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35. STANDARIZATION
OF RADIONUCLIDE TECHNIQUES FOR NEPHROUROLOGIG STUDIES: An IAEA
Cooperative group study in Latin America and the Caribbean undertaken
under the auspices ARCAL.
Barragan
L, Bernal P, Britton
K, Cerqueira A, Estrella O, Fraxeda R, García E,
Hilson A, Lagos G, Morales R, Orellana
P, Padhy A, Sixt R, Soroa V, Touya E, Yerovi M.
The economic and health situation in Latin-America and the Caribbean
differ between countries. For nuclear medicine, factors such
the availability of radiopharmaceuticals and equipment, may
present problems, as may lack of knowledge and protocols. A
major problem in this area is that some countries do not have
local production of radiopharmaceutical which makes them expansive.
Beside different national rules regulate the use if imported
products which may prohibit their wide spread use. There is
a well known non-homogenous state of equipment, but all of the
countries have at least planar cameras with a PIP system (developed
by IAEA) that allows dynamic acquisition. There is a lack of
software for processing to get the different quantitative data
necessary for better interpretation of the studies. A lack of
knowledge and diffusion of radionuclide techniques among clinicians
is another difficulty.
Some of
the problems above have been addressed by a group of regional
experts, who work during 15 months writing a Manual of Nephro-Urologic
Procedures, considering the national and regional realities.
In spite of the differences we were able to write a harmonized
Manual for static renal scan, dynamic renal scan, both baseline
and with pharmacological interventions (diuretic and ACE inhibitors)-
transplant studies, cystography (direct and indirect), clearance
studies, radiopharmaceutical and equipment quality controls.
It was also possible to develop a model renal software to be
used with PIP systems.
We conclude
that in spite of the differences, with a common effort of the
countries involved and with the significant support of the International
Atomic Energy Agency it is possible to improve the quality of
nuclear nephrourology practice in the region.
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