SNMMI Leadership Update: Working Together to Advance Nuclear Medicine and Molecular Imaging.

I am so honored to serve as SNMMI’s 2016–2017 president. Seeing all the exciting research presented at the society’s Annual Meeting in San Diego, CA, has certainly energized me for the year ahead. I am indeed fortunate to be following Dr. Hossein Jadvar as president. Thanks to his leadership, the Therapy Center of Excellence (CoE) was established to support the development and utilization of targeted radionuclide therapy (TRT) as well as collect data to demonstrate the efficacy of specific TRTs and make the case for funding. I fully endorse the important work of the Therapy CoE going forward. The Pathways to the Future of Nuclear Medicine Task Force, also set up by Dr. Jadvar, is another priority. We need to address the challenges before us and identify training pathways that ensure the delivery of high-quality, valuedriven clinical nuclear medicine practice. Quality of care must be our driving impetus. SNMMI’s Evidence and Quality Department has already set up multidisciplinary workgroups to develop evidence-based appropriate use criteria (AUC) for a number of diagnostic imaging services. This work-intensive, collaborative process takes significant time and resources, but the SNMMI leadership will continue to support the development of a comprehensive library of multidisciplinary, evidence-based AUC for high-value nuclear medicine procedures. Starting in January 2017, the Protecting Access to Medicare Act of 2014 will require the use of AUC prior to ordering advanced diagnostic imaging services. The shortage of 99Mo, from which 99mTc is derived, is an ongoing concern. For too long, we have relied on aging nuclear research reactors outside the United States. They have gone offline for extended periods in past years, causing critical shortages of 99mTc. Compounding the issue, these reactors have been using highly enriched uranium (HEU), a nonproliferation issue. The United States accounts for half of the world’s demand for 99Mo, and the Department of Energy National Nuclear Security Administration has recognized the need for domestic production that does not use HEU. It is, therefore, providing matching funding opportunities for research and development of new 99Mo domestic production methods. The good news is that a number of U.S. companies have developed innovative, non-HEU production methods and will soon be in full operation. This is a worldwide concern, and other countries are taking similar action. The Australian Nuclear Science and Technology Organisation began 99Mo production with low-enriched uranium (LEU) targets several years ago. I will be working with the Nuclear Medicine Global Initiative on this and other shared concerns. Another focus area in the year ahead will be the Qualified Person Training Program for manufacturing release of radiopharmaceuticals. The manufacture and production of radiopharmaceuticals are dependent on skilled personnel who are cross-trained in several disciplines. More individuals with pharmacy or chemistry background need to be trained in production and release of radiopharmaceuticals. This is a newly designed program for which we are now putting together a budget. Regulatory and reimbursement issues go hand in hand and will be a top priority in the year ahead. SNMMI will continue advocating for appropriate reimbursement and making the case for expeditious approval of new nuclear medicine and molecular imaging tracers that have potential to improve lives. It goes without saying that education and outreach remain fundamental to all SNMMI endeavors. We must work with referring physicians so that they understand the value of specific nuclear medicine and molecular imaging procedures. An informed public will also strengthen support of nuclear medicine’s place in providing quality care. Ours is a rapidly evolving field with exciting research on new technologies and methods for diagnosis and therapy happening around the world. Ongoing education is essential for practitioners to stay current. SNMMI has a key responsibility to provide courses and workshops that ensure members have the resources they need to provide the highest level of care. As I begin my year as president of SNMMI, I know that the work ahead will require collaboration and the help of many. I look forward to working with physicians, technologists, pharmacists, and research scientists to accomplish our many objectives. Nuclear medicine and molecular imaging are already improving patient care and outcomes; they have the potential to play an even greater role in highquality health care. Sally W. Schwarz, MS, RPh, BCNP