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Review

Theranostics & Nuclear Medicine Review

Eligibility and sequencing review for theranostic approaches that combine imaging with treatment.

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What is theranostics?

Theranostics is an approach in which the same molecular target is used first for imaging and then for treatment. A patient whose imaging shows uptake may be a candidate for radioactive therapy directed at that same target.

PSMA in prostate cancer and the somatostatin receptor in neuroendocrine tumors are the best-known examples of this approach.

What is reviewed

  • Interpretation of somatostatin receptor (Ga-68 DOTA) or PSMA imaging findings
  • Eligibility for Lu-177 PSMA or Lu-177 DOTATATE (PRRT) therapy
  • Indication for radioiodine (I-131) therapy
  • The sequence and timing of this therapy among other systemic treatments
  • Safety assessment with respect to kidneys and bone marrow
  • Which tests will be used to monitor response

Files requested

  • Ga-68 DOTA PET/CT, PSMA PET/CT or the relevant scintigraphy report
  • Pathology report (including Ki-67 in neuroendocrine tumors)
  • Kidney function tests and complete blood count
  • A summary of treatments received

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