Defining the Medical Imaging Requirements for a Rural Health Center

156 Pages·2017·4.272 MB·English

by  Cari Borrás (eds.)

Cari Borrás Editor
Defining the
Medical Imaging
Requirements for
a Rural Health
Center
fi
De ning the Medical Imaging Requirements
for a Rural Health Center
á
Cari Borr s
Editor
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De ning the Medical
Imaging Requirements
for a Rural Health Center
123
Editor
Cari Borrás
HTTG
Washington, DC
USA
ApublicationpreparedundertheaegisoftheHealthTechnologyTaskGroup(HTTG)ofthe
International Unionof Physical andEngineering Sciencesin Medicine (IUPESM)
ISBN978-981-10-1611-0 ISBN978-981-10-1613-4 (eBook)
DOI 10.1007/978-981-10-1613-4
LibraryofCongressControlNumber:2016943444
©SpringerScience+BusinessMediaSingapore2017
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Foreword
TheHealthTechnologyTaskGroup(HTTG)wasfirstproposedbythewriteratthe
World Congress of Medical Physics and Biomedical Engineering at Seoul, Korea,
in 2006. The idea was accepted by the International Union for Physical and
Engineering Sciences in Medicine (IUPESM) with the election of myself as chair
and Joachim Nagel as co-chair. In 2010, Joachim Nagel became chair and Cari
Borrás, co-chair. Cari Borrás served as chair from 2012 to 2015, and it was under
her chairmanship that this book was produced.
The HTTG is intended “to assist countries in defining their health technology
needs, and identifying and rectifying health system constraints for adequate man-
agementandutilizationofhealthtechnology,particularlythroughtraining,capacity
building and the development and application of appropriate technology.”
One of the HTTG activities is the organization of workshops, and another is to
publish the proceedings of these workshops. The workshop on palliative radio-
therapy for developing countries was the first such venture.1
This current publication is based on the topics and recommendations of the
Second Medical Physics HTTG Workshop, which addressed the medical imaging
requirements for ahealthcenter.Agroup ofexperts inmedicalphysics,consisting
of physicists and physicians from many countries around the world, held scientific
meetingsduringthe18thInternationalConferenceonMedicalPhysics:Scienceand
Technology for Health for All, in Porto Alegre, Brazil, April 17–20, 2011. The
conference was sponsored by the International Organization for Medical Physics
(IOMP), the Latin American Association of Medical Physics (ALFIM), and the
Brazilian Association of Medical Physics (ABFM). The program and the presen-
tations made at that the workshop, as well as those for all HTTG Workshops from
2008 until 2015, can be found in the IUPESM Web site.2
1Workshop on Palliative Radiotherapy for Developing Countries, Ho Chi Min City, Vietnam,
2008.Ed:AllenBJ,RahmanO.VividPublishing,Fremantle,Australia2010.
2http://www.iupesm.org/health-technology-tas-group-httg/.
v
vi Foreword
TheideaofthisbookarosefromtherecommendationsdrawnatthePortoAlegre
Workshop. It seemed that it was worthwhile expanding on the conclusions in a
didactic manner. Cari Borrás, as editor, considered that the publication should
emphasize rural health centers within resource-limited areas of developing coun-
tries. To ensure that the subjects are covered from that point of view, the authors
wereselectedeither fromdeveloping countriesorfromthosehavinghadextensive
experience working in them.
This book differs from the usual approach, whereby most books on the subject
startbyexplainingmedicalimagingmodalitiesandthenlistwhattheyaregoodfor.
Instead, this book starts by describing the health situations that present most often
in a rural health center and then suggests how some imaging modalities, such as
X-rays and ultrasound, can support the clinical diagnoses. With such limited
resources,howcanthecenter function well,whatdoesthestaffneedtoknow,and
who can be consulted? The role of telemedicine is expected to be of major
importance in the integration of the rural service with the major hospital system,
bringing specialist expertise to the smallest medical centers. These substantial
challenges need careful planning if the centers are to achieve their objectives.
This book describes the crude reality of rural medical services in the emerging
world. Even the clinical images shown in Chap. 2 come from medical facilities in
remote areas. By sharing their experiences, the authors have imparted their
knowledgeandcommitmenttomeetingthechallengesfacingruralmedicalcenters.
These challenges need to be addressed by thoughtful planning, careful equipment
andimagingprotocolselection,continuousstafftraining,andtheimplementationof
quality control programs. This publication attempts to cover these issues; I com-
mend it to the rural health centers of the world.
Prof. Barry J. Allen, Ph.D., D.Sc., AO
Past-President IOMP, IUPESM
Contents
Part I Medical and Public Health Needs of a Rural Health Center
1 Characteristics of a Rural Health Center . .... .... .... ..... .... 3
Marlen Perez-Diaz, Consuelo Varela Corona and Cari Borrás
2 Medical Imaging Needs in a Rural Health Center
from a Clinical Point of View... .... .... .... .... .... ..... .... 7
José Luis Rodríguez Monteagudo
Part II Medical Imaging Modalities
3 Medical Imaging Equipment Characteristics
at the Health Center Level: Overview.... .... .... .... ..... .... 43
William Hendee
4 Technical Specifications of Medical Imaging Equipment . ..... .... 49
Kwan Hong Ng, Jeannie Hsiu Ding Wong and Sock Keow Tan
Part III Planning a Medical Imaging Service
5 Equipment and Physical Infrastructure... .... .... .... ..... .... 77
Cari Borrás and K. Siddique-e Rabbani
6 Basic Training and Continuing Education of Technical
Staff in Rural Health Centers... .... .... .... .... .... ..... .... 95
Slavik Tabakov
7 Tele-Imaging and Networking .. .... .... .... .... .... ..... .... 105
K. Siddique-e Rabbani and Trevor D. Cradduck
vii
viii Contents
Part IV Operational Considerations
8 Quality Control, Radiation Safety and Maintenance
Programs.. .... .... .... ..... .... .... .... .... .... ..... .... 119
Cari Borrás
9 Patient Referral to Secondary and Tertiary
Health Care Levels .. .... ..... .... .... .... .... .... ..... .... 135
Cari Borrás and Patrick Cadman
Recommendations Made by the Participants of the Workshop
“Defining the Medical Imaging Requirements of a Health Station”,
Porto Alegre, Brazil, April 2011 ... .... .... .... .... .... ..... .... 147
Editor and Contributors
About the Editor
Cari (Caridad) Borrás, D.Sc., DABR, DABMP, FACR, FAAPM, FIOMP a
native of Spain went, as a Fulbright scholar, to the USA, where she worked as a
radiological physicist in Philadelphia, San Francisco, and Washington, DC. There,
she managed for 15 years the radiological health program of the Pan American
Health Organization/World Health Organization and then, for two years, went to
Recife,Brazil,asavisitingprofessoroftheFederalUniversityofPernambuco.She
chaired for nine years theScience Committee of the International Organization for
Medical Physics and, for six, co-chaired/chaired the Health Technology Task
GroupoftheInternationalUnionofPhysicalandEngineeringSciencesinMedicine
(IUPESM). For her scientific, educational, and professional contributions to med-
ical physics, she has been given awards by the IUPESM, the Spanish (Sociedad
Española de Física Médica), American (American Association of Physicists in
Medicine), Latin American (Asociación Latino-Americana de Física Médica) and
international (International Organization for Medical Physics [IOMP]) medical
physics societies, by the American Board of Radiology and by the American
CollegeofClinicalEngineering.In2013theIOMPalsoincludedheramongthe50
outstanding medical physicists over the last 50 years.
Contributors
Barry J. Allen, Ph.D., D.Sc., OA is an internationally recognized expert on tar-
geted alpha therapy (TAT) for cancer. He developed new targeting agents for the
treatment of melanoma and prostate and other cancers, leading to world first trials
of intralesional and systemic targeted alpha therapy for metastatic melanoma.
Earliermajorcontributionsweretoneutroncapturetherapy(NCT)andinvivobody
composition (IVBC). He initiated the Health Technology Task Group (HTTG) for
developingcountries.ProfessorAllenisapastpresidentoftheInternationalUnion
ix
x EditorandContributors
of Physical and Engineering Sciences in Medicine (IUPESM), the International
Organization for Medical Physics (IOMP), the Asia-Oceania Federation of
Organizations for Medical Physics (AFOMP), and the Australasian College of
Physical Scientists and Engineers in Medicine (ACPSEM). His contributions were
recognized when he was included in the 50 outstanding medical physicists at the
50th Anniversary Conference on Medical Physics in 2013 and his appointment as
an officer in the Order of Australia in 2015.
Patrick Cadman, M.Sc. obtained his degree in medical radiation physics at
McGill University. He worked for many years at the Department of Medical
Physics, Saskatoon Cancer Centre, Saskatoon, Saskatchewan, Canada, from where
he recently retired. One of his research interests explored the possibility of
Cobalt-60 tomotherapy. He is a fellow of the Canadian Association of Medical
Physics and of the Canadian College of Medical Physicists.
TrevorD.Cradduck,Ph.D. earnedaPh.D.attheUniversityofSaskatchewanin
medicalphysics.HespentmanyyearsattheVictoriaHospitalinLondon,Ontario,
and finished up there as professor and chairman of the University of Western
Ontario’s Division of Nuclear Medicine. In 1995, he was asked to manage the
implementationofametropolitanareanetworkknownasLARG*net,andin1997,
he moved on to ONet which, at that time, provided the Internet services to all the
universitiesandcollegesinOntario.In1999,hewasinvitedtobecometheDirector
of Telehealth in Alberta where he remained for three years before retiring. The
CanadianSocietyofNuclearMedicinehonoredDr.Cradduckwithits2014CANM
Emeritus Award, in recognition of the contributions made to the nuclear medicine
community.
William Hendee, Ph.D. is a distinguished professor emeritus of biophysics,
bioethics, radiology, and radiation oncology at the Medical College of Wisconsin.
He is also a professor emeritus of radiology at the University of Colorado. Before
his retirement in 2014, Prof. Hendee was editor of Medical Physics, the most
widelydistributedandreadjournalinmedicalphysicsandengineeringintheworld.
Hehaswrittenoredited24booksinmedicalphysicsandistheauthororco-author
of over 450 scientific publications. Dr. Hendee has received gold medals from the
Roentgen Ray Society, Radiological Society of North America, American College
of Radiology, and the American Association of Physicists in Medicine.
KwanHongNg,Ph.D.,DABMP,MIPEM,CSc,FInstP,FIOMP,AMM,FASc
is a professor at the Department of Biomedical Imaging, University of Malaya,
KualaLumpur,Malaysia.Hehaspioneeredvariousinnovativelearningapproaches
inmedicalphysicsandactivelypromotedmedicalphysicseducation,research,and
professional practice. He has been honored as one of 50 outstanding medical
physicistsintheworldbytheIOMP.Heisthefounderandpresidentemeritusofthe
South East Asian Federation of Organizations for Medical Physics and was a
member of the HTTG.