By Ben Garcia

KUWAIT: Nuclear and molecular imaging and related sciences are key components of Kuwait’s nation building since the 1970s, providing fundamental insights in the health and wellbeing of individuals. Kuwait has a vision to improve the level of nuclear medicine and molecular imaging services up to international standards, as well as be locally acknowledged with the aim of improving patients’ health within Kuwait, where over 1.3 million are covered with the service.

Adan Hospital nuclear medicine has gone through remarkable changes and continuous modernization since the health ministry took over it from a private administration in 2015, and currently has five of the latest gamma CT-scan cameras, a positron imaging device associated with CT-scan for molecular imaging, an integrated radiology pharmacy, thyroid clinic, thyroid activity meter and a carbon-14 device for stomach germ tests.

Patients have undergone several medical tests at the nuclear medicine department over the past five years with a remarkable gradual increase in numbers in 2019, when 5,248 tests were conducted including over 1,920 cardiac stress tests, 1,417 stomach germ tests using carbon-14, 415 molecular imaging tests and 465 thyroid and radioactive iodine tests.

Adan Hospital’s nuclear medicine department is the Ministry of Health’s (MoH) only nuclear medicine unit to be awarded UKAS 2008 and ISO 2015 quality certificates for three consecutive years, which had a huge impact on the comprehensive management of nuclear medicine services. It also has an online patient appointment service with a maximum waiting list of 48 hours for all nuclear medicine tests and a maximum of 14 days for molecular imaging, which paves the path towards turning into a paperless unit to match Kuwait’s strategy of digitalizing health services.

Adan Hospital’s nuclear medicine has effectively contributed to introducing nuclear medicine services through holding local conferences and workshops such as a CT-scan workshop, thyroid workshop, the nuclear medicine week, holding several lectures and practical training for specialized doctors registered with the Kuwait Institute for Medical Specialties (KIMS) in collaboration with the devices’ manufacturing companies’ local agents, which all resulted in having a highly trained team to provide medical services.

Nuclear medicine has also achieved effective progress in terms of research and development including research on coronary heart disease, lung cancer with a blood test for vital signs, childhood hyperinsulinemia, checking patients’ exposure to radiation during CT-scans, treatment and imaging of the synovium of the knee joint with E90 using the CT-scan aided positron device and 3D printing of medical applications.

Nuclear medicine has also received research grants from the Kuwait Foundation for the Advancement of Sciences (KFAS), and research results were published in prestigious international journals including the Journal of Medicine, Journal of Internal Medicine, International Journal of Recent Scientific Research in the US and many others.

The nuclear medicine facility at Adan Hospital is one of eleven in Kuwait. Its mission statement is to be a nationally recognized center of excellence, matching the international standard with the aim of further improving the health of Kuwait’s patients. Kuwait Times spoke to Dr Iman Al-Shammeri, Head of the Nuclear Medicine Department at the Ministry of Health.

Kuwait Times: What are the services and facilities you provide to your patients at the nuclear medicine department?
Al-Shammeri: Nuclear medicine under my headship started in Nov 2015 with a gamma camera and a staff of around 12 people only. This nuclear medicine department at Adan Hospital was run by the private sector from 2005, and was turned over to us in 2015. They completed the project, so the next step was to turn over the facility to us. It was a BOT project. We took over the facilities and started recruiting staff, physicians and technologists – now we have more than 60 people in my department.

KT: What is the latest technology here that you are using that is comparable with international standards?
Al-Shammeri: We are proud to provide the latest technology procedure in the world like positron emission therapy-computed tomography (PET-CT). We use it for cancer patients, and also for other things, especially in screening and diagnostic imaging. The unit accommodates five state-of-the-art SPECT and SPECT/CT cameras, a PET/CT suit, well-equipped radiopharmacy, thyroid clinic and associated facilities. It’s like a radiology department, but we differ from radiology in many aspects.

Radiation penetrates the body to create images, but at our nuclear department, the source of radiation is the patient themselves. We inject the patient with radiation or it can be taken orally, and the person starts radiating and will be detected with the gamma camera. PET is a type of nuclear medicine procedure; it means that a tiny amount of a radioactive substance – called a radiopharmaceutical (radionuclide or radioactive tracer) – is used during the procedure to assist in the examination of the tissue under study.

KT: So this is not a treatment facility?
Al-Shammeri: Technically no, but we have physicians, nurses and medical technologists here. Our work is 10-20 percent therapy; treatment is at the hospital – we are more into imaging and diagnosis. Treatment is mainly for benign thyroid cases, thyrotoxicosis or cancer, and is always at the huge facility at Sabah Hospital (Kuwait Cancer Control Center).

We now have 11 nuclear medicine centers all over Kuwait in all seven governorates. Sheikh Jaber Hospital also has such facilities. In the 80s, we only had two nuclear medicine facilities – one in Mubarak Hospital and the other in Sabah Hospital. In early 2000, the total increased to eight, and now 11. The latest were in Jaber Hospital, which opened last year, and in Sabah Hospital.

KT: Give us a breakup of patients.
Al-Shammeri: In 2019, we recorded 5,248 patients at Adan – half of them Kuwaitis. We are second after KCCC in terms of the number of patients. In other areas, 70 percent of the patients are expats. Also, male patients are always more than female patients. Our services here are 100 percent supported by the government.

KT: How is the training and development in your department?
Al-Shammeri: We have a very good lineup of staff, and I can say we are almost 70 percent Kuwaiti. Kuwaitization is real in our department and I am happy that the staff is satisfied. We have programs for continuous learning and training for the doctors, technologists, nurses and physicists.

KT: Kuwaitis normally go abroad seeking medical treatment – can a facility like this lessen the burden?
Al-Shammeri: Our facilities are complete with advance technology – if before we used to send them abroad just for diagnosis, nowadays we conduct diagnostics here and send them for treatment. We show the result of the tests and we send them together with the scanned images, so they are happy – it’s a testimony of success. We have programs like seminars and workshops to educate and arm people with knowledge. We promote our department in schools and malls to make them realize that we value their health.

KT: What other activities do you have in nuclear medicine?
Al-Shammeri: Nuclear medicine is progressing actively in research and development, including in coronary artery disease, lung cancer and biomarkers, pediatric hyper-insularism, CT dose audit, Y90 PET/CT synovectomy and 3D printing for medical applications in association with other specialties nationally and internationally, and has been successful in receiving a number of research grants from KFAS. Nuclear medicine is also involved dynamically in organizing conferences and workshops such as CT workshop, thyroid workshop, in-house teaching and trainings.