Theranostics

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UT Southwestern Medical Center’s theranostic services tap into the power of molecular imaging technology and targeted radioligand therapy to treat various cancers and cancer-related bone pain.

Theranostics has the potential to improve patient outcomes, improve quality of life, and decrease pain with comparatively less downtime than some other treatments for numerous illnesses, particularly cancer.

Precise, Personalized Treatment for Cancer and Other Conditions

Theranostics – a combination of “therapy” and “diagnostics” – is a branch of nuclear medicine that uses both imaging technology and targeted therapies to identify and treat diseases such as cancer as well monitor response to treatment. It involves using a radiopharmaceutical (a drug that contains a small amount of radioactive material) to target and destroy unhealthy cells while leaving surrounding tissue untouched.

UT Southwestern offers consultation visits for patients seeking theranostic care in our state-of-the-art clinic. Our highly trained team has extensive experience with nuclear medicine and molecular imaging and therapies.

We offer advanced imaging techniques and analytical tools that may not be available at other medical centers. UT Southwestern Medical Center has received the Society of Nuclear Medicine and Molecular Imaging designation as a Comprehensive Radiopharmaceutical Therapy Center of Excellence.

The seek-and-destroy mission of Theranostics

UT Southwestern is giving patients access to this new technique – a combination of therapy and diagnostics – to precisely seek, find, and destroy metastatic cancer cells by combining advanced imaging techniques with targeted, injection-based molecular therapy.

Read more in our Medblog

Conditions We Treat with Theranostics

We offer a variety of theranostic options to treat various diseases and conditions, including:

  • Neuroendocrine tumors:
    • For somatostatin receptor positive tumors, we use Lutathera®. This medicine specifically targets and enters the cells that have somatostatin receptors. We offer dosimetry to calculate the dose that a specific tumor received.
  • Thyroid disorders (benign and malignant):
    • Thyroid cancer and hyperthyroidism may be treated with iodine 131 (I-131), a radioactive isotope of iodine.
    • To help identify thyroid disease and prepare for radioiodine treatment, we may prescribe Thyrogen® stimulation, a medication designed to act identical to thyroid-stimulating hormone (TSH).
    • For patients with thyroid cancer, we offer dosimetry-based I-131 therapy, a way of determining the optimal personalized dose of I-131 for the patient.
  • Bone pain palliation therapies we provide include:
    • Radium-223 (Xofigo®), a radiopharmaceutical used to treat advanced prostate cancer that has spread to the bones.
  • Prostate cancer: We offer Lutetium-177 labeled radioligand therapy for PSMA radionuclide the prostate cancer cells.
  • Pheochromocytomas and paragangliomas: We offer I-131-MIBG for the treatment of unresectable, locally advanced, or metastatic pheochromocytomas or paragangliomas that are positive for the norepinephrine transporter as determined by an MIBG scan.
  • Meningiomas and Meningiomatosis: When treating meningiomas that are refractory to other therapies, surgically unresectable, and for meningiomatosis, we use LUTATHERA®.

How Theranostics Works

Theranostics involves two stages:

  • First, we use a diagnostic technology, such as positron-emission tomography combined with computed tomography (PET/CT) or SPECT/CT (single photon emission tomography/computed tomography) and a type of radiopharmaceutical called a molecular imaging probe to identify the specific biological targets of the radioligand therapy and the extent of a patient’s disease.
  • Then, we use a different radiopharmaceutical to target the abnormal cells and deliver radiation to them, while leaving healthy cells intact.

The first stage may be repeated to determine how the patient is responding to treatment.

For example, a patient with prostate cancer would go through a diagnostic imaging procedure followed by targeted therapy if the imaging study identifies the target:

  • First, they would be injected with a radiopharmaceutical and undergo a PET scan. In this scan prostate cancer cells that carry the protein prostate-specific membrane antigen (PSMA) on their surface are localized because the radiopharmaceutical binds to the PSMA. This allows us to see prostate cancer cells anywhere in the body.
  • Then, the patient would be injected with a different radiopharmaceutical, that also binds to PSMA, but is labeled with Lutetium-177, which delivers radiation to the cancer cells. This ultimately causes the cancer cells to be destroyed.

Theranostics: What to Expect

We guide patients through each step of our theranostic process. In general, patients eligible for theranostics will be referred by a UT Southwestern doctor or other oncologists (medical, surgical, or radiation).

Our team reviews the referral and our Nurse Coordinator will follow up with each patient with personalized recommendations.

Recommendations could include:

  • Diagnostics such as PET, a CT scan, or MRI scan.
  • A consultation with a nuclear medicine specialist.

Once these steps have been completed, our treatment team reviews treatment options with the patient.