Theranostics Grabs SNMMI Spotlight

The emerging field of theranostics – in which two radiopharmaceuticals work in tandem for diagnostic and therapeutic purposes – is one of the most exciting new areas of medicine. Nowhere is this more evident than at this week’s SNMMI 2023 meeting in Chicago

Theranostics involves the use first of a highly targeted diagnostic radiotracer to detect pathology with a technology like PET, then sending in another tracer to deliver a stronger radioactive payload to the site of disease – almost the definition of precision medicine. Some estimates are that theranostics could soon develop into a market worth $30B.

In addition to talks on theranostics, SNMMI 2023 highlights so far have included presentations covering the following:

  • An ultra-high-resolution brain PET scanner that can visualize and quantify nuclei in the brainstem for the first time, opening up new inquiries into neurological disorders like Alzheimer’s disease
  • The discovery of the optimal tracer kinetic model for quantifying myocardial uptake of 18F-flutemetamol in patients with transthyretin (ATTR) cardiac amyloidosis, a buildup of amyloid plaque in the heart
  • A technique called augmented whole-body scanning via magnifying PET (AWSM-PET) that uses two high-resolution add-on detectors as an “outsert” to improve image resolution and reduce noise
  • Imaging of rheumatoid arthritis with 68Ga-FAPI PET/CT, which showed a greater number and degree of affected joints than FDG-PET/CT
  • A PET radiotracer called 18F-Cholestify has the potential to improve neuroimaging by visualizing metabolic cholesterol degradation in the brain.

The commercial side of SNMMI 2023 is active as well. Siemens Healthineers, GE HealthCare, and United Imaging Healthcare are launching new hybrid scanners, and other vendor news includes the following: 

  • Blue Earth Diagnostics is touting its recent shipments of Posluma, a PET radiotracer targeting PSMA in prostate cancer patients
  • GE HealthCare is migrating AIR technologies found on its MRI scanners to its new Signa PET/MRI AIR system (see below) 
  • Isotopia is discussing its plans for a US radioisotope manufacturing facility
  • Lantheus researchers are presenting talks on AI-enabled PSMA-PET reporting using its Pylarify AI software
  • Mediso received FDA clearance for its InterView Fusion and InterView XP multimodality image processing and reporting software
  • Siemens Healthineers has launched a new PET/CT scanner, Biograph Vision.X, sporting a 20% improvement in time of flight (see below)
  • Subtle Medical is demonstrating its SubtlePET solution, which uses AI to remove noise for low-count PET images, enabling up to 75% faster PET scans
  • Telix Pharmaceuticals is highlighting clinical results of several agents: the Illucix gallium-based prostate cancer imaging agent; ProstACT lutetium-based antibody-directed prostate cancer therapy; and TLX250-CDx, a zircon-89-based tracer for diagnosing clear cell renal cell carcinoma.
  • United Imaging Healthcare is launching uMI Panorama, a new wide-bore PET/CT scanner (see below).  

The Takeaway

This week’s proceedings in Chicago illustrate the new energy that theranostics is bringing to nuclear medicine and molecular imaging, one of radiology’s most venerable modalities. Stay tuned for the announcement of SNMMI’s Henry N. Wagner, Jr. Image of the Year award, always a conference highlight.  

BAMF & United Imaging’s Precision Medicine Milestone

BAMF Health took a big step in its precision medicine strategy, installing United Imaging’s uEXPLORER total-body PET/CT scanner as it prepares to open its theranostics treatment center. 

Founded in 2018, BAMF Health (Bold Advanced Medical Future) has applied a unique approach to developing advanced treatments, combining the world’s “most advanced” radiopharmacy, its proprietary AI platform, and top molecular imaging technology to deliver hyper-personalized and targeted treatments.

Installing United Imaging’s uEXPLORER total-body PET/CT scanner represents a key final addition to BAMF Health’s precision medicine stack, and makes it the first institution in the US using total-body PET for theranostics. More importantly, the uEXPLORER will allow BAMF Health to deliver more effective and efficient theranostics treatments by:

  • Imaging patients’ entire bodies in a single scan (vs. “eyes to thighs”)
  • Detecting and targeting signs of cancer smaller than two millimeters (vs. 1 cm)
  • Scanning patients in just one minute (vs. up to 1hr)
  • Reducing radiation dosage by up to 40x

BAMF Health’s launch might also represent an early theranostics paradigm shift, highlighting the potential role of private clinics (vs. academic/large institutions) and total-body PET/CT systems (vs. “whole”) with the advanced therapy.

BAMF Health will begin treating patients for prostate cancer and neuroendocrine tumors at its Michigan-based clinic this summer, but plans to deliver a wide range of personalized treatments that extend well beyond cancer in the future (e.g. Alzheimer’s, Parkinson’s, cardiac diseases, endometriosis, chronic pain) and treat patients from around the country.

The Takeaway

Although BAMF Health still has a lot to prove, its upcoming clinical launch might be a key milestone in the evolution of theranostics and molecular imaging.

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