Theranostics Certification – Legacy Providers
19 September 2023
The process for recognition of retrospective/legacy experience in Theranostics for qualified practicing Nuclear Medicine Specialists has been finalised by the RACP College Education Committee (CEC) which oversees the Committee for Joint College Training (CJCT) – stating that the process will be managed by the AANMS and its Theranostics Committee, along with the CJCT in Nuclear Medicine.
The principles for documentation and validation of legacy experience as a basis for certification are modelled upon those for PET, that were developed in consultation with the AANMS, RACP and RANZCR. This does not alter access to items which are currently listed on the MBS as of 1 September 2023.
Initial round Applications are due back to AANMS by 16 October 2023.
It is appreciated that this has been a lengthy development process, so the decision has been made to have an initial round of applications prior to the November 2023 meeting of the CJCT, therefore applications are due back to AANMS by 16 October 2023. There is no need for concern, or rush, as there will be regular application periods open each year, with this legacy provider pathway open until 2030.
Follow these links for details on how the application process works and for the application form.
Please submit the application form to: theranostics.certification@aanms.org.au, by C.O.B. 16 October 2023. You will receive an acknowledgement and receipt/tax invoice after payment is confirmed.
It is anticipated that there may be an initial flurry of applications, so please be aware that some may be held over until the next meeting of the CJCT.
Congratulations to all involved in developing this process, as Australia continues to set the standard for practice in this field.
Amendments to the Medicare Benefits Schedule from 1 July
Changes to the Diagnostic Imaging Services Table and Changes to Therapeutic Nuclear Medicine
30 June 2023
Changes to the DI Services Table and Changes to Therapeutic NM are now available on MBSonline. The following links may be of assistance in understanding the upcoming changes:
The XMLs and link to the July news page can be found here.
Download the fact sheets:
Factsheet – Changes to DI Services Table
Factsheet – Changes to Therapeutic Nuclear Medicine
Australian National Diagnostic Reference Levels for NM
15 May 2023
In 2020 AANMS agreed to participate in a review of the National Diagnostic Reference Levels (NDRLs) for nuclear medicine. The Liaison Panel reviewing the NDRLs included representatives from ARPANSA, the AANMS, the ANZSNM, the Australian Diagnostic Imagine Association (ADIA), the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM), and the Diagnostic Imaging Accreditation Scheme (DIAS) Advisory Committee.
The Liaison Panel has agreed on recommendations to revise the existing adult nuclear medicine NDRLs, based on data submitted to a national survey conducted between October 2021 and March 2022. In addition to revising the DRL values, the Panel recommends that:
- The number of DRLs for general nuclear medicine is reduced to focus on the most common procedures
- DRLs be introduced for 68Ga DOTA-TATE and prostate cancer positron emission tomography (PET) procedures (68Ga PSMA and 18F DCFPyL)
- DRLs for the CT component of hybrid imaging be defined in terms of volume computed tomography dose index (CTDIvol) in addition to dose length product (DLP), (the existing DRLs are only in terms of DLP)
- The DRLs for the CT component of PET/CT imaging are categorized based on arm positioning.
Transitional arrangements relating to Diagnostic Imaging Accreditation Scheme (DIAS) requirements will be discussed with the DIAS Advisory Committee and the Australian Commission on Safety and Quality in Health Care (ACSQHC). It is anticipated that a transition period will apply after the announcement of the revised NDRLs. During the transition period, comparisons against either the previous NDRLs or the revised NDRLs would be accepted for the purposes of compliance with DIAS Standard 3.2.
ARPANSA is confident that the data considered by the Liaison Panel is a good reflection of current practice at Australian nuclear medicine imaging facilities. The AANMS Board has endorsed these NDRLs for nuclear medicine and recommends to AANMS members that they use the ARPANSA data to inform their practices.
The AANMS Board thanks those AANMS members, including A/Prof. George Larcos, for their input into this review.
The ARPANSA documents can be downloaded below:
Proposed Revisions
Nuclear_Medicine_Quantiles
Revised_NM_DRLs_Summary_Tables
Nuclear Medicine in the News – Targeted Alpha Therapy
31 March 2023
The Australian Financial Review has a prominent article on the world-leading research conducted by Professor Michael Hofman, Dr Mohammad Haskali and colleagues at the Peter MacCallum Cancer Centre, Essen University Hospital Germany and the University of California at Los Angeles and San Francisco.
The team’s development of what is described as “liquid radiation” or targeted alpha therapy is hailed as a new pillar in the treatment of cancer, and demonstrates that among the groups working in this field, Australia is a leader. AANMS President, Associate Professor Sze Ting Lee, says, “The fact that it is an Australian innovation is also exciting. Australia is definitely punching above its weight in developing nuclear medicine technology for the world.”
AANMS President’s interview: 25 years of non-indexation of nuclear medicine impeding access and affordability
16 March 2023
The AANMS President’s Australian Health Journal interview ahead of the budget has been released.
Click on the following links to view:
Pre-Budget Submission: Strengthening Medicare Through the Re-Indexation of Nuclear Medicine Items on MBS
10 February 2023
Australian patients requiring nuclear medicine services are facing higher out of pocket costs as a result of inaction from successive governments to adequately fund and index nuclear medicine items on Medicare for more than 20 years.
Read the submission here.
Australian Meetings 2025
NOTE: We will continue to keep these lists updated, but please check with the organising body before making any plans.
ANZSNM 55th Annual Scientific Meeting
23 – 25 May 2025
Melbourne Convention and Exhibition Centre
Further information
CSANZ 73rd Annual Scientific Meeting
14 – 17 August 2025
Brisbane Convention and Exhibition Centre
Further information
RANZCR Annual Scientific Meeting
23 – 25 October 2025
Melbourne Convention and Exhibition Centre
Website
International Meetings 2025
SNMMI Annual Meeting 2025 – abstract submission now open – deadline 13 January 2025
21 – 25 June 2025
New Orleans, Louisiana, USA
Website
Abstract submission
EANM Congress 2025
4 – 8 October 2025
International Barcelona Convention Center, Barcelona, Spain
Further information
Past News Items:
News 2022
News 2021
News 2020
Professor Michael Quinlan AO
Physician and Nuclear Medicine Physician (22.05.1938 – 02.10.2020)
Professor Michael Quinlan was a pioneer of Nuclear Medicine. He was the first Nuclear Medicine Physician in Western Australia, having trained in Nuclear Medicine at Johns Hopkins University, Baltimore under the guidance of Dr Henry Wagner. He worked initially at Royal Perth Hospital in the Department of Medical Physics and he then established the Nuclear Medicine Department at Sir Charles Gairdner Hospital in 1970. He later also established Nuclear Medicine at St John of God Hospital.
Professor Quinlan was committed to education and training, and he established the first Nuclear Medicine registrar training program in WA. He was a foundation member and committee member of the Australian and New Zealand Society of Nuclear Medicine (formed in 1969).
In addition to his commitment to Nuclear Medicine, he made significant contributions to many WA health organisations and universities including Notre Dame (Foundation Dean of College of Health 1999, Chancellor 2008-2011), Adjunct Professor at the University of Western Australia, Fellow of Royal Australian College of Physicians (awarded College medal 1998), Director of Medical Teaching Unit St John of God Hospital, Emeritus Consultant Sir Charles Gairdner Hospital. In 2018 he was awarded the Order of Australia for his work in medicine and clinical services.
Professor Quinlan had a lifelong commitment to medicine, particularly in teaching and education, however those that worked with him reflect on his genuine care and compassion for patients.
Professor Quinlan passed away after a brief illness in October 2020.
Ros Francis FRACP FAANMS, 14 January 2021
AANMS and ANZSNM made a joint submission to the House of Representatives Standing Committee on Health, Aged Care and Sport Inquiry into the approval processes for new drugs and novel medical technologies in Australia.
The inquiry has a focus on the treatment of rare diseases and conditions where there is high and unmet clinical need. It consider s Australia continuing to be well positioned to access new drugs and novel medical technologies in a timely manner and respond to emerging global trends.
The joint submission noted Australia has an opportunity to develop a new industry of national significance and has the foundations for a very strong competitive advantage compared to other countries in the development of novel radiopharmaceuticals and theranostics. This could become a significant national industry generating economic returns, employment and expertise. It would also give Australian patients early access to the latest treatments in trials and novel therapies.
The submission also recommended consideration should be given to a new “class” of “drug” that is a “radiopharmaceutical”.
The submission is available to be viewed here HERE or on the Committee website HERE
18 November 2020
ANSTO have advised that there will be a delay in the restart of ANSTO’s OPAL reactor due to an anomaly identified in scheduled maintenance. This will impact nuclear medicine product supply from 23 November 2020 onwards.
Some members may have already received an email communication from ANSTO.
The ANSTO website lists the affected products and has further details on the situation.
ANSTO have advised it will be at least four weeks before full domestic nuclear medicine supply is available.
ANSTO is currently working with the international nuclear medicine community to source supply of Molybdenum-99 and Iodine-131. However, from 30 November even if the supply is secured, they expect less than 50 per cent of usual supply.
The Nuclear Medicine Working Group has met to discuss the issue and the AANMS, ANZSNM and RAINS representatives have emphasised the importance of planning any supply reductions given the impacts on practitioners and patients.
ANSTO Customer Service will be in contact with customers to discuss a supply plan for 23 November onwards. The ANSTO customer service contact number is 1800 251 572.
Please check the ANSTO website for updates. AANMS will also provide members with any updated information that is available.
22 September 2020
The AANMS is a part of 12 medical groups who have joined the AMA and 16 existing leading medical organisations to sign up to a guide aimed at empowering patients with important information to understand medical costs.
Informed Financial Consent: A Collaboration Between Doctors and Patients is a guide that gives patients confidence to discuss and question fees with their doctors before treatment, lessening the chance of unexpected bills afterwards.
The guide is available here Informed-financial-consent-September 2020-v2
18 September 2020
The Presidents of peak medical associations have united to write to Health Minister Greg Hunt, calling for an urgent review of Medicare changes to cardiac diagnostic services that are leaving patients out of pocket and at risk of missing out on care.
The associations, representing GPs and other specialists, nuclear medicine specialists, pathologists, diagnostic imaging specialists, radiologists, and rural doctors, have told Minister Hunt that their advice was ignored when the changes were first proposed as part of the Medicare Benefits Schedule (MBS) Review.
“Patients who have previously received cardiac diagnostic services by a general practitioner, nuclear medicine specialist, or pathologist are either no longer funded to receive those services, will face higher out-of-pocket costs, or will only access those services in limited circumstances,” AMA President, Dr Omar Khorshid, said today.
“Coronary heart disease is the leading cause of burden of disease in Australia, and is higher in regional and remote areas than in major cities.
“Cardiovascular disease deaths are the greatest contributor to the mortality gap between Aboriginal and Torres Strait Islander Australians and other Australians.
“It makes no sense to make patients pay more, or have to be referred to a non-GP specialist, to have a basic heart test.”
Minister Hunt has indicated that some of the changes will be reviewed next year, but the Presidents said that will be too late.
“Several of the changes will significantly reduce patients’ access to prompt and appropriate cardiac diagnostic services,” the letter warns.
“These changes have occurred through a fundamentally flawed review, consultation, and implementation process.
“Insufficient regard was had for the range of other medical providers who are vital in providing comprehensive cardiac diagnostic services to patients.
“This includes general practitioners who are trained and experienced to provide the services that have now been restricted. They have a key role in being at the centre of a patient’s care, and enabling timely access to care.
“Nuclear medicine specialists and pathologists, including those within admitted hospital settings, are now also restricted from providing care that is accepted as clinical best practice and that supports and complements the services of cardiologists.
“We understand that you intend reviewing some of the cardiac diagnostic changes in six months’ time. In our view, this review will be too late.
“During this time, patient access to care will be compromised, and some patients will also face higher costs.
“Care that could easily be provided in a primary care setting will now need to be referred, and this will inevitably result in increased costs to the MBS.
“We know that access to non-GP specialist services in some rural and metropolitan areas is limited, and that the viability of some diagnostic imaging practices in these areas is also under threat.”
The signatories include the AMA, the Royal Australian College of General Practitioners (RACGP), the Australasian Association of Nuclear Medicine Specialists (AANMS), the Australian College of Rural and Remote Medicine (ACRRM), Australian Pathology, the Australian and New Zealand Society of Nuclear Medicine (ANZSNM), and the Australian Diagnostic Imaging Association (ADIA).
Background
- On 1 August, the MBS replaced 18 cardiac test items and replaced them with 29 new items that changed which doctors can request tests, which tests they can provide, and for which patients.
Since 1 August, patients attending their GP for an ECG will only be paid a Medicare rebate of $19 instead of the previous rebate of $32.25.
- GPs will no longer attract a rebate for producing a report or a clinical note for the ECG trace.
Almost all patients with suspected coronary artery disease must be referred for stress echo tests first, not a myocardial perfusion scan (MPS).
- Stress echo tests may not provide the comprehensive information necessary for some groups of patients.
- For medium-to-high risk patients, there will be a substantial increase in the volume of subsequent unnecessary and expensive tests, such as invasive coronary angiograms, to obtain the information that could have been acquired non-invasively using MPS.
- Angiograms cost the health system an average of $1,500. Out-of-pockets for patients for the actual procedure are low – about $10 – however, they usually need to be admitted to hospital, so could be up for an excess payment to their insurer.
- Nationally, in 2016-2017, 64 per cent of cardiac stress tests and imaging were requested by GPs, 26 per cent by cardiologists, and 10 per cent by other health professionals.
21 August 2020
The AANMS would like to congratulate to Dr Shyam Sankaran on winning the 2020 AANMS Registrar Research Award for his presentation Excellent suppression of physiological myocardial FDG activity in patients with cardiac sarcoidosis prepared with a 24-hour high fat very low carbohydrate diet and prolonged fasting.
Dr Sankaran undertook the research for this presentation while completing his first year of nuclear medicine training at The Alfred Hospital in 2019, and is currently completing his advanced training at Monash Health in Melbourne.
The AANMS would like to congratulate all the Award Entrants and acknowledge their work in applying and presenting. Thank you to the judging panel and all others involved.
The AANMS would also like to thank ANZSNM in providing the platform for the Awards and presentations, and in making the Annual Scientific Meeting possible via the online platform.
29 June 2020
The Australasian Association of Nuclear Medicine Specialists (AANMS) has been made aware of several enquiries to the Department of Health regarding PET services. The AANMS would take the opportunity to note that:
Clause 2.4.2 in the Diagnostic Imaging Services Table Regulations (DIST) requires Medicare funded PET services to be performed in a ‘comprehensive facility’. Comprehensive facility is defined in Part 3 of the DIST as ‘a facility where all of the following services are performed (whether or not other services are also performed) : PET, computed tomography, diagnostic ultrasound, medical oncology, radiation oncology, surgical oncology and x-ray’.
Further, clause 2.4.5 in the DIST requires the owner or operator of PET equipment to make a written declaration to the Chief Executive of Medicare that the place where Medicare funded PET services are provided, is a ‘comprehensive facility’. In making such a declaration, the owner or operator is asserting that all elements of the requirement have been met.
The intention of the ‘comprehensive facility’ requirement is to ensure that the services required for cancer diagnosis and treatment are provided in a location that allows patients to have access to high quality, multi-disciplinary care. Ready access to imaging, and the specialists reporting these images, facilitates the multidisciplinary team (MDT) process and allows for consistency of reporting and regular feedback. Best practice for PET provision and interpretation is best achieved when the scans are able to be assessed in light of other relevant factors of patient history and treatment options.
To achieve this, PET services are hospital or cancer-centre based where there is a formal network of patient care. When the ‘comprehensive facility’ definition was reviewed in 2018 by the Diagnostic Imaging Clinical Committee (DICC) of the Medicare Benefits Schedule (MBS) Review Taskforce, the DICC agreed the definition should be retained to prevent the proliferation of low-quality PET services without the context of appropriate cancer service provision. The DICC also agreed that PET should be performed in a hospital setting with the involvement of the patient’s referring doctor where appropriate.
All Medicare funded diagnostic imaging services, including PET services must be rendered from a practice accredited under the Diagnostic Imaging Accreditation Scheme (DIAS).
Ultimately, it is the responsibility of individual business owners to undertake their own due diligence. If it is your intention to establish a practice providing Medicare funded PET services, you will need to ensure that the operational arrangements meet the legislative requirements.
The AANMS supports these measures which are designed to ensure best practice in PET service provision. We would also take the opportunity to strongly reinforce our support for personal supervision in nuclear medicine and PET and our belief that personal supervision provides a better imaging outcome and improved patient care.
8 May 2020
On 8 May 2020 the AANMS held their Annual General Meeting. The meeting elected the new Board for the next two years – 2020-2022.
The New AANMS President is Dr Geoff Schembri FRACP FAANMS (NSW). Geoff was previously Vice President of the AANMS.
The AANMS Board members for 2020-2022 are:
President
Dr Geoffrey (Geoff) Schembri FRACP FAANMS (NSW)
Vice-President
Associate Professor Sze Ting Lee FRACP FAANMS (VIC)
Honorary Treasurer
Dr Michelle Nottage FRANZCR FAANMS (SA)
Immediate Past President
Associate Professor Paul Thomas FRACP FAANMS (QLD) (ex officio)
DIRECTORS
Associate Professor Nathan Better FRACP FCSANZ FAANMS (VIC)
Dr Scott Beuzeville FRACP FAANMS (NSW)
Dr Samuel (Sam) McArthur FRANZCR FAANMS (VIC)
Dr Lisa Tarlinton FRANZCR FAANMS (NSW)
Dr Elizabeth Thomas FRACP FAANMS (WA)
Dr Eva Wegner FRACP FAANMS (NSW)
In April the AANMS wrote to the Federal Minster for Health Greg Hunt requesting, under his powers in the Therapeutic Goods Act Section 18A Exemption because of emergency, to remove the current restrictions to supply within the same State or Territory, and also the restriction to only supply hospitals or public institutions.
On 2 May the Therapeutic Goods Amendment (Radiopharmaceutical and Radiopharmaceutical Active Ingredients) Regulations 2020 came into effect. The purpose of the Regulations is to enable public and private hospitals and public institutions that do not hold a manufacturing licence under the Act to manufacture radiopharmaceuticals or radiopharmaceutical active ingredients (RAI) for the treatment of a patient in another State or Territory, so that the radiopharmaceuticals or RAI can be transported to the patient in a timely manner. This eliminates the need for patients to travel interstate for diagnosis or treatment.
As AANMS advocated for, the exemption is necessary to facilitate the continued supply of radiopharmaceuticals to patients around Australia which has been negatively impacted by the unforeseen reduction in commercial flights between Australian capital cities caused by the COVID-19 emergency.
Where a hospital or institution is able to obtain sufficient supplies of radiopharmaceuticals or RAI from a manufacturer licensed under the Act, the radiopharmaceuticals or RAI should be obtained from that licensed manufacturer. The exemptions will apply for the duration of the COVID-19 outbreak.
See the full Explanatory Statement.
See the full Therapeutic Goods Amendment 2020.
As the reimbursement rate for the PET item numbers was set prior to the PET/CT era, the AANMS has successfully made the case with the Department of Health that item 61505 should be extended to PET because of the additional time and cost of providing this service. Item 61505 will be co-claimable with PET items from 1 May 2020.
Item 61505 (CT scan performed at the same time and covering the same body area as single photon emission tomography for the purpose of anatomic localisation or attenuation correction where no separate diagnostic CT report is issued and only in association with items 61302 – 61650) has until now been limited to SPECT only.
Note that the existing DOTA PET item number currently includes the 61505 equivalent $100 fee and this items’ fee will be reduced by $100 to allow 61505 to be claimed with all PET studies, including the DOTATATE PET items.
For an overview of the changes go to Diagnostic imaging and related changes effective 1 May 2020