Establishing Radiopharmaceutical Centers of Excellence

Global expansion of radiopharmaceutical therapy (RPT) and the rising need for patient-centered approaches present opportunities for innovation in the United States and New Zealand. The first part of this paper outlines in detail the Society of Nuclear Medicine and Molecular Imaging's Radiopharmaceutical Therapy Center of Excellence designation, including its tiers, criteria, and practical blueprint for establishing RPT centers. The New Zealand center is presented as a practical framework for building a center that adheres to the country's rules and regulations. In the United States, the Society of Nuclear Medicine and Molecular Imaging established a Center of Excellence designation that is awarded to centers performing RPT with the highest standards of care. The Center of Excellence program sets the framework for successfully establishing RPT centers, aiding expansion nationwide. Expansion is especially necessary in underserved and rural communities that lack access to nuclear medicine services and RPT. Although many common challenges exist that make it more difficult to expand RPT services, potential solutions can be used to overcome these challenges and successfully establish well-rounded RPT programs. Establishing RPT centers that are engrained with the Center of Excellence values is highly beneficial to patients, referring providers, and payers. With highly skilled Centers of Excellence, RPT is no longer the future of medicine; it is the present of precision health care. In New Zealand, Hawke's Bay on the North Island's east coast lacked PET/CT and radiopharmaceutical services. In 2022, the decision was made to design and construct a molecular imaging and therapy center. Embedded in this design was emphasis on patient journey, radiation safety, cultural sensitivity, future readiness, sustainability, and ensuring continuous service delivery. Like the United States, New Zealand faced a shortage of nuclear medicine technologists. Compounding this challenge was that New Zealand had only 1 radiopharmacist at the time. As a result, nuclear medicine technologists had to upskill rapidly, especially in radiopharmaceutical synthesis, to meet the demands of the service. After extensive collaboration among the physicist, planning team, and nuclear medicine staff, a consensus was reached on a design that successfully integrated all key expectations. Despite challenges, there are centers in the United States and New Zealand that have succeeded in performing RPT with the highest level of expertise in training, personnel, equipment, radiation safety, and patient management and are at the forefront of innovation with regard to RPT.