Nuclear medicine; PRRT; PSMA; Radionuclide theranostics; Theranostics; Iodine Radioisotopes; Humans; Male; Precision Medicine; Radionuclide Imaging; Nuclear Medicine; Thyroid Neoplasms; Radiology, Nuclear Medicine and Imaging; General Medicine
Abstract :
[en] The theranostics concept using the same target for both imaging and therapy dates back to the middle of the last century, when radioactive iodine was first used to treat thyroid diseases. Since then, radioiodine has become broadly established clinically for diagnostic imaging and therapy of benign and malignant thyroid disease, worldwide. However, only since the approval of SSTR2-targeting theranostics following the NETTER-1 trial in neuroendocrine tumours and the positive outcome of the VISION trial has theranostics gained substantial attention beyond nuclear medicine. The roll-out of radioligand therapy for treating a high-incidence tumour such as prostate cancer requires the expansion of existing and the establishment of new theranostics centres. Despite wide global variation in the regulatory, financial and medical landscapes, this guide attempts to provide valuable information to enable interested stakeholders to safely initiate and operate theranostics centres. This enabling guide does not intend to answer all possible questions, but rather to serve as an overarching framework for multiple, more detailed future initiatives. It recognizes that there are regional differences in the specifics of regulation of radiation safety, but common elements of best practice valid globally.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
Herrmann, Ken ; Department of Nuclear Medicine, University of Duisburg-Essen, Duisburg, Germany. ken.herrmann@uk-essen.de ; German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany. ken.herrmann@uk-essen.de
Giovanella, Luca; Clinic for Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
Santos, Andrea; Department of Nuclear Medicine, Hospital Cuf Descobertas, Lisbon, Portugal
Gear, Jonathan; Joint Department of Physics, Royal Marsden NHS Foundation Trust, Sutton, UK
Kiratli, Pinar Ozgen; Department of Nuclear Medicine, Hacettepe University, Ankara, Turkey
Kurth, Jens; Department of Nuclear Medicine, Rostock University Medical Center, Rostock, Germany
Denis-Bacelar, Ana M; National Physical Laboratory, Teddington, UK
Hustinx, Roland ; Centre Hospitalier Universitaire de Liège - CHU > > Service médical de médecine nucléaire et imagerie onco
Patt, Marianne; Department for Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
Wahl, Richard L; Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
Paez, Diana; Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Application, International Atomic Energy Agency, Vienna, Austria
Giammarile, Francesco; Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Application, International Atomic Energy Agency, Vienna, Austria
Jadvar, Hossein; Division of Nuclear Medicine, Department of Radiology, University of Southern California, Los Angeles, CA, USA
Pandit-Taskar, Neeta; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Ghesani, Munir; Diagnostic, Molecular & Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Kunikowska, Jolanta; Nuclear Medicine Department, Medical University of Warsaw, Warsaw, Poland
KH reports personal fees from Bayer, personal fees and other from Sofie Biosciences, personal fees from SIRTEX, non-financial support from ABX, personal fees from Adacap, personal fees from Curium, personal fees from Endocyte, grants and personal fees from BTG, personal fees from IPSEN, personal fees from Siemens Healthineers, personal fees from GE Healthcare, personal fees from Amgen, personal fees from Novartis, personal fees from ymabs, all outside the submitted work. LG reports personal fees from Roche Diagnostics and SNIBE for advisory board participation, and research support from Roche Diagnostics., all outside the submitted work. AMDB is supported by the National Measurement System of the UK Department for Business, Energy and Industrial Strategy. RLW has research contracts from Siemens, Bayer, Actinium Pharmaceuticals, and serves (with compensation) on the scientific advisory boards of Seno Medical and Clarity Pharmaceuticals. HJ serves on the advisory board of Radiomedix, is a consultant to Bayer and Blue Earth Diagnostics, an investigator for ImaginAb, and on the speaker's bureau of Lantheus. MG reports fee for speakers bureau of Novartis, Blue Earth and Ionetix (not active currently). The remaining authors have no relevant conflict of interest to declare with regards to this comment.This guideline was only possible, thanks to the tremendous support of the EANM headquarters and especially Nuria Serra. The authors want to eternally thank them for their support, help and patience.
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