Feature
Opportunities for IRs in radiotheranostics
By Islam Elhelf, MD, PHD
reserved for IR. As a physician trained in both interventional radiology and nuclear medicine, I believe we have reached a point where IRs need to be well informed about radiotheranostics and potential IR opportunities as we move towards intra-arterial radiotheranostic therapies in the future.
I
What are radiotheranostics? Radiotheranostics are a platform that combines the diagnostic and therapeutic aspects of oncology practice into one paradigm. In radiotheranostics, a chemically
30 IRQ | SPRING 2023
nterventional radiology is an essential player in modern clinical oncology practice—almost all tumor boards nowadays have a seat
sophisticated ligand is designed to attach to tumor-specific receptors. When the ligand is linked to a diagnostic radionuclide, a high-quality diagnostic scan is produced that accurately maps the sites of active disease and the density of tumor-specific receptors. When the same ligand is linked to a therapeutic radionuclide, the resultant radiopharmaceutical attacks the same receptors with high accuracy resulting in highly selective therapeutic effect.
The two common clinical applications of radiotheranostics nowadays are the use of Lutathera for treatment of gastroenteropancreatic neuroendocrine tumors (GEP NETs) and the use of Pluvicto for treatment of
castration-resistant metastatic prostate cancer. Taking NETs as an example, gallium-68 DOTATATE (Ga DOTATATE) is commonly performed first to check the extent of the disease and to evaluate the presence of sufficient receptor density prior to proceeding with the treatment. If the scan is favorable, treatment with Lutathera is then started. Treatment is in the form of intravenous infusions; usually four sessions with 8-week intervals between sessions.
How I learned about radiotheranostics I first discovered radiotheranostics in my radiology residency at the University of Iowa, which is a big hub of nuclear medicine. During one of the nuclear medicine lectures, the speaker talked about radiotheranostics as one of the emerging fields of nuclear medicine. At that time, this field was in early clinical practice.
As someone interested in interventional oncology, I was impressed by the advantages that radiotheranostics can bring to the field of oncology. It did not take me long to decide I wanted to do a
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40
