Mediso Installs Advanced TheraMAX SPECT/CT System for Theranostic Imaging at Heidelberg University Hospital

Mediso has successfully installed its AnyScan® TRIO-TheraMAX SPECT/CT system at the Department of Nuclear Medicine, Heidelberg University Hospital, enhancing the department’s capabilities in theranostic imaging—a rapidly evolving field that combines targeted therapy with diagnostic imaging.

Specifically engineered to meet the complex clinical demands of Targeted Radionuclide Therapies, the TheraMAX system is optimized for imaging radioisotopes that emit alpha and beta particles alongside high- and ultra-high-energy gamma photons—isotopes such as 177Lu, 225Ac, 212Pb, and 131I. These are far more challenging to image than conventional diagnostic isotopes like 99mTc, requiring highly sensitive and precise systems for quantitative imaging and dosimetry—capabilities current standard SPECT/CT systems often lack.

“The TheraMAX expands the imaging capabilities of our department for radioligand therapy,” said Professor Dr. Clemens Kratochwil, lead physician at the Department of Nuclear Medicine, Heidelberg University Hospital. “We treat patients with a wide range of novel radiopharmaceuticals labelled with 177Lu or 225Ac, some of them as part of clinical trials for developing improved and more individualized patient care. In addition, the TheraMAX supports our department by increasing the capacity of our department for 99mTc-PSMA scans for radioligand therapy inclusion.”

Initial results have been promising. “First scans of patients treated with 225Ac suggest that the duration of whole-body quantitative SPECT/CT may be reduced, allowing image-based dosimetry,” Dr. Kratochwil added.

The TheraMAX system features three large-surface detectors—offering a detection area up to five times larger than that of conventional 12-detector CZT systems—providing full 360° angular coverage. Its 15.9 mm thick NaI crystalsenhance sensitivity for high-energy photons, while the 123 photomultiplier tubes per detector head contribute to high spatial resolution and PET-like image quality.

In particularly challenging applications such as 225Ac-PSMA therapy, where the administered activity results in very low count rates (4–8 MBq), the TheraMAX delivers a 300% increase in sensitivity compared to dual-detector systems. This allows for whole-body scans under 30 minutes, with a minimum 80 cm axial field of view.

Beyond its theranostic strengths, the system is versatile enough to handle routine nuclear medicine procedures. It enables ultra-fast quantitative total-body SPECT/CT, completing scans up to 2 meters in length within 10 minutesfor isotopes like 177Lu and 99mTc.

Another key innovation is the RoboCart™, an automated collimator exchange system. “The maximum imaging performance is ensured by the newly developed RoboCart™ allowing effortless switching between applications with low and ultra-high energy isotopes. This motorized cart automates collimator exchange on all three detector heads simultaneously within 5 minutes,” said István Bagaméry, Managing Director of Mediso Ltd.

With this installation, Heidelberg University Hospital further strengthens its position at the forefront of nuclear medicine and theranostics, while Mediso reinforces its role as a leading innovator in hybrid imaging technologies.