Theranostics could be cited for speeding in this year’s Road to RSNA. It's only been a few years since a dedicated track in nuclear medicine and molecular imaging was established at the meeting, and the practice already dominates it.
Theranostics is featured in dozens of studies in eight scientific sessions, as well as twice a day (10 out of 41 total) on the main stages of the Learning Center at McCormick Place. Topics cover the safety and effectiveness of lutetium-177 (Lu-177) prostate-specific membrane antigen (PSMA)-617 (Pluvicto) in patients with prostate cancer to its cost, as well as whether PSMA-PET radiotracers are equally effective for detecting the disease.
Notably, the development of PET fibroblast activation protein inhibitor (FAPI) imaging agents – touted as having great potential in theranostics – appears to have reached a fever pitch. All studies in the sole slated session on novel radiopharmaceuticals this year are on FAPI-PET tracers. They appear promising for detecting liver cancer, bladder cancer, breast cancer, and interstitial lung disease.
There’s plenty of other exciting research, including new findings using PET/CT in women with breast cancer and one study suggesting PET/MRI can diagnose myocardial injury in long COVID patients.
AI studies in nuclear medicine appear to be picking up steam as well. Researchers are asking whether ChatGPT is effective at answering common questions from Pluvicto patients, for instance, as well as whether models can improve amyloid PET imaging in Alzheimer’s disease patients or help save clinicians time by segmenting neuroendocrine tumors on PET/CT images.
Below is just a sample of the content on offer. With a few minutes free, for instance, you might want to check out any one of 14 nuclear medicine and molecular imaging scientific poster sessions featuring 26 studies slated throughout the week. For more information on those presentations and other abstracts, see the full RSNA 2024 meeting program.
FAPI-PET/CT superior to FDG-PET/CT in liver cancer patients
Sunday, December 1 | 9:00 a.m.-9:10 a.m. | S1-SSNMMI01-1 | Room S405
Gallium-68 (Ga-68) FAPI-PET/CT imaging appears superior to FDG-PET/CT for assessing hepatocellular carcinomas (HCCs). In a large prospective trial, the approach was more accurate – enough so that it could possibly replace FDG-PET/CT in the future, according to research in this session.
FAPI-PET/CT superior for detecting primary and metastatic breast cancer
Sunday, December 1 | 9:30 a.m.-9:40 a.m. | S1-SSNMMI01-4 | Room S405
Ga-68 FAPI-PET/CT significantly enhances the detection rate and staging of primary and metastatic breast cancer, demonstrating superior sensitivity and specificity compared with F-18 FDG-PET/CT, according to this study. Crucially, it also resulted in upstaging in 23.7% of cases, the group noted.
Theranostics cost-effective in men with mCRPC
Sunday, December 1 | 10: 40 a.m.-10:50 a.m. | S2-STCE1-2 | Learning Center Theater 1
The use of theranostic radionuclides such as radium-223 or Lutetium-177 to treat men with metastatic castration-resistant prostate cancer (mCRPC) is more cost-effective in the long term than traditional chemotherapy and radiotherapy, suggests a study in this session. This is due to improved survival and quality of life, despite its higher initial costs, according to the researchers.
Treatment-related factors enhance PSMA expression
Monday, December 2 | 8:20 a.m.-8:30 a.m. | M1-SSNMMI02-3 | Room S405
Certain prostate cancer features on prostate specific membrane antigen (PSMA)-PET may be useful in selecting candidates who are more likely to respond to lutetium-177 PSMA-617, according to a study in this session. PSMA expression in prostate cancer cells varies and there is a scarcity of research on factors that lead to higher PSMA expression, the group noted.
F-18 PSMA-DCFPyL and Ga-68 PSMA-11 deemed equivalent
Monday, December 2 | 8:30 a.m.-8:40 a.m. | M1-SSNMMI02-4 | Room S405
PET radiopharmaceuticals F-18 prostate specific membrane antigen (PSMA)-DCFPyL and a gallium-68 (Ga-68) PSMA-11 appear equivalent for determining patient eligibility for prostate cancer treatment with lutetium-177 (Lu-177) PSMA-617, say researchers in this session.
AI segments lesions on Ga-68 DOTATATE PET/CT images
Monday, December 2 | 3:10 p.m.-3:20 p.m. | M7-SSNMMI03-2 | Room S405
In this session, researchers will present an automated deep-learning AI model that could help clinicians segment rare neuroendocrine tumors (NETs) on whole-body 3D gallium-68 (Ga-68) DOTATATE PET/CT images.
Are Lu-177 PSMA-617 outcomes applicable in a community setting?
Tuesday, December 3 | 2:40 p.m.-2:50 p.m. | T7-STCE2-2 | Learning Center Theater 2
During this session on theranostics, a study suggests that targeted education is needed to support the delivery of lutetium-177 (Lu-177) prostate-specific membrane antigen (PSMA)-617 to patients. Earlier use in real-world community settings compared with ideal settings (as in clinical trials) could improve outcomes, the group noted.
FES-PET shows promise for staging invasive lobular carcinoma
Tuesday, December 3 | 5:00 p.m.-5:10 p.m. | T8-SSNMMI04-4 | Room S405
A mid-study analysis presented during this session suggests that F-18 fluoroestradiol (FES) PET/CT may detect unsuspected stage IV invasive lobular carcinoma. Yet FES-PET may fail to identify multiple metastatic axillary lymph nodes in comparison to sentinel lymph node biopsy, researchers found.
Dedicated brain PET system shows promise in Alzheimer’s disease imaging
Wednesday, December 4 | 8:50 a.m.-9:00 a.m. | W1-SSNMMI05-6 | Room S405
A high-resolution dedicated brain PET system could augment visual reading in the early diagnosis of dementia, suggests a study in this session. The system detected significantly more amyloid plaque than conventional PET scans.
Can AI chatbots answer questions for patients on Lu-177 PSMA-617 therapy?
Wednesday, December 4 | 2:20 p.m.-2:30 p.m. | W6-SSNMMI06-6 | S405
In response to common questions from lutetium-177 (Lu-177) prostate-specific membrane antigen (PSMA)-617 patients, Gemini provided easy-to-understand answers and ChatGPT-4 demonstrated high accuracy, yet neither AI chatbot provided completely accurate answers to all questions, according to a study in this session on prostate cancer therapy.
AI denoising software valuable for amyloid PET/CT studies
Thursday, December 5 | 8:20 a.m.-8:30 a.m. | R1-SSNMMI07-3 | Room S405
A study in this session suggests that count-poor and noisy amyloid brain PET/CT studies can be rendered clinically useful through AI denoising software.
PET/MRI detects myocardial injury in long COVID patients
Thursday, December 5 | 1:30 p.m.-1:40 p.m. | R6-SSNMMI08-1 | Room S405
A PET/MRI study by a group in Germany in this session suggests that the modality holds promise in evaluating myocardial injury in long COVID patients. The approach not only detected injury but also helped differentiate between chronic active and healed myocardial injury, the group noted.