Las Vegas, Nevada ( Dr. Daniel Pryma gave the first presentation of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) meeting in Las-Vegas 2019. In his talk, he gave an overview of the nuclear medicine physician leading patient care team.

The field of nuclear medicine is vast and expansive, dealing with therapeutic radiopharmaceuticals which are quite complex and are unlike any other given treatment. This type of treatment has unique risks, benefits, and includes dosing considerations, with timeliness requiring explicit expertise.

It is critical to evaluate the patient before initiating this unique treatment. The appropriateness of treatment, the risks vs. benefits, and other options need to be clearly explained to the patient before informed consent is made. The nuclear medicine physician needs to perform proper dose calculation, ordering and administering of these medications. Furthermore, full knowledge regarding the required concomitant and adjunctive medications that are provided with therapeutic radiopharmaceuticals is needed. Patients must be followed after therapy and in between doses, assessing toxicity, progression and additional issues. Dr. Pryma emphasized that during treatment with the therapeutic radiopharmaceuticals, the nuclear medicine physician should assume the temporary role of the physician in charge of the patient.

Whether you are in a community- or academic center, the minimum requirements to initiate a service that provides treatment with radiopharmaceuticals include.

  1. Patient consultation space
  2. Capacity to documents medical decision making
  3. Hot lab
  4. Administration space
  5. Follow-up consultation space

Dr. Pyrma also highly recommends that tumor boards are formed at the initiating center and that the nuclear medicine physician partake in them, and significantly contribute as much as possible. Much of the multidisciplinary cancer care today is centered on the tumor boards. The role of the nuclear medicine physician is most important in these meetings and his potential contributions are critical. According to Dr. Pyrma multidisciplinary care is regarded as the standard care today. Although a lot of disciplines are usually involved in multidisciplinary care, each subspecialty should respect all others, and understand is jurisdiction and limits, while always thinking on the best interest of the patient.

Radiopharmaceutical therapy has been growing extensively with lots of associated excitement and investment, with many relevant papers being published, and professional meetings being maximally attended. Nuclear medicine physicians need to be amid the team, ensuring good, safe, and appropriate use.

Presented by: Daniel Alexander Pryma, MD, Associate Professor of Radiology at the Hospital of the University of Pennsylvania

Written by: Hanan Goldberg, MD, Urology Department, SUNY Upstate Medical University, Syracuse, New-York, USA @GoldbergHanan at the 2019 SNMMI Therapeutics Conference: Therapies, Theranostics, and Building Your Radionuclide Clinical Practice, October 25-27, 2019 in Las Vegas, Nevada.