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Concept: International Atomic Energy Agency


Radiotherapy is used for cure or palliation in around half of patients with cancer. We analysed data on radiotherapy equipment in 33 European countries registered in the Directory of Radiotherapy Centres (DIRAC) database, managed by the International Atomic Energy Agency. As of July, 2012, Europe had 1286 active radiotherapy centres. The average number of teletherapy machines per radiotherapy centre ranged from 1·2 to 7·0 in different countries. Nordic countries, the UK, the Netherlands, and Slovenia all have large centres with four to ten teletherapy machines. Most western and southern European countries have several small centres with one or two machines, with few larger centres. The fragmentation in radiotherapy services that prevails in many European countries might affect the economic burden of radiotherapy and its quality. Eastern and southeastern European countries need to expand and modernise their radiotherapy equipment.

Concepts: European Union, Europe, Netherlands, International Atomic Energy Agency, Eastern Europe, NATO, Slovenia, Northern Europe


The International Atomic Energy Agency (IAEA) Water Balance Model with Isotopes (IWBMIso) is a spatially distributed monthly water balance model that considers water fluxes and storages and their associated isotopic compositions. It is composed of a lake water balance model that is tightly coupled with a catchment water balance model. Measured isotope compositions of precipitation, rivers, lakes, and groundwater provide data that can be used to make an improved estimate of the magnitude of the fluxes among the model components. The model has been developed using the Object Modelling System (OMS). A variety of open source geographic information systems and web-based tools have been combined to provide user support for (1) basin delineation, characterization, and parameterization; (2) data pre-processing; (3) model calibration and application; and (4) visualization and analysis of model results. In regions where measured data are limited, the model can use freely available global data sets of climate, isotopic composition of precipitation, and soils and vegetation characteristics to create input data files and estimate spatially distributed model parameters. The OMS model engine and support functions, and the spatial and web-based tool set are integrated using the Colorado State University Environmental Risk Assessment and Management System (eRAMS) framework. The IWBMIso can be used to assess the spatial and temporal variability of annual and monthly water balance components for input to water planning and management.

Concepts: Lake, Risk, Geographic information system, Drainage basin, International Atomic Energy Agency, Isotope, Composition, Water balance


Peptide receptor radionuclide therapy (PRRNT) is a molecularly targeted radiation therapy involving the systemic administration of a radiolabelled peptide designed to target with high affinity and specificity receptors overexpressed on tumours. PRRNT employing the radiotagged somatostatin receptor agonists (90)Y-DOTATOC ([(90)Y-DOTA(0),Tyr(3)]-octreotide) or (177)Lu-DOTATATE ([(177)Lu-DOTA(0),Tyr(3),Thr(8)]-octreotide or [(177)Lu-DOTA(0),Tyr(3)]-octreotate) have been successfully used for the past 15 years to target metastatic or inoperable neuroendocrine tumours expressing the somatostatin receptor subtype 2. Accumulated evidence from clinical experience indicates that these tumours can be subjected to a high absorbed dose which leads to partial or complete objective responses in up to 30 % of treated patients. Survival analyses indicate that patients presenting with high tumour receptor expression at study entry and receiving (177)Lu-DOTATATE or (90)Y-DOTATOC treatment show significantly higher objective responses, leading to longer survival and improved quality of life. Side effects of PRRNT are typically seen in the kidneys and bone marrow. These, however, are usually mild provided adequate protective measures are undertaken. Despite the large body of evidence regarding efficacy and clinical safety, PRRNT is still considered an investigational treatment and its implementation must comply with national legislation, and ethical guidelines concerning human therapeutic investigations. This guidance was formulated based on recent literature and leading experts' opinions. It covers the rationale, indications and contraindications for PRRNT, assessment of treatment response and patient follow-up. This document is aimed at guiding nuclear medicine specialists in selecting likely candidates to receive PRRNT and to deliver the treatment in a safe and effective manner. This document is largely based on the book published through a joint international effort under the auspices of the Nuclear Medicine Section of the International Atomic Energy Agency.

Concepts: Medicine, Cancer, Ionizing radiation, Oncology, Receptor antagonist, Agonist, International Atomic Energy Agency, Inverse agonist


The United Nations Refugee Agency’s Health Information System issues analytical reports on the current camp conditions and trends for priority reproductive health issues. The goal was to assess the status of reproductive health by analyzing seven indicators and comparing them to standards and host country estimates.

Concepts: Health care, Demography, International Atomic Energy Agency, United Nations, Health informatics, United Nations High Commissioner for Refugees, League of Nations, Western Sahara


This document describes best practice and evidence based recommendations for the use of FDG-PET/CT for the purposes of radiotherapy target volume delineation (TVD) for curative intent treatment of non-small cell lung cancer (NSCLC). These recommendations have been written by an expert advisory group, convened by the International Atomic Energy Agency (IAEA) to facilitate a Coordinated Research Project (CRP) aiming to improve the applications of PET based radiation treatment planning (RTP) in low and middle income countries. These guidelines can be applied in routine clinical practice of radiotherapy TVD, for NSCLC patients treated with concurrent chemoradiation or radiotherapy alone, where FDG is used, and where a calibrated PET camera system equipped for RTP patient positioning is available. Recommendations are provided for PET and CT image visualization and interpretation, and for tumor delineation using planning CT with and without breathing motion compensation.

Concepts: Cancer, Ionizing radiation, Oncology, Lung cancer, Non-small cell lung carcinoma, Positron emission tomography, Radiation therapy, International Atomic Energy Agency


The American College of Radiology (ACR) and the European Society of Radiology (ESR) held the second joint Global Summit on Radiological Quality and Safety on October 10-11, 2015 in Barcelona. The programme addressed the issues of safety, professional performance, practice improvement and customer service. Participants came from national and international radiological societies; partner medical societies; global organisations such as the International Atomic Energy Agency and the World Health Organisation; and patient advocacy groups. The objective was to exchange ideas and develop common strategies to improve and harmonise quality and safety in radiology on a global level. Participants debated and proposed improvement initiatives at the conclusion of the meeting.

Concepts: Management, International Atomic Energy Agency, World Health Organization, Western culture, The Conclusion, Service, Customer service, Voluntary association


Feedback from industrial accidents is provided by various state or even international, institutions, and lessons learned can be controversial. However, there has been little research into organizational learning at the international level. This article helps to fill the gap through an in-depth review of official reports of the Fukushima Daiichi accident published shortly after the event. We present a new method to analyze the arguments contained in these voluminous documents. Taking an intertextual perspective, the method focuses on the accident narratives, their rationale, and links between “facts,” “causes,” and “recommendations.” The aim is to evaluate how the findings of the various reports are consistent with (or contradict) “institutionalized knowledge,” and identify the social representations that underpin them. We find that although the scientific controversy surrounding the results of the various inquiries reflects different ethical perspectives, they are integrated into the same utopian ideal. The involvement of multiple actors in this controversy raises questions about the public construction of epistemic authority, and we highlight the special status given to the International Atomic Energy Agency in this regard.

Concepts: Scientific method, Epistemology, Learning, Knowledge, Logic, International Atomic Energy Agency, Safety, Utopia


The optimal radiotherapy regimen for elderly and/or frail patients with newly diagnosed glioblastoma remains to be established. This study compared two radiotherapy regimens on the outcome of these patients.

Concepts: Medicine, Radiation therapy, International Atomic Energy Agency


For estimation of residents' exposure dose after a nuclear accident, the reduction factor, which is the ratio of the indoor dose to the outdoor dose is essential, as most individuals spend a large portion of their time indoors. After the Fukushima nuclear accident, we evaluated the median reduction factor with an interquartile range of 0.43 (0.34-0.53) based on 522 survey results for 69 detached wooden houses in two evacuation zones, Iitate village and Odaka district. The results indicated no statistically significant difference in the median reduction factor to the representative value of 0.4 given in the International Atomic Energy Agency (IAEA)-TECDOC-225 and 1162. However, with regard to the representative range of the reduction factor, we recommend the wider range of 0.2 to 0.7 or at least 0.2 to 0.6, which covered 87.7% and 80.7% of the data, respectively, rather than 0.2 to 0.5 given in the IAEA document, which covered only 66.5% of the data. We found that the location of the room within the house and area topography, and the use of cement roof tiles had the greatest influence on the reduction factor.

Concepts: Statistics, Statistical significance, Interquartile range, Factor analysis, Ratio, International Atomic Energy Agency, Semi-detached, House


Namie Town was heavily contaminated by the Fukushima Daiichi Nuclear Power Station accident. The thyroid equivalent dose for residents who lived in Namie was estimated using results of whole body counting examinations which were carried out by the Japan Atomic Energy Agency a few months after the nuclear accident. Photon peaks of (131)I and (134)Cs were previously measured by the authors using a NaI(Tl) scintillation spectrometer and that information was used to estimate the (131)I/(134)Cs activity ratio of total intake in the present study. The maximum values of (131)I/(134)Cs activity ratio corresponding to thyroid uptake factors of 0.3, 0.1 and 0.03 were evaluated to be 0.9, 2.6 and 8.7, respectively. The maximum value of the (131)I/(134)Cs activity ratio was used to obtain the most conservative thyroid equivalent dose estimation. The maximum internal exposure of the thyroid to (131)I on the basis of (134)Cs accumulated in the body measured by the whole body counter was estimated to be 18mSv. This value was much smaller than 50mSv that the International Atomic Energy Agency recommends as the dose at which exposed persons should take stable iodine tablets.

Concepts: Chernobyl disaster, Uranium, International Atomic Energy Agency, Iodine, Gamma ray, Lists of nuclear disasters and radioactive incidents, Nuclear safety, Three Mile Island accident