Three ways to see biology in action with nuclear medicine

While patients can share the same diagnosis, their tumors can behave completely differently. Molecular imaging helps reveal that difference, supporting clinicians in the decision-making process best suited to the patients.

The need for this kind of precision is growing. Global cancer cases are expected to nearly double by 2050, and improved access to quality imaging and treatment could prevent millions of those deaths.

That shift is increasingly visible at GenesisCare, one of the UK’s leading private cancer centers. Their newly introduced center in Surrey is equipped with the latest advancements in cancer care, where Professor Vineet Prakash, FRCP, FRCR, Dual Consultant in Radiology and Nuclear Medicine, uses PET/CT imaging alongside AI-assisted treatment planning to guide his assessment: "I'm more confident in my diagnosis. I'm not giving unequivocal or indeterminate findings," he says. "For our patients, this confidence can save them time because it potentially reduces the need for unnecessary further investigations and imaging." *

Cardiology: Is the heart muscle suffering?

In cardiology, nuclear medicine helps answer a question most other scans can't: is the heart muscle getting enough blood, or is there evidence of a significant change? That distinction helps determine what happens next for the patient, whether that means a procedure to restore blood flow, or ongoing care management, such as medication.

Cardiovascular disease is the leading cause of death globally, affecting more than 500 million people worldwide and taking the lives of roughly 19 million people per year. Addressing a burden of that scale depends on continued advances in medical technology with tools that help clinicians diagnose disease earlier to manage the issues more effectively.

Myocardial perfusion imaging (MPI) is one such tool helping answer the question above by comparing blood flow to the heart while at rest and under stress. PET and SPECT myocardial perfusion imaging offer different capabilities depending on the clinical question, patient and available tracer. PET scans can produce sharper images than SPECT technology, but PET tracers historically decay too quickly to pair with treadmill exercise—so PET studies relied on medication to simulate the effect of exercise instead. SPECT tracers can support treadmill exercise testing and remain an important part of nuclear cardiology practice. Historically, however, the short half-life of commonly used PET perfusion tracers limited the ability to combine PET imaging with treadmill exercise. 

A newer PET imaging agent for coronary artery disease may help address part of that limitation: it lasts long enough for a patient to exercise on a treadmill, while still producing PET-quality images. In April 2025, Catholic Health's St. Francis Hospital & Heart Center on Long Island, New York, became one of the first hospitals in the U.S. to put that combination to use in an exercise-stress study. 

"In cardiovascular disease, the challenge is rarely just detecting that disease is present. The challenge is understanding its significance and determining the most appropriate next step for each patient," says Jamieson M. Bourque, MD, MHS, FASNC, Professor of Medicine and Radiology, University of Virginia. "Advances in myocardial perfusion imaging are giving clinicians more detailed physiological information, helping support more informed decisions about diagnosis, risk stratification and patient management, providing patient-specific insights that support a more precise and personalized approach to cardiovascular care."

Neurology: When structure looks the same, but biology doesn't

In neurology, nuclear medicine reveals brain activity that structural scans cannot show. Patients can share similar symptoms and normal-looking MRIs while their underlying biology can still differ in one of two ways: one patient's brain may be functioning abnormally, demonstrating high or low activity in certain regions, while another's may contain a specific harmful molecule building up where it shouldn't. A clean structural scan can hide either.

Dementia is a growing global health challenge. The number of people living with dementia is expected to nearly double every 20 years, according to Alzheimer's Disease International. Diagnosing it earlier and more accurately depends on tools that can see the disease itself, rather than infer it from symptoms alone.

Amyloid PET imaging looks for that second kind of signal—a specific molecule, not a pattern of activity. A tracer designed to attach directly to amyloid plaques, a buildup of protein that is a defining feature of Alzheimer's disease, is injected into the bloodstream. A PET scanner then shows whether that buildup is present in the brain, and how extensive it is, giving clinicians a direct biological answer instead of an inference based on cognitive testing alone.

As the understanding of Alzheimer's disease continues to evolve, amyloid PET is playing an increasingly important role in helping clinicians assess amyloid pathology and support more informed patient management decisions. Clinicians now have access to a growing range of tools that can help identify appropriate patients, support treatment decisions and better understand disease progression over time. Recent regulatory developments, including expanded indications in the United States, reflect the evolving role of amyloid PET in clinical practice.

"The use of quantification in amyloid PET imaging has steadily moved from research to clinical practice, where it can aid in more confident and accurate diagnosis," says Phillip Kuo, MD, PhD, Section Chief of Nuclear Medicine and Director of Theranostics at City of Hope National Medical Center. "Now quantification can also play a critical role in initiating and monitoring amyloid-targeted therapy for Alzheimer's disease and determining when it can be discontinued."

For clinicians, that clarity can change how confidently they can act. For patients and families living with uncertainty, it can mean answers sooner, and a clearer path forward.

"Alzheimer's is a population-level disease, so we need complementary tools, not just one," says Suchandrima Banerjee, General Manager, Neurology Care Pathway at GE HealthCare. "Newer blood-based tests help us screen and triage patients faster, but amyloid PET is what ultimately helps confirm the amyloid pathology causing the diagnosis. It's also how we watch a therapy work overtime, seeing whether plaque levels are being reduced. That's the difference between treating a patient and knowing the treatment is working."

Bringing it together: Precision at scale

Nuclear medicine does not work in isolation. Across all three specialties, it functions like an air traffic controller—coordinating what is moving, changing, and interacting inside a patient's body, but scaling that role requires infrastructure that many health systems are still building.

"Radiopharmaceutical innovation is moving quickly, and health systems everywhere are being asked to build the readiness to match it," says Erez Levy, Executive Director of Molecular Imaging at GE HealthCare. "That means imaging hardware, software, workflows, and supply chains all evolving together—it's less about catching up, and more about laying the foundation this next generation of care will need."

Catholic Health's Care Alliance shows what that looks like in practice: more than 40 sites across Long Island, spanning cardiology, oncology, neurology, and women's health.

"The collaboration also gives our physicians and care teams a meaningful voice in shaping the future of care," says Gary Havican, Interim President, CEO, and COO of Catholic Health, "so innovation is guided by real clinical and patient needs."

That kind of system-wide investment exists to serve something much more individual: treatment plans built from more precise, informed decisions tailored to the patient.

Three specialties. Three questions. One shared discipline:

• Detect disease earlier.
• Characterize it accurately.
• Decide the right next step.
• Personalize the treatment path.
• Monitor whether it is working.

Precision medicine depends on understanding what makes each patient different. Nuclear medicine's contribution is simple: it helps make those differences visible and helps care teams make better-informed decisions when they matter most.

*The statement by the GE HealthCare customer described here is based on their own opinions and experiences and on results that were achieved in the customer’s unique setting. Since there is no typical hospital and many variables exist, such as hospital size, case mix, etc., there can be no guarantee that other customers will achieve the same results.