Emory has been named Georgia's first and only Comprehensive Radiopharmaceutical Therapy Center of Excellence by the Society of Nuclear Medicine and Molecular Imaging (SNMMI). The designation recognizes Emory's expertise in providing patients at Winship Cancer Institute of Emory University with advanced radiopharmaceutical therapies with the guidance of advanced imaging technology. Radiopharmaceutical therapies are radioactive drugs that are injected into the bloodstream to deliver radiation directly and specifically to cancer cells for the treatment of cancers such as thyroid, neuroendocrine and prostate cancer.
SNMMI Centers of Excellence must meet strict regulatory, training, experience and performance criteria. According to SNMMI, the goal is to help "assure patients, their families, referring physicians and payors that rigorous procedures are in place and followed, leading to appropriate patient selection and outcomes from radiopharmaceutical therapy."
"This recognition is a testament to the exceptional level of patient care we provide using the most advanced technologies and radiotherapeutics,” says David M. Schuster, MD, professor and director of the Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, at Emory University School of Medicine and Winship Cancer Institute of Emory University. “Providing radiopharmaceutical therapies using a multidisciplinary team approach is a step toward personalized medicine. Our team of 18 board-certified nuclear medicine physicians, along with our nurse navigators, nuclear medicine technologists and medical physicists go above and beyond every day for our patients and their families."
There are three levels of SNMMI Center of Excellence certification: Registered Therapy Site, Clinical Center of Excellence and Comprehensive Center of Excellence. To earn the highest level of designation – Comprehensive Center of Excellence, centers must offer at least three different radiotherapeutic treatments. Emory offers five:
- Radioactive iodine therapy (Nal-131) for differentiated thyroid cancer and hyperthyroidism;
- Lu-177 DOTATE therapy for metastatic inoperable well-differentiated neuroendocrine tumors;
- Lu-177 PMSA therapy for metastatic prostate cancer;
- Ra-223 for painful bone metastases; and
- Nal-131 MIBG therapy for pheochromocytoma/paraganglioma and neuroblastoma.
A center also must employ advanced imaging technologies such as dual positron emission tomography (PET)/computed tomography (CT) and single-photon emission computed tomography (SPECT)/CT when providing radiopharmaceutical therapies. Emory Healthcare offers these imaging modalities and radiotherapeutics at Emory University Hospital, Emory University Hospital Midtown, Emory Saint Joseph's Hospital, Emory Johns Creek Hospital, Emory Decatur Hospital, Grady Memorial Hospital and the Atlanta Veterans Affairs Medical Center.
Emory University Hospital is the only place in Georgia offering 3.0T whole-body magnetic resonance imaging (MRI) and time-of-flight whole-body positron emission tomography (PET) by a single, integrated scanner. This next-generation dual imaging capability means reduced exposure to radiation and faster scanning time as well as a more complete view of disease presence and process for patients with neuroendocrine tumors, or recurring and metastatic prostate, cervical, ovarian and rectal cancers.
Such advanced imaging capability supports a second requirement for Comprehensive Centers of Excellence: a robust research program.
"Emory is trailblazing the development and testing of novel radiopharmaceuticals for diagnostic and therapeutic, or theragnostic, uses," says Schuster. "We have a growing radiopharmaceutical lab program and an audacious research agenda to advance the quality of care we offer to our patients."
For example, Emory developed the novel radiotracer 18F-fluciclovine, which earned FDA approval in 2016 for detecting recurring prostate cancer. Schuster led the initial clinical trials of the radiotracer at Emory. Last year, he and colleagues published in The Lancet the results of additional trials confirming that patient survival significantly improved with the use of F-fluciclovine-PET-CT imaging studies to guide treatment decisions and planning for patients after they had surgery to remove the cancerous prostate.
None of this work would be possible without the close collaboration of the Emory Division of Nuclear Medicine and Molecular Imaging with Winship Cancer Institute of Emory University, Georgia's first and only National Cancer Institute-designated Comprehensive Cancer Center, a prestigious distinction given only to the top 3% of cancer centers nationwide for conducting cancer research and providing training that is transforming cancer care, prevention, detection and survivorship.
"Winship is a national leader in radiopharmaceutical therapies for patients with cancer," says Suresh S. Ramalingam, MD, executive director of Winship Cancer Institute and the Roberto C. Goizueta Distinguished Chair for Cancer Research. "The SNMMI Comprehensive Center of Excellence designation signifies that our science is advancing and optimizing nuclear medicine and molecular imaging in ways that improve human health and inspire hope."
Training to deliver excellent care
Emory is also training the next generation of nuclear medicine professionals to deliver this outstanding level of care, through its Nuclear Medicine Residency, PET/CT Imaging (Molecular Imaging and Theragnostics) and Nuclear Radiology fellowship programs. Says Erin Grady, MD, director of nuclear medicine education, "We want patients everywhere to benefit from our expertise and advancements."