Integrating PET for tumour hypoxia in radiotherapy planning: Insights from Portuguese radiotherapy and nuclear medicine technologists.

INTRODUCTION

In the era of personalised medicine, tumour hypoxia (TH) is critical in radiotherapy (RT) response due to its role in tumour resistance. Positron Emission Tomography (PET) enables non-invasive assessment of TH and supports heterogeneous dose-escalation to hypoxic sub-volumes, improving treatment efficacy. This study explores Nuclear Medicine Technologists (NMT) and Radiotherapy Technologists (RTT) perceptions of PET-based TH (PET-TH) assessment and implementation in RT planning in Portugal.

METHODS

We conducted an observational cross-sectional survey of RTTs and NMTs currently working in Portuguese healthcare institutions. Statistical tests were used to assess associations and compare distributions using IBM® SPSS®.

RESULTS AND DISCUSSION: A total of 66 participants, 57 (86.4 %) females, with a mean age of 33.68 (±8.13) years, were included: 23 (34.8 %) NMTs and 43 (65.2 %) RTTs. While 65.2 % of NMT departments had PET scans with RT-compatible settings, only 8.7 % had performed PET-TH studies. Among RTTs, 88.4 % reported that their treatment planning systems were compatible with PET/CT fusion, yet only 9.3 % had used PET in RT planning. RTTs received more training in TH (p = 0.006) and rated their knowledge higher than NMTs (p = 0.042). Greater professional experience and higher perceived knowledge were associated with better performance on evaluation items (p = 0.027; p = 0.037). Regardless of institution type, 92.4 % expressed interest in interprofessional collaboration to support individualised planning.

CONCLUSION

The assessed departments possess infrastructures for PET-TH integration, yet clinical implementation remains limited. Knowledge and professional experience are associated with competency. Targeted training for Technologists and interdisciplinary workflows may improve PET-TH adoption.

IMPLICATIONS FOR PRACTICE: Addressing knowledge and workflow could facilitate PET integration into RT planning and potentially enhance treatment outcomes. Future efforts should focus on interdisciplinary collaboration.