April 30, 2010, T. Golikova, Minister of Health and Social Development

In our country, laid a strong scientific tradition of nuclear technology, which, in turn, have strong potential for innovative development of domestic medicine.

First of all, the development of nuclear medicine is associated with diagnosis and treatment of cancer. However, the methods of nuclear medicine (radionuclide diagnostics and therapy and radiosurgery treatment methods, and proton beams) are increasingly used in a variety of socially significant diseases - cardiac, neurological, endocrinological, and other.

Over the past 10 years, mortality from cancer has risen to 13.8% and was the second leading cause of mortality in our country. Moreover, in nineteen eighty-eight regions of the figure is 10% higher than the national average.

In Russia each year for the first time revealed some 480 000 cases of malignant tumors. That is, cancer rates have now stands at 333.7 cases per 100 000 population. Over the past ten years, the incidence increased by 16%.

Currently registered in oncology facilities is more than 2.5 million patients, ie 1.8% of the population.

Unfortunately, about 60% of newly registered patients are identified on the third and fourth stages of the disease. This reduces the possibility of treatment. As a result, more than 200 thousand Russians become disabled each year from cancer (13.5% of total persons with disabilities).

Effectiveness of medical care for patients with cancer depends on the level of development and introduction of modern medical practice of nuclear medicine.

Development of nuclear medicine technology in Russia is far behind the world level.

Use of nuclear energy for peaceful purposes was begun in the USSR in the mid 50s.

In 1958, under a special government decree, was the Institute of Medical Radiology, Academy of the USSR mednauk in Obninsk for the development of new diagnostic, therapeutic, and research technologies in medicine and biology.

Until the 70s the development of peaceful nuclear technology in our country is about in line with those in the U.S., developed countries in Europe and Japan. Backlog, including by radionuclide methods began with the 80's (2-5 times) and increased to 2000 years (5-10 times).

According to statistics, in the U.S. diagnostic radionuclide studies are an average of forty patients per thousand people per year in Japan - 25 patients, Austria - 19 patients, in Russia - only 7 patients.

In the world of medical practice, using about 190 radiodiagnostic methods.

In Russia, the practice of medicine used 22 radiopharmaceuticals for computed tomography, and about 20 imported kits for radioimmunoassay, and only three ultra short radionuclide for positron emission tomography (PET).

Annual sales of only about 210 million rubles.

By the expert data, the need of the Russian population in the radiopharmaceutical is satisfied by no more than 1-3%.

Precondition of Nuclear Medicine - safety for the patient, reducing the risk at diagnosis with the use of radioactive drugs. You need to implement short-and ultra short radiopharmaceuticals, which reduce the radiation dose to the patient.

Production of short-lived radioisotopes in the diagnosis of Russia - an important impetus for the development of positron emission scanner, which provides a unique diagnostic information about the tumor and evaluate the effectiveness of the treatment.

Basic units for diagnosis using radionuclide - gamma-ray scanner. They are used in diagnostic studies of internal human organs and systems, primarily in cancer and cardiac diseases.

Today in Russia there are less than 200 gamma-ray scanners with needs - more than 300. With 80% of vehicles already worn - operate more than 10 years. And there is only one prototype gamma-ray imager of the domestic (in KB № 83 FMBA).

More sensitive and advanced diagnostic capabilities have positron emission scanner. The need for them is not less than one instrument at a half million people, which is not less than 90-95 scanners.

At the same time, there really are 7 points of positron emission scanner.

3 - in Moscow (CDB Office of the President of the Russian Federation, CB № 1 Office of the President of the Russian Federation, the Scientific Center for Cardiovascular Surgery. ANBakulev RAMS)

3 - St. Petersburg (Institute of Human Brain Sciences, Military Medical Academy, Central Research Institute of Radiology).

Since 2010 - one in Chelyabinsk.

In the U.S., today employs 300 full points, positron emission scanner, as well as more than 1,500 offices, equipped with positron emission scanner.

Thus, today the U.S. is one such scanner has less than 200 000 people.

And not looking at it in the next few years in the U.S. expected a sharp increase in market radio pharmaceutical preparations. Already in 2009 the market in the U.S. reached radio pharmaceutical preparations1.16 billion dollars. By 2017 it is expected to further increase 4-fold to 4.76 billion dollars a year.

This rapid growth is expected by increasing the amount of research in cardiology, oncology and neuroscience with traditional markers and with the advent of more effective markers.

The United States has a mobile installation PET scanners that will make the positron emissonnuyu more affordable for the population.

Annually in radionuclide therapy in Russia in need of about 50 thousand people, including:

4000 - thyroid cancer patients;

6000 - liver cancer patients;

14 000 - with other cancers;

7000 - with diseases of the locomotor system.

At present, there is the only branch of radionuclide therapy in Obninsk (Medical Radiological Research Center RAMS, Obninsk, Kaluga reg.). And put into operation department of radionuclide therapy in Chelyabinsk.

Average availability of radionuclide therapy in European countries: an "active" bed for 340 thousand population, while in most developed EU countries (Germany, Britain, Austria) - an active bed at 100-200 thousand. In Russia there are only 50 "active" beds, which is 15 times less than required.

For radionuclide therapy, following the recommendations of the World Health Organization, you must have a minimum of 3 linear accelerators per million population, more than 400 plants.

Currently, linear accelerators in Russia more than 100. About half of them - the domestic production. They also have a high degree of wear.

Success treating cancer, cardiovascular, neurodegenerative, endocrine diseases are largely determined by the introduction of modern methods of radiosurgery. According to expert data, high-tech interventions radiosurgery (gamma knife) require approximately 211 patients per million population is 30 000 per year.

In 2009, our country have been only about 700 operations at 2 plants (Institute of Neurosurgery. NNBurdenko RAMS, Moscow, and the International Institute of biological systems to them. SM Berezina , St. Petersburg).

To reduce death and disability in the population from cancer in 2009 within the national project "Health" launched the National Cancer Program, it provides:

• organization of mass screening examinations of the population;

• create a network of modern, well equipped and staffed by trained personnel of the regional and district oncology dispensary;

• the widespread introduction of effective methods of nuclear medicine - radionuclide diagnostics and radionuclide therapy.

Stepwise inclusion of all regions in the cancer program will allow 2016 to create and equip medical equipment 8 federal health care facilities, 78 regional and seven regional cancer centers.

Important role in the implementation of the program is the creation of specialized centers or radiology departments with so-called "active" berths. By 2016 Russia will be in effect for at least 14 centers of positron emission scanner and 90 radionuclide laboratories and 7 branches of radionuclide therapy, which is projected to increase detection of cancer pathology at early stages up to 75% and significantly improve treatment outcomes. Investing one dollar in radionuclide diagnosis and treatment brings the state from 4.5 to 6 dollars at the expense of effective early detection and timely and effective treatment.

Health Ministry and the Federal Medical-Biological Agency in conjunction with the "Rosatom" draft organization of new radiopharmaceuticals and medical devices and form a network of services to assist high-tech medical care, which was supported by the Commission under the President of Russia's modernization and technological Russia's economic development.

Size of the financing referred to the competence of health care for 2010 is 557 million rubles, which will be spent on designing and reconstruction of "Factory of Medical Radioactive agents" of the Federal Medical-Biological Agency in Moscow for production of new Radiopharmaceuticals (the cost of reconstruction and organization of production - 385 million rubles).

In the reconstructed areas (in accordance with the requirements of GMP) will be installed specialized equipment, which will be the latest edition of radiopharmaceuticals.

This generator isotope gallium-68, allowing to detect micrometastases in the early stages. Generator in an approved form for medical use in the world market is not.

To the needs of the population of Russia to organize 10 such plants.

Generator Sr / Rb (strontium / rubidium)

Rubidium-82 - radiopharmaceutical for positron emission scanner, derived from strontium-82.

Rubidium is used in diagnosing patients with suspected coronary artery disease. Rubidium-82 can also be used in the study of brain function, gastrointestinal tract, liver and kidneys.

Generator provides high-precision images, minimizing the radiation dose, allowing multiple healthcare organizations to conduct clinical trials without the need for expensive cyclotrons.

Currently, the generator of rubidium-82 is not produced either in Europe or in Asia. He is the national development of the Institute for Nuclear Research.

Planned release of the generators - up to 500 pcs. per year (per 2015), among them: to meet the requirements in Russia - up to 300 pcs. per year.

Planned generators export to CIS countries (Ukraine, Belarus, Kazakhstan) - 200 pcs. per year.