CONTENTS
- Introduction
- RCA and RCA Regional Office
- Survey Results on the Medical Applications of Radiation Technologies in the RCA Member States
- Survey the Regional and International Development and Financial Organizations Related to Human Health Activities
- Concluding Remarks
- Acronyms Related to Human Health
I. INTRODUCTION
The mandate of the Regional Cooperative Agreement Regional Office (RCARO) is to increase RCA awareness and promoting partnerships for RCA programme. In order to carry out this mandate more successfully, it is needed to learn the status of current and potential end-users in radiation applications of the Member States (MSs). The studies on the status of human health related activities of the RCA Member States and regional & international development and financial organizations for the use as a database is a substantial notion of the RCARO. This will assist the Member States in pursuit of deriving medical applications of radiation technologies for the socioeconomic development of respective MSs. It will also be benefited for RCA project participants for maintaining close relationships with the end-users.
Apart from the aforementioned, the invited staff from the RCA Member States to RCARO will also assist to (i) gather knowledge and experience on RCA management through the working in an institute of excellence in the region (ii) develop inter personal relationship through out the programme which will be beneficial for the strengthening of inter institutional cooperation (iii) enhance the understanding about the Korean experience on effective use of nuclear technology for its socioeconomic development.
The applications of radiation technologies are widely utilized in MSs to meet the basic human needs and to enhance the capacity buildup in Thematic Areas viz., Agriculture, Health, Industry, Environment, Energy/Research Reactors/Waste Management, and Radiation Protection. For developing medical application, radiation technologies are used in the field of nuclear medicine, applied radiation biology and radiation therapy, dosimetry and medical radiation physics, and nutrition and human related environmental studies. Due to the proper utilization of radiation technologies in human health sector recently life expectancy has risen dramatically in the developing countries.
The nuclear technologies are employed in numerous ways in the medical field. In developing countries; emphasis is placed on preventive medicine, early detection of hepatitis and neonatal hypothyroidism, accurate evaluation of nutritional deficiencies and timely diagnosis of common hereditary diseases. The application of radiation technologies are span in many disciplines- such as radioimmunoassay, radiotherapy, radiopharmaceutical productions and sterilization techniques for transplantation and medical instruments.
Radiation techniques are being adapted to treat cancer in the developing world. IAEA also give the priority for the establishment of quality assurance programme for radiation dosimetry and treatment of cancer. One of the treatments is for advanced cervical cancer, which is the most common female cancer.
In the field of public health, RCA has supported projects on the measurement of the level of toxic elements in foodstuffs, treatment of cervix cancer by radiotherapy, management of liver cancer using transarterial therapy. The RCA has recognized the value of health care in the Southeast Asian region and has contributed establishing Human Tissue Banks to serve the region. Chemical compounds labeled with short-lived radioactive isotopes are useful for diagnostic purposes, especially to study how well an organ is functioning.
The RCA programme has proven to be an effective mechanism for increasing regional self-reliance, fostering linkages and collaboration amongst its MSs through consensus. It has been able to produce tangible outputs from participation in well designed projects, despite the varying stages of development and diversity among Member States.
The success of the RCA as a reliable regional framework for cooperation is linked to the unique benefits provided by the application of nuclear science and technology to address regional needs. To further develop and strengthen technical cooperation among the regional MSs and to achieve Millennium Development Goals for sustainability through regional cooperation in radiation technology, the RCARO has incepted in Daejeon, Korea for the overall benefit of the region.
The Human Health related IAEA/RCA projects for 2005-2006 cycle are-
Distant Assisted Training for Nuclear MedicineTechnicians(EXTENSION)
Distance Education in Radiation Oncology (CONTINUATION)
Strengthening Medical Physics through Education and Training (EXTENSION)
Improvement in QA for Brachytherapy of Frequent Cancers in the Region (NEW)
Prevention of Osteoporosis and Promotion of Bone Mass in Asian Populationsusing a Food-based Approach (NEW)
Tumor Imaging Using Radioisotopes (NEW)
II. RCA AND RCA REGIONAL OFFICE
A. Regional Cooperative Agreement (RCA)
RCA-a window to the future-acronym stands for Regional Co-operative Agreement for the co-operation with each other and with the IAEA to promote and co-ordinate co-operative research, development (R&D) and training projects in nuclear science and technology through their appropriate national institutions in East Asia and the Pacific region under the auspices of the IAEA. It is an intergovernmental agreement.
It was about 45 years ago (early 1960s), the IAEA, India and the Philippines came together under a three-way agreement to jointly operate an Indian neutron diffraction machine in the Philippines and was called the “India-Philippines-IAEA (IPA) Agreement”. Other inter-country activities on nuclear technology applications followed. Their success begged the question: why not develop a structure for promoting inter-country collaboration?This laid the foundation of the Regional Co-operative Agreement (RCA) and was formalized in 1972, involving the Agency and ten government parties of the Asia and the Pacific region. The earliest signatories to the original agreement, according to the records we have seen were the following: India (7June 72), Vietnam (12 June 72), Indonesia (16 Oct 72), Thailand (4 Dec 72), Philippines (17 April 73), Singapore (Sept. 74), Pakistan (6 Sept 74), Korea (9 Oct 74) Bangladesh (23 Oct 74) and Sri Lanka (9 Mar 76); now there are seventeen (17) in RCA which are as follows: Australia, Bangladesh, People's Republic of China, India, Indonesia Republic of Korea, Japan, Malaysia, Mongolia, Myanmar, New Zealand, Pakistan, Philippines, Singapore, Sri Lanka, Thailand and Vietnam. The newest members are Mongolia (1922), Myanmar (1994) and New Zealand (1994).
The RCA agreement has the IAEA as a partner, not a party. It is one of four regional cooperative agreements under the aegis of the IAEA. The other three-a pioneering approach in the United Nations-has been replicated are ARCAL for Latin America, formed in 1984, and AFRA, for Africa, formed in 1990 and ARASIA for Middle East (formed in 2002). Of the four agreements the RCA can be considered the most mature, most committed, and enviable. It is the most mature being the longest, not necessarily the oldest, running regional agreement – in its 33rd year now; it is most committed since many member states are now not only participating actively in its activities but also contributing financially to support projects; it is enviable since it is a model for other regional projects and is a pioneering approach to Technical Cooperation among Developing Countries (TCDC) in the United Nations System.
The functions of IAEA within the framework of the Agreement is: to perform the secretariat duties required under the agreement; to support the co-operative projects through technical assistance and other IAEA programmes, as resources allow; to administer the project funds; and, to prepare an annual report. The IAEA is not a signatory to the RCA.
The vision of RCA is:
Security and Safety of Food & Nutrient
To produce cheap & nutritious food
Health Care
Good health care at affordable price for mass population
Industrial Development
To improve economy & provide employment
Energy
Fuel of the economy
Depletion of conventional sources
Environmental Care & Protection
Efficient technology ensuring environmental integrity
Since 1995, RCA has re-focused its activities to reflect the increasing ability of the developing states to support their own activities scientifically and the global trend towards research that is more applied and focused upon the needs of end-users. The new mission of RCA is to be recognized as the source of regional competence in nuclear science applications, to ensure a problem-solving focus in its activities, and to widen the range of funding sources.
During last three decades RCA has shown remarkable achievements in the following Thematic Areas:
Agriculture:
Asian Regional Project on Radiation Preservation of Fish and Fishery
Food Irradiation of Food and Horticulture Products
Mutation Breeding (more than 500 varieties)
Industry:
NDT :radiography, ultrasonic testing, magnetic particle testing, liquid penetrant testing and Eddy current testing
NCS : Pulp & paper, coal and petro-chemical industries
Tracer Techniques
Health:
Nuclear medical applications for diagnostics and treatment
Cancer therapy
Radiation sterilization of tissue grafts to improve tissue banking
Radiation Protection:
To build radiation protection infrastructure
Waste Safety
Environmental monitoring
Radiation protection for workers and public
Energy:
Tools for planning electricity expansion schemes
Plant management & operational safety
Radioactive waste management
Technical Co-operation:
Expert missions
Training programmes
Regional Resource Units (RRU)
B. RCA Regional Office (RCARO)
An RCA office that represents all Member States of the RCA is needed in order to make an orchestrated effort with the related department of the IAEA. There has been no such structure in the RCA history while the Agency has administratively supported RCA Member States for effective and efficient programme implementation. Although the Agency initiated the creation of the RCA, the real ownership of the RCA programmes is of the Member States. The RCA office will thus act as a bridge between the MemberStates and the Agency. Hence to enhance RCA ownership by MSs, it was recommended to establish RCA Regional Office at Yangon Meeting in 1997
The RCA National Representatives meeting held in Mumbai in 2000 was a significant year for the RCA family since the Government of Korea offered to host the RCA Regional Office in Korea, and the Member States have welcomed the offer. In 2001 Dhaka meeting of RCA National Representatives supported for the establishment of the RCA Regional Office in Korea and at that time a Task Force Group (Australia and Korea take Lead) is requested to prepare draft Working Paper. RCA 30th GC in 2001 in Vienna agreed in Principle the Establishment of RCA Regional Office in Korea for 2-year interim period to finalize Legal Provisions and other preparations. Thus RCA Regional Office (RCARO) has opened on March 2002, Wednesday, 17:00 at NuclearTrainingCenterBuilding at KAERI, Daejeon, Korea. The 31st RCA General Conference Meeting in Vienna in September 2002 adopted the ‘Working Paper on the Establishment and Operation of the RCA Regional Office in Korea’ that stipulated details of operation and management of RCARO. The Working Paper was amended by the 32nd RCA General Conference in Vienna in September 2003 that incorporated the adoption of a RCA Resolution on the Establishment of the RCA Regional Office.
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III. SUERVEY RESULTS ON THE STATUS OF THE MEDICAL APPLICATIONS OF RADIATION TECHNOLOGIES IN THE RCA MEMBER STATES
Australia
The Australian Nuclear Science and Technology Organization (ANSTO) is responsible for delivering specialized advice, scientific services and products to government, industry, academic and other research organizations as Australia's national nuclear research and development organization and the centre of Australian nuclear expertise. ANSTO's science has applications in a diverse array of areas including health, the environment and industry. Diseases such as cancer, Alzheimer's and heart disease are some of the areas they work in within the health domain. Every Australian, for instance, will, on average, have a nuclear medicine treatment using a radiopharmaceutical produced at ANSTO in their lifetime. It is an active partner and founder member of the RCA. It’s a donor country for RCA activities and participates in the following active Medical Application related RCA projects as a valuable contributor for the regional development.
Strengthening Medical Physics Through Education and Training.
Improved Training for Nuclear Medicine Technicians
Distance Learning in Radiation Oncology
Improvement of Research Reactor Operation and Utilization Phase II
MEDICAL APPLICATIONSCOUNTRY: Australia
NAME OF INSTITUTION / ADDRESS / MAJOR ACTIVITIES
Peter MacCallum Cancer Centre / St Andrews Place
EastMelbourne Vic 3002, Australia
Tel: 61 3 9656 1111
/ Services offer a multi-disciplinary approach to the diagnosis/investigation, treatment and follow-up of cancers: Breast Service, Gastrointestinal Service, Urology Service, Gynaecologic Oncology Service, Haematology Service, Head & Neck Service, Lung Service, Melanoma & Skin Oncology Service, Neuro-Oncology Service, Paediatric and Late Effects Service, Sarcoma Service etc.
-Radiation therapy (including Brachytherapy), Chemo-radiation, Chemotherapy, Radio immunotherapy, and Hormonal therapy etc.
Research within the broad framework of four research programs, namely Cellular & Molecular Biology, Stem Cell, Cancer Immunologyand Cancer Genomics & Genetics
VITA MEDICAL LIMITED / PO Box 350, Menai Central,
NSW 2234, Australia
Tel+61(0) 2 9541 0411
Facsimile: : +61(0) 2 9543 0960
/ -Innovator, manufacturer and distributor of diagnostic medical products.
-Specializes in lung ventilation imaging in the field of nuclear medicine
High Flux Australian Reactor (HIFAR)
Australian Nuclear Science and Technology Organization (ANSTO) / PMB 1 Menai NSW 2234
Australi
E-mail: / -Production of much needed radioisotopes for medical purposes and for industry
-Production of gamma ray sources for Sterilization purposes, Cancer therapy, Industry etc.
ANSTO Radiopharmaceuticals and Industrials (ARI) / PMB 1 Menai NSW 2234
Australia
Tel: + 61 (02) 9717 9502
Fax: + 61 (02) 9543 6511
E-mail: / Preclinical and clinical radiopharmaceutical development
• Drug synthesis, particularly in oncology and neurology applications
• Non-invasive imaging of the drug delivery process for specificity and targeting
• Assessment of drug delivery with visual evidence of deposition profiles
• 'Proof-of-concept' studies to evaluate drug delivery and disposition in patients with targeted therapeutics.
• Access to the full range of reactor and cyclotron produced radioisotopes.
Royal PrinceAlfredHospital. / PET Centre,
Sydney, Australi / -All types of radiation injected diagnosis using PET and SPECT imaging techniques which rely on cyclotron-produced radiopharmaceuticals.
-Specially LEUKOSCAN STUDY, for use in diagnostic imaging of the long bones and feet in patients with suspected osteomyelitis and where patients do not have access to ex-vivo WBC scanning
National Medical Cyclotron (NMC) / ANSTO Radiopharmaceuticals and Industrials (ARI)
PMB 1 Menai NSW 2234
Australia
Tel: + 61 (02) 9717 9502
Fax: + 61 (02) 9543 6511 / -Cyclotron-produced radioisotopes used in SPECT include: Gallium-67 used to diagnose soft tissue tumors and some inflammatory lesions, Thallium-201, used to assess heart conditions, Iodine-123, used to diagnose certain thyroid diseases, Iodine-123 labeled tracers commonly used to monitor neurodegenerative diseases and cancer, Thallium-201 as thallous chloride used in nuclear medicine for assessing the firmness of the heart etc.
.-Currently developing an Indium-111 production system for use in SPECT for diagnosing inflammatory bowel disease. Further development in PET based pharmaceuticals include F-18 Dopa and Carbon-11 labeled compounds which will be used at the PET Centre, Royal Prince Alfred Hospitals.
-ANSTO's manufacturing arm, dispatches the cyclotron-produced radiopharmaceuticals to hospitals and nuclear medicine practices across Australia
-Development of new radiopharmaceuticals has designed and built automated production systems for SPECT radiopharmaceuticals so they will be available to hospitals across Australia
- Expand production for the overseas market
End-usersare the medical physicists, nuclear medicine physicians, radiation technologists working in different hospitals and nuclear medicine across Australia and in the overseas markets.
Radio Pharmacology Laboratories / Dr Nabil Morcos
Leader, Research and Development
ANSTO Radiopharmaceuticals and Industrials
Telephone + 61 (02) 9717 9242
Fax + 61 (02) 9543 6588 / -Various radiobiological studies
-Applications of radioisotopes in autoradiography, drug bio-distribution, drug metabolism, and receptor and transporter binding under physiological or pathological conditions
-Nuclear medicine Pre-clinical research into new radiopharmaceuticals as diagnostics or therapeutics
-Pharmacokinetics and Toxic kinetics Evaluation of stability, distribution and clearance of drugs or toxicants in vivo
-Functional Imaging and quantitative assessment of biological responses to internal or external stimuli in the model system
Radiopharmaceutical Chemistry Laboratories / ANSTO Radiopharmaceuticals and Industrials
Telephone + 61 (02) 9717 9242
Fax + 61 (02) 9543 6588 / Radiopharmaceutical preparation, organic synthesis, biological evaluations, and handling of short lived radioisotopes.
SIRTeX Medical / -Developing a biocompatible radioactive micro-sphere treatment for liver cancer sufferers, with fewer side-effects than alternative treatments such as chemotherapy
-More than 800 000 new cases of primary or secondary liver cancer are diagnosed each year, with life expectancies varying from months to years, worldwide.
Global Medical Solutions / John Hodder
Managing Director, / -Provides a wide range of radiopharmaceuticals and associated products and services for nuclear medicine applications that include diagnosing heart disease, treating thyroid conditions and detecting tumors.
Austin & Repatriation Medical Centre / Dept of Nuclear Medicine
Level 1, Harold Stokes Block, Studley Road
Heidelberg, Melbourne, Victoria, Australia 3084
Tel: (+61 3) 9496 5718
Fax: (+61 3) 9457 6605
E-mail: / -The Department boasts comprehensive "Hot" and "Cold" Laboratories and manufactures many of the pharmaceuticals (99mTcS/C, 99mTcMAA, 99mTcDTPA, 99mTcMDP, 99mTcRBC, 99mTc HMPAO etc.) and used for diagnosis (Liver, Spleen, Bone Marrow, Lung, Brain, Kidney, and Thyroid Scan etc.) routinely, in-house.
-The most commonly used radio nuclides within Nuclear Medicine includes: 32-P, 51-Cr, 67-Ga, 89-Sr, 90-Y, 99m-Tc, 111-In, 131-I, 201-Tl amongst others.
Centre for Positron Emission Tomography / AustinHospital, Austin Health, Studley Road, Heidelberg, Melbourne, Victoria, Australia 3084
Tel: (+61 3) 9496 5669
Fax: (+61 3) 9457 6605
E-mail:
/ -The tracers/radiopharmaceuticals routinely produced in the centre are: [15O] oxygen, [15O]carbon monoxide, [15O]water, [13N]ammonia, [18F]FDG, [18F]FMISO, [18F]MPPF, , [18F]FLT, [11C]flumazenil, [11C]PIB, [11C]choline etc.
-Appropriate amounts of the four positron emitters commonly used radio nuclides in this PET centre are: 15O, 13N, 11C and 18F and can be obtained with 10 MeV protons and 5 MeV deuterons.
The WA PET/Cyclotron Services / 1st Floor, G Block
SirCharlesGairdnerHospital,
Phone: 61 8 9346 2656
Fax: 61 8 9346 3610
/ -The most common radioisotopeproduced by the cyclotron located at the Hospital is Fluorine-18 or 18F and used in their PET as 18F-labelled fluorodeoxyglucose or FDG (radiopharmaceutical). It is used extensively in tumor, brain and heart imaging studies.
-Researchers are striving for the development of new radiopharmaceuticals e.g., C-11 methionine, F-18 FLT and F-18 fluorocholine.
BANGLADESH