Theranostics and nuclear medicine practice in Asia-Pacific: an IAEA regional study

The Asia-Pacific region, comprising more than half of the world's population, includes both developed and developing nations. Understanding the current status of nuclear medicine (NM) and theranostics in this dynamic region is essential for identifying strengths and weaknesses and for establishing a roadmap for future NM development both regionally and globally. The International Atomic Energy Agency (IAEA) conducted this survey to achieve these goals. Diverse data acquisition resources were employed to enroll eligible countries from the Asia-Pacific region. The NM staff per million population was calculated to assess the density for each NM specialty. Statistical analyses, including normality tests and the Mann‒Whitney U test, were performed via Stata version 17. Approximately 62% of the countries offer nuclear medicine services, mainly in Western Asia and Southeast Asia. Eastern Asian countries constitute more than two-thirds of all NM centers and cyclotrons in the region. Specifically, Japan also has the highest number of NMs, centers, and cyclotrons and SPECT density. Currently, only 30 countries provide radionuclide therapy and practice NM theranostics. Japan, Australia, Kuwait, and South Korea are among the countries with abundant NM staff per million people. Compared with developing countries, developed Asia-Pacific countries provide significantly more NM services (p value: 0.0001). The study reveals considerable variability among Asia-Pacific countries. Nearly half of the surveyed countries do not practice theranostics, and lack radiopharmacists. Building collaborations between model countries and those lacking NM services is crucial to enhancing theranostic practice and availability.