Trends in nuclear medicine and the radiopharmaceutical sciences in oncology: workforce challenges and training in the age of theranostics

Andrew M Scott¹, Brian M Zeglis², Suzanne E Lapi³, Peter J H Scott⁴, Albert D Windhorst⁵, May Abdel-Wahab⁶, Francesco Giammarile⁷, Diana Piaez⁷, Amirreza Jalilian⁸, Peter Knoll⁶, Aruna Korde⁹, Shrikant Vichare⁷, Nayyereh Ayati¹⁰, Sze Ting Lee¹¹, Serge K Lyashchenko¹², Jingjing Zhang¹³, Jean Luc Urbain¹⁴, Jason S Lewis¹⁵

Affiliations

¹ Department of Molecular Imaging and Therapy, Austin Health, Melbourne, VIC, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia; School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia; Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia.
² Department of Chemistry, Hunter College, City University of New York, New York, NY, USA; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Radiology, Weill Cornell Medical College, New York, NY, USA.
³ Department of Radiology and Department of Chemistry, O'Neal Comprehensive Cancer Center at UAB, University of Alabama at Birmingham, Birmingham, AL, USA.
⁴ Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
⁵ Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands; Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
⁶ Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
⁷ Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria.
⁸ Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria.
⁹ Division of Physical and Chemical Sciences, International Atomic Energy Agency, Vienna, Austria.
¹⁰ Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia.
¹¹ Department of Molecular Imaging and Therapy, Austin Health, Melbourne, VIC, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia; School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia; Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia; Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; School of Health and Biomedical Science, RMIT University, Melbourne, VIC, Australia.
¹² Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Radiology, Weill Cornell Medical College, New York, NY, USA.
¹³ Department of Diagnostic Radiology, National University of Singapore, Singapore; Clinical Imaging Research Centre, Nanomedicine Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
¹⁴ Department of Diagnostic Imaging (Radiology and Nuclear Medicine), Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
¹⁵ Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Radiology, Weill Cornell Medical College, New York, NY, USA; Department of Pharmacology, Weill Cornell Medical College, New York, NY, USA. Electronic address: lewisj2@mskcc.org.

PMID: 38821099
PMCID: PMC11345887
DOI: 10.1016/S1470-2045(24)00037-8

Review

Trends in nuclear medicine and the radiopharmaceutical sciences in oncology: workforce challenges and training in the age of theranostics

Andrew M Scott et al. Lancet Oncol. 2024 Jun.

. 2024 Jun;25(6):e250-e259.

doi: 10.1016/S1470-2045(24)00037-8.

Authors

Affiliations

¹ Department of Molecular Imaging and Therapy, Austin Health, Melbourne, VIC, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia; School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia; Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia.
² Department of Chemistry, Hunter College, City University of New York, New York, NY, USA; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Radiology, Weill Cornell Medical College, New York, NY, USA.
³ Department of Radiology and Department of Chemistry, O'Neal Comprehensive Cancer Center at UAB, University of Alabama at Birmingham, Birmingham, AL, USA.
⁴ Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
⁵ Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands; Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
⁶ Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
⁷ Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria.
⁸ Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria.
⁹ Division of Physical and Chemical Sciences, International Atomic Energy Agency, Vienna, Austria.
¹⁰ Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia.
¹¹ Department of Molecular Imaging and Therapy, Austin Health, Melbourne, VIC, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia; School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia; Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia; Department of Surgery, University of Melbourne, Melbourne, VIC, Australia; School of Health and Biomedical Science, RMIT University, Melbourne, VIC, Australia.
¹² Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Radiology, Weill Cornell Medical College, New York, NY, USA.
¹³ Department of Diagnostic Radiology, National University of Singapore, Singapore; Clinical Imaging Research Centre, Nanomedicine Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
¹⁴ Department of Diagnostic Imaging (Radiology and Nuclear Medicine), Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
¹⁵ Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Radiology, Weill Cornell Medical College, New York, NY, USA; Department of Pharmacology, Weill Cornell Medical College, New York, NY, USA. Electronic address: lewisj2@mskcc.org.

PMID: 38821099
PMCID: PMC11345887
DOI: 10.1016/S1470-2045(24)00037-8

Erratum in

Correction to Lancet Oncol 2024; 25: e250-59.
[No authors listed] [No authors listed] Lancet Oncol. 2024 Aug;25(8):e336. doi: 10.1016/S1470-2045(24)00378-4. Lancet Oncol. 2024. PMID: 39089311 No abstract available.

Abstract

Although the promise of radionuclides for the diagnosis and treatment of disease was recognised soon after the discovery of radioactivity in the late 19th century, the systematic use of radionuclides in medicine only gradually increased over the subsequent hundred years. The past two decades, however, has seen a remarkable surge in the clinical application of diagnostic and therapeutic radiopharmaceuticals, particularly in oncology. This development is an exciting time for the use of theranostics in oncology, but the rapid growth of this area of nuclear medicine has created challenges as well. In particular, the infrastructure for the manufacturing and distribution of radiopharmaceuticals remains in development, and regulatory bodies are still optimising guidelines for this new class of drug. One issue of paramount importance for achieving equitable access to theranostics is building a sufficiently trained workforce in high-income, middle-income, and low-income countries. Here, we discuss the key challenges and opportunities that face the field as it seeks to build its workforce for the 21st century.

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Conflict of interest statement

Declaration of interests Outside the submitted work: AMS reports trial funding from EMD Serono, ITM, Telix Pharmaceuticals, AVID Radiopharmaceuticals, Fusion Pharmaceuticals, and Cyclotek; research funding from Medimmune, AVID Radiopharmaceuticals, Adalta, Antengene, Humanigen, Telix Pharmaceuticals, and Theramyc; and payment for participation in advisory boards of Imagion and Immunos. BMZ reports research funding from Evergreen Theragnostics, equity in Summit Biomedical Imaging, and has licensed technologies to Clarity Pharmaceuticals. SEL reports research support from Navidea Biopharmaceuticals, Fusion Pharmaceuticals, Cytosite Biopharma, Viewpoint Molecular Targeting, and Genzyme Corporation, and has acted as an advisor for NorthStar Medical Radioisotopes and Trevarx biomedical. PJHS reports research support from Bristol Myers Squibb, Telix Pharmaceuticals, and Radionetics Oncology; has acted as an adviser to Synfast Consulting and Telix Pharmaceuticals; and holds equity in Bristol Myers Squibb, Telix Pharmaceuticals, and Novartis. ADW reports their role as Editor-in-Chief of Nuclear Medicine and Biology. JSL reports research support from Clarity Pharmaceuticals and Avid Radiopharmaceuticals; has acted as an adviser of Alpha-9 Theranostics, Clarity Pharmaceuticals, Earli, Evergreen Theragnostics, Inhibrix, Precirix, and Telix Pharmaceuticals; is a co-inventor on technologies licensed to Diaprost, Elucida Oncology, Theragnostics, CheMatech, Clarity Pharmaceuticals, and Samus Therapeutics; is the co-founder of pHLIP; and holds equity in Summit Biomedical Imaging, Telix Pharmaceuticals, Clarity Pharmaceuticals, and Evergreen Theragnostics. AMS is supported by National Health and Medical Research Council grant number 1177837. SEL is supported by the Department of Energy as part of the DOE University Isotope Network, under grant DESC0021269. PJHS is supported by grant R01 EB021155. JSL is supported by National Institutes of Health grant R35 CA232130. MA-W, AJ, AK, PK, SV, STL, SKL, DP, JZ, JLU, and FG report no competing interests. All other authors declare no competing interests.

Figures

**Figure 1:**
**(A)** Nuclear medicine physicians per million people; **(B)** Radiochemists and Radiopharmacists per million people; (C) Nuclear medicine technologists per million people; **(D)** Medical physicists per million people; (E) Nurses in nuclear medicine per million inhabitants

See this image and copyright information in PMC

References

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Trends in nuclear medicine and the radiopharmaceutical sciences in oncology: workforce challenges and training in the age of theranostics

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Trends in nuclear medicine and the radiopharmaceutical sciences in oncology: workforce challenges and training in the age of theranostics

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