Interview with Dr. Seigo Kinuya, WFNMB2022 Congress Chair Professor, Department of Nuclear Medicine, Kanazawa University, Japan

Dr.Seigo Kinuya

WFNMB2022 Congress Chair Professor, Department of Nuclear Medicine, Kanazawa University, Japan

Interview by Dr.Francois Lamoureux

You are the chair of the next congress of the world federation of nuclear medicine and biology (WFNMB) in kyoto japan 7-11 september 2022. could you give us an overview of the event.

We are preparing to have on-site face-to-face congress. I hope that the pandemic of COVID-19 with the progress made in vaccination throughout the world.

We will focus on what’s going on in nuclear medicine by inviting prenarry speakers on the topics of theranostics, neurology, cardiology, molecular imaging, AI and so on. One of Japanese Nobel Prize winners, Dr. Koichi Tanaka who invented mass spectrometric analyses of biological macromolecules, will be invited. Recently, his group published a key article in Nature regarding liquid biopsy for Alzheimer’s disease. As you know, therapeutic drug, aducanumab, for Alzheimer’s disease was approved by the US FDA very recently. Amyloid PET is connected to these trend, and Dr. Tanaka’s lecture will have great impact on nuclear medicine community in this regard.

One of the major missions of WFNMB is to educate young people in the field and promote the development of nuclear medicine in developing countries. For this sake, we wil prepare travel grants to join the congress. Our President Dr. Jean-Luc Urbain gave me a very good idea to have a session dedicated to the educational challenges.

One of highlights of the very first congress of WFNMB held in 1974 in Tokyo was the attendance of the then Crown Prince and Princess at the opening ceremony. We are negotiating with the authority to invite a member of the Japanese Imperial Family for the opening ceremony once again. Our request form is now on the table of the Cabinet office and I am sure that the nuclear medicine community in the world will be celebrated

We are expecting 4000 participants domestically and internationally. You will be one of them!

What have been the most important changes that you have seen in the field of Nuclear Medicine over the last 5 years!

Development of theranostics in the world is the biggest one. In my country Japan, not many people paid attention to targeted radionuclide therapy for many years although therapies such as radioiodine therapy for thyroid disease and 89Sr bone pain palliative therapy have been widely adapted in the clinic. It was a kind of niche field in medicine. However, many people began to recognize the successful achievement of PRRT for neuroendocrine tumors and PSMA therapy prostate cancer. Introduction of alpha therapy with 223Ra for prostate cancer patients further pushed them toward this field. Then, successful story of 225Ac-PSMA ignited their hearts. I have been involved in targeted radionuclide therapy for 35 years. Frankly speaking, I have not expected to see the current situation. I would sincerely appreciate the big efforts of our colleagues in the world.

How do you see the field of Nuclear Medicine evolving during the next 5 years!

The role of theranostics will get bigger and bigger in clinical practice. In Japan, Lutathera, 177Lu- DOTATATE, is going to be approved. 131I-MIBG for pheochromocytoma will follow. Clinical trial of 177Lu- PSMA for prostate cancer is being prepared. Physician-led clinical trial of 64Cu-ATSM for brain tumors is on the way.

In addition, clinical trials of targeted alpha therapy with 211At (NaAt) for 131I-refractory thyroid cancer and 211At-MABG for pheochromocytoma are almost ready to be initiated. PET imagings will also surely grow. Currently, we are doing clinical trial of 68Ga-PSMA aiming governmental approval in my University hospital. We are also expecting that amyloid PET will be reimbursed after the domestic approval of Aducanumab.

How do you see the training of residents and technologists in our Nuclear Medicine training programs!

In order to offer patients with proper medical management, all professionals including physicians, nurses, technologists and nuclear physicists should collaborate at the high level. All of them should acquire updated technique and information. Furthermore, communication is quite important.

Task shifting in hospitals has been promoted by the Ministry of Health, Labour and Welfare (MHLW) in my country for more than 10 years. For this sake, we should understand the roles of each occupation. Mutual training program should be needed. For instance, Japanese Society of Nuclear Medicine (JSNM) has been discussing about JSNM Technology in this regard in response to the Governmental order.

As the chair of the WFNMB congress, what is your greatest wish for the specialty of Nuclear Medicine !

For the future of nuclear medicine, new technologies in both instruments and drugs are of course required. However, development of human resources is the most important thing. In addition, we need more young people than ever in order to keep growing. In my country, we have not succeeded to get a good number of young fellows in nuclear medicine for many years primarily due to the shrink of nuclear medicine examinations because of the alteration of medical care insurance system about 20 years ago. However, we have now very attractive tools of theranostics and PET imaging in our hands. WFNMB congress is a very good opportunity not only for the international development but also for the advertisement of nuclear medicine to young doctors in my country.

You are currently the president of JSNM. What are you doing to promote nuclear medicine in Japan and your neighboring countries in Asia?

Perhaps, Japan is one of the most underdeveloped countries in theranostics mean. Lutathera is just going to be approved 4 years after EU approval. 68Ga-DOTATATE/DOTATOC is not available due to complicated regulations, and we have to use old- fashioned 111In-octreotide instead. Patients go abroad to undergo PRRT or PSMA therapy  to Europe or Australia. This situation is a shame of the Japanese nuclear medicine community. Five years ago, JSNM launched the National Conference for Nuclear Medicine Theranostics in which I have been serving as the president. Nuclear physicians, clinicians, patients and industrial people gather in this platform. Lobby activities or advocacy activities to the officials of Ministries and members of Parliament are going to bear fruit. Now, we have many supporters among representatives. Officials are getting to understand the necessity to develop radionuclide therapy in this country. Consequently, the word “targeted radionuclide therapy” was installed in the official statements of MHLW such as “Cancer Control Act” and “Requirements for Core Hospitals for cancer control “.

One of the biggest issues is a lack of domestic production of therapeutic radionuclides. After years of lobby activities, 2 representatives required a plan for domestic production of radionuclides, especially 225Ac, at the occasion of parliament assembly on May 31, 2021. Four Ministers related to this issue responded affirmatively.

Public lectures are often provided to make people know the role of nuclear medicine in clinic. Many of ordinary people even do not know what nuclear medicine is. They cannot imagine what targeted radionuclide therapy is. We need to continue this activity at any occasion.

Mutual activities with other societies have been going on. We have MOU with SNMMI, EANM and the societies of Asian countries. JSNM proposes symposium in annual congress of SNMMI and EANM every year, and collaborative sessions are regularly prepared which have a good reputation.

Many of Asian countries are not well developed in nuclear medicine practice. So that, supporting educational activities is essential in this region. JSNM has been working together with Asia Oceania Association of Nuclear Medicine and Biology (AOFNMB), Asian Regional Corporative Council of Nuclear Medicine (ARCCNM) and so on.

The collaborative work with the International Atomic Energy Agency (IAEA) was initiated in 2018 by the leadership of the past president of JSNM, Prof. Jun  Hatazawa. The Consortium of 11 Universities and Institutions  in  Japan has MOU  with  IAEA. This aims to provide young people in Asia with educational occasions. Workshops and hands-on  meetings  are  set up in Japan. Although this activity is suspended now due to COVID-19, it will be resumed hopefully next year.