 categorised and 5 with numerical scale) and 3 open questions. The indicators evaluated were: physician's information about available tests, test indications and diagnostic information, accessibility, delay in the examination and reception of the diagnostic report, usefulness of diagnostic information and overall satisfaction with the department. Two hundred and fifteen questionnaires were sent. RESULTS: Seventy eight questionnaires were returned, so the response index was 36.3 %. The 44.6 % of physicians surveyed considered that they had sufficient information about the tests and 59.5 % were satisfied with the indications and diagnostic information. The accessibility was 7 or more out of 10 for 78.5 %. The 64.9 % of physicians considered the delay in performing examinations to be correct but the satisfaction was lower in the delay between performance and reception of the diagnostic report. The diagnostic information was considered useful by 81.9 % and relevant in the management of patients by 70.5 % of the participants surveyed. The overall satisfaction was > or = 7 out of 10 in 86.8 %. CONCLUSIONS: Overall satisfaction was high, although the level of knowledge about available tests and the delay between test performance and report reception could be improved.

Estudio de satisfacción de facultativos como criterio de calidad en Medicina Nuclear / Study of physician satisfaction as a quality criterion in Nuclear Medicine

Objetivo. Obtener un conocimiento de la percepción y grado de satisfacción de los facultativos peticionarios de pruebas gammagráficas como usuarios finales del Servicio de Medicina Nuclear. Material y métodos. Se confeccionó un cuestionario auto-administrado compuesto por 10 preguntas cerradas (5 categorizadas y 5 de escala numérica) y 3 preguntas abiertas. Se valoraron como indicadores: la información de los facultativos acerca de nuestra cartera de servicios, indicaciones e información diagnóstica de las pruebas, accesibilidad, demora en la realización de la exploración y recepción del informe diagnóstico, utilidad de la información diagnóstica emitida y grado de satisfacción global con el servicio. Se enviaron 215 encuestas. Resultados. Setenta y ocho encuestas fueron devueltas, lo que constituyó un índice de respuesta del 36,3 %. El 44,6 % de los encuestados opinó tener suficiente información acerca de las pruebas y el 59,5 % sobre las indicaciones e información diagnóstica de las mismas. El grado de accesibilidad de los facultativos del servicio fue de >= 7 puntos sobre 10 para el 78,5 %. El 64,9 % de los facultativos consideró correcta la demora en la realización de exploraciones pero la satisfacción fue menor (39,2 %) para la valoración de la demora entre la realización y la recepción del informe diagnóstico. El 81,9 % de los encuestados calificó la información diagnóstica aportada por nuestras pruebas como útil y el 70,5 % como relevante en el manejo de sus pacientes. El grado de satisfacción global fue >= 7 sobre 10 para el 86,8 %. Conclusiones. La satisfacción global fue alta, aunque el nivel de conocimiento de los facultativos peticionarios acerca de las técnicas disponibles y la demora percibida por los mismos entre la realización y la recepción del informe diagnóstico son aspectos mejorables

Objective. To determine the perception and satisfaction level of referring physicians requesting scans as final users of the Nuclear Medicine Department. Material and methods. A self-administered questionnaire was designed; it was composed of 10 closed questions (5 categorised and 5 with numerical scale) and 3 open questions. The indicators evaluated were: physician's information about available tests, test indications and diagnostic information, accessibility, delay in the examination and reception of the diagnostic report, usefulness of diagnostic information and overall satisfaction with the department. Two hundred and fifteen questionnaires were sent. Results. Seventy eight questionnaires were returned, so the response index was 36.3 %. The 44.6 % of physicians surveyed considered that they had sufficient information about the tests and 59.5 % were satisfied with the indications and diagnostic information. The accessibility was 7 or more out of 10 for 78.5 %. The 64.9 % of physicians considered the delay in performing examinations to be correct but the satisfaction was lower in the delay between performance and reception of the diagnostic report. The diagnostic information was considered useful by 81.9 % and relevant in the management of patients by 70.5 % of the participants surveyed. The overall satisfaction was >= 7 out of 10 in 86.8 %. Conclusions. Overall satisfaction was high, although the level of knowledge about available tests and the delay between test performance and report reception could be improved

Nuclear medicine scans in Beijing: insights from the Beijing Quality Control Centre Survey 2005-2006.

OBJECTIVE: To survey nuclear medicine scans carried out in Beijing during 2005. METHODS: Forty-two nuclear medicine departments were surveyed by using mailed questionnaires sent during September 2006. RESULTS: By the end of January 2007, 30 out of 42 hospitals had replied to our survey. The estimated annual number of SPECT procedures was 6.72 per 1000 population during 2005. Among SPECT applications, whole-body bone scans (n=23,090) were performed with the highest frequency, followed by myocardial perfusion imaging (n=19,092), and renal function imaging (n=10,287). The estimated number of myocardial perfusion scintigraphy scans was 1530 procedures per million population. The annual number of PET procedures was 0.25 per 1000 population. Most of these PET and SPECT examinations used relative monotonous radiotracers and most patients were in the age group of 40-70 years. However, for each cancer and each type of application, age distributions slightly varied. In addition, the analysis of gender distribution revealed that the number of male patients was higher than for female patients. CONCLUSION: The number of nuclear medicine scans carried out in Beijing during 2005 was considerable, with unbalanced clinical applications. Excluded myocardial perfusion scintigraphy, the frequencies of some applications were still lower than in western countries. Furthermore, most procedures used relatively monotonous radiotracers. Most patients were in the age group of 40-70 years and were male.

[Waste of resources as a result of cancelled or delayed diagnostic imaging of hospitalized patients]. / Resursespild ved manglende aflysning eller forsinkelse af billeddiagnostiske undersøgelser hos indlagte patienter.

INTRODUCTION: When diagnostic imaging is cancelled on short notice or an examination is delayed, the Imaging Department suffers a loss. Based on voluntary reporting of such events, we have estimated the total expenditure involved. MATERIALS AND METHODS: For one year an orderly reported cases in which, when he arrived to fetch an inpatient, the latter was no longer in the ward or was not ready. From this study material we estimated the waste of time for the staff and the total price of cancelled or delayed examinations, spread over various categories. This sum is related to the estimated cost of one preventive measure: letting the orderly check in the hospital's electronic administrative system whether the patient is still in the ward indicated. RESULTS: A total of 436 cancelled or delayed examinations were reported in 2004. In 249 cases the examination was cancelled, and since the recorded total number of cancellations was 1,435, we estimate the total number of cancelled or delayed exams to be approximately 2,500 (1,435 x 436/249). The estimated total waste of time is 66 weeks (1(1/2) years' work). The estimated price of the cancelled or delayed examinations is 2.4 million Danish kroner. When we relate the savings if the problem is solved to the cost of prevention, we find that it would be clearly profitable to address fluoroscopy and CT scanning. Conversely, addressing bone X-rays would generate a loss. CONCLUSION: We conclude that there is a very large waste of resources caused by cancelled or delayed imaging examinations.

Preliminary analysis of the resources in brachytherapy in Europe and its variability of use.

PURPOSE: The main objective of the program <> is to establish a group with detailed information on brachytherapy throughout Europe. METHODS: The data was compiled by the general coordinator, the ESTRO, and the <> through a website. RESULTS: A total of 32 countries reported data from at least 50% of their centres (criteria of inclusion). Countries were grouped in three categories based on the time of incorporation to the European Union. The majority of treatments belonged to gynaecological tumours. A large spread was found regarding workload of specialists depending on centre and group. CONCLUSION: Collection of information by a website is a feasible methodology. An increase in brachytherapy treatment was observed in all 3 groups by a rate of more than 20% (year 2002 versus year 1997). These results advocate for the continuation of the PCBE study to demonstrate the development in the field, such as an increase or decrease of patient numbers per tumour category.