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- Integrating PET for tumour hypoxia in radiotherapy planning: Insights from Portuguese radiotherapy and nuclear medicine technologistsPublication . Sousa, Ruben Diogo Oliveira; Faria, Brígida Mónica; Bravo, Isabel; Costa, Pedro; Costa, Pedro; Faria, Brigida MonicaIn 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. 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®. 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. 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. Addressing knowledge and workflow could facilitate PET integration into RT planning and potentially enhance treatment outcomes. Future efforts should focus on interdisciplinary collaboration.
