Precision oncology seeks to deliver the right set and sequence of therapies at the right time to each patient. Several clinical and translational initiatives to personalize radiation oncology and nuclear medicine therapies are underway. In radiation oncology, advanced functional and molecular imaging play an increasingly important role in the patient-specific planning, delivery, assessment, and adaptation of radiation therapy. Examples include cancer imaging with PET/CT for target definition and response-adaptive tumor dose escalation in intracranial / head-and-neck / thoracic disease sites, as well as physiologic imaging with PET/CT and SPECT/CT for functional lung / liver / marrow tissue avoidance planning strategies. In nuclear medicine, theranostic agents and radionuclide therapies also rely on imaging for planning, verification, and regional dosimetry, using increasingly individualized techniques. Examples include neuroendocrine tumor theranostics with 177Lu-dotatate SPECT, prostate cancer theranostics with 177Lu-PSMA SPECT and 68Ga-PSMA PET, and hepatic radioembolization image-guided treatment planning and dose verification with combinations of 99mTc-MAA SPECT and 90Y-microsphere SPECT/PET.
In order to provide personalized management of cancer patients, synergies should be developed between multimodal image-guided therapies across radiation oncology and nuclear medicine. Professional cross-pollination and knowledge transfer between nuclear medicine and radiation oncology communities are more critical than ever in the era of precision medicine. This joint AAPM-SNMMI symposium seeks to bring together experts to raise awareness and promote collaboration around combined image-guided nuclear medicine and radiation oncology therapies. Continued interactions between society members may inform future best clinical practices and technical workflows for combination therapies that improve outcomes of individual patients.
1. To understand personalized approaches in image-guided radionuclide therapies and nuclear medicine theranostics, ranging from 90Y radioembolization, 177Lu-dotatate and 177Lu/68Ga-PSMA planning.
2. To understand personalized approaches for functional image-guided external beam radiation therapy, with emphasis on PET and SPECT imaging for intracranial, thoracic, and hepatic cancers.
3. To increase awareness of synergies between nuclear medicine and radiation oncology image-guided treatment strategies, with emphasis on precision medicine and combination therapies.
Funding Support, Disclosures, and Conflict of Interest: NIH/NCI R01CA204301