UCLA Health Nuclear Medicine and Theranostics: Pioneering Precision Diagnostics and Targeted Therapies

UCLA Health is at the forefront of modern medicine, offering comprehensive imaging and minimally invasive treatment services through its Department of Radiology and the newly established Department of Nuclear Medicine and Theranostics. The creation of the new Department of Nuclear Medicine and Theranostics at UCLA Health marks a significant advancement in the field, being the first independent department of its kind in the United States. This reflects a commitment to broadening clinical services, accelerating research, and enhancing collaboration across UCLA Health, the David Geffen School of Medicine at UCLA, and the UCLA Jonsson Comprehensive Cancer Center. This new structure builds upon decades of achievement within the respected Ahmanson Translational Theranostics Division.

The Growing Need for Nuclear Medicine and Theranostics

Across the MENA region, rising cancer rates mean that demand for high-precision cancer care continues to grow. While many countries have expanded their nuclear medicine services and improved access to PET/CT imaging, the availability of fully integrated theranostic programs, including advanced radiopharmaceuticals and multi-cycle radioligand therapy, remains uneven due to a shortage of trained medical staff and high equipment costs. The launch of UCLA Health’s new department directly responds to this global demand. The department’s biomedical cyclotron and radiochemistry facilities ensure a consistent, reliable supply of the specialized isotopes required for complex treatments.

What is Nuclear Medicine?

Nuclear medicine uses small amounts of radioactive tracers or drugs to help doctors diagnose and treat a variety of diseases. During a nuclear medicine procedure, your doctor uses a large scanner to take detailed pictures of your body. The radioactive tracer or drug is attracted to specific organs, bones, tissues or cells. Your doctor uses special cameras that can image where the tracers accumulate and "light up" in your body. Before your procedure, your doctor or a nuclear medicine technologist will give you a small amount of radioactive tracer. Most tracers are injected into a vein, some are swallowed or inhaled. This is followed by a scan. Depending on the type of procedure, you may need to wait a few hours or a few days between getting the tracer and having the scan. After your scan, it is safe for you to go home and resume your usual activities. Reactions to nuclear medicine tracers and drugs are extremely rare. If you have concerns or any allergies, talk to your doctor. Nuclear medicine procedures are safe. When the images from your scan are ready, your doctor reviews them and creates a report for your care team.

Nuclear Medicine Procedures at UCLA Health

At the UCLA Health Ahmanson Translational Imaging Division, experts use nuclear medicine procedures to diagnose, manage and treat a range of conditions. UCLA Health is skilled at using groundbreaking imaging technology to deliver the highest level of care to people of all ages. Nuclear medicine experts work with a coordinated team of specialists to treat neuroendocrine tumors (NETs) and prostate cancer. Convenient care is offered, performing nuclear medicine procedures at several locations, including inpatient and outpatient clinics in Westwood, Santa Monica, Thousand Oaks and Santa Clarita.

Diagnostic Applications

At UCLA Health, nuclear medicine procedures are used to:

Diagnose conditions: Scans of the heart, thyroid, liver, kidneys, gallbladder, lungs and other organs are performed to see how the organs are working and to diagnose a range of conditions.
Manage disease and plan treatments: The results of nuclear medicine scans are used to gather information about the character, and stage of the disease as well as how it is responding to therapy.

Therapeutic Applications

Provide effective therapies: Nuclear medicine allows delivering therapy directly to certain cancers. The team uses sophisticated imaging technology to deliver the latest advances in care.

Johannes Czernin, MD, acting chair of the new department, emphasized that nuclear medicine is undergoing a profound transformation, driven by advances in imaging technology and the development of novel radiopharmaceuticals that allow visualization and treatment of disease with unprecedented precision. These advances are especially visible in whole-body PET imaging, which enables clinicians to identify disease at the molecular level, often earlier and with greater accuracy than through conventional imaging.

Specific Nuclear Medicine Procedures Offered

UCLA Health offers a range of nuclear medicine procedures, including:

Cardiac Perfusion Scan: This imaging study evaluates blood flow through the arteries of your heart. A small amount of safe, radioactive tracer is injected into a vein. As the tracer moves through your heart muscle, images are taken with a scanner that allows checking the blood vessels in your heart. This test is performed while you are resting and after exercise (nuclear stress test). A cardiac perfusion scan helps to see how much blood is reaching the heart. Your doctor may ask you to walk on a treadmill or do another activity that increases your heart rate before doing the second scan.
PSMA PET/CT Scan for Prostate Cancer: This advanced imaging study allows locating prostate tumors so more effective treatments can be developed. The test uses a safe, radioactive tracer that is injected into a vein in your arm. Using a sophisticated scanner, images of your prostate and surrounding organs are viewed. Once the tracer highlights them on the scan, the location of any tumors can be pinpointed. This advanced technology leads to more precise diagnoses and therapies. In 2018, Dr. Calais collaborated with UCSF’s Tom Hope, MD, to demonstrate that PSMA PET imaging detects significantly more prostate cancer lesions than conventional methods. The technique received approval from the Food and Drug Administration in 2020 and is now standard. Dr. Calais then co-led phase II clinical trials, evaluating Lutetium-177 vipivotide tetraxetan (Pluvicto), a targeted radiopharmaceutical therapy for metastatic, treatment-resistant prostate cancer. UCLA Health nuclear medicine experts use PET/CT with an imaging probe that targets the prostate-specific membrane antigen (PSMA). PSMA PET/CT scans help diagnose and stage prostate cancer with unparalleled accuracy.
Lutathera® Therapy for Neuroendocrine Tumors (NETs): UCLA Health offers Lutathera®, a modern treatment for advanced (metastatic) neuroendocrine tumors of the stomach, gut or pancreas. These tumors are sometimes called carcinoid tumors. As part of a clinical trial prior to FDA approval, UCLA Health experts treated more patients with Lutathera® than any other medical center in the nation. Lutathera® is a type of peptide receptor radionuclide therapy (PRRT), a treatment that targets tumors and delivers a high dose of radiation to destroy them. When your doctor injects Lutathera® through a vein, it travels through your bloodstream and attaches to the cells of the neuroendocrine tumor. Lutathera® (Lutetium 177-DOTATATE) has been shown to reduce disease progression in people with these tumors. To deliver treatments for NETs, a close working relationship is maintained with a multispecialty team that includes oncologists, endocrinologists, surgeons and interventional radiologists.

Positron Emission Tomography/Computerized Tomography (PET/CT)

Positron Emission Tomography/Computerized Tomography (PET/CT) is an imaging test that produces high resolution pictures of the body's biological functions and anatomic structures. These images show body metabolism and other functions rather than simply the gross anatomy and structure revealed by a standard CT or MRI scan. This is important because functional changes are often present before obvious structural changes in tissues are evident. PET/CT imaging can uncover abnormalities that might otherwise go undetected. PET/CT is believed to be the most accurate imaging test available to evaluate lung cancer, colon cancer, breast cancer, melanoma, lymphoma, head and neck cancer, and esophageal cancer. In published research studies, PET has been shown to have an approximately 90% accuracy in many of these cancer types. PET is the most accurate imaging test available to determine the presence of a dementia process such as Alzheimer's disease. Patients who have severe kidney problems or who are allergic to iodine can have a PET/CT without the I.V. An itching sensation or shortness of breath may indicate an allergic reaction to the contrast. You will be scanned for approximately 30 minutes and may receive additional I.V. contrast depending on your physician's request. Normal reactions when getting I.V.

Theranostics at UCLA Health

Theranostics combines diagnostic imaging and targeted therapy using radioactive drugs. This approach allows doctors to:

Identify patients who are most likely to benefit from a specific therapy.
Target the therapy directly to the tumor cells, minimizing damage to healthy tissues.
Monitor the patient's response to therapy and adjust the treatment plan as needed.

UCLA is home to one of the premier theranostics research programs in the United States.

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Side Effects of Theranostics

Side effects of theranostics imaging and therapy The most common side effect of theranostics imaging is claustrophobia during the full-body PET scan, while theranostics therapy can be accompanied by fatigue, constipation or diarrhea, dry mouth, nausea, anemia (below-normal red blood cell count), and bone pain. Less common side effects of theranostics therapy include decreases in cells that help fight infection. Because side effects can vary depending on the disease being treated, it is important to consult with your theranostics care team prior to receiving treatment.

Who is a Candidate for Theranostics?

Theranostics treatments are available for certain patients with prostate cancer, neuroendocrine tumors (NETs), thyroid cancer, or Graves’ disease. Following diagnosis, your oncologist may refer you to the UCLA Health Theranostics care team for a consultation to determine whether you are a candidate for theranostics therapy.

Why Choose UCLA Health for Theranostics Therapy?

You are in good hands when you choose UCLA Health for your theranostics therapy. Whether at our state-of-the-art Outpatient Theranostics Center or through our field-leading research in the laboratory and clinic, our team of physicians, researchers, and staff are focused on bringing the best care to our patients.

UCLA Health's Expertise in Theranostics

Pioneering clinical trials: UCLA Health Theranostics physicians help bring innovative and effective treatments to UCLA Health patients by leading and participating in pioneering theranostics-based clinical trials such as NCT02940262. These studies led to FDA approval, Medicare reimbursement status, and inclusion in the prostate cancer management guidelines by the National Comprehensive Cancer Network (NCCN). The team led the Phase II RESIST-PC clinical trial to establish the safety and efficacy of Pluvicto (177Lu-PSMA-617) in treating metastatic castration-resistant prostate cancer, and participated in the pivotal Phase III VISION clinical trial which further demonstrated the efficacy of Pluvicto against metastatic castration-resistant prostate cancer. Based on the positive results of this study, the FDA approved Pluvicto for use in the United States.
Experience and expertise: Since 2022, the team has administered over 430 cycles of theranostics therapy to patients with metastatic castration-resistant prostate cancer, NETs, thyroid cancer, and Graves’ disease.

Nuclear Medicine Scans: What to Expect

A nuclear medicine scan is an imaging test to create pictures of your organs and bones. It uses a special camera and a small amount of radioactive material called a radiotracer. A nuclear medicine scan can create pictures of your heart, lungs, liver, and gallbladder. Nuclear medicine scans help healthcare providers diagnose health conditions such as cancer, injuries, and infections. They can also show how well the organs like your heart and lungs are working. Normal reactions when getting I.V. You should feel fine.

Safety and Preparation

Nuclear medicine scans are largely safe. The dose of radiation in the tracer is quite small. It is generally not a cause for serious concern. The risk of toxic or allergic reactions with tracers is also low. Some people may get pain or swelling at the site of injection. In rare cases, allergic reactions may occur in some people. The way you get ready for a nuclear medicine scan depends on the type of scan you will have. Follow your healthcare provider's instructions. Tell your provider about all the medicines you take. Ask if it’s OK to take them before your test. This includes prescription and over-the-counter medicines. It also includes vitamins, herbs, and other supplements. Follow all instructions you are given for not eating or drinking before the test. You may be told not to have caffeine or tobacco for a certain amount of time before the test. Your scan may take a few hours. Bring something you can do if you need to wait.

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During the Scan

You will be given a radioactive tracer. It may be injected, swallowed, or inhaled. If injected, you will get an IV (intravenous) line. Your scan may then be done right away. Or you may need to wait a few hours or even days to allow the tracer to concentrate in the part of the body being studied. You may be scanned many times during 1 day. This depends on the type of nuclear scan you have. Are breastfeeding (You may need to pump breastmilk before the procedure. You will lie on a narrow imaging table. A large camera is placed close to your body. Stay as still as you can while the camera takes the pictures. This will ensure the best images. The table or camera may be adjusted to take more pictures.

After the Scan

Most of the radioactive tracer will leave your body through pee and poop in a few days. Drink plenty of water to help clear the tracer from your body. After using the toilet, put the lid down and flush the toilet right after you use it. Your healthcare provider will discuss the test results with you during a follow-up visit or over the phone. Some of the tracer in your body will naturally lose its radioactivity with time. Talk with your healthcare provider about any steps you need to take with sex, or being close to pregnant people or children after the test.

International Services

For international patients, UCLA Health’s integrated theranostics infrastructure is a critical advantage. Beyond clinical excellence, UCLA Health International Services provides dedicated support to help patients and families navigate the logistical and cultural aspects of receiving care abroad. Services include online second opinions, virtual consultations, assistance with logistical arrangements, and in-person Arabic-language support throughout the treatment journey.

Harbor-UCLA Medical Center: A Cornerstone of Healthcare

At the forefront of modern medicine, the Department of Radiology at Harbor-UCLA Medical Center provides comprehensive imaging and minimally invasive treatment services. Harbor-UCLA Medical Center is one of only five Level I Trauma Centers in Los Angeles County. The hospital is the cornerstone of healthcare services for more than 700,000 residents in the greater South Bay catchment area. Diagnostic Radiology is the cornerstone of medical imaging, enabling accurate and early detection of disease across all organ systems. The team collaborates closely with referring clinicians to ensure that imaging findings translate into timely, effective patient care. Interventional Radiology is a subspecialty that uses image-guided, minimally invasive techniques to diagnose and treat a wide range of conditions. The four-year Diagnostic Radiology Residency Program at Harbor-UCLA Medical Center has been ACGME accredited since 1971. The residency program is designed to meet all requirements for board eligibility in diagnostic radiology. The Radiology Faculty at Harbor-UCLA Medical Center comprise a diverse group of specialists with decades of experience and a passion for resident education. Selection for the Diagnostic Radiology Residency Program is made through the National Resident Matching Program (NRMP).

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