New Delhi: What if doctors could create a virtual version of a cancer patient and use it to predict how the disease might respond to a radioactive treatment before giving the actual drug?That is the possibility outlined by a group of nuclear medicine researchers, including one from an NCR-based hospital, in a new paper published in Frontiers in Biomedical Technologies.The paper, “Digital Twins in Nuclear Medicine: A Pathway to Personalized Theranostics,” is authored by Swagat Dash of Sarvodaya Hospital, Faridabad, along with researchers from Geneva University Hospital, Switzerland, Razavi Hospital in Iran and Bushehr Medical University Hospital in Iran. It proposes the use of a “theranostic digital twin”, a computer model of an individual patient to simulate different treatment scenarios before therapy is administered.The concept builds on theranostics, a form of precision cancer care in which molecular imaging is used to identify cancer cells carrying a particular target and a targeted radioactive medicine is then used to treat them.In prostate cancer, for instance, PSMA PET, a scan that uses a radioactive tracer to locate prostate cancer cells carrying the PSMA protein, shows doctors where the cancer is and how strongly it expresses the treatment target. A radioactive drug such as lutetium-177 PSMA can then be used to target those cells.The challenge is that two patients with apparently similar cancers can respond very differently to the same treatment. However, the proposed digital twin could combine scans, clinical information, blood tests and other patient data with AI and models of how the radioactive drug behaves in the body.In practical terms, doctors could potentially ask which dose is most likely to attack this patient’s tumour while limiting radiation exposure to healthy organs. It also proposes predicting which patients are likely to respond and who may face side effects involving organs such as the kidneys or bone marrow.“Instead of waiting to see whether a treatment works after it has started, doctors could compare different treatment options on a patient’s digital twin before deciding which approach is most suitable,” Dash, associate director and head of Nuclear Medicine at Sarvodaya Hospital.The paper cites prostate-cancer research showing that patients whose tumours absorbed more of the radioactive tracer used in PSMA scans had a 91% treatment-response rate, compared with 52% among those whose tumours absorbed less. Importantly, these are findings from earlier clinical research, not results produced by a digital-twin system.The tech, however, is still at the research stage. The authors say it will require large, standardised patient datasets, models combining AI with established biological knowledge and continuous updating as the patient’s disease and response change. It adds that the digital twin is meant to support, not replace, doctors. However, if applied in clinical practice, it could move cancer care “from reacting to treatment outcomes towards predicting them in advance,” noted the doctor.
