Pediatric Precision Nuclear Medicine: How Theranostics Is Reaching Children With Cancer

What Is Theranostic Nuclear Medicine and How Does It Apply to Children?

Theranostics — a portmanteau of therapeutics and diagnostics — uses radioactive compounds that can both identify and treat cancer at the molecular level. A diagnostic scan first reveals whether tumor cells express a specific molecular target, and if they do, a therapeutic dose of a targeted radionuclide is delivered directly to the cancer. This approach has transformed care for certain adult cancers, particularly neuroendocrine tumors treated with lutetium-177 DOTATATE (Lutathera), which received FDA approval in 2018.

Now, leading pediatric institutions are working to bring these capabilities to children. The collaboration between the University of Kansas Health System, Children's Mercy Kansas City, and BAMF Health — announced in April 2026 — represents one of the most ambitious efforts to build a fully integrated theranostic research and treatment center that explicitly includes pediatric patients. Children's Mercy, a nationally ranked children's hospital, brings critical expertise in managing the unique physiological and dosimetric challenges of treating younger patients with radiopharmaceuticals.

Which Childhood Cancers Could Benefit From Targeted Radiopharmaceuticals?

Neuroblastoma — the most common extracranial solid tumor in children — has long been treated with MIBG (meta-iodobenzylguanidine) therapy, an early form of targeted radionuclide treatment. The FDA approved iobenguane I-131 (Azedra) in 2018 for MIBG-positive pheochromocytoma and paraganglioma, and research continues into optimizing similar targeted radiotherapy for pediatric neuroblastoma. Newer theranostic pairs targeting somatostatin receptors and other molecular markers are expanding the potential applications in childhood cancers.

The integrated center model — combining PET/CT imaging, cyclotron-produced radiopharmaceuticals, and treatment delivery under one roof — addresses a critical bottleneck in pediatric nuclear medicine. Many radiopharmaceuticals have extremely short half-lives and must be produced and administered within hours. According to the Society of Nuclear Medicine and Molecular Imaging, fewer than a dozen centers in the United States currently offer comprehensive theranostic services, and even fewer are equipped to treat pediatric patients with the specialized dosing, sedation, and radiation safety protocols children require.

What Does This Mean for the Future of Pediatric Cancer Treatment?

The Kansas partnership, which also involves the University of Kansas Medical Center and BAMF Health — a company specializing in theranostic infrastructure — aims to create a destination center for both research and clinical care. This model could accelerate enrollment in pediatric radiopharmaceutical trials, which have historically been hampered by the scarcity of facilities capable of producing, imaging, and delivering targeted radionuclides in a child-friendly clinical environment.

The World Health Organization estimates that approximately 400,000 children develop cancer each year worldwide, with survival rates varying dramatically by geography — roughly 80% in high-income countries but as low as 20% in low-income settings. While theranostics alone will not close this gap, expanding precision approaches in pediatric oncology could improve outcomes for children with relapsed or refractory disease who have exhausted conventional chemotherapy and radiation options. As more institutions invest in integrated nuclear medicine infrastructure, the hope is that theranostic treatments currently available only at a handful of academic centers will become more widely accessible to the pediatric patients who need them.