Theranostics in Bangladesh: Current Status, Challenges, and Future Perspective

Abstract

Background and Current Status of Theranostics Therapeutic nuclear medicine (NM) in Bangladesh began in the early 1980s with the application of radioactive iodine for treatment of thyroid cancer and primary hyperthyroidism. Since then, NM practice has remarkably developed in the country with the advancement of instrumentation, radiopharmacy, and information technology. The government took the initiative to establish four PET-CT centers at different NM centers, including one at the National Institute of Nuclear Medicine and Allied Sciences (NINMAS). A further development is the installation of a cyclotron center (18-MeV cyclotron) at NINMAS by the government's fund. Currently, NM is providing good health services to oncology patients throughout the country. More than 20 NM centers are functioning in different parts of the country, and therapeutic NM has an important place. However, conventional radioactive iodine still remains the major theranostic application. Challenges and Future Perspective The expansion and development of therapeutic NM for other cancers have been limited due to a number of challenging factors. A brief overview of the history and current status of NM in Bangladesh is presented here with an examination of factors that pose as obstacles to the introduction and development of new therapeutic technologies. Finally, future perspectives are discussed with ways to mitigate existing problems and challenges. Keywords Theranostics . Bangladesh . Radioactive iodine therapy . Bangladesh atomic energy commission .

Biochemical Outcome of Repeated Radioactive Iodine Therapy in Patients with Primary Hyperthyroidism– Follow Up of a Decade

“…The reported incidence of hyperthyroidism (HT) in cross-sectional case series from Bangladesh isaround 1% (1,2). Like most other countries in the world, radioactive iodine therapy (RAIT) has been a second-line treatment for primary hyperthyroidism in Bangladesh for the past five-decade with reportedly satisfactory short term outcomes (3)(4)(5). Data from large cohort showed a cumulative incidence of hypothyroidism after RAIT observed over 30 years in patients with Graves' disease (GD) to be more than 80%, while it remained less than 40% in patients with toxic nodular goiter (3).…”

“…Data from large cohort showed a cumulative incidence of hypothyroidism after RAIT observed over 30 years in patients with Graves' disease (GD) to be more than 80%, while it remained less than 40% in patients with toxic nodular goiter (3). In smaller cohorts with uncategorized diagnoses, the incidence of hypothyroidism following RAIT was up to 40% at one year (6)(7)(8)(9). Repeated administration of RAIT may be required in patients with HT (9) which is reported to be 12% in a cohort comprising solely of GD and 23% in another mixed cohort consisting of GD, multinodular goiter (MNG) and solitary toxic nodule (STN) (10,11).…”