1. IMPLEMENTAÇÃO DO PET NO BRASIL: NECESSIDADES E DESAFIOS CLAUDIO MENEGHETTI INCOR-FMUSP IMPLEMENTATION OF PETs IN BRAZIL: NEEDS AND CHALLENGES JUNHO- 2005

2. PET SYMPOSIUM SETTING UP A PET IMAGING CENTER WFNMB & ALASBIMN THE ECONOMICS BEHIND CLAUDIO MENEGHETTI- BRAZIL

3. IAEA DIRECTORY OF CYCLOTRONS USED FOR RADIONUCLIDE PRODUCTION IN MEMBER STATES 206 ENTRIES FOR CYCLOTRONS OPERATING IN 34 MEMBER STATES USA 90 EUROPE 54 JAPAN 38 LATIN AMERICA 8*

4. INCOR-FMUSP -1998 COINCIDENCE HIBRID SCINTILATION CAMERA CNEN/IPEN ROLE BRAZILIAN HISTORICAL

5. OUR PROBLEM: CNEN/IPEN/SBBMN RECOGNITION OF CNEN AND MC&T MONOPOLIUM FLEXILILITY MC&T, GOVERN, BRAZILIAN SOCIETY APPROVED IN SENATE AND CONGRESS PROBLEMS ?? FHC-LULA AND ??? PET IN BRAZIL

6. PET DEDICADO INCOR- 2003 DEDICATED PET

7. CYCLOTRON AND PET IN BRAZIL - 2005 RIO DE JANEIRO - CYCLOTRON 11 MEV SAO PAULO - CYCLOTRON 30 MEV – MULTIPLE USE RIO DE JANEIRO - 2 PET BARRA / SAMARITANO SAO PAULO - 4 PET INCOR/HSL/HCOR/EISNTEIN PLACE WITH A IMMEDIATE POTENCIAL INSTALLATION RECIFE – BELO HORIZONTE – PORTO ALEGRE

8. PET IMAGING CENTER IN LATIN AMERICA CYCLOTRONS IN LATIN AMERICA ARGENTINA 2 CYCLOTRONS BRAZIL 4 CYCLOTRONS* CHILE 1 CYCLOTRON MEXICO 1 CYCLOTRON VENEZUELA 1 CYCLOTRON

9. LATIN AMERICA PERSPECTIVES LIMITATIONS Device / inhabitants Distribution Imported Devices/cost Reimbursement

10. LATIN AMERICA PERSPECTIVES BRAZIL LIMITATIONS 170.000.000 INHABITANTS 8 CAMERA BASED PET 6 DEDICATED PET 2 PRODUTIVE CYCLOTRON 2 CITIES – SÃO PAULO AND RJ

11. SNM AIM * The Society of Nuclear Medicine is an international scientific and professional organization founded in 1954 to promote the science, technology and pratical application of nuclear medicine. * The SNM and SNMTS are commited to providing continuing education, opportunities, and other professional development information to anyone interested in the field of Nuclear Medicine. HTTP:// WWW.SNM.ORG

12. WHAT CAN THE FIRST WORLD AND AIEA DO TO IMPROVE THE PERSPECTIVES IN THE USE OF PET IN LATIN AMERICA? * To facilitate the participation of experts in L.A. congress as to spread out the use of PET in Oncology, Cardiology and Neurology. * To facilitate the training of L.A. human resources. * To promote political influence on National Nuclear Energy Comissions and Governamental Instituitions as to facilitate the introduction and utilization of this technology in Latin America.

13. WHAT CAN THE ALASBIMN AND LOCAL ASSOCIATIONS DO TO IMPROVE THE PERSPECTIVES IN THE USE OF PET IN L.A ? * To promote political influence on National Nuclear Energy Comissions and Governamental Instituitions as to facilitate the cyclotrons installation. * To promote lectures about PET applications in the main congress related to oncology, neurology and cardiology.

14. CYCLOTRON FOR PET USE

15. PET IMAGING CENTER IN LATIN AMERICA WHAT DO WE NEED?

16. PET IMAGING CENTER IN LATIN AMERICA UNDERSTANDING LATIN AMERICA WHY ECONOMY IS A BIG PROBLEM IN LATIN AMERICA?

17. PET IMAGING CENTER IN LATIN AMERICA CAMERA BASED PET $500,000 DEDICATED PET $1,500,000 DEDICATED PET/CT $2,200,000 SMALL CYCLOTRON $2,000,000 PRODUCTION CYCLOTRON $3,000,000

18. PET IMAGING CENTER IN LATIN AMERICA USA PET SCINTIGRAPHY $2,000 LATIN AMERICA PET SCINTIGRAPHY $1,000 USA INTEREST RATE LOW LATIN AMERICA INTEREST RATE HIGH BRAZIL NATIONAL 19,75%/YR BRAZIL INTERNATIONAL 8,5%/YR BRAZIL TRANSPORT, INSURANCE AND TAXES 30%

19. PET IMAGING CENTER IN LATIN AMERICA PRICE OF SCINTIGRAPHY 1998 R$1800 2003 R$3000 2005 R$3000 1 DOLAR = 1 REAL 1998 1 DOLAR = 2,5 REAL 2005 YOU BUY THE MACHINE IN AMERICAM DOLLARS AND HAVE TO PAY THE SAME PRICE WITH REAL, 250% HIGHER WITH THE CHEAPER SCINTIGRAPHY. PET SCINTIGRAPHY IN BRAZIL

20. PET IMAGING CENTER IN LATIN AMERICA CYCLOTRON UNITED STATE AND EUROPE START WITH $700 PER FDG DOSE. NOWADAYS, WITH MORE PET BUYING DOSES, THE PRICE IS BETWEEN $300 AND $400. IN LATIN AMERICA YOU NEED TO START, EVEN WITH LESS USERS, RANGING $300. REMEMBER, THE PET TEST NEED TO BE NEAR $1000 AND THIS PRICE IS VERY EXPENSIVE TO BRAZIL. SO, YOU HAVE $600 OR $700 TO PAY DIRECT AND INDIRECT COSTS, INCLUDING THE NATIONAL TAXES AND MACHINE. IF YOU BOUGHT THE PET BY $1,500,000, YOU HAVE ONLY OF INTEREST RATE AFTER ONE YEAR, TO PAY $127,500 OR 127 SCINTIGRAPHIES, MAINTENANCE MORE THAN 150 TEST/YR.

21. PET IMAGING CENTER IN LATIN AMERICA PET SCINTIGRAPHY IS VERY IMPORTANT AND SHOWED TO BE PROFIT TO THE PATIENTS AND TO THE MEDICAL DECISIONS. PET SCINTIGRAPHY IMPROVE THE PATIENT TREATMENT AND THE RESULTS ARE BETTER. THE MEDICINE, IN ALL COUNTRIES OF THE WORLD, NEEDS A PET FACILITIES. THE COUNTRIES HAVE DIFFERENT POLITICS ABOUT HEALTH AND DIFFERENT HEALTH ABOUT THE OWN ECONOMY. THE ECONOMY IS CONCENTRATED IN THE DEVELOPED COUNTRIES AND THEY DONT HAVE DIFFERENT TREATMENT TO DIFFERENT KIND OF ECONOMY. PET SCINTIGRAPHY

22. PET IMAGING CENTER IN LATIN AMERICA WHAT CAN THE BIG COMPANIES DO FOR LATIN AMERICA? DIFFERENT PRICES? DIFFERENT FINANCING? DIFFERENT TAXES? ALL THESE DIFERENCES AT THE SAME TIME ?

23. DO WE HAVE OTHER KIND OF PROBLEM? THE PET OF INCOR, A PUBLIC HOSPITAL, WAS A DONATION FROM THE MINISTRY OF HEALTH SINCE 2003. DO THEY PAY THE PET SCINTIGRAPHY? TODAY THE PRODUTION BELONGS TO THE GOVERN. WE ARE 2005 AND, NOW THEY GAVE US 500 FDG DOSE IN ORDER TO PROVE THAT PET IS A GOOD TEST FOR THE POPULATION. THE WORLD PROVED THAT MANY YEARS AGO. WHAT ARE OUR NEEDS AND CHALLENGES?

24. PAULISTA SOLUTION IPEN + FMUSP + SC&T-SP DEDICATED CYCLOTRON – SAO PAULO IPEN? FMUSP? DEDICATED CYCLOTRON – CENTRE STATE ( JAU? ) 2 PET MOBILE INVOLVED WITH HEALTH SECRETARY SP

25. PET-CT MOBILE

26. ESTADO DE SP RESOLVE? PET-CT MOBILE

27. PET MOBILE

28. WHAT ARE OUR NEEDS AND CHALLENGES? WE ARE NOT A POOR CONTINENT. WE HAVE A BAD MONEY DISTRIBUTION. AS WE HAVE ECONOMIC PROBLEM DISTRIBUTION AND WE CAN NOT STOP THE SCIENCE EVOLUTION, WE NEED A POLITICAL SOLUTION. WE KNOW WHAT WE HAVE TO DO.

29. WHAT ARE OUR NEEDS AND CHALLENGES? WE ARE THE “WITHOUT CYCLOTRON AND PET” LETS DO A MARCH TO BRASILIA, TO MC&T AND TO CNEN CLAUDIO MENEGHETTI-INCOR-FMUSP