Guidance on medical physics expert support for nuclear medicine

Abstract

The Ionising Radiation (Medical Exposure) Regulations require employers to appoint suitable medical physics experts (MPE) for Nuclear Medicine services, and they also define the areas where MPEs are required to provide advice and specify matters that they must contribute towards. Applications for employer licences under IR(ME)R require employers to specify the level of MPE support available and if this is provided by on-site MPEs or remotely. Assessment of these applications by the Administration of Radioactive Substances Advisory Committee (ARSAC) has highlighted variability in the levels of MPE support being provided for similar services across the UK. A working party including representatives from IPEM, ARSAC, BIR and BNMS was formed and has produced these recommendations on MPE support. Nuclear medicine services were divided into seven broad categories and MPE support for each category has been considered. However, some services that differ from the scenarios provided in this guidance may require different levels of MPE support. PET/CT and γ camera imaging have been considered separately here, although it is recognised that both PET/CT and γ cameras are often sited within the same department in many centres. The separation has been done for pragmatic purposes, as there are felt to be sufficient differences in the MPE role requirements. This guidance sets out recommendations for MPE support, and broader physics support, to run a safe nuclear medicine service and defines the responsibilities of these staff for a range of clinical nuclear medicine services. The recommendations on MPE support made are advice, but will assist employers in meeting regulatory requirements.

Nearly double the patients and dramatic changes over 14 years of UK MRT: Internal Dosimetry Users Group survey results from 2007 to 2021

“…177 Lu based agents have the benefit over primarily alpha emitters such as 223 Ra-Chloride of convenient imaging and the potential to perform dosimetry. The importance of which has been recognised in legislation [24], guidelines from several UK legislative entities [25,26] as well as by many professional groups [27][28][29][30], particularly for this therapy. Provision of a dosimetry service will similarly require investment in facilities, equipment, staff and their training but would help stratify patients, if nothing else helping identify patients for whom the treatment and its associated cost will not be beneficial.…”

Scientific support for nuclear medicine

“…It is recommended that this report is read in conjunction with the publication formulated by an IPEM-led UK expert working group ‘ Guidance on medical physics expert support for nuclear medicine’ [2] as this report will recommend levels of overall scientific support to a range of nuclear medicine service delivery models described in that publication. In addition, it may be useful to refer to the most recent European staffing guidance which contains detailed algorithms for calculating staffing numbers [3].…”

“…The author also wishes to recognise a number of individuals and groups: Claire Greaves for the previous version of this report, Fergus McKiddie and other members of the working party which led to the publication of ‘ Guidance on medical physics expert support for nuclear medicine’ [2] and Matthew Walker with other members of IPEM Special Interest Groups. Thanks also to Ian Armstrong, Charnie Kalirai, Richard Fernandez, Belinda Stiles and James Scuffham.…”

“…The BNMS has endorsed the recent guidance on provision of MPEs to Nuclear Medicine [2]. Table 1 is reproduced from the guidance and shows the recommended level of MPE support for seven categories of service delivery in terms of Whole Time Equivalents (WTE).…”

“…There have been several publications which detail the role of the UK physicist in nuclear medicine [1,2,34–36]. Tables 2 and 3 build on the roles outlined in these sources and while they include a broad range of responsibilities, an attempt has been made to separate core duties in Table 2 (led and carried out or supervised by physicists) and non-core which might be provided by physicists or other healthcare professionals depending on the skill mix available (Table 3).…”