Currie Geoffrey
Charles Sturt University, Wagga Wagga, New South Wales, Australia.
J Med Radiat Sci. 2025 Mar;72(1):156-164. doi: 10.1002/jmrs.836. Epub 2024 Nov 1.
Theranostics is a new term for long-established principles in nuclear medicine. The generalisability of the term means there is a very broad use of the term across the medical literature, not all of which is consistent with the intent in nuclear medicine. The term molecular theranostics better reflects the philosophy and application in nuclear medicine. Even with a clearer definition, there are a number of challenges or controversies whose debate provides a richer understanding of the principles and applications of molecular theranostics. Radioiodine imaging and therapy of hyperthyroidism and thyroid cancer provide the historical context for theranostics. The prototype molecular theranostic is the Ga/Lu DOTATATE pair that targets somatostatin receptor subtype 2 in neuroendocrine tumors. The potential value of precision medicine of radiation dosimetry in molecular theranostics needs a balanced discussion with limitations of reactive dosimetry and the opportunities for predictive or pre-treatment dosimetry. Despite challenges and limitations, molecular theranostics is a powerful tool in the precision medicine landscape. Molecular theranostics is a vehicle for improved outcomes in cancer patients with a future-facing portfolio of opportunities.
治疗诊断学是核医学中早已确立的原则的一个新术语。该术语的通用性意味着它在医学文献中被广泛使用，但并非所有使用都与核医学中的意图一致。分子治疗诊断学这个术语更能反映核医学中的理念和应用。即使有了更清晰的定义，仍存在一些挑战或争议，对这些的讨论能让人更深入地理解分子治疗诊断学的原则和应用。放射性碘对甲状腺功能亢进和甲状腺癌的成像及治疗为治疗诊断学提供了历史背景。分子治疗诊断学的原型是针对神经内分泌肿瘤中生长抑素受体2亚型的镓/镥 钇 奥曲肽组合。分子治疗诊断学中放射剂量测定的精准医学潜在价值需要与反应性剂量测定的局限性以及预测性或治疗前剂量测定的机会进行平衡讨论。尽管存在挑战和局限性，但分子治疗诊断学在精准医学领域是一个强大的工具。分子治疗诊断学是改善癌症患者治疗结果的一种手段，有着一系列面向未来的机会。
