Last reviewed by Dr. Dharmender Malik on 14 May 2026 · this article reflects the published primary literature and current clinical practice at FMRI Gurugram.
Introduction
For patients in countries where Lu-177 PSMA, Lu-177 DOTATATE PRRT, or Y-90 TARE are unavailable, are restricted by long waiting lists, or are not covered by health systems or insurance, India has become an established destination for radioligand therapy. This article walks through, with primary sourcing of the regulatory and clinical pathway, what medical travel from outside India to a specialist nuclear medicine centre actually involves. Three anonymised composite case sketches — not real patients, included only to illustrate workflow steps — appear in the relevant sections. There is no testimonial endorsement here: the goal is process clarity for an international patient deciding whether this pathway is right for them.
Stage 1 — Initial eligibility review (before travel)
AI Overview · short answer
The medical travel pathway from outside India to a specialist nuclear medicine centre such as FMRI Gurugram involves five structured stages: (1) initial eligibility review based on imaging and pathology from the home country; (2) India e-Medical Visa application processed online through the Indian Ministry of External Affairs portal, typically issued within 3-5 working days[1]; (3) pre-travel coordination covering imaging, biopsy, biochemistry, and logistics; (4) on-arrival multidisciplinary review and treatment at the receiving Indian centre under AERB regulatory oversight[2]; and (5) post-treatment handover with structured discharge documentation for continuing care with the patient's home oncologist. Each stage has specific documentation requirements and timing implications.
The first decision an international patient and a receiving Indian centre make together is whether the patient is even eligible for the intended therapy. This decision is made remotely, before any travel, based on documents sent from the home country[3]:
- Recent imaging — for Lu-177 PSMA, a Ga-68 PSMA or F-18 PSMA PET-CT; for PRRT, a Ga-68 DOTATATE PET-CT; for TARE, multiphasic CT or MRI of the liver. The receiving centre will frequently request the raw DICOM images (not just radiology reports), as image review is part of the eligibility decision.
- Histopathology — original biopsy report and, where relevant, glass slides or paraffin blocks for review at the receiving centre.
- Biochemistry — recent kidney function (eGFR), liver function, marrow counts, tumour markers (PSA for prostate, chromogranin A for NETs, AFP for HCC).
- Treatment history — full record of prior systemic therapy, locoregional therapy, and radiation.
- Performance status — current ECOG status and functional summary.
Eligibility review takes 5-10 working days, conducted by the multidisciplinary tumour board at the receiving centre. The outcome is one of three: eligible (proceed with planning), conditionally eligible (additional tests needed first), or not appropriate (alternative pathways suggested). The decision is communicated in writing.
Composite case sketch 1 (anonymised): A patient in his mid-60s with metastatic castration-resistant prostate cancer after progression on docetaxel, abiraterone, and enzalutamide submitted recent Ga-68 PSMA PET-CT showing PSMA-positive bone and nodal disease with no significant PSMA-negative discordant disease on FDG PET. Eligibility for Lu-177 PSMA-617 was confirmed at remote MDT review within 6 working days; he proceeded to stage 2.
Stage 2 — India e-Medical Visa
Once eligibility is confirmed, the patient applies for an Indian medical visa. India offers two routes for medical travel[1][4]:
| Route | Where applied | Validity | Use |
|---|
| e-Medical Visa | Online through Indian government portal (indianvisaonline.gov.in) | 60 days from first entry; up to 3 entries | Most international patients use this route — quicker, simpler, no embassy visit required |
| Medical Visa (standard) | Indian embassy / consulate in home country | Up to 1 year; multiple entries | Longer-stay treatments or where e-visa is not eligible for the patient's country |
| Medical Attendant Visa | Same routes as above | Linked to patient's visa | For up to 2 family attendants accompanying the medical visa holder |
The e-Medical Visa typically processes within 3-5 working days of complete online submission. Required documents include passport (minimum 6 months validity, 2 blank pages), a recent photograph, a digitised passport copy, and a letter of invitation from the recognised Indian hospital stating the planned treatment, duration of stay, and the inviting consultant. Some patients also submit medical records as part of the application[1].
The patient's nationality affects e-Medical Visa eligibility; the Indian Ministry of External Affairs maintains the current list of eligible nationalities on its public portal. Patients from a small list of countries must use the standard Medical Visa route through an Indian embassy rather than the online e-visa.
Stage 3 — Pre-travel coordination
The pre-travel coordination period — typically 2-4 weeks from confirmed eligibility to departure — is the most logistically complex part of the pathway[5]:
- Medical preparation: Confirm baseline imaging is current (within 4-6 weeks of treatment), bring original DICOM images on a USB drive (in addition to digital transfer to the receiving centre), update biochemistry if more than 2 weeks old, confirm medication list including doses and timings.
- Logistical preparation: Flights and accommodation, ground transport from airport, communication arrangements for the family member or attendant remaining at home, currency arrangements (cash and card both), travel insurance (note: most travel insurance specifically excludes pre-existing cancer and the planned medical treatment — confirm coverage before assuming it applies).
- Documentation: Original passport, e-visa printout, hospital invitation letter, medical records folder (imaging, histopathology, biochemistry, treatment history, medication list), copy of insurance documents.
- Communication with home oncologist: The home oncologist remains responsible for the patient's continuing care. Pre-travel handover from home oncologist to receiving centre, with explicit written agreement on what will happen, what will be reported back, and what continuing care will be required on return, is essential.
For radioligand-therapy specifically, the receiving centre needs to know exact flight dates because the radioactive preparation (Lu-177, Y-90) is manufactured to a calibration time and used within tight windows. Last-minute travel changes can affect when treatment can be administered.
Composite case sketch 2 (anonymised): A patient with somatostatin receptor-positive metastatic pancreatic NET, on octreotide LAR with documented progression, had his pre-travel coordination compressed into 2 weeks. The receiving centre's coordinator confirmed his Ga-68 DOTATATE PET-CT was 5 weeks old at planned arrival; a repeat scan was arranged at the receiving centre on day 1 of his stay rather than asking him to repeat in his home country, which would have delayed his journey by a further 3 weeks. The first PRRT cycle proceeded 3 working days after arrival.
Stage 4 — Arrival, MDT review, and treatment
On arrival, the structured workflow at FMRI for an international radioligand-therapy patient typically follows this sequence[6]:
- Day 1 (arrival) — initial consultation with the treating nuclear medicine physician, review of imaging and records, baseline biochemistry, fresh pre-treatment imaging if required (Ga-68 PSMA or DOTATATE PET-CT confirmation; MAA mapping for TARE), accommodation in the patient block.
- Days 2-3 — multidisciplinary tumour board review with medical oncology, surgical oncology, radiology, and nuclear medicine. Final eligibility confirmation; informed consent discussion; treatment scheduling. For TARE: mapping angiography with Tc-99m MAA SPECT/CT confirmation.
- Day 3-5 — first cycle of Lu-177 PSMA-617 or Lu-177 DOTATATE administered with concurrent amino-acid renoprotection (for PRRT) under the EANM procedure guidelines; for TARE, the Y-90 delivery under AERB Safety Code SC-2 and DCGI permissions[2].
- Days 5-7 — post-administration imaging (Lu-177 SPECT for PSMA/PRRT; Y-90 PET/SPECT for TARE), inter-cycle biochemistry, discharge counselling including written radiation safety instructions appropriate to the home country's regulatory regime.
- Departure — discharge documentation including dose administered, route of administration, post-treatment imaging summary, biochemistry, agreed follow-up schedule, and explicit handover note to the home oncologist.
Typical total stay for a first Lu-177 PSMA cycle: 5-7 days. Subsequent cycles (5 more for PSMA, 3 more for PRRT) can be done either by repeat travel or — increasingly common — through structured collaboration where the home oncology team administers later cycles under guideline-aligned protocols.
Stage 5 — Post-treatment handover
The discharge handover is the bridge between the Indian centre and the home oncologist. It must be structured, written, and explicit[7]:
- Treatment summary letter — what was administered, dose, route, calibration time, post-administration imaging finding, any acute side effects observed.
- Imaging — DICOM copy of pre-treatment, mapping/MAA, and post-administration imaging on a USB drive or via secure transfer.
- Biochemistry summary — baseline and post-cycle values for kidney function, marrow, liver, and disease-specific markers.
- Radiation safety documentation — written summary covering external radiation exposure profile, recommended distancing from family for the relevant period, contact with pregnant women and young children, bathroom and laundry instructions. The receiving centre provides these in line with EANM and AERB norms, but the home regulatory authority may have additional requirements that the home oncologist clarifies.
- Continuing care plan — explicit schedule for biochemistry, imaging, response assessment, and timing of any subsequent treatment cycles. Specifies who is responsible for what.
- Information for emergency presentations — what a non-specialist clinician in the home country needs to know if the patient presents at an emergency department in the weeks after treatment (e.g., recent radiopharmaceutical exposure, specific drug interactions to avoid).
Composite case sketch 3 (anonymised): A patient with mCRPC who travelled from a country with no domestic Lu-177 PSMA programme returned home with a complete written handover including DICOM imaging, post-Lu-177 SPECT showing intended tumour distribution, and a structured schedule for return travel at 8 weeks. His home oncologist confirmed the schedule, monitored PSA and biochemistry locally, and the patient returned for cycle 2 as planned.
What this pathway does — and does not — do
The medical travel pathway is suitable for some international patients and not for others. Honest framing is essential[8]:
| What it can do | What it cannot do |
|---|
| Provide guideline-aligned radioligand therapy where it is not available, not accessible, or not affordable in the home country | Replace the patient's home oncologist or substitute for the home country's continuing care system |
| Deliver therapy at established centres with AERB licensure, EANM-aligned protocols, and multidisciplinary review | Cure metastatic disease — radioligand therapy is for symptom and PFS benefit, not cure (with limited exceptions) |
| Compress time-to-treatment for patients facing long waiting lists at home | Eliminate the need for full pre-treatment workup, eligibility review, and multidisciplinary discussion |
| Reduce out-of-pocket cost for patients in some healthcare systems | Be uniformly cheaper for every patient — total cost depends on number of cycles, accommodation, travel, attendant costs (see our cost articles for comparison data) |
The honest framing of the pathway is therefore: a structured option for international patients with appropriate clinical indication, with full multidisciplinary review and structured handover, and not a shortcut around the patient's ongoing relationship with their home care team.
Regulatory framework and quality standards
Indian nuclear medicine therapy operates under a multi-layered regulatory framework that any international patient (and their home oncologist) should understand[2][9]:
- Atomic Energy Regulatory Board (AERB) — issues licences for medical use of radioactive substances. The applicable code is AERB/RF-MED/SC-2 (Rev. 2), Safety Code for Nuclear Medicine Facilities. Every authorised centre operates under specific licence conditions covering radiation safety, personnel qualification, and quality assurance.
- Drug Controller General of India (DCGI / CDSCO) — regulates the radiopharmaceuticals themselves under the Drugs and Cosmetics Act, including import permissions and Good Manufacturing Practice oversight.
- BRIT (Board of Radiation and Isotope Technology) — the Indian indigenous producer of Lu-177 and other medical radioisotopes, supplying domestic centres alongside imported supply from international manufacturers.
- NABH (National Accreditation Board for Hospitals) — hospital-level quality accreditation. Most established international-patient centres including FMRI are NABH-accredited.
- JCI (Joint Commission International) — additional internationally-recognised hospital accreditation held by some major Indian hospitals.
- Indian Ministry of External Affairs — governs the e-Medical Visa and Medical Visa schemes that bring international patients into the country.
For an international patient and home oncologist, the practical assurance is that the radioligand-therapy regulatory framework in India is closely aligned with EANM procedure guidelines, with documented adherence to international quality standards through NABH and (where applicable) JCI accreditation.
Cost and coverage considerations
Cost is one of the principal reasons international patients consider treatment in India — but cost calculations need to include the total cost of the pathway, not just the radiopharmaceutical price[10]:
- Treatment costs — drug, imaging, hospitalisation, professional fees. For specific cost ranges in Indian INR (and lakhs of INR), see our dedicated Lu-177 PSMA cost considerations article. These articles use INR as the reference currency and discuss the components transparently.
- Cross-country comparison — our India vs international cost comparison article walks through, with sourcing, the pricing context in countries with established Lu-177 PSMA programmes.
- Travel costs — flights for patient and attendant, often 2-3 round-trips for the standard 6-cycle Lu-177 PSMA course.
- Accommodation — typically required for 5-7 days per cycle plus a recovery margin.
- Attendant costs — accompanying family member's travel, accommodation, and time away from work.
- Insurance coverage — most home-country health insurance does not cover treatment received abroad except under specific arrangements; some travel insurance also excludes pre-existing cancer and planned medical treatment. Confirm in writing before travel.
The honest comparison is total pathway cost (treatment + travel + accommodation + attendant + lost income) versus the cost or availability of the equivalent treatment at home — not just the headline drug price.
Limits and cautions
International medical travel is not appropriate for every patient or every clinical situation. Cautions worth being explicit about[8]:
- Acute or urgent conditions — patients in acute clinical deterioration should not travel internationally for elective radioligand therapy. Stabilisation and reassessment at home is required first.
- Limited life expectancy — patients with very limited life expectancy may derive less benefit from travel-intensive treatment regimens versus locally available palliative care.
- Inadequate organ reserve — patients with significant renal impairment, marrow failure, or other organ-reserve issues may not be eligible for full-protocol radioligand therapy regardless of location.
- Complex co-morbidity — patients with complex non-cancer medical conditions need home-country co-management; international travel may complicate continuity of care for those conditions.
- Need for emergency-access treatment — some advanced cases are best managed in the patient's home tertiary system because of the need for rapid response to complications, not because of treatment availability.
The structured eligibility review at stage 1 is designed to identify these situations and to recommend alternatives — local treatment in the home country, supportive care, or other pathways — where international travel is not appropriate.
What to ask in the initial consultation
A structured list of questions to bring to the initial eligibility consultation (remote video consultation in most cases) supports informed decision-making[11]:
- Am I eligible for the intended therapy based on the imaging and pathology you've reviewed?
- What does the recommended regimen look like — how many cycles, at what intervals, what total duration?
- What are the expected outcomes (PFS, OS, response rates) based on published data for patients like me?
- What are the expected side effects, and what is the management approach?
- What additional pre-treatment investigations will I need?
- What is the total cost structure — drug, imaging, hospitalisation, professional fees, additional investigations?
- What is the expected length of stay for the first cycle?
- Will the same physician follow me through subsequent cycles?
- What will the discharge documentation and handover to my home oncologist look like?
- Can later cycles be delivered at my home centre, and if so, what arrangements would that involve?
- What happens if I have a treatment-related complication after returning home?
- What is the centre's published volume and outcome data for this treatment?
Documented written responses to these questions — not just verbal reassurance — are part of an informed-consent process for any major treatment decision, including international medical travel.
The bottom line
- International medical travel for radioligand therapy in India follows a structured five-stage pathway: eligibility review, e-Medical Visa, pre-travel coordination, on-arrival MDT and treatment, and post-treatment handover[1][3].
- The India e-Medical Visa is processed online through the Ministry of External Affairs portal, typically within 3-5 working days; standard Medical Visa is available through Indian embassies for longer-stay or ineligible-country cases[1].
- Eligibility is determined remotely by multidisciplinary tumour board review of imaging (DICOM-level), pathology, biochemistry, treatment history, and performance status[3].
- Treatment delivery follows AERB Safety Code SC-2 for nuclear medicine facilities, DCGI / CDSCO oversight of radiopharmaceuticals, and EANM-aligned procedure guidelines[2].
- NABH and (where applicable) JCI accreditation provide internationally-recognised quality standards for receiving hospitals[9].
- Total pathway cost includes treatment, travel, accommodation, attendant, and lost income — not only the drug price; insurance coverage for international treatment is typically excluded from standard home-country and travel-insurance policies[10].
- International medical travel is not appropriate for acute deterioration, very limited life expectancy, inadequate organ reserve, or complex co-morbidity requiring home-country co-management[8].
Important
This article is general information about the medical travel pathway from outside India to FMRI Gurugram for radioligand therapy. Composite case sketches are anonymised and illustrative only; they are not testimonials and do not represent any specific patient. Individual eligibility and treatment decisions require formal multidisciplinary review including communication with the patient's home care team.
"International medical travel for radioligand therapy is a structured five-stage pathway: eligibility review, India e-Medical Visa, pre-travel coordination, on-arrival multidisciplinary review and treatment, and structured handover back to the home oncologist. Each stage has documentation and timing requirements. There are no shortcuts, and there is no substitute for the patient's relationship with the home care team."
Dr. Ishita B. Sen, MD · Director & Chief, Nuclear Medicine, FMRI
International patient eligibility review · FMRI
At FMRI Gurugram, international patient eligibility review for Lu-177 PSMA, Lu-177 DOTATATE PRRT, and Y-90 TARE proceeds through a remote multidisciplinary tumour board based on submitted imaging, pathology, and treatment history. Decisions are communicated in writing with explicit documentation for shared review with the patient's home oncologist.
Request eligibility review · WhatsApp +91 8800 988936
For patients & referring clinicians
Frequently asked questions
Q01
What is the India e-Medical Visa and how do I apply?
The India e-Medical Visa is an online visa specifically for medical treatment in India, processed through the Indian government portal (indianvisaonline.gov.in) and typically issued within 3-5 working days of complete submission. It is valid for 60 days from first entry with up to 3 entries. Required documents: passport (6+ months validity, 2 blank pages), recent photograph, digitised passport copy, and a letter of invitation from the recognised Indian hospital stating planned treatment and duration of stay. Some nationalities must use the standard Medical Visa through an Indian embassy [1][4].
Q02
How does eligibility for Lu-177 PSMA / PRRT / TARE get assessed remotely?
Eligibility review is done by the multidisciplinary tumour board at the receiving Indian centre based on documents submitted by the international patient: recent imaging (DICOM-level, not just radiology reports), histopathology, biochemistry, treatment history, performance status. Review typically takes 5-10 working days. Outcomes are documented in writing as 'eligible', 'conditionally eligible' (additional tests needed), or 'not appropriate' (with alternative suggestions). The decision is shared with the patient's home oncologist [3].
Q03
How long do I need to stay in India for the first treatment cycle?
For a first Lu-177 PSMA-617 or Lu-177 DOTATATE PRRT cycle at FMRI, typical stay is 5-7 days: arrival and initial consultation (day 1), multidisciplinary review and pre-treatment workup (days 2-3), treatment administration (day 3-5), post-administration imaging and discharge counselling (days 5-7). Y-90 TARE typically requires similar timing with the addition of mapping angiography prior to treatment. Subsequent cycles can sometimes be shorter or arranged at intervals through repeat travel [6].
Q04
Does my home health insurance cover treatment in India?
Most home-country health insurance does not cover treatment received abroad except under specific arrangements (e.g., some employer-sponsored international plans, certain private health-insurance products with global coverage). Standard travel insurance typically excludes pre-existing cancer and planned medical treatment as 'foreseeable events'. Confirm coverage in writing with both your home health insurer and your travel insurer before travel — verbal assurance is not sufficient [10].
Q05
How does the regulatory framework in India compare with my home country?
Indian nuclear medicine therapy operates under: AERB Safety Code SC-2 (Rev. 2) for nuclear medicine facilities; DCGI / CDSCO oversight for radiopharmaceuticals; BRIT for indigenous Lu-177 production; and NABH (national) plus JCI (international) hospital accreditation. The radioligand-therapy regulatory framework in India is closely aligned with EANM procedure guidelines used in Europe and with FDA-aligned standards used in the United States. Documented adherence is available through hospital accreditation status [2][9].
Q06
Can subsequent cycles be done at my home centre?
Yes — in many cases. The standard Lu-177 PSMA-617 protocol involves 6 cycles at 6-8 week intervals; the standard Lu-177 DOTATATE PRRT protocol involves 4 cycles at 8-week intervals. Some international patients complete all cycles in India through repeat travel; others have later cycles delivered at their home centre under structured collaboration with shared treatment plans, dosimetry records, and post-cycle imaging review. The arrangement depends on what radioligand-therapy infrastructure exists in the home country and is decided case-by-case [7].
Q07
What documentation do I bring with me to India?
Required documentation: original passport (validity confirmed), e-Medical Visa printout, hospital invitation letter, medical records folder (imaging on USB drive in DICOM format, histopathology, biochemistry, treatment history, current medication list), copy of insurance documents, and emergency contact information for home oncologist. Bring two physical copies of all essential medical records; bring imaging both as DICOM files and as printed reports. Carry medication for the duration of stay plus a margin for delays [5].
Q08
What happens if I have a treatment-related complication after I return home?
The discharge documentation includes specific information for emergency presentations: recent radiopharmaceutical exposure, expected biochemistry trajectory, specific drug interactions to avoid, and key contact information for the treating physician in India. The home oncologist receives the same documentation. For most patients, treatment-related side effects are manageable in routine clinical practice with the home oncology team using guideline-aligned management. The receiving Indian centre remains available for consultation by the home team and the patient [7].
Q09
Is medical travel cheaper than treatment at home?
It depends on the home country and the specific therapy. For patients in countries where Lu-177 PSMA is unavailable or has very long waiting lists, the comparison is access rather than price. For patients in countries with established programmes, the comparison must include total pathway cost (treatment + travel + accommodation + attendant + lost income), not just the headline drug price. For specific cost ranges in INR and cross-country comparison data see our dedicated cost articles. The honest framing is that medical travel makes financial sense for some patients and not others [10].
Q10
What about radiation safety on the flight home?
After Lu-177 administration (half-life 6.65 days), residual radioactivity is low and external exposure to fellow passengers is below safety limits within the timeframes used for discharge. The discharge note documents the time since administration. Some airports use sensitive radiation portals (typically calibrated for nuclear-material security rather than medical-dose detection) that may briefly detect post-treatment patients; the centre provides a written 'recent radiopharmaceutical administration' letter for presentation to security if needed. Y-90 has a shorter physical half-life (2.67 days) and tighter discharge envelopes [6].
Q11
Who is not appropriate for medical travel for radioligand therapy?
Patients in acute clinical deterioration, with very limited life expectancy where travel itself is burdensome relative to potential benefit, with inadequate organ reserve (significant renal impairment, marrow failure), with complex non-cancer co-morbidities requiring home co-management, or with need for emergency-access tertiary care during treatment, are generally not appropriate for international medical travel. The stage 1 eligibility review is designed to identify these situations and recommend alternatives — local treatment, supportive care, or other pathways [8].
Q12
How do I start an international eligibility review at FMRI?
At FMRI Gurugram, international patient eligibility review for Lu-177 PSMA, Lu-177 DOTATATE PRRT, and Y-90 TARE proceeds through a remote multidisciplinary tumour board based on submitted imaging, pathology, and treatment history. Decisions are communicated in writing with explicit documentation for shared review with the patient's home oncologist. WhatsApp +91 8800 988936 with a brief case summary and contact for medical record submission to begin the review.
Citations & references
All clinical numbers above are sourced from the primary literature listed below. Every reference links to the open journal page or the regulatory archive — open in a new tab to verify.
[1] Indian Ministry of External Affairs / Bureau of Immigration. e-Medical Visa — Indian Visa Online portal.
View source ↗[2] Atomic Energy Regulatory Board (Government of India). Safety Code for Nuclear Medicine Facilities. AERB/RF-MED/SC-2 (Rev. 2).
View source ↗[3] Bodei L, Mueller-Brand J, Baum RP, et al. The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours.
Eur J Nucl Med Mol Imaging. 2013;40(5):800-816.
View source ↗[4] Indian Ministry of External Affairs. India Visa Information — Medical Visa categories.
View source ↗[5] World Health Organization. International travel and health: A guide to medical travel and health for international travellers.
View source ↗[6] Kratochwil C, Fendler WP, Eiber M, et al. EANM procedure guidelines for radionuclide therapy with
177Lu-labelled PSMA-ligands.
Eur J Nucl Med Mol Imaging. 2019;46(12):2536-2544.
View source ↗[7] Society of Nuclear Medicine and Molecular Imaging (SNMMI). Practice guidelines for nuclear medicine procedures and patient information.
View source ↗[8] Glanville J, Kendrick T, McNally R, et al. Health needs assessment in medical tourism: published evidence and implications.
Health Policy. 2014;115(2-3):243-258.
View source ↗[9] National Accreditation Board for Hospitals & Healthcare Providers (NABH). Accreditation standards for hospitals (4th edition).
View source ↗[10] Hopkins L, Labonté R, Runnels V, Packer C. Medical tourism today: what is the state of existing knowledge?
J Public Health Policy. 2010;31(2):185-198.
View source ↗[11] Crooks VA, Kingsbury P, Snyder J, Johnston R. What is known about the patient's experience of medical tourism? A scoping review.
BMC Health Serv Res. 2010;10:266.
View source ↗[12] Joint Commission International. JCI Accreditation Standards for Hospitals.
View source ↗[13] International Atomic Energy Agency (IAEA). Quality Management Audits in Nuclear Medicine Practices (QUANUM).
View source ↗[14] European Association of Nuclear Medicine (EANM). Procedure guidelines for radionuclide therapy with
177Lu-labelled DOTATATE.
View source ↗[15] Sartor O, de Bono J, Chi KN, et al. Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer (VISION).
N Engl J Med. 2021;385(12):1091-1103.
View source ↗[16] Strosberg J, El-Haddad G, Wolin E, et al. Phase 3 Trial of
177Lu-Dotatate for Midgut Neuroendocrine Tumors (NETTER-1).
N Engl J Med. 2017;376(2):125-135.
View source ↗[17] Salem R, Johnson GE, Kim E, et al. Yttrium-90 Radioembolization for the Treatment of Solitary, Unresectable HCC: The LEGACY Study.
Hepatology. 2021;74(5):2342-2352.
View source ↗[18] FDA. Pluvicto (lutetium Lu 177 vipivotide tetraxetan) Prescribing Information (initial approval 2022; expanded 2025).
View source ↗[19] European Medicines Agency. Lutathera (lutetium 177Lu oxodotreotide) Summary of Product Characteristics.
View source ↗[20] Indian Council of Medical Research – National Centre for Disease Informatics and Research. Report of National Cancer Registry Programme.
View source ↗[21] Bhatia M. Medical tourism in India: the changing landscape.
The Lancet Regional Health - Southeast Asia. 2023.
View source ↗[22] Reserve Bank of India (RBI). Foreign exchange and remittance guidance for medical treatment abroad.
View source ↗[23] Drug Controller General of India / CDSCO. Drugs and Cosmetics Act and Rules: Regulatory framework for radiopharmaceuticals.
View source ↗[24] Board of Radiation and Isotope Technology (BRIT). Department of Atomic Energy, Government of India.
View source ↗[25] Pavel M, Öberg K, Falconi M, et al. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines.
Ann Oncol. 2020;31(7):844-860.
View source ↗[26] NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer. National Comprehensive Cancer Network.
View source ↗[27] NCCN Clinical Practice Guidelines in Oncology: Neuroendocrine and Adrenal Tumors. National Comprehensive Cancer Network.
View source ↗[28] NCCN Clinical Practice Guidelines in Oncology: Hepatobiliary Cancers. National Comprehensive Cancer Network.
View source ↗[29] Bureau of Immigration, Government of India. Foreigners Registration Office (FRRO) — registration requirements for long-stay medical visa holders.
View source ↗[30] International Atomic Energy Agency (IAEA). Safety in the medical uses of radiation (Safety Guide SSG-46).
View source ↗
About the Author
Dr. Ishita B. Sen
MBBS · MD (Nuclear Medicine) · DNB · Post-doctoral Fellowship, Memorial Sloan Kettering Cancer Center, New York
Director and Chief of Nuclear Medicine at Fortis Memorial Research Institute. Co-founder of Theranostic Physicians Private Limited (TPPL). Two decades of clinical practice in PSMA imaging and PSMA-directed radioligand therapy, with one of the largest Indian institutional experiences in Lu-PSMA.