Theranostics in Practice: Lessons Learned from Clinical Perspectives-Part 1.

This article is a practical, technologist-focused overview of implementing theranostic care in nuclear medicine, emphasizing real-world workflow, coordination, and patient-centered considerations.

Key points:

• Scope and intent: The authors draw on hands-on experience delivering theranostic therapies, sharing practical lessons rather than theoretical concepts. The focus is on how technologists can optimize care and contribute meaningfully to outcomes.

• Patient selection and preparation:
• Highlights the importance of clear criteria for selecting appropriate patients for theranostic imaging and therapy.
• Stresses thorough pre-scan and pre-therapy preparation (instructions, safety considerations, and expectation setting) to minimize delays and errors.

• Imaging setup and workflow:
• Describes strategies to standardize imaging protocols for theranostic agents, with attention to consistency and reproducibility.
• Covers scan preparation and timing around therapy, including logistics that affect image quality and patient throughput.

• Therapy delivery across major indications:
• Uses examples from thyroid cancer, neuroendocrine tumors, and prostate cancer to illustrate how workflows and requirements differ by disease and radiopharmaceutical.
• Emphasizes tailoring imaging and therapy processes to the specific indication while maintaining clear, structured protocols.

• Team communication and coordination:
• Underscores that successful theranostics demands close collaboration among technologists, nuclear medicine physicians, oncologists, nurses, and support staff.
• Notes that clear role delineation, standardized communication pathways, and proactive problem-solving reduce errors and improve efficiency.

• Posttherapy follow-up and patient experience:
• Stresses the impact of thorough follow-up on toxicity monitoring, response assessment, and patient satisfaction.
• Highlights how technologist-led communication and troubleshooting (e.g., handling side effects, clarifying instructions) can meaningfully improve the patient journey.

• Technologist role and evolving practice:
• Frames technologists as central contributors in this evolving field, not just in image acquisition but in workflow design, quality assurance, and patient advocacy.
• Reflects on how iterative learning—from each case and each new protocol—drives continuous improvement in theranostic care.

Overall, the article offers a concise, experience-based guide to operationalizing theranostics in nuclear medicine, emphasizing preparation, protocolization, and multidisciplinary teamwork as the foundations for safe, efficient, and patient-centered practice.