Choose timezone
Your profile timezone:
MEDAMI 2026 Valencia
→
Europe/Zurich
BIOHUB VLC
BIOHUB VLC
C. de la Travesía, Poblados Marítimos, 46024 Valencia
John Olivier Prior,
Paul Rene Michel Lecoq
(CERN)
Description
Following the series of previously conducted symposia on dedicated medical imaging instrumentation to answer specific medical needs, the 9th issue of this event will be held in the beautiful city of Valencia, Spain. The workshop will address the huge medical and societal challenges related to poor access of two thirds of the world population to efficient early diagnostic imaging tools.
Nuclear Medical Imaging is at the forefront of molecular imaging diagnostic, theragnostic and treatment efficacy assessment techniques for many diseases (cancer, neurodegenerative impairment, cardiovascular disorders, etc.), particularly in the rapidly growing context of personalized medicine.
However, there is a dramatic imbalance in the access to molecular imaging diagnostic tools between high-income countries (HICs) and low- and medium-income countries (LMICs). Given the rapid adoption of new imaging technologies in high-income countries (HICs) to improve health outcomes, there are growing concerns around potential widening of disparities between such countries and the majority of people worldwide without access to nuclear imaging. It is therefore of paramount importance for LMICs to invest in imaging technologies that are best suited to address local causes of death and disability, such as fractures (nearly 50 millions people in LMICs), cancer, cardiovascular and neurodegenerative diseases, just to cite a few. In a microsimulation based on 11 types of cancer, the Lancet Commission in Oncology found that scaling up imaging technology in LMICs would significantly improve cancer survival, with a return up to 180 dollars for every 1 dollar invested.
Technologies designed primarily (but not only) for LMICs can make huge strides towards addressing specific population health needs within the local context. This concept considers limited human resources and infrastructure and incorporating end-user feedback from the initial design stage. They are often portable/mobile, addressing the geographic and space barriers that often exist in LMICs, and they are not intended to cheaply mimic high-end technology, but focus on intentionally addressing local health care needs while considering local challenges. Expert-level reading can be approached by the use of local or distant AI technology.
The cross-fertilisation between physics and medicine has the potential to pave the way to the development of cost-effective and portable imaging approaches. This would allow for a better deployment of nuclear imaging modalities in LMICs, with a huge societal and economic impact with high return for each invested dollar. This ambitious goal, in line with the 3rd out of 17 UN Sustainable Development Goals (SDG) for 2030: “Good Heath and Well Being” for everyone. has been the subject of a World Health Organisation (WHO) resolution on strengthening medical imaging capacity (WHA78.13) adopted by the 78th World Health Assembly in May 2025 and endorsed by a number of statements, including the World Federation of Nuclear Medicine and Biology (WFNMB), the International Society of Radiology (ISR), the International Organization of Medical Physics (IOMP) and the International Atomic Energy Agency (IAEA).
The MEDAMI workshops are unique in that they address a medical imaging topic from the medical, clinical, instrumentation and lately also from the affordability perspectives. We invite experts from different backgrounds relevant to the selected subject disciplines, including biology, nuclear medicine, radiochemistry, physics, and engineering to foster multidisciplinary interactions leading to novel, cutting-edge applications using the latest technological developments. In addition to the subject of the particular conference, the stakeholders from academia, medical institutions and organizations, regulatory agencies and industry, have the opportunity to jointly discuss the strategic directions to better address this important medical and societal challenge.
We are therefore excited to announce the IXth MEDAMI workshop to be held on May 15-17 2026 at the Terminal Hub[1] at the Valencia harbour, Valencia (Spain).
For interested people and to minimize traveling costs, this workshop will immediately follow the more technically oriented FTMI/TBPET/PSMR 2026 workshop on May 11-14 2026 at the Las Arenas hotel in Valencia[2], to shape the future of PET imaging.
We are currently working on finalizing logistical details such as registration fees (and modalities), accommodation options, and the scientific program. Check regularly the indico website, still under construction, with more relevant information, at the following address:
https://indico.cern.ch/event/1570977/overview
For the time being, book these days in your agenda! We are looking forward to welcoming you in Valencia in May 2026.
Program chairs
John Prior
Paul Lecoq
International Advisory Committee
● John Prior, CHUV Lausanne, Switzerland
● Paul Lecoq, CERN, Geneva, Switzerland and I3M (CSIC/UPV), Valencia, Spain
● Antonio J. Gonzalez, I3M (CSIC/UPV), Valencia, Spain
● Nicola Belcari, University of Pisa and INFN Pisa, Italy
● Jose Maria Benlloch, I3M (CSIC/UPV), Valencia, Spain
● Massimo Carpineli, University Milano Bicocca, Italy
● Klaus Schonenberger, EPFL Lausanne, Switzerland
● Franco Garibaldi, ISS & INFN, Rome, Italy
● York Haemisch, Direct Conversion/Varex, Munich, Germany
● Peter Križan, University of Ljubljana, Slovenia
● Rok Pestotnik, University of Ljubljana, Slovenia
● Roger Lecomte, Université de Sherbrooke, Canada
● Craig Levin, Stanford University, USA
● Stan Majewski, University of California, Davis, USA
● Vesna Sossi, University of British Columbia, Vancouver, Canada
● Charalampos Tsoumpas, UMCG, University of Groningen, Netherlands
Local Organizing Committee
● Antonio J. Gonzalez, I3M (CSIC/UPV), Valencia, Spain
● Paul Lecoq, I3M (CSIC/UPV), Valencia, Spain & Metacrystal SA, Geneva, Switzerland
● Marta Freire, I3M (CSIC/UPV), Valencia, Spain
● Fiammetta Pagano, I3M (CSIC/UPV), Valencia, Spain
● Patricia Sanjuan, Turevents & Go, Valencia, Spain
● Daniela Alvarado, Turevents & Go, Valencia, Spain
Contact: Patricia Sanjuan, Daniela Alvarado
-
-
2:00 PM
→
2:20 PM
WelcomeConveners: John Olivier Prior, Paul Rene Michel Lecoq (CERN)
-
2:00 PM
Welcome to MEDAMI: Medical context & Practical information 10m
Info on schedule, uploading presentations, coffee breaks and Saturday lunch.
Speaker: John Prior & Paul Lecoq -
2:10 PM
Official welcome from the Director Division of Human Health, International Atomic Energy Agency 5m
Short official welcome
Speaker: Ms Abdel Wahab May -
2:15 PM
Official welcome from the Director “People: Health and Society”, DG Research and Innovation, European Commission 5m
NA
Speaker: Ms Pilar Aguar Fernandez
-
2:00 PM
-
2:20 PM
→
3:20 PM
Session 1: Invited talksConvener: Paul Rene Michel Lecoq (CERN)
-
2:20 PM
The WHA78.13 Resolution on strengthening medical imaging capacity: what it means for nuclear medicine globally 20m
In May 2025, the WHA78.13 Resolution on strengthening medical imaging capacity has been unanimously voted by the WHO Member States. This presentation will show what it means for nuclear medicine and theranostics globally for all stakeholders, including the member states themselves, the national medical associations of specialists, the Non-States Actors, the professional societies, the industry and equipment manufacturers. The Global Diagnostics Coalition has been founded at the same time and has a role in implementing this WHA78.13 resolution.
Speaker: Prof. John O. Prior (Lausanne University Hospital) -
2:40 PM
Nuclear medicine is a priority medical device required to strengthen medical imaging capacity. 20m
“Strengthening medical imaging capacity” is the name of the WHA78.13 resolution (1), approved by all Member States in the Assembly of the World Health Organization in May 2025, acknowledging the global need. This resolution and the discussion by Member States, recognized that medical imaging is indispensable for diagnosis and treatment of communicable, non-communicable diseases and health conditions, nevertheless the medical technologies required to perform the medical imaging tests are not affordable, not available, and not accessible in multiple low- and middle-income countries. Specifically, Medical Imaging, including nuclear medicine are required to diagnose cancer, hormonal diseases, cardiovascular diseases among other conditions, which should be included in the packages of priority interventions of a Universal health coverage national initiative.
Patients globally need to have access to medical devices, which include those for prevention, diagnostic, treatment, and palliative care. WHO has developed a list of Priority Medical devices, including for cancer management (2) and for cardiovascular diseases ( 3), which is published and also integrated in a web-based database called MeDevIS,(4) which also includes types of technologies, technical specifications and training material when available.
Nuclear medicine technologies are listed in the WHO Priority Medical Devices and have been disseminated to Ministries of Health in seminars, and Fora. The problem lies on the limited economical support as well as human resources to manage these technologies, which sometimes are far from the basic services that can be made available for the population in need.
Nuclear medicine technologies are costly, require specific infrastructure, access to stable energy, consumables, radioactive substances and most important, technical and clinical staff to have proper, appropriate and safe use to diagnose patients promptly and the clinical interventions and medicines to treat them accordingly.
It is important to consider that Biomedical engineers, medical imaging technicians, and Nuclear medicine doctors are needed to ensure good patient outcomes.
WHO and Ministries of Health cannot do the work alone, especially in low- and middle-income countries, therefore, the resolution also encourages NGOs and non-state actors to support the deployment of this equipment and the human resources required.
Technology has been evolving exponentially, and the cost are diminishing, nevertheless, much more has to be done, and the WHA78.13 invites all those concerned to strengthen medical imaging, complementing with another Resolution approved in 2023 that is WHA76.5 (5) Strengthening diagnostics capacity, which is based on the benefits from prompt diagnosis to enhance faster treatment and avoid complications and costly interventions and negative social implications.
The experts could support WHO and Member States by developing training material which can be used by the WHO Academy (6) to train health care workers globally, as well as participating in the Global Diagnostic Coalition (7), where multiple NGOs are uniting efforts to increase diagnosis capacity globally, especially for those patients living in low- and middle-income countries.
Much remains to be done and the collaboration is needed more than ever to ensure patients have a prompt diagnosis and effective treatments, anywhere in the world.
References:
1. WHA78.13. World Health Assembly, 78 (2025). Seventy-eight World Health Assembly: Geneva, 21-30 May 20235: resolutions and decisions, annexes. World Health Organization. https://apps.who.int/gb/ebwha/pdf_files/WHA78/A78_R13-en.pdf
2. World Health Organization (2017). WHO list of priority medical devices for cancer management. World Health Organization. https://iris.who.int/handle/10665/255262. License: CC BY-NC-SA 3.0 IGO
3. World Health Organization (2021). WHO list of priority medical devices for management of cardiovascular diseases and diabetes. World Health Organization. https://iris.who.int/handle/10665/341967. License: CC BY-NC-SA 3.0 IGO
4. MEDEVIS https://medevis.who-healthtechnologies.org/
5. WHA76.5. World Health Assembly, 76 (2023). Seventy-sixth World Health Assembly: Geneva, 21-30 May 2023: resolutions and decisions, annexes. World Health Organization. https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_R5-en.pdf
6. WHO Academy https://www.who.int/about/who-academy
7. Global Diagnostics Coalition https://www.who.int/initiatives/global-diagnostic-coalitionSpeaker: Mrs Adriana VELAZQUEZ BERUMEN (Medical Devices expert) -
3:00 PM
The role of the IAEA in supporting the implementation of the WHA78.13 Resolution: from policy to practical capacity building in medical imaging and nuclear medicine 20m
The World Health Assembly Resolution WHA78.13 on strengthening medical imaging capacity represents a major global commitment to improving equitable access to diagnostic and therapeutic technologies. The International Atomic Energy Agency (IAEA), through its longstanding mandate in the peaceful applications of nuclear science, plays a central role in translating this policy framework into operational capacity-building activities.
This presentation will discuss how the IAEA supports Member States in implementing the objectives of the WHA resolution through integrated programmes covering infrastructure development, human resource training, quality assurance, radiation safety, and regulatory guidance. Particular emphasis will be placed on nuclear medicine and molecular imaging, where the Agency has developed coordinated initiatives in equipment deployment, radiopharmacy support, clinical training, and international networking.
Examples from recent regional and global projects will illustrate how policy-level commitments can be translated into sustainable national capabilities. The presentation will also discuss challenges related to workforce shortages, technology sustainability, and regulatory harmonization, highlighting opportunities for collaboration between international organizations, governments, and professional societies to ensure effective implementation of the resolution.Speaker: Francesco Giammarile
-
2:20 PM
-
3:20 PM
→
3:50 PM
Coffee Break
-
3:50 PM
→
6:10 PM
Situation of Nuclear Medicine in Low- and Medium-Income Countries: Session 2Convener: John Olivier Prior
-
3:50 PM
Assessment of Nuclear Medicine Infrastructure in the Democratic Republic of Congo: Report of a IAEA Expert Mission 13m
Background and Mission Purpose
In November 2020, amidst the specific challenges of the global SARS-CoV-2 pandemic , an IAEA Technical Cooperation Expert Mission was conducted to assess the nuclear medicine situation in the Democratic Republic of Congo (DRC). Mandated under project ZA16014, "Sustaining Nuclear Medicine Infrastructure for the Improvement of the Management of Communicable and Non-Communicable Diseases," the audit was carried out by Dr. Renaud Guignard. The primary site of evaluation was the Cliniques Universitaires de Kinshasa (CUK), under the local leadership of Pr. Symphorien Ditu Mpandamadi.Objectives
The mission was structured around three pivotal objectives:- Technical evaluation of the performance of a newly installed Mediso Anyscan dual-head SPECT gamma-camera.
- Quantitative and qualitative assessment of nuclear medicine (NM) clinical activities.
- Identification of urgent needs regarding radiopharmacy, radioprotection, and specialized clinical equipment.
Historical Context and Findings
The DRC has a long culture of nuclear medicine, birth of the CGEA in 1959 and the first radioimmunological procedures in 1970. However, the service has faced prolonged interruptions due to socio-political instability and equipment failures. At the time of the audit, the previous Siemens E-Cam camera had been non-functional since 2016, and critical infrastructure, such as the Comecer hot cell and thyroid counters, were out of service. Qualitative evaluation using the IAEA QUANUM tool revealed an overall score of 51.6%, with clinical services scoring lowest at 40.0%.SWOT Analysis
The mission identified significant strengths, notably the visionary leadership and high motivation of the CUK staff, coupled with historical expertise and ongoing IAEA support. Conversely, weaknesses included a lack of a stable functional budget and limited recognition of NM benefits by local health authorities. Threats were primarily external, involving unreliable infrastructure (power and IT) and heavy dependence on foreign radiopharmaceutical providers.Recommendations and Strategic Roadmap
The audit concluded with a prioritized roadmap:
- Top Priority: immediate completion of acceptance and reference tests for the new Mediso SPECT device.
- Urgent: comprehensive staff training for new SPECT procedures—ideally in French—and fixing hot cell software issues.
- Short-term (<6 months): procurement of essential radioprotection gear (shielded syringes, leaded aprons) and implementation of cardiac imaging.
- Long-term (2-5 years): transitioning toward multimodality with SPECT-CT and PET-CT installations to address cardiovascular and oncological diseases.This mission highlights the critical importance of regular expert audits to bridge the gap between technological installation and sustainable clinical performance in medium-income countries.
Speaker: Renaud Guignard -
4:03 PM
Development and implementation of nuclear medicine services at the university clinics of Kinshasa (2020–2025) 13m
Background and implementation (2019 – 2022)
Following a strategic partnership between the University Clinics of Kinshasa (CUK) and the International Atomic Energy Agency (IAEA), facilitated by the CGEA/CREN-K, a Mediso SPECT Anyscan dual-head gamma camera was acquired in 2019. Technical installation and initial acceptance testing were completed in 2020 with support from regional maintenance teams and IAEA expert oversight. Clinical operations officially commenced in 2022 following expert validation, with the initial session focusing exclusively on thyroid scintigraphy, recording 15 examinations (December 2022).Operational expansion (2023)
The service achieved full operational status in 2023 under the guidance of IAEA expert Professor Bouyoucef Sala. This period marked a significant expansion in clinical activity, with 108 examinations conducted across three distinct sessions (February; April; June-July). Furthermore, diagnostic procedures were diversified beyond thyroid scans (n=60) to include myocardial (n=12), renal (n=14), bone (n=21), and pulmonary scintigraphy (n=1).Technical challenges and resilience (2024–2025)
Clinical activity faced a total interruption in 2024 due to critical power circuit failures. This technical setback was resolved through the implementation of a dedicated power protection and backup system, including UPS units and stabilizers. Consequently, operations resumed in 2025, recording 84 examinations across three sessions (June; September-October; November). Despite a slight decrease in overall volume compared to 2023, the diagnostic scope continued to evolve with the successful introduction of cerebral scintigraphy (n=2).Conclusions and perspectives
The 2020–2025 period reflects a progressive and resilient trajectory for nuclear medicine at CUK. Current strategic priorities focus on increasing patient flow through clinical popularization and the adoption of complex protocols in neurology, cardiology, and oncology to optimize patient care in the Democratic Republic of Congo.Speaker: Renaud Guignard -
4:16 PM
The current status and perspective of nuclear medicine in Burkina Faso in 2026: Challenges in technology deployment and sustainability. 14m
Introduction:
In sub-Saharan Africa, the transition toward molecular imaging remains a significant public health challenge. The establishment of the first nuclear medicine (NM) department in Burkina Faso at the Yalgado Ouédraogo University Hospital (CHUYO) in January 2012 marked a strategic turning point. Following fourteen years of operation, this study aims to provide a longitudinal assessment of the NM ecosystem in Burkina Faso, identifying systemic barriers to technology sustainability and outlining the strategic roadmap for the next decade.
Materials and Methods:
The present descriptive cross-sectional study examined the availability of personnel, equipment, and the supply chain for radiopharmaceuticals. We analyzed the evolution of scintigraphy activities and clinical indications performed from January 2012 to December 2025.
Results:
For over a decade, nuclear imaging procedures in Burkina Faso (BF) relied on a single operational centre equipped with a Mediso dual-head single-photon emission computed tomography (SPECT) gamma-camera (Nucline SPIRIT DH-V). A critical expansion phase began in 2024 with the installation of a second department featuring a Siemens Symbia SPECT/CT, marking the entry into hybrid imaging.
Despite this progress, only 3,317 examinations were conducted over 14 years, yielding a modest annual average of 237 exams. Oncological investigations dominate the clinical landscape (51% using 99mTc-MDP), followed by renal (18%), thyroid (16%), myocardial (10%), and pulmonary scans (5%).
However, advanced services such as metabolic radiation therapy and radioimmunology remain unavailable, and the lack of dedicated equipment continues to hinder essential quality control for radiopharmaceuticals. The specialized workforce includes ten NM physicians, six technologists, three medical physicists, and a single radiopharmacist
Discussion:
The operational history of NM in Burkina Faso highlights the vulnerability of high-tech medical services in LMICs. The erratic trend in scintigraphy procedures is directly associated with recurrent work stoppages due to equipment breakdowns and chronic challenges in procuring radiopharmaceuticals. The absence of integrated maintenance contracts and the slow pace of equipment replacement compromise service viability. Furthermore, the shortage of medical physicists and radiopharmacists exerts a deleterious effect on clinical quality and safety standards. To overcome these hurdles, priority must be accorded to continuous professional training and the regionalization of supply chains
Conclusion:
While the 2012 milestone laid the foundation for NM, persistent infrastructural and logistical obstacles have limited its full potential. The ongoing deployment of the new department is a catalyst for innovation, likely leading to the introduction of PET imaging in Burkina Faso by 2028, provided that sustainable maintenance and training strategies are implemented.
Keywords:
Burkina Faso; SPECT/CT deployment; LMICs (Low- and Medium-Income Countries); Technology sustainability; Hybrid imaging perspectivesSpeaker: Dr Renaud Guignard (Service de médecine nucléaire Montpellier) -
4:30 PM
Bridging the Gap: The SFMN Francophonie Working Group’s Educational Initiative for Nuclear Medicine in LMICs 20m
In view of the restricted and sporadic availability of NM procedures, an important impediment to the effective implementation of nuclear medicine technologies (NMTs) in LMICs is the sustainability of human capital expertise. In order to address this issue, the Francophonie Working Group ("GT Francophonie") of the French Society of Nuclear Medicine (SFMN) has launched a robust continuous training programme. This programme has been designed to sustain the deployment of NMTs across French-speaking LMICs, particularly in Africa. The cornerstone of this initiative is a series of monthly multidisciplinary webinars. The objective of these sessions are:
- To facilitate multidisciplinary interaction. In accordance with MEDAMI's objective of facilitating cross-fertilisation, the organisation's webinars serve as a forum that assembles NM professionals with practitioners specialising in fields such as surgery and oncology.
- To provide practical expertise. Each session focuses on "hands-on" clinical cases and technical protocols, addressing the specific needs of end-users in resource-limited settings.
- To provide support for strategic development. The programme facilitates the optimisation of utility of existing/advanced NM instrumentation by local teams through the sharing of expert-level reading and protocol standardisation.
This educational framework is in alignment with the 2025 WHO resolution on the strengthening of medical imaging capacity. By prioritising human capital alongside technological investment, the SFMN GT Francophonie ensures that NMTs are not merely installed, but effectively utilised to address local health issues.
The SFMN's involvement in these regular exchanges contributes to the UN sustainable development goal of "good health and well being" for all, demonstrating the feasibility of cost-effective and sustainable nuclear imaging through shared knowledge and international cooperation.
Speaker: Renaud Guignard -
4:50 PM
Bridging the Gap: Bringing Nuclear Oncology to the Heart of Central Africa A Cyclotron for Kinshasa — Opportunities and Challenges 20m
The Democratic Republic of Congo (DRC), with a population exceeding 102 million, currently operates with fewer than five nuclear medicine physicians, no PET/CT scanner, and no radiopharmaceutical production facility. Against a backdrop of more than 50,000 new cancer cases diagnosed annually and a single private radiotherapy unit serving the entire country, the gap between oncological need and diagnostic capacity is among the widest on the African continent.
This presentation provides an overview of the current state of nuclear medicine in Kinshasa, benchmarked against European standards, and examines the realistic conditions under which a medium-energy cyclotron could be established at the University of Kinshasa (UNIKIN/CGEA) to support the country's first oncology centre.
Drawing on lessons from both successful and failed initiatives across Africa, the presentation maps the key opportunities, alongside the critical challenges that any such project must address: such as energy infrastructure, human resource retention,and long-term financial sustainability.Speaker: Prof. Dr. Ken Kudura -
5:10 PM
Dynamic Status of Nuclear Medicine in Africa 20m
Nuclear medicine and molecular imaging (NMMI) has experienced remarkable global growth over the past 50 years and now plays a crucial role in the development and implementation of strategies for managing major public health challenges in many countries. During this period, significant advances in technology, computing software, radiopharmacy, and instrumentation have enhanced the impact of nuclear medicine across numerous medical fields. As a result, it is now widely regarded as an essential and prominent modality for the diagnosis and treatment of various diseases.
Over the last three decades, Africa has demonstrated steady progress in NMMI. In regions such as South Africa and North Africa, development has been comparable to that observed in more developed parts of the world. In contrast, in many other African countries, growth has remained limited, mainly consisting of the expansion of basic clinical services, including diagnostic studies using technetium-99m (99mTc) and therapeutic applications with iodine-131.
The development of NMMI across Africa has been closely linked to effective technical cooperation with the International Atomic Energy Agency (IAEA), which has provided multifaceted support tailored to the needs and capacities of individual countries. Any discussion of nuclear medicine development in Africa inevitably highlights the unique and central role of the IAEA.
Nuclear medicine is a key focus of the IAEA’s human health cooperation programs. Over the past two decades, 29 African countries have implemented at least three specific projects related to nuclear medicine. These national projects have aimed at introducing or expanding nuclear medicine services at national or regional levels, developing quality assurance programs, and implementing advanced imaging technologies such as positron emission tomography/computed tomography (PET/CT). The highest success rates of these initiatives are generally observed when they are well aligned with national health priorities and programs.Speaker: Salah Eddine Bouyoucef (Emeritus Professor Nuclear Medicine Faculty of Medicine/University Hospital Bab El Oued Algiers Algeria) -
5:30 PM
Ten years of experience in developing medical imaging solutions for low-resource settings 20m
We report ten years of experience in developing sustainable medical imaging solutions for low-resource settings, from the development of a CBCT prototype in 2016 to the implementation of radiology service digitalization in three sub-Saharan African countries.
The CBCT project, ImagXEco, was funded by the University of Louvain-la-Neuve and the Walloon Region with the aim of developing a multifunctional X-ray medical device capable of 3D CBCT, 2D radiography, and fluoroscopy imaging. However, the project fell short due to market uncertainties and the complexity of the medical device certification process.
At the end of the ImagXEco project, the digitalization of existing radiology services was identified as the best option to pursue the initial goal of providing sustainable solutions and a commercial company, MDS-Imaging srl, was founded in May 2020 to implement the following solutions:
1. “DRuP” to upgrade existing film or CR X-Ray installations to full Digital Radiography
2. “DRuP+” to replace existing X-Ray generator with a model designed for low and/or unstable power sources
3. “RadStream” to install a completely new Digital X-Ray system
4. “PACS” to provide access to images for all authorized personnel within the hospital, using Orthanc, an open-source lightweight DICOM server
5. “PACS+” to integrate radiology services with the hospital Electronic Medical Record ”EMR”, store and distribute images within the hospital, using Orthanc and OpenclinicGA.The CBCT project (2016–2019) was a valuable learning experience in terms of technical implementation and needs assessment, and it contributed to the creation of MDS-Imaging in 2020. The need for diagnostic imaging is considerable; however, many examinations are not performed because patients often cannot afford them.
Since 2020, MDS-Imaging srl has installed and maintained the following systems: six “DRuP” (five in District Hospitals and one in a Teaching Hospital); six “PACS+” (in five District Hospitals and two Teaching Hospitals); one “DRuP+” in a District Hospital; and one “RadStream” in a District Hospital.
These installations were funded either directly by the hospitals (50%) or donated by NGOs (50%). In both cases, these installations are sustainable only if they are financially viable and can be maintained by the hospitals. Therefore, the population must have sufficient income to pay for the services or benefit from national health insurance.Speaker: Mr Merence Sibomana (MDS-Imaging srl) -
5:50 PM
AI Inclusion in Nuclear Medicine to Strengthen Imaging Capacity in Low- and Middle-Income Countries 20m
Artificial intelligence (AI) has the potential to fundamentally reshape nuclear medicine by enabling high-quality imaging and advanced clinical decision support in resource-constrained settings. This presentation explores how AI-driven innovations can help bridge both technological and knowledge gaps in low- and middle-income countries (LMICs), thereby strengthening global equity in nuclear medicine and theranostics.
The first part focuses on AI methods that enhance the value of low-cost and widely available imaging systems. We will present approaches that enable quantitative equivalence to high-end modalities, including AI-based reconstruction of three-dimensional dosimetry from planar measurements. In addition, we will demonstrate cross-modality synthesis techniques, such as generating PET-like images from SPECT acquisitions, to approximate the diagnostic and quantitative capabilities of more advanced systems. These strategies aim to maximize the utility of existing infrastructure while minimizing the need for costly hardware upgrades.
The second part addresses the knowledge and implementation gap, which remains a major barrier to the adoption of theranostics in LMICs. We will discuss the emerging role of large language models (LLMs) and autonomous AI agents in supporting clinical workflows, and decision-making. By embedding domain knowledge and proper logics into LLM chatbots, these tools can facilitate rapid capacity building, reduce dependency on highly specialized expertise, and support safe and effective deployment of theranostic practices.
Together, these technological and knowledge-centric AI approaches outline a scalable pathway toward more inclusive nuclear medicine, enabling broader access to precision diagnostics and therapy worldwide.Speaker: Kuangyu Shi (University of Bern)
-
3:50 PM
-
2:00 PM
→
2:20 PM
-
-
8:30 AM
→
9:30 AM
Situation of Nuclear Medicine in Low- and Medium-Income Countries: Session 3:Convener: Francesco Giammarile
-
8:30 AM
Scaling Prostate Cancer Care in Low- and Middle-Income Countries: The Role of PSMA PET in the Era of Rising Incidence 20m
Prostate cancer incidence is projected to nearly double worldwide, from 1.4 million cases in 2020 to 2.9 million by 2040, with the greatest proportional increase occurring in low- and middle-income countries (LMICs). Late-stage presentation remains the norm in these settings, driving higher mortality despite the availability of effective diagnostic and therapeutic strategies. A recent Lancet Commission highlights the urgent need for resource-adapted diagnostic pathways, including the integration of advanced imaging modalities such as prostate-specific membrane antigen (PSMA) PET, which offers improved staging accuracy and potential cost-effectiveness when appropriately deployed. Strategic implementation of PSMA PET, alongside education and early detection programs, represents a key opportunity to shift diagnosis toward earlier stages and improve outcomes in LMICs.
Speaker: Massimo Valerio -
8:50 AM
Starting off Theranostics in small hospitals in developing countries 20m
Research Objective
To investigate how to begin targeted molecular therapies in less resourceful hospitals in developing countries
Introduction
Theranostics refers to use of the same radiopharmaceuticals for diagnostics and targeted molecular therapy (Konrad et al., 2021). It is a new treatment modality that promises personalized radiation therapy for cancer patients. It has been in practice in developing countries for a while, especially through the use of I-131/ I-123. It can be applicable to both SPECT/CT as well as PET/CT. The practice has however been expanded to include other radionuclides in other parts of the world to include such radionuclides as Lu-177, Y-86/Y-90, Ra-223 etc. for diagnostics/ therapeutics of several cancers. Developing countries are also developing an appetite for this contemporary molecular theranostics. As a matter of fact, it won’t take long before you hear of a country practicing this contemporary theranostics practice.
What is of concern, however, is the dosimetry involved in theranostics. It is discouraged to offer standard doses to all patients undergoing nuclear medicine diagnostics/therapies due to different body sizes, pharmacokinetics etc. As a matter of fact, offering standard doses may lead to either under-dosing or overdosing the tumors as well as misrepresenting the doses received by the internal organs at risk (Li et al.,2017). From the literature, many countries, especially in developed nations, are carrying patient specific QA (PSQA) on theranostics and preliminary investigations show that there is no uniformity in the dosimetry carried out (Taprogge et al.,2021). Developing countries face more challenges in the sense that there are human resource challenges especially in the field of medical physics, skills in the area, equipment resource scarcity and the conflict of machine time in respect to offering theranostics services vs carrying out dosimetry.
Besides the human resource requirements, less resourced hospitals do not have the necessary tools for measuring dose to know the amount of dose to be delivered to the patients. However, it is good to start from somewhere even if it means offering rudimentary radionuclides such as I-131.
Methodology
This research will be carried throughout the republic of Kenya to find out what centers are doing to implement theranostics in the nuclear medicine department. We will be checking out how the centers that are doing nuclear medicine whether they are offering theranostics services, the tools they are using to carry out PSQA, qualification of the nuclear medicine personnel, sources of funding as well as the much they charge on patients. We will use questionnaires to collect the data and use MS spreadsheet to analyze the data collected.
Expected Significance
This research is of utmost importance to industry practitioners (in nuclear medicine). The world is now evolving towards more personalized treatments and developing countries should not be left behind. There are several benefits of theranostics that all patients around the globe can benefit from and in as much as there are significant benefits, patient safety is also of paramount importance. This is therefore a clarion call for developing countries to mobilize their resources to ensure we benefit from the technological treatment trends (theranostics) and at the same time protect our patients from the harmful effects of radiation if not properly quantified.Key words
Starting Theranostics, PSQA, DosimetryReferences
Li, T., Ao, E. C., Lambert, B., Brans, B., Vandenberghe, S., & Mok, G. S. (2017). Quantitative imaging for targeted radionuclide therapy dosimetry-technical review. Theranostics, 7(18), 4551.
Lotter, K., Diemling, M., Sohlberg, A., Wiedner, H., Haug, A., & Maringer, F. J. (2021). Comparing calculated and experimental activity and dose values obtained from image-based quantification of 90Y SPECT/CT Data. Zeitschrift für Medizinische Physik, 31(4), 378-387.
Taprogge, J., Wadsley, J., Miles, E., & Flux, G. D. (2021). Recommendations for multicentre clinical trials involving dosimetry for molecular radiotherapy. Clinical Oncology, 33(2), 131-136.Speaker: Bob Omondi -
9:10 AM
Establishment of Local Production of 18F-Florbetapir for Cost-Effective Amyloid PET Imaging of Alzheimer’s Disease at Siriraj Hospital, Thailand 20m
Background: Alzheimer’s disease (AD) is the leading cause of dementia worldwide and poses an escalating public health burden, particularly in aging populations. Accurate early diagnosis is essential for optimal patient management and the implementation of emerging disease-modifying therapies. Positron emission tomography (PET) imaging with 18F-Florbetapir enables noninvasive in vivo detection of β-amyloid plaques, a defining neuropathological feature of AD, and has demonstrated superior diagnostic accuracy compared with clinical assessment alone. Nevertheless, access to amyloid PET imaging remains limited in many countries due to the high cost and restricted availability of radiopharmaceuticals.
Methods / Development: The Siriraj Cyclotron Centre has developed the capability for local production of 18F-Florbetapir using a modified in-house synthesis protocol derived from previously published methods and related Alzheimer’s disease research conducted by Siriraj Nuclear Medicine team and collaborators. Production is performed using an automated synthesis system involving nucleophilic substitution of 18F-fluoride, followed by purification and sterile formulation suitable for intravenous administration. Comprehensive quality control testing is conducted in accordance with established radiopharmaceutical standards to ensure product identity, purity, safety, and suitability for clinical use.
Future Implementation: The patent protection associated with the licensed commercial production of 18F-Florbetapir is anticipated to expire in 2027. In preparation for this development, the Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital, plans to implement a clinical amyloid PET imaging service utilizing locally produced 18F-Florbetapir. This initiative aims to provide a cost-effective diagnostic modality while maintaining high standards of image quality, production reliability, and patient safety. Establishing domestic manufacturing capability is expected to reduce dependence on imported radiopharmaceuticals, enhance accessibility for patients in Thailand, and support clinical and translational research in neurodegenerative disorders.
Conclusion: The establishment of local 18F-Florbetapir production at Siriraj Hospital represents a significant advancement toward expanding access to advanced molecular imaging for Alzheimer’s disease in Thailand. Following the anticipated expiration of patent restrictions, this program has the potential to deliver affordable, high-quality amyloid PET services while strengthening national capacity in both clinical care and research on neurodegenerative diseases. Upon successful implementation, this program has the potential to serve as a model for other centers in Thailand and throughout Southeast Asia to establish local production of various radiopharmaceuticals, thereby enhancing regional capacity and expanding access to advanced medical services.
Reference:
1. Siriprapa T, Thientunyakit T, Gelovani J. Amyloid PET Radiopharmaceuticals and Imaging for Clinical and Research Applications in Thailand. Siriraj Med J. 2023 Sep. 1;75(9):688-9.
2. Tanyaluck Thientunyakit, Weerasak Muangpaisan, Orasa Chawalparit, Chakmeedaj Sethanandha, Siriwan Piyapittayanan, Tossaporn Siriprapa and Kuntarat Arunrungvichian, Brain amyloid PET scan in Alzheimer’s disease, mild cognitive impairment and normal aging: The first prospective longitudinal study in Thailand. Journal of Nuclear Medicine May 2021, 62 (supplement 1) 1061.
3. Tossaporn Siriprapa, Tanyaluck Thientunyakit, Production and Quality Control of [F-18 ]Florbetapir PET Tracers for Diagnosing Cardiac Amyloidosis by Two CFN Multi-Purpose Synthesizers at Siriraj Hospital. International Conference on Integrated Medical Imaging in Cardiovascular Diseases.Speaker: Tossaporn Siriprapa
-
8:30 AM
-
9:30 AM
→
10:40 AM
Session 4: Nuclear Medicine Deployment in LMICs: Enabling TechnologiesConvener: Antonio Gonzalez
-
9:30 AM
Enabling Neuroimaging in Low- and Middle-Income Countries: Development of a Compact, High-Performance DOI and TOF-Enabled Brain PET System 18m
Background: Positron emission tomography (PET) provides crucial dynamic and quantitative information for brain function, making it an important tool in neuroscience research and clinical diagnosis. However, conventional whole-body PET scanners are not specifically designed for brain imaging and often suffer from insufficient spatial resolution and sensitivity. Furthermore, deploying standard whole-body systems in Low- and Middle-Income Countries (LMICs) is severely restricted by high capital costs, massive facility footprint requirements, and limited radiotracer production infrastructure. Dedicated brain PET systems can address these limitations by reducing the detector aperture, which yields a larger geometric acceptance angle and consequently higher sensitivity.Objective: This work presents the development and evaluation of a high-performance dedicated brain PET/CT system incorporating Depth-of-Interaction (DOI) and Time-of-Flight (TOF) capabilities. We aim to demonstrate how this compact architecture serves as an enabling technology for LMICs by simultaneously reducing hardware costs and radiotracer dose requirements without compromising imaging quality.Methods: The dedicated brain PET system consists of ten panels, forming a compact detector face-to-face diameter of 366.1 mm and an axial field of view (AFOV) of 280.6 mm. The detector modules are constructed using LYSO crystals ($2.0\times2.0\times20.0~mm^{3}$) coupled to a Multi-Pixel Photon Counter (MPPC) array. To enable high-resolution DOI decoding, light-sharing windows are introduced between the scintillator crystals, allowing a variable fraction of scintillation photons to pass through depending on the depth of interaction. The system performance was evaluated according to the NEMA NU 2-2018 methodology, and preliminary human brain imaging was conducted.Results: The implementation of DOI effectively mitigates parallax errors, maintaining spatial resolution across the field of view. According to the NEMA NU 4-2018 standard, the system achieves an excellent mean spatial resolution of 2.25 mm. Due to the compact geometry, the measured sensitivities reached $16.12~cps/kBq$ at the center and $16.75~cps/kBq$ at a 10 cm radial offset. Furthermore, the system achieves a coincidence timing resolution of 284 ps. This timing performance enables effective TOF localization, which improves the signal-to-noise ratio and image quality in PET reconstruction. In a preliminary clinical demonstration, a 28-year-old female volunteer was imaged using a significantly reduced 18F-FDG dose of only 2.6 mCi. Despite the lower signal-to-noise ratio inherent to higher spatial resolution , the system successfully revealed fine structural details in several brain regions.Conclusion and LMIC Impact: The proposed dedicated brain PET system proves that high-performance neuroimaging is feasible within a resource-constrained context. By reducing the detector ring diameter to 366.1 mm, the required volume of costly LYSO crystals is drastically minimized, directly lowering capital equipment costs. The integration of DOI and a 284 ps TOF timing performance compensates for the smaller geometry, maximizing photon utilization. This high sensitivity allows for diagnostic-quality imaging at substantially lower injected radiotracer doses (e.g., 2.6 mCi), significantly alleviating the burden on local radiopharmacies in LMICs. Ultimately, this compact architecture provides a cost-effective, scalable pathway to democratize advanced molecular neuroimaging globally.
Speaker: Qiyu Peng -
9:48 AM
Toward More Accessible Brain PET: Initial Human FDG Imaging with the SmartBrain Wearable Dedicated PET 18m
In low- and medium-income countries and other resource-constrained settings, deployment of advanced PET systems remains limited by high capital cost, large space requirements, complex installation, and demanding infrastructure. Brain PET is particularly difficult to expand under these conditions. Dedicated, compact, and lower-barrier technologies may therefore represent an important pathway for improving access to molecular brain imaging.
SmartBrain is a wearable dedicated brain PET system developed to support human brain imaging in a compact form factor and under awake conditions. Rather than replacing conventional whole-body PET/CT, the system is intended as a more deployable, brain-focused alternative for selected neuroimaging applications. Preliminary program data indicate that the system has already entered multi-center human feasibility evaluation and has been used in more than 10 awake human brain imaging studies. In same-subject comparison experiments, SmartBrain produced visually interpretable FDG brain images and showed image quality that was competitive with, and in some cases superior to, conventional PET in brain-focused imaging tasks. Initial dynamic human FDG imaging further demonstrated tracer arrival, early vascular signal, and progressive uptake in brain tissue over time.
In addition to feasibility in human imaging, SmartBrain shows characteristics that are directly relevant to deployment. Compared with conventional PET systems, the platform is designed around a substantially more compact footprint, with space requirements on the order of 4 m² rather than more than 20 m² for standard PET installations. The system is also being developed toward markedly reduced overall cost, with an estimated reduction of approximately 90% relative to conventional PET. Spatial resolution is approximately 1.7 mm, compared with about 3.5 mm for typical conventional PET systems used as reference in the project materials. The wearable design also enables awake and more naturalistic imaging conditions, expanding potential use cases beyond the traditional fully supine, stationary workflow.
These preliminary results suggest that a wearable dedicated brain PET such as SmartBrain may serve as an enabling technology for expanding access to brain molecular imaging, especially in settings where conventional PET deployment is difficult. Further work is needed in quantitative correction, workflow standardization, broader clinical validation, and deployment pathway assessment. Nevertheless, this approach may provide a practical technical route toward more accessible nuclear medicine imaging for brain applications.Speaker: Qiyu Peng (Shenzhen Bay Laboratory) -
10:06 AM
Towards Equitable Cardiovascular Care: A High-Performance, Cost-Effective Cardiac-Dedicated TOF-PET System for Resource-Limited Settings 17m
Cardiovascular disease (CVD) remains a leading cause of global mortality, with a disproportionately high burden in low- and middle-income countries (LMICs). Despite the gold-standard status of Positron Emission Tomography (PET) for quantifying myocardial flow reserve, the widespread adoption of this technology in LMICs is hindered by the prohibitive cost and space requirements of oncology-centric, whole-body systems. In response to these gaps, we present a cardiac-dedicated PET system that integrates ultra-high resolution ($1\ \text{mm}$ spatial and $3\ \text{mm}$ DOI) with $\text{sub-}250\ \text{ps}$ timing performance for precision diagnostics. By delivering superior clinical imaging within an economically viable, compact footprint and a streamlined maintenance framework, this architecture offers a scalable solution to the critical shortage of advanced cardiovascular imaging tools in resource-limited settings.
Our system architecture is optimized specifically for the unique challenges of cardiac imaging, such as high-frequency motion and small target sizes. The current design utilizes a modular 20-panel configuration, yielding an axial field-of-view of $236.4\ \text{mm}$ and an aperture diameter of $493.28\ \text{mm}$. Each detector module incorporates an $8 \times 10$ LYSO crystal array coupled with a light-sharing window for depth-of-interaction (DOI) decoding, which is essential for maintaining uniform spatial resolution across the field of view. Technical characterization demonstrates that the system achieves state-of-the-art performance, including a detector-level coincidence time resolution (CTR) of 234 ps FWHM and a simulated intrinsic spatial resolution of $1.0\ \text{mm}$. Furthermore, the system integrates an advanced ECG-gating pipeline. Initial validation using a prototype system with eight detector panels demonstrated successful dynamic scans in rabbit ($n=1$, $2.0\ \text{kg}$) and rat ($n=1$, $216.2\ \text{g}$) models, where cyclic myocardial filling and ejection phases were clearly delineated across eight temporal gates.
By leveraging a cardiac-dedicated architecture, this work offers a strategic and highly viable pathway for deploying advanced imaging in resource-constrained LMICs. Unlike conventional PET systems which face significant deployment barriers, this specialized architecture optimizes clinical throughput. Furthermore, its compact mechanical design not only enhances system sensitivity to reduce radiotracer dose requirements, but also lays a robust foundation for the future of mobile PET instrumentation. Subsequent research will focus on the full-scale system integration of a clinical-standard human cardiac-dedicated PET device, encompassing hardware optimization and the advancement of high-performance reconstruction and correction algorithms
Speaker: Qiyu Peng -
10:23 AM
Potential Applications of Total-Body PET in Low- and Middle-Income Countries 17m
Positron emission tomography (PET) is an essential modality for clinical diagnosis and biomedical research. While the prohibitive initial cost of total-body PET (TB-PET) systems often presents a significant barrier for low- and middle-income countries (LMICs), these systems offer overwhelming advantages over conventional PET scanners. By providing an extended axial field of view (AFOV), TB-PET enables simultaneous multi-organ dynamic imaging. More importantly for resource-limited settings, the ultra-high sensitivity of TB-PET allows for ultra-low injected tracer doses, ultra-fast scanning speeds, and exceptionally high patient throughput. These operational efficiencies can effectively offset the high capital investment by maximizing daily scan volumes and alleviating tracer supply constraints.
We have developed a high-performance TB-PET system featuring a massive 200 cm AFOV to fully leverage these advantages. The current baseline system employs 2 mm LYSO crystal pixels and integrates light-sharing windows to enable precise depth-of-interaction (DOI) estimation. Performance evaluations demonstrated an outstanding central sensitivity of 180.34 cps/kBq and a coincidence timing resolution of approximately 320 ps. Phantom studies confirmed the system's ability to clearly resolve 2 mm structures and perform high-fidelity dynamic whole-body imaging.
To further promote the accessibility of this technology in LMICs, targeted hardware cost reductions are essential. For instance, we have successfully developed and validated a low-cost BGO-DOI-PET detector in a preclinical animal system. Migrating this proven Bismuth Germanate (BGO) DOI technology into the human TB-PET architecture can drastically reduce expensive detector material costs while maintaining the critical DOI capability needed to mitigate parallax errors across the extended AFOV.
In conclusion, the integration of cost-effective BGO-DOI detectors into a high-efficiency TB-PET framework provides a highly translatable and economically viable solution. This strategic adaptation holds immense potential to democratize advanced multi-organ molecular imaging and improve healthcare equity in LMICs.Speaker: Qiyu Peng
-
9:30 AM
-
10:40 AM
→
11:10 AM
Coffee Break
-
11:10 AM
→
12:30 PM
Nuclear Medicine Deployment in LMICs: Enabling Technologies: Session 5Convener: Roger lecomte
-
11:10 AM
Low-Cost BGO PET System with DOI Measurement for Small-Animal Imaging 20m
Background: Bismuth germanate (BGO) crystals offer low cost, high density, excellent 511 keV photon stopping power and ultra-low intrinsic background, making them ideal for high-sensitivity positron emission tomography (PET) systems, especially for expanding the accessibility of molecular imaging in resource-limited settings, in which time resolution is not a critical requirement, such as high-sensitivity preclinical imaging or dedicated organ PET systems. However, BGO’s low light yield has long impeded accurate depth-of-interaction (DOI) measurement, which is necessary to eliminate parallax error and improve PET spatial resolution uniformity.
Methods: In this study, a high-resolution BGO PET detector with DOI capability was developed and validated on a small-animal PET system prototype. The detector comprised a 10×8 BGO array with a crystal size of 1.5×1.5×20 mm^3 coupled to a multi-pixel photon counter (MPPC) array in a 2×2 couplling configuration. A 6-mm-thick light-sharing window (LSW) was implemented at the upper region between adjacent crystals for DOI encoding. A rapid DOI calibration method based on vertical line source irradiation and histogram matching was proposed for efficient system-level DOI calibration.
Results: In detector-level evaluation, the detector achieved an intrinsic full width at half maximum (FWHM) DOI resolution of 4.4 mm, a DOI mean absolute error (MAE) of 2.2 mm and an average energy resolution of 17.4% at 511 keV. In system-level evaluation, the rapid DOI calibration method thus improved the uniformity of spatial resolution, achieving a FWHM spatial resolution of 1.4 mm at the system center.
Conclusions: This study confirms the technical feasibility of BGO-based PET systems with high-precision DOI measurement, overcoming BGO’s low light yield limitation via optimized LSW design and efficient DOI decoding strategy. This low-cost BGO PET system with DOI capability for small-animal imaging meets the performance requirements of high-sensitivity imaging; notably, the LSW design features easy fabrication and low maintenance costs, while the proposed rapid DOI calibration method avoids labor- and time-intensive mechanical collimation, drastically reducing system calibration costs in terms of professional equipment and human resources. Combined with BGO’s inherent material cost advantage, these merits render the technology highly adaptable to resource-limited settings such as low- and middle-income countries (LMICs). Furthermore, BGO’s mature manufacturing process endows this technology with strong scalability for large-scale crystal array systems (e.g., clinical total-body human PET systems), providing a cost-effective, easy-to-maintain and calibration-efficient solution for high-sensitivity preclinical small-animal and clinical PET imaging, and thus advancing the universal accessibility of advanced molecular imaging technology in LMICs.
Speaker: Mr Xin Yu (Institute of Biomedical Engineering, Shenzhen Bay Laboratory) -
11:30 AM
Jagiellonian PET: Democratizing access to positron emission tomography with low-cost, modular, lightweight, and portable PET scanners based on plastic scintillators 20m
Pawel Moskal$^{1,2}$, Ewa Stępień$^{1,2}$
1 Institute of Physics, Jagiellonian University, Poland,
2 Center for Theranostics, Jagiellonian University, Cracow, Poland.Positron Emission Tomography (PET) has an unparalleled impact on the day-to-day practice of personalized medicine. Yet, PET scanners are extremely expensive, and only a small fraction of the world population, living in the wealthiest countries, has access to this diagnostic method.
The Jagiellonian PET (J-PET) is a novel, cost-effective PET technology based on plastic scintillators [1,2]. J-PET is constructed based on low-cost, axially arranged plastic scintillators, which may enable the construction of PET scanners that are several times less expensive compared to current PET systems that are based on radially arranged crystal detectors [3].
In the talk, the description of the J-PET's operational principle will be followed by a presentation of the first lightweight, portable J-PET system. This system, weighing only 60 kg, is based on plastic scintillators and features an adaptive imaging volume with a 50 cm axial field-of-view [4]. We will present the first PET images from clinical examinations performed with the modular J-PET scanner at the Medical University of Warsaw and the University Hospital in Kraków. We will also present arguments demonstrating that J-PET is a solution for making advanced diagnostics more accessible and affordable worldwide, potentially benefiting millions of patients and driving further innovations in medical imaging, including in low- and medium-income countries.J-PET is the first multi-photon scanner capable of positronium [5] and quantum entanglement imaging [6]. We will also present the first positronium images of the brain of patient with glioblastoma, which indicates the potential for enhancing the specificity of PET diagnostics [4].
References:
[1] P. Moskal et al., Nucl. Instrum. Meth. A 764, 317 (2014)
[2] P. Moskal et al., Phys. Med. Biol. 66, 175015 (2021).
[3] P. Moskal, E. Ł. Stępień, PET Clinics 15, 439 (2020).
[4] P. Moskal, …, E. Stępień, Science Advances 10, eadp2840 (2024).
[5] P. Moskal et al., Science Advances 7, eabh4394 (2021).
[6] P. Moskal et al., Science Advances 11, eads3046 (2025)Speaker: Prof. Pawel Moskal (Jagiellonian University) -
11:50 AM
Design of Walk-Through PET-CT aiming for minimal motion and high throughput 20m
The Walk-Through (WT) PET-CT system is designed to significantly improve patient throughput, comfort, and cost-efficiency in clinical environments. Conventional tomographic imaging systems such as PET and CT scanners are limited by large physical footprints and inefficiencies in patient handling, which have become the primary bottleneck for throughput despite advances in acquisition speed. The proposed system addresses these challenges by rethinking both the technical configuration and the patient experience, enabling upright, fast, and user-friendly imaging.
At its core the system features a vertical “walk-through” PET scanning concept, in which patients enter the scanner and remain in a standing position between two detector panels for a short duration (30 seconds to 2 minutes). This flat-panel design, inspired by airport security scanners, eliminates the need for complex patient positioning on beds, thereby reducing handling time, increasing the number of patients scanned per day and enabling more efficient use of the produced radiotracer. The latter is particularly important given the high cost and short half-life of PET tracers.
The CT component is designed as a vertical, cost-effective system compatible with the flat-panel PET configuration, enabling anatomical imaging and attenuation correction while maintaining a compact footprint. Deep learning based sinogram completion and iterative reconstruction is used to reduce the number of required projection angles.
The vertical orientation requires the development of a novel multimodality gantry and ergonomic patient support for both PET and CT imaging. Throughout this process, a user-centred, iterative design approach is followed, incorporating feedback from patients, clinicians, and technical experts. The patient support structure is designed to ensure comfort and stability while minimizing motion during scanning, which is critical in upright imaging.
We compared motion and patient experience between a WT-PET scanner with head support, and a conventional cylindrical PET-CT. WT-PET showed increased motion, most pronounced at the shoulders (~2x: 1.91 ± 1.07 vs. 0.98 ± 0.77 mm) and moderate at the head (1.84 ± 1.17 vs. 1.30 ± 0.68 mm), for 5-min upright versus 8-min conventional scans. Various motion management strategies are being investigated. The system will use smooth rotational and translational mechanics to minimize patient perception of movement and reduce imaging artifacts both within and between modalities. During PET, motion is mitigated by performing very short frame reconstructions followed by image registration. Between modalities, registration will be achieved using AI-derived anatomical maps from PET aligned with CT images.
From a market perspective, the proposed system responds to a growing global demand for accessible and efficient imaging solutions. Current PET-CT and standalone CT systems are expensive, bulky, and resource-intensive, limiting their availability, especially in lower-resource settings. By reducing system complexity, footprint, and cost while increasing throughput, the WT-PET-CT has the potential to democratize access to advanced imaging technologies in developing regions.Speaker: Stefaan Vandenberghe -
12:10 PM
Multiplexed SiPM Readout and Real-Time FPGA Processing for Pixelated BGO PET Detectors 20m
We present a modular FPGA-based data acquisition and real-time processing architecture for SiPM-based PET detectors, developed in the context of compact, low-cost PET imaging. The system combines a multiplexed readout of a SiPM array with free-running high-speed ADCs and on-chip FPGA processing to extract event energy, timestamp, and interaction position in real time. The approach emphasizes compactness, scalability, and low-latency operation, while reducing channel count and system complexity. First measurements demonstrate correct operation and clear crystal identification in flood maps, highlighting both the potential and current limitations of SiPM multiplexing. This work aims at enabling cost-efficient, flexible, and scalable PET imaging systems.
Speaker: Prof. Nicola Belcari (Department of Physics, University of Pisa)
-
11:10 AM
-
12:30 PM
→
2:00 PM
Lunch Break
-
2:00 PM
→
3:40 PM
Session 6: Deployment of Nuclear Medicine in LMICs: Enabling TechnologiesConvener: Andrea Gonzalez Montoro
-
2:00 PM
The 10 ps TOFPET challenge: A way to the deployment of PET imaging to LMICs 20m
Nuclear Medical Imaging is at the forefront of molecular imaging diagnostic, theragnostic and treatment follow-up techniques for a number of diseases (cancer, neurodegenerative impairment, cardiovascular disorders, etc…), particularly in the rapidly growing context of personalised medicine.
However, there is a dramatic unbalance for the access to molecular imaging diagnostic tools between highly developed and low- and medium-income countries (LCMIs).
Low-cost technologies designed specifically for LMICs can make huge strides toward addressing precise population health needs within the local context. The very fruitful cross-fertilisation between physics and medicine opens new ways to the development of cost-effective and portable imaging approaches, allowing a better deployment of nuclear imaging modalities in LMICs, with a huge economic impact and high return for each invested dollar.
In particular fast timing techniques, as promoted by the 10 ps TOFPET challenge, are highly relevant for the development of cost-effective, organ specific, light and easy transportable scanners, addressing the geographic barriers that often exist in LMICs. They are not intended to cheaply mimic high-end technology but focus on intentionally addressing local health care needs while considering local challenges.
At 100 ps coincidence time resolution, the resulting effective sensitivity gain allows reducing by the same factor the dose injected to the patient and could extend PET usage from simple diagnostic to screening populations at risk of high prevalence diseases in LMICs. Lower doses also allow distributing radiotracers at larger distances from the production cyclotron, significantly reducing the cost of the radiotracer production infrastructure. Open geometries with a reduced number of channels (spaced rings, plates) can be considered because of the reduction of artifacts from incomplete tomographic coverage. Moreover, if the TOF resolution approaches 50 ps, it starts becoming the dominant factor influencing the spatial resolution, over the crystal dimensions, allowing the use of larger size crystals and a further reduction of the number of channels.Speaker: Paul Rene Michel Lecoq -
2:20 PM
POSICS: A Handheld Gamma Camera for Real-Time Intraoperative Imaging and Augmented Reality Surgical Guidance 20m
Precise intraoperative localization of tumors and sentinel lymph nodes remains a major challenge in oncologic surgery. Radio-guided surgery (RGS), widely used in procedures such as sentinel lymph node biopsy (SLNB) and radioguided occult lesion localization (ROLL), relies on the detection of radiotracers ( most commonly $^{99m}$Tc ) accumulated in metabolically active tissues. Despite its clinical success, the standard instrumentation used during surgery remains handheld gamma probes, which provide only acoustic feedback and limited spatial information. The absence of direct imaging can lead to prolonged localization time, increased invasiveness, and strong dependence on operator experience.
To overcome these limitations, we developed POSICS, a compact handheld gamma camera designed for real-time intraoperative imaging. The system employs position-sensitive silicon photomultipliers (LG-SiPMs) to achieve high-precision gamma detection in a lightweight and fully wireless device weighing approximately 350–400 g. Its ergonomic design allows seamless integration into the surgical workflow while providing direct imaging capability within the operating room.
Unlike conventional probes, POSICS provides real-time visual imaging of radiolabeled tissues, allowing surgeons to identify activity hotspots and verify lesion removal directly during the procedure. Performance characterization demonstrates millimetric spatial resolution, reaching approximately 1.4 mm at contact, with sensitivities up to 481 cps/MBq depending on the collimator configuration. These performance levels enable precise detection of tumors and sentinel lymph nodes while maintaining the portability required for intraoperative use.
A major advantage of the system is the speed of image acquisition. Preclinical trials have shown that radiolabeled tumors can be localized within seconds, achieving imaging precision comparable to that obtained with large nuclear medicine systems such as SPECT scanners, but without the long acquisition times or complex reconstruction procedures typically required. This rapid imaging capability enables continuous intraoperative feedback and supports faster surgical decision-making.
Beyond two-dimensional imaging, POSICS also enables three-dimensional reconstruction of radiotracer distributions. The feasibility of 3D reconstruction has already been demonstrated in laboratory studies and is currently being evaluated in ongoing preclinical trials. This capability aims to provide depth information on radiolabeled lesions relative to the surgical surface, potentially improving surgical navigation and margin assessment.
An additional innovation of the platform is the integration of Augmented Reality (AR) visualization. Gamma images can be spatially registered with the patient’s anatomy and projected through AR interfaces, enabling surgeons to visualize radioactive targets directly within the surgical field by wearing AR glasses. By combining precise gamma imaging with spatially registered visualization, POSICS transforms nuclear medicine data into an intuitive intraoperative navigation tool.
The technology is protected by a filed European patent, and the project has received significant recognition within the clinical innovation ecosystem, including the Innovation Prize from the Hôpitaux Universitaires de Genève (HUG).
By combining high-precision gamma imaging, rapid acquisition, emerging 3D capability, and augmented reality visualization, POSICS represents a new generation of intraoperative nuclear imaging systems aimed at enabling image-guided precision surgery and improving outcomes in cancer treatment.
Speaker: Domenico Della Volpe (Universitè de Genève) -
2:40 PM
Versatile and Mobile DOI-TOF PET and SPECT for Diagnostic and Research Imaging 20m
Overview: We report on ongoing research and development of versatile small footprint PET and SPECT imaging and dosimetry technology that shows great promise for diagnostic imaging and as high resolution insert cameras enhancing MRI scans. The employment of the depth of interaction (DoI) and time of flight (ToF) boosts the sensitivity and enables flat panel imaging that dramatically lower the cost of a diagnostic station. Flexible geometrical and detection designs provide a multi-modal platform that is configurable to a mobile clinical vehicle or a hospital room. The versatility of our family of instrument designs presents an unparalleled complete nuclear imaging diagnostics system that can fit various budgetary constraints in a broad range of clinical implementations.
Our technology: In partnership with MD Anderson Cancer Center and three Portuguese institutions – PETsys Electronics, the University and LISP of Coimbra, and the University of Lisbon – we have designed, fabricated, and tested a novel in-beam PET scanner for brain imaging during proton therapy. The scanner employs state-of-the-art detector technology, including the PETsys’ ToF-enabled front-end electronics. The camera has demonstrated 200ps coincidence time resolution (CTR) and 2mm spatial resolution. This pilot system forms the technical foundation for our further developments.
Initial Scope: Our startup Onco Imaging LLC (OI) extends this technology by development of a double-ended readout to enable DoI measurements – critical for accurate localization of detected gamma rays. The ultimate technical goal is to design compact, economical imaging modules for both affordable clinical integration and research applications, creating unprecedented tools for radiation biomedical research, in clinics and in research labs.
DoI and ToF challenge: Achieving high-resolution PET imaging requires excellent DoI and ToF resolutions. ToF capabilities are already integrated into the PETsys electronics and are expected to improve with the adoption of their upcoming second-generation application-specific integrated circuit (ASIC). Robust active DoI measurement, on the other hand, requires collecting scintillation light at both ends of each crystal pixel. Simulations indicate that if DoI is known within 2–3mm, PET spatial resolution improves by about 30% in practical clinical geometries. OI and PETsys have discussed a preliminary concept for this double-ended readout, which now requires full implementation and testing. Although the concept is mechanically and electronically fairly straightforward, it must be carefully validated to ensure the desired performance.
Versatility: We enhance the capabilities of the first instrument realized as “ToF PET for Proton Therapy” executed by the US-Portugal consortium. A new double-ended readout, necessary for DoI, and gamma collimation extend the technology to enable prompt gamma imaging (PGI) using single photon emission computed tomography (SPECT) during the beam spill. Our instruments respond to wide-ranging needs not only in proton therapy or oncological imaging and dosimetry but also in neurological clinical diagnostics and in research.
The ultimate technical objective is to develop cost-effective imaging modules suitable for either clinical integration and research applications, or for a mobile clinic. We will present how these concepts have been validated so far and are now being implemented at a commercial level.Speaker: Karol Lang (University of Texas at Austin) -
3:00 PM
What PET Scanner Developers Should Do - and Can Do - to Promote Wider Adoption of PET 20m
A substantial portion of PET scanner costs is driven by detector components. However, reducing the number of detectors inevitably leads to a quadratic loss in sensitivity. To address this challenge, we improved the sensitivity-cost balance by focusing on brain imaging. Specifically, adopting our original hemispherical detector geometry increases sensitivity by a factor of 1.5 compared with a conventional cylindrical configuration while using the same number of detectors. This compact geometry also reduces the angular deviation effect and enhances spatial resolution. In our commercial system, VRAIN, we achieved a spatial resolution of 2.2 mm (rod separation with iterative reconstruction) and an excellent TOF resolution of 229 ps [Akamatsu et al 2022 PMB 225011]. We are now working toward 1‑mm resolution through the development of our original crosshair light-sharing (CLS) detector, which provides both TOF and DOI capabilities [Narita et al 2025 PMB 12NT01]. Nevertheless, approximately 65% of material costs originate from electronics. Although multiplexing can reduce the number of electronic channels, maintaining overall system performance presents a critical trade-off [Kang et al 2025 PMB 225001].
In Japan’s universal healthcare system, amyloid PET has been reimbursed since December 2023. Yet as of June 2025, only 1,345 amyloid PET scans were performed per month compared with 46,730 FDG‑PET scans - less than 3% (survey response rate: 78.4%) [Isotope News, 2026. No 803, p 62]. Although amyloid PET is expected to grow with wider adoption of Alzheimer’s disease therapeutics, clear demand for dedicated brain PET scanners has not emerged. In low‑ and middle‑income countries (LMICs), where cardiovascular disease and cancer represent more pressing healthcare priorities, the market potential for dedicated brain PET systems would be even more limited. It may therefore be more practical to apply the technological insights gained from developing brain‑dedicated PET systems toward improving general-purpose whole‑body PET.
Based on Japan’s PET/CT reimbursement structure, radiopharmaceutical costs account for nearly 60% of the total expense for an FDG‑PET exam, and more than 80% in the case of amyloid PET. In contrast, the estimated equipment cost per scan - derived from depreciation - is only about ¥10,000 (~$63), negligible relative to ~¥50,000 (~$313) for a single FDG dosage and ~¥190,000 (~$1,188) for a single amyloid PET drug. These figures indicate that reducing equipment cost alone will not substantially promote the wider adoption of PET.
Speaker: Dr Taiga Yamaya (National Institutes for Quantum Science and Technology (QST)) -
3:20 PM
Sponsor Keynote: United Imaging: Engineered for Access: How Modular Design and Workflow Efficiency supports sustainable PET/CT implementation in LMICs 20m
Gold sponsor keynote talk
Speaker: Stewart Young
-
2:00 PM
-
3:40 PM
→
4:10 PM
Coffee Break
-
4:10 PM
→
6:10 PM
Session 7: Deployment of Nuclear Medicine in LMICs: Enabling TechnologiesConveners: Marco Paganoni, TBD
-
4:10 PM
Affordable crystals for PET technology 20m
The deployment of advanced nuclear medicine technologies in low- and middle-income countries (LMICs) remains severely limited by the high cost and complexity of current imaging systems, particularly positron emission tomography (PET) and total-body PET scanners. These systems require expensive scintillation materials, sophisticated electronics, and highly specialized infrastructure, creating barriers that prevent widespread adoption in resource-constrained settings. To address these challenges, there is a critical need for enabling technologies that focus on cost reduction, scalability, and material efficiency without compromising diagnostic performance. This work proposes a research program centered on the development of novel, low-cost scintillation materials through the study of luminescence mechanisms in ionic crystals, targeting the next generation of affordable PET systems.
Ionic crystals exhibit a remarkable combination of cross luminescence and spatially localized electronic excitation. These two properties could enable good timing while adding spatial information in bulk single crystals. The talk would discuss bottlenecks in current detector technology and highlight physical mechanisms of interest for the development of lower cost PET detectors.Speaker: Rosana Martinez Turtos (Aarhus University) -
4:30 PM
Emerging Scintillator Technologies Toward Cost-Effective TOF PET 20m
The dominant scintillator in clinical PET, lutetium-yttrium oxyorthosilicate (LYSO), requires expensive and energy-intensive crystal growth. The high instrumentation cost of LYSO-based PET systems limits their global deployment across much of the world. This presentation discusses two scintillator approaches offering realistic paths toward high-performance PET at substantially reduced cost, without compromise on diagnostic capability.
The first is a revival of bismuth germanate (BGO). Once considered outdated due to its slow decay time and modest light yield, BGO has regained relevance through SiPM-based detection of Cerenkov photons, which unlocks time-of-flight (TOF) capability long thought unattainable with this material. At roughly one quarter the material cost of LYSO, BGO-based TOF PET offers a compelling cost-to-performance ratio. The higher stopping power of BGO, combined with TOF capability, has the potential to deliver image quality comparable to current LYSO-based TOF PET systems.
The second approach involves lutetium oxide (Lu2O3)-based ceramic scintillators, specifically Lu2O3:Yb and the newly developed (Lu,Y)2O3:La. Rather than conventional single-crystal growth, these materials are produced by ceramic processing, a more scalable process with better dopant uniformity and lower fabrication cost. Their high density (8.6–9.4 g/cm3 versus 7.1 g/cm3 for LYSO) means thinner detector elements suffice for equivalent 511 keV stopping power, directly reducing material consumption. The (Lu,Y)2O3:La ceramic achieves a coincidence timing resolution of ~238 ps between identical 5-mm thick ceramic pixels, indicating TOF potential, and a light yield of approximately 19,000–21,200 ph/MeV. Simulations indicate that a 3 × 3 × 16 mm3 (Lu,Y)2O3:La pixel provides equivalent overall detection efficiency to a 20 mm LYSO pixel, while also offering better 511 keV photopeak absorption efficiency at that thickness, confirming the material efficiency advantage.
BGO and Lu2O3-based ceramics can address the cost problem from different angles. BGO benefits from considerably cheaper raw materials than LYSO single crystal, while Lu2O3-based ceramics take advantage of a manufacturing route that avoids the cost and complexity of Czochralski crystal growth. Both require further development: BGO TOF PET demands careful electronics and detector design to fully exploit Cerenkov timing, while ceramic scintillators are still at an early stage of development, requiring improvements in light yield and decay time to match LYSO at the system level. Both technologies are genuine candidates for the next generation of PET instrumentation, with a cost structure that can support much broader global deployment.Speaker: Dr Sun Il Kwon (University of California, Davis) -
4:50 PM
QATrack+: Enabling low-cost quality assurance for nuclear medicine in resource-constrained settings 20m
QATrack+ is a free, open-source web application designed to manage quality control (QC) and quality assurance (QA) data in medical physics. Although it was originally developed for radiotherapy applications, its flexible architecture has enabled increasing adoption in diagnostic imaging and nuclear medicine departments worldwide. In low- and middle-income countries (LMICs), access to robust and affordable QA infrastructure remains a considerable barrier to the safe and effective deployment of nuclear medicine technologies. Commercial QA management systems are often cost-prohibitive and require specialized support, which limits their scalability in resource-constrained environments with limited local expertise. In many settings, QA activities remain dependent on spreadsheets and fragmented tools, increasing the risk of inconsistency and user error.
QATrack+ addresses these challenges through a lightweight, server-based platform built on the Django web framework and written in the Python programming language, allowing for low-cost deployment on local or cloud infrastructure. Its extensible design enables users to implement custom scripts for automated analysis of QC data, which seamlessly integrates into a variety of applications, such as nuclear medicine imaging performance monitoring, radionuclide calibration tracking, and longitudinal system stability assessment. Its flexibility also accommodates emerging and non-standard imaging systems, which makes it suitable for use with prototype instrumentation. The platform facilitates centralized data management and querying, providing the means for remote oversight and harmonization across multiple departments or centres.
Beyond data management, QATrack+ supports structured and reproducible QA workflows through configurable test lists for routine procedures (e.g., system startup, shutdown, and scheduled QA tasks), automated evaluation against tolerance and action levels with clear pass/fail feedback, and integrated procedural and reference documentation. These features streamline workflows, reduce user error, improve consistency, and promote the standardization of QA programs. Role-based access control and transparent workflows facilitate training and knowledge transfer for residents, technicians, and qualified personnel, helping build workforce capacity in settings with limited expertise. Furthermore, ongoing developments in interface localization aim to address the technical, cultural, and linguistic needs in diverse regions, exemplified by multilingual support (e.g., English, French, and Spanish), which enhances accessibility and usability, particularly in LMICs.
Over the past 14 years, QATrack+ has been adopted in over 20 countries, which demonstrates its versatility and sustainability across a wide range of QA settings. As the project transitions to a community-driven maintenance model, it presents an opportunity for global collaboration in developing QA solutions tailored to LMIC needs and the expanding role of nuclear medicine, while enabling functionality comparable to commercial systems without the associated financial barriers. In this context, QATrack+ provides a scalable, low-cost QA infrastructure that supports the safe, standardized, and sustainable deployment of nuclear medicine technologies, ultimately contributing to improved quality of care globally.
Speaker: Dr Matthew Strugari (Grupo de Investigación Biomédica de Imagen (GIBI230), Instituto de Investigación Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 46026, Valencia, Spain) -
5:10 PM
High Performance, Cost-Effective Large Axial Field of View TOF-PET System Design 20m
A challenge to widespread access to the transformational potential that long axial field-of-view (LAFOV) positron emission tomography (PET) systems bring to cancer imaging is their higher cost. There are new time-of-flight PET (TOF-PET) detectors and system implementations that can maintain and improve sensitivity and reconstructed image quality at substantially reduced material cost. We propose a novel scintillation and Cherenkov photon counting PET detector concept comprising economical bismuth germanate (BGO) scintillators with state-of-the-art (SoA) silicon photomultiplier (SiPM) electronic readout and low-cost, high-performance data acquisition, capable of ≤100 ps full-width-at-half-max (FWHM) coincidence time resolution (CTR) and high resolution, three-dimensional (3D) positioning of 511 keV photon interactions. The combination of these two capabilities enables system geometries to be investigated which can be placed close to patients, making more efficient use of emissions data and detector area to match and improve image quality, in comparison to LAFOV PET rings using significantly reduced detector area and proportionally, cost. This approach thereby leverages excellent CTR to overcome limited angle tomography effects from removing detectors, reconstructed image signal-to-noise (SNR) gain from time-of-flight (TOF-PET) with ≤100 ps CTR, 3D positioning capabilities to address resolution losses associated with an increase in oblique lines of response with LAFOV detectors in close proximity to patients, higher 511 keV photon stopping power and photofraction of BGO scintillators in comparison to standard lutetium oxyorthosilicate (LSO) crystals in modern PET systems to meet reconstructed image quality achieved by LAFOV systems in lower cost implementations.
We constructed a prototype Cherenkov/scintillation photon counting detector comprising a 2x42.7x20 mm3 semimonolithic BGO crystal and demonstrated its capability to achieve ≤100 ps FWHM CTR and 3.5x2.0x4.1 mm3 average 3D positioning resolution. To demonstrate more efficient use of detector area and emissions data with this detector concept, we simulated a dual panel TOF-PET system with 75 cm-wide, 49 cm axial length panels (50 cm spacing between panels), comprising our prototype detector technology. This system has the same number of detector modules as a Siemens Vision TOF-PET system (78 cm bore, 26 cm AFOV). We directly compared reconstructed image quality of these two system designs for imaging of 5, 10, and 20 mm liver lesions with 8:1 tumor-to-background activity concentration. The dual panel system exhibited 48, 24, and 20% improvement in contrast-recovery-coefficient for the 5, 10, and 20 mm lesions, respectively, while also nearly doubling the AFOV. We present measured CTR and 3D positioning resolution with a prototype detector for this new system design and also simulations comparing a dual-panel PET imaging prototype based on this new detector technology with a state-of-the-art, LAFOV, LSO-based TOF-PET system.
Speaker: Joshua Cates (Lawrence Berkeley National Laboratory) -
5:30 PM
High-Performance Modular TOF-PET Imager as an Enabling Technology for Affordable Nuclear Medicine in LMICs 20m
The limited deployment of positron emission tomography (PET) in low- and middle-income countries (LMICs) is primarily driven by the high cost and complexity of conventional systems. We present a high-performance, modular time-of-flight (TOF) PET detector concept under development within the Horizon Europe EIC Pathfinder project PetVision, aimed at significantly reducing system cost while maintaining state-of-the-art imaging performance.
The proposed architecture integrates fast silicon photomultipliers (SiPMs) with compact, low-noise front-end electronics and high-speed digitisation to achieve coincidence timing resolution (CTR) below 100 ps FWHM. Detector modules are based on 3 × 3 mm² channel pitch with 10 mm long LYSO scintillator crystals, coupled to high photon detection efficiency SiPM arrays. The readout chain is built around the PoETIC ASIC, enabling precise timing extraction with a power consumption of approximately 10 mW per channel, supporting high channel density with manageable thermal load.
A key innovation is the use of large-area flat-panel detectors (≈30 × 30 cm²), enabled by the excellent TOF performance. This approach departs from conventional cylindrical PET geometries and allows flexible, reconfigurable system layouts. The enhanced timing resolution compensates for reduced scintillator volume, enabling a substantial decrease in scintillator material—one of the primary cost drivers—while preserving sensitivity and image quality. The modular panel design further reduces system complexity, facilitates scalable assembly, and simplifies integration.
The system is currently at TRL 3, with component-level validation including SiPM tile performance, front-end electronics characterisation, and timing measurements, supported by detailed Monte Carlo simulations. Ongoing developments target TRL 5–6 through integration of full detector panels, scalable readout architecture, and prototype system validation. Early results indicate that the proposed concept can match the performance of current clinical PET systems while significantly reducing material and system costs.
By combining advances in photosensor technology, compact low-power electronics, and system-level optimisation, this work establishes modular TOF-PET as a key enabling technology for cost-effective and scalable nuclear medicine imaging. The proposed approach provides a viable pathway toward broader deployment of PET systems, including in resource-constrained environments, supporting improved access to advanced diagnostic imaging.
Speaker: Rok Pestotnik (Jozef Stefan Institute (SI)) -
5:50 PM
Democratizing Early Cancer Diagnosis in LMICs through a High-Efficiency, Low-Cost Enabling Technology: 3D-CBS Based on 3D-Flow 20m
Introduction
Nuclear medicine in Low- and Medium-Income Countries (LMICs) faces a critical challenge: access to life-saving technologies such as Positron Emission Tomography (PET) is restricted by unsustainable acquisition costs. While next-generation Total-Body PET (TBPET) systems offer superior clinical advantages, current market prices—reaching approximately $22.6 million per unit in 2024—remain prohibitive for developing economies. This paper presents the 3D-CBS (3D Complete Body Screening) system as an enabling technology capable of drastically lowering these barriers. Methodology and Enabling Technology The competitive advantage of 3D-CBS lies in the 3D-Flow digital processing architecture, which enables the use of lower-cost, slower crystal detectors by extracting maximum information through complex real-time algorithms while eliminating the electronic “dead time” typical of conventional systems. This increased processing capability enhances the extraction of weak radiation signals, making it technically feasible to identify very early tumor clusters—on the order of fewer than 100 cancer cells. This represents a substantial improvement over the current diagnostic threshold of approximately 1 millimeter, corresponding to about one million cells. Economic Feasibility Analysis The sustainability of this project is confirmed by a detailed analysis based on 59 quotations from industry manufacturers, quantifying the cost of hardware components at $2 million. This production efficiency allows for an estimated final sale price of approximately $3.5 million. In contrast, state-of-the-art Total-Body PET systems such as the EXPLORER were sold in Italy in 2024 at approximately €21 million per unit (≈$22.6 million). This represents a cost difference of more than sixfold,, which has profound implications for global accessibility, particularly in low- and middle-income countries.Clinical and Social Impact in LMICs
Implementing 3D-CBS in LMICs would significantly transform oncological management through:
• Affordable Mass Screening: A safe, 2-minute total-body exam could be offered at an estimated cost of approximately €200.
• Increased Survival Rates: Early-stage diagnosis is associated with survival rates of up to 98% for prevalent conditions such as breast and prostate cancer.
• Resource Optimization: High examination speed allows for a high daily patient volume, making the investment sustainable for local healthcare infrastructures.These features make the 3D-CBS suitable for large-scale screening programs. This combination of speed, safety, and affordability could enable widespread deployment, including in resource-constrained environments.
Conclusion
The 3D-CBS system offers a pragmatic response to the need for ultra-high diagnostic sensitivity at an affordable cost. The validity of this approach can be objectively verified through the "Known Dataset Test," a laboratory experiment designed to measure detection capability and computational efficiency under controlled conditions. This provides a concrete pathway toward reducing premature cancer mortality on a global scale.This approach could significantly expand access to early cancer diagnosis, reduce global healthcare costs, and ultimately save millions of lives.
Speaker: Dario Crosetto (Crosetto Foundation for the Reduction of Cancer Deaths)
-
4:10 PM
-
8:30 AM
→
9:30 AM
-
-
8:30 AM
→
9:30 AM
Nuclear Medicine Deployment in LMICs: Enabling Technologies: Session 8Convener: Marta Freire
-
8:30 AM
Compton cameras for medical imaging 20m
Compton cameras are systems that can image photons in a higher energy range than gamma cameras. While they are not intended to replace PET, which can achieve high resolution and sensitivity if this modality is available, or gamma cameras, which are cost effective and have good performance at photon energies below 300 keV, Compton cameras can be advantageous for obtaining good image quality with higher energy radionuclides, or when activities are low, thus complementing the use of other imaging modalities or offering alternatives when those are not available or not optimal.
Compton cameras can achieve good performance in a wide energy range, providing good resolution and high sensitivity, while in gamma cameras these two parameters are inversely coupled. They also offer 3D imaging with just one detector. In that case, the limited resolution in the direction perpendicular to the detectors can be improved by setting another system at 90º, without needing a ring, and thus limiting the detector cost. Another advantage is their portability since they do not need heavy collimators. Low detector cost, portability and wide energy range imaging can constitute important advantages in Low- and Medium-Income Countries.
The IRIS group of IFIC (Valencia) has developed a Compton camera prototype with LaBr3 crystals capable of imaging photons from 300 keV to several MeV. The system MACACO III was able to image metastatic lesions in patients treated with 131I-NaI and to visualize 6 mm diameter rods filled with Ac-225. The latest prototype, MACACO III+, has imaged Derenzo-like phantoms with rods ranging from 3 to 6 mm diameter filled with FDG and with I-131 and a thyroid-shaped phantom filled with I-131, both uniformly and also with a warm background with hot spots in 10:1 activity ratio. Mouse phantoms and live mice injected with I-131 have also been imaged successfully and compared to a gamma-SPECT system from MOLECUBES. Simulations show promising results with Ac-225 with MACACO III+ and measurements are being carried out. In order to address the limited depth resolution, the group is working on a system consisting of two Compton cameras placed at 90º.
In addition, the European project AIDER coordinated by the IRIS group addresses the improvement of Compton cameras for enhancing image quality and enabling imaging of photons with energies down to ~ 200 keV. The project will develop a system consisting of two detector planes, each plane made of four detectors of 50 mm x 50 mm size consisting of LaBr3 or CeBr3 crystals coupled to SiPM arrays. Encapsulating the crystal with the photodetector will improve light collection and enhance energy resolution. Dedicated readout electronics will ensure good timing resolution.
Speaker: Gabriela Llosá (IFIC, CSIC-UV) -
8:50 AM
From ⁶⁸Ga-PSMA PET to ⁹⁹ᵐTc-PSMA SPECT: Learning Cross-Modality Harmonization for Diagnostic Nuclear Medicine. 20m
Background:
While ⁶⁸Ga-PSMA PET is the reference standard for prostate cancer imaging, its availability remains limited in many regions. In contrast, ⁹⁹ᵐTc-PSMA SPECT is more accessible but suffers from lower spatial resolution, higher noise, and inconsistent quantification. These differences hinder direct comparison across modalities and restrict the integration of SPECT data into multi-centre studies. This work proposes a data-driven approach to bridge this gap via cross-modality image translation.
Methods:
We propose a 3D ResUNet-based framework to map ⁹⁹ᵐTc-PSMA SPECT volumes to PET-like uptake distributions. The model was trained on paired scans from 40 prostate cancer patients who underwent both ⁶⁸Ga-PSMA-11 PET and ⁹⁹ᵐTc-HYNIC-PSMA SPECT (mean interval: 38 ± 12 days). PET and SPECT images were aligned using multimodal rigid registration.
The dataset was split into 35 training and 5 independent test cases. Quantitative evaluation was performed both voxel-wise and at the organ level. Organ uptake (liver, kidneys, prostate, and salivary glands) was extracted using CT-based segmentations generated with TotalSegmentator, with manual segmentation of salivary glands. Global image similarity was assessed using normalized mean absolute error (NMAE).
Results:
The proposed model reduced voxel-wise NMAE from 0.53 ± 0.07 to 0.36 ± 0.07, corresponding to a >30% improvement in global agreement with PET. The synthesized pseudo-PET volumes consistently demonstrated improved visual and quantitative alignment with ground truth PET compared to the original SPECT inputs.
At the organ level, mean uptake deviation decreased from 158% to 20.5%. The largest improvement was observed in the liver (250% → 4.82%). Kidney uptake showed low baseline discrepancy (~5%), with minimal change after harmonization. Prostate uptake error was reduced from 353% to 58%, and salivary gland error from 22.33% to 13.25%.
Conclusion:
This study demonstrates the feasibility of learning a direct mapping from ⁹⁹ᵐTc-PSMA SPECT to PET-like representations using 3D convolutional networks, enabling improved cross-modality consistency in quantitative imaging.
A key limitation is the mismatch in acquisition timing (~3 h post-injection for SPECT vs ~1 h for PET), which introduces biological variability. Ongoing work focuses on acquiring matched time-point data to disentangle temporal biodistribution effects from tracer-specific differences.
Future directions include decoupling resolution enhancement from biodistribution translation using multi-task or modular architectures, and validating the approach on larger, multi-centre datasets. This framework has the potential to facilitate the inclusion of SPECT data in PET-centric studies and to support more equitable access to advanced imaging workflows.Speaker: Alejandro López Montes -
9:10 AM
Lithium Neutron Cancer Therapy: A Paradigm Shift Beyond Boron-Based Therapy 20m
Gil Gonçalves1,2
1Centre for Mechanical Technology and Automation (TEMA), Mechanical Engineering Department, University of Aveiro, 3810-193 Aveiro, Portugal;
2Intelligent Systems Associate Laboratory, 4800-058 Guimarães, PortugalCancer remains one of the leading causes of mortality worldwide, particularly in aggressive and therapy-resistant tumors, underscoring the urgent need for more selective and effective therapeutic strategies. Neutron Capture Therapy (NCT) is an advanced binary radiotherapeutic modality based on neutron capture reactions of specific isotopes that generate high linear energy transfer (LET) particles capable of selectively destroying cancer cells. To date, clinical NCT has relied primarily on ^10B-containing agents such as boronophenylalanine (BPA) and sodium borocaptate (BSH). However, these compounds exhibit significant limitations, including suboptimal tumor selectivity, heterogeneous intratumoral distribution, rapid systemic clearance, and the need for high systemic doses to achieve therapeutic boron concentrations, thereby restricting clinical efficacy.
Here, we introduce 6Li as a novel neutron-active therapeutic agent, establishing the foundation for Lithium Neutron Cancer Therapy (LiNCT).[1] Upon thermal neutron irradiation, the 6Li reaction generates highly energetic particles with high LET and short path lengths, enabling highly localized energy deposition at the cellular scale and offering strong potential to address tumor heterogeneity.
Compared with 10B-based systems, 6Li presents several conceptual and practical advantages, including a distinct nuclear reaction pathway with favorable energy partitioning, simplified chemical speciation that facilitates stable incorporation into nanocarriers, and reduced reliance on complex boron-rich molecular architectures. In addition, 6Li enables the achievement of high intracellular payload concentrations through controlled nanoencapsulation rather than systemic overexposure. Importantly, lithium compounds can be fully confined within sealed nanocapsules, thereby minimizing premature leakage and off-target toxicity, which are intrinsic limitations of many small-molecule boron agents.[2]
To enable safe and efficient intracellular delivery, we develop biomimetic nanocapsules fabricated via microfluidic technology, allowing precise control over size, surface chemistry, isotope loading, and release kinetics.[3] This strategy ensures reproducibility, scalability, and GMP compatibility. Furthermore, to address the multidimensional design space governing colloidal stability, neutron capture efficiency, and biological targeting, we integrate a closed-loop, machine-learning-guided optimization framework for rational nanoparticle engineering.
This integrated nanotechnology and data-driven platform positions LiNCT as a promising next-generation alternative to conventional boron-based NCT, paving the way toward improved selectivity, safety, and therapeutic performance.References
[1] G. Gonçalves Lithium filled nanocapsules and use thereof WO2023180615A1
[2] G. Gonçalves et al. Lithium halide filled carbon nanocapsules: Paving the way towards lithium neutron capture therapy (LiNCT), Carbon 208 (2023)
[3] G. Gonçalves et al., Advances in Microfluidic-Based Core@Shell Nanoparticles Fabrication for Cancer Applications, Adv. Healthc. Mater. 13 (2024)Acknowledgements
This work is funded by FCT, under UID/00481 – TEMA and the project CarboNCT 2022.03596.PTDC (DOI: 10.54499/2022.03596.PTDC).Speaker: Gil Gonçalves
-
8:30 AM
-
9:30 AM
→
10:30 AM
Deployment of Nuclear Medicine in LMICs: Pitfalls & Opportunities: Session 9Convener: Willy Vangu
-
9:30 AM
Scaling Up Nuclear Medicine and Molecular Imaging in LMICs: IAEA Initiatives in Infrastructure, Training, and Sustainability 20mSpeaker: francesco Giammarile
-
9:50 AM
Enabling Global Access: Lessons in Universal Innovation and Deployment of X-ray in LMICs. 20m
Background: Nuclear medical imaging is vital for modern diagnostics, yet access remains profoundly unequal between high-income countries (HICs) and low- and middle-income countries (LMICs). Historically, LMICs have relied on importing or donated equipment designed for HICs. Unfortunately, the WHO estimates that only 10% to 30% of donated medical equipment becomes operational at its destination. This frequent failure stems not from low clinical value, but from design, deployment, and financing models mismatched to local realities and constraints.
Methodology: Towards bridging this gap, we present and propose a holistic, multidisciplinary framework that we applied towards improving global access to X-ray diagnostic imaging. Predicated on cooperation with local stakeholders, interdisciplinarity, and entrepreneurship, the framework addresses four core questions:
• What impact is sought? Addressed via an Impact Canvas, distinguishing tangible outputs (the device) from long-term societal impact (reduced mortality).
• In what context will it operate? Evaluated via a Context Analysis focusing on infrastructural, environmental, financial, personnel, and governance constraints.
• Who must be engaged? Mapped via a Product Value Chain ensuring engagement across regulators, hospital leadership, biomedical technicians, and training institutions.
• How will it remain sustainable? Answered via a Sustainable Business Model Canvas balancing financial viability with environmental and social sustainability.
Outcomes: This framework is actively driving real-world impact. The resulting technology is currently deployed in South African townships (Alexandra and Soweto) using a novel model where the company builds and operates X-ray centres, and patients pay discounted rates. Having also attracted significant interest in France and the UK, this framework proves it is possible to develop universally adaptable solutions, achieving what we term "Universal Innovation."
Lessons for Nuclear Medicine: Though our primary case study was diagnostic X-ray, this logic is highly relevant to nuclear medicine, where technology, infrastructure, and workforce constraints are even more tightly coupled. Key transferable lessons include:
• True Affordability: Acquisition price is a poor proxy for affordability. Total Cost of Ownership (TCO)—including consumables, training, maintenance, and utilities—is the true decision variable.
• Contextual Resilience: Equipment must be intentionally designed to withstand unstable electricity, harsh environments, and intermittent supply chains.
• Continuous Capacity Building: Training is not a one-off event. Workflow support, continuous education, and remote expert access (e.g., teleradiology) are essential.
• Business Models Matter: Long-term serviceability and predictable maintenance (e.g., integrating multi-year warranties over fragile annual contracts) are prerequisites for scaling.
Conclusion: To sustainably scale nuclear medical imaging in LMICs, the global health community must move beyond simplistic equipment donations and adopt a comprehensive systems approach. By embracing "Universal Innovation," we can drastically reduce equipment failure rates. Ultimately, we hope that this holistic framework may inspire and provide a transferable blueprint for expanding equitable access to life-saving nuclear medicine in resource-constrained settings.Speaker: Dr Solomzi Makohliso (Ecole Polytechnique Fédérale de Lausanne) -
10:10 AM
Expansion of Nuclear Medicine in Africa: Opportunities and Challenges 20m
Over the past three decades, several key factors have driven the growth of nuclear medicine in Africa:
• Capacity building: The development of national policies and strategies by Member States in collaboration with the International Atomic Energy Agency.
• Expansion of clinical services: Growth in key areas such as oncology, nuclear cardiology, pediatrics, radionuclide therapy, and PET imaging, contributing to improved cancer diagnosis and treatment.
• Evidence of impact: Demonstrated improvements in the cost-effectiveness of healthcare systems, along with increased awareness among policymakers regarding major health burdens, including cancer, cardiovascular diseases, and pediatric conditions.
Despite these advances, nuclear medicine services in Africa face several important challenges:
• Limited government funding for public health, resulting in significant financial constraints.
• Need for alternative funding mechanisms, including public–private partnerships, support from foundations, and international donors.
• Difficulties in ensuring project continuity, as policy directions may change with successive administrations.
• These constraints collectively impact the sustainability and long-term development of nuclear medicine services.
• In addition, several technical and logistical challenges persist, ranging from the irregular supply of radiopharmaceuticals to issues related to the maintenance and quality control of equipment.Speaker: Salah Eddine Bouyoucef (Emeritus Professor Nuclear Medicine Faculty of Medicine/University Hospital Bab El Oued Algiers Algeria)
-
9:30 AM
-
10:30 AM
→
11:00 AM
Coffee Break
-
11:00 AM
→
12:00 PM
Deployment of Nuclear Medicine in LMICs: Pitfalls & Opportunities: Session 10Convener: Salah Bouyoucef
-
11:00 AM
Nuclear Medicine in Côte d’Ivoire : operational status, strategic challenges, and perspectives of the Abidjan Nuclear Medicine Institute (IMENA) 20m
Introduction :
The Abidjan Nuclear Medicine Institute (IMENA) serves as the sole specialized facility for nuclear medicine in Côte d’Ivoire. Operational since October 2023, IMENA represents a major sovereign investment by the Ivorian government to integrate molecular imaging into the national healthcare system.
This study provides an assessment of the initial operational phase, an analysis of current infrastructural constraints, and outlines a strategic roadmap to address the growing diagnostic needs of the West African sub-region.
Institutional and technical framework :
Housed in a purpose-built two-story facility, IMENA’s technical platform was established through a privileged partnership with the International Atomic Energy Agency (IAEA). The current instrumentation includes a dual-head SPECT gamma camera, a laminar flow ventilated hood with an integrated dose calibrator, and specialized equipment for radioimmunoassay (RIA).
The multidisciplinary team consists of four nuclear physicians, eight residents, a radiopharmacist, a medical physicist, and a robust technical staff of thirteen technologists and nine nurses.
Clinical Activity and Oncological Burden:
Since its inauguration, IMENA has experienced a continuous surge in clinical demand, performing approximately 3,622 scintigraphic procedures to date. The clinical landscape is heavily dominated by oncology, with bone scans accounting for 71.5% (n=2,588) of total activity. Other procedures include renal (n=467), thyroid (n=402), and myocardial perfusion (n=85) scans.
These figures underscore the critical role of nuclear medicine in managing chronic diseases, particularly in an oncological context where hybrid imaging is becoming the gold standard.
Challenges and Strategic Barriers:
Despite successful operationalization, several factors limit the full integration of nuclear medicine into the Ivorian care pathway:
• Technological gaps: the absence of hybrid imaging (SPECT/CT) and high-end diagnostic tools restricts diagnostic accuracy for complex cases.
• Logistical fragility: difficulties in the supply chain for cold kits and ready-to-use radiopharmaceuticals hinder service continuity.
• Human resources: a persistent deficit in highly specialized professionals remains a bottleneck for scaling up activities.Perspectives and Roadmap :
To optimize performance and expand its diagnostic scope, IMENA has defined five priority axes:
1. Infrastructural modernization: transitioning to hybrid imaging with the acquisition of SPECT/CT and the planned construction of a PET/CT and cyclotron unit.
2. Specialized training: establishing local and regional degree programs for physicians, physicists, and radiopharmacists.
3. Supply chain fluidity: enhancing the procurement of generators and radiopharmaceuticals.
4. Maintenance excellence: implementing sustainable equipment maintenance strategies.
5. Radiation protection: continuous improvement of safety protocols for both staff and patients.
Conclusion :
IMENA illustrates the high potential of NM in Côte d’Ivoire. Strengthening its infrastructure and regional partnerships will be decisive in ensuring sustainable development and improving access to high-quality specialized care in West Africa.
Keywords :
Côte d’Ivoire; IMENA; Nuclear medicine; SPECT technology; oncological burden; LMICs (Low- and Medium-Income Countries)Speakers: Prof. Annick Kouamé-Koutouan (Abidjan Institute of Nuclear Medicine (IMENA)), Dr Nathalie KOUASSI-ABOUKOUA (Abidjan Institute of Nuclear Medicine (IMENA)) -
11:20 AM
Bridging the Gap: Building Sustainable Nuclear Medicine Services in Low- and Middle-Income Countries 20m
Nuclear medicine plays an increasingly important role in modern healthcare, especially in the diagnosis and management of cancer, cardiovascular disease, and other serious conditions. Even so, access to these services remains limited in many low- and middle-income countries (LMICs). In many cases, the issue is not simply a lack of equipment. The bigger challenge lies in building systems that can actually support and sustain nuclear medicine services over time.
Many LMICs continue to face a combination of obstacles, including limited infrastructure, shortages of trained professionals, inconsistent radiopharmaceutical supply, weak maintenance systems, and insufficient long-term funding. These barriers often slow progress and make it difficult for services to grow in a stable and equitable way.
This abstract explores the need for a practical and sustainable approach to expanding nuclear medicine in LMICs. Rather than focusing only on technology acquisition, it emphasizes the importance of planning across several connected areas: infrastructure, workforce development, financing, regulation, and supply chain reliability. A service cannot function effectively when one of these elements is missing, even if the others are in place.
A more realistic path forward is to treat nuclear medicine development as a health system issue rather than a stand-alone technical investment. This means linking new services to national health priorities, strengthening training opportunities for multidisciplinary teams, improving regulatory support, and creating funding models that are viable beyond the initial setup phase. Regional collaboration may also help countries share expertise, reduce costs, and improve access to essential materials and services.
Digital tools and international partnerships can support this process, but they are most useful when introduced as part of a broader long-term strategy. What seems clear is that sustainable progress depends on thoughtful coordination, not isolated purchases or short-term initiatives.
Expanding nuclear medicine in LMICs is both a technical and policy challenge. With the right framework, countries can move from fragmented efforts to more resilient and accessible services that better meet patient needs. A structured, system-based approach offers a practical way to reduce disparities and support the responsible growth of nuclear medicine where it is needed most.
Speaker: Dr Subhash Kheruka (Sultan Qaboos Comprehensive Cancer Care and Research Centre, UMC, Muscat, Oman) -
11:40 AM
Nuclear Medicine in South Africa: Equity and Sustainability in an LMIC Context 20m
South Africa has one of the most developed nuclear medicine systems in a low and middle income country (LMIC) setting and offers valuable insights into the challenges and opportunities of sustaining nuclear medicine in resource constrained environments. The country faces a dual burden of infectious diseases and rising non communicable diseases, including cancer and cardiovascular disorders, for which nuclear medicine provides essential diagnostic and therapeutic solutions.
Services include SPECT, SPECT/CT and PET/CT imaging, cyclotron based radiopharmaceutical production, and expanding theranostics across public and private sectors. South Africa also plays a strategic global role in medical radioisotope production. However, access remains highly inequitable, reflecting common LMIC challenges. Advanced technologies and specialist expertise are concentrated in urban centres and predominantly within the private sector, while public services face infrastructure limitations, workforce shortages, equipment constraints, and long waiting times.
Despite these constraints, opportunities exist through growing clinical demand, expanding theranostics, public–private collaboration, and regional training initiatives. Strategic investment in human capital, infrastructure, and health system integration could improve equity and position South Africa as a reference model for nuclear medicine development in LMICs.Speaker: Willy Vangu (CM Johannesburg Academic Hospital, University of the Witwatersrand)
-
11:00 AM
-
12:00 PM
→
1:00 PM
Session 11: General Discussion and ConclusionsConvener: John Olivier Prior
-
8:30 AM
→
9:30 AM