Imaging works as a gatekeeper for theranostics. The first presentation elucidates the significance of target (PSMA, somatostatin receptors) visualization, quantification and heterogeneity in treatment of patients with Lu-177 DOTATATE and Lu-177 PSMA. Methods for response assessments of Lu-177 PSMA and Lu-177 DOTATATE are also briefly discussed.

Molecular imaging using PET and SPECT is an increasingly used for cancer diagnosis, treatment, and treatment response evaluation. Recent progress in radiopharmaceutical therapy demands effective and quantitative PET and SPECT imaging application for seeing the cancer targets and visualizing what has been treated. In Physics I, principles of PET and SPECT imaging, challenges and application of quantitation are discussed.

Physics II covers principles of radioactivity and its measurement challenges. Various instruments for measuring and analyzing the radioactivity are also explained. 

Physics III covers some radiation safety basics related to starting up a new radiopharmaceutical therapy program. These include updating the facility radioactive materials license, patient screening and education along with some special situations presented by patients, management of household waste, preparing for treatment day, release criteria, and after-treatment care. 

Physics IV focuses on the development of standard operating procedures (SOPs) as one of a number of tasks for implementing a radiopharmaceutical therapy. In order to develop an SOP, one needs to learn about the therapy, allocate resources, and be familiar with radioactive material use regulations.

Topics:

• Principles of Clinical Molecular Imaging for Radiopharmaceutical Therapy ‒ Vikas Prasad, MD, PhD
• Physics I: Image Acquisition and Quantitation (PET, SPECT) ‒ Rameshwar Prasad, MS, PhD
• Physics II: Instrumentation and Mathematics Pertaining to the Use and Measurement of Radioactivity ‒ Rameshwar Prasad, MS, PhD
• Physics III: Radiation Protection for Radiopharmaceutical Therapies ‒ Jessica Clements, MS
• Physics IV: Regulatory Issues and Standard Operating Procedures (SOP) ‒ Jacqueline Esthappan Zoberi, PhD