A Review of Theranostics: Perspectives on Emerging Approaches and Clinical Advancements

Radiol Imaging Cancer. 2023 Jul;5(4):e220157. doi: 10.1148/rycan.220157.


Theranostics is the combination of two approaches-diagnostics and therapeutics-applied for decades in cancer imaging using radiopharmaceuticals or paired radiopharmaceuticals to image and selectively treat various cancers. The clinical use of theranostics has increased in recent years, with U.S. Food and Drug Administration (FDA) approval of lutetium 177 (177Lu) tetraazacyclododecane tetraacetic acid octreotate (DOTATATE) and 177Lu-prostate-specific membrane antigen vector-based radionuclide therapies. The field of theranostics has imminent potential for emerging clinical applications. This article reviews critical areas of active clinical advancement in theranostics, including forthcoming clinical trials advancing FDA-approved and emerging radiopharmaceuticals, approaches to dosimetry calculations, imaging of different radionuclide therapies, expanded indications for currently used theranostic agents to treat a broader array of cancers, and emerging ideas in the field. Keywords: Molecular Imaging, Molecular Imaging-Cancer, Molecular Imaging-Clinical Translation, Molecular Imaging-Target Development, PET/CT, SPECT/CT, Radionuclide Therapy, Dosimetry, Oncology, Radiobiology © RSNA, 2023.

Keywords: Dosimetry; Molecular Imaging; Molecular Imaging–Cancer; Molecular Imaging–Clinical Translation; Molecular Imaging–Target Development; Oncology; PET/CT; Radiobiology; Radionuclide Therapy; SPECT/CT.

Publication types

  • Review

MeSH terms

  • Humans
  • Male
  • Neoplasms* / diagnostic imaging
  • Neoplasms* / therapy
  • Positron Emission Tomography Computed Tomography
  • Precision Medicine*
  • Radioisotopes / therapeutic use
  • Radiopharmaceuticals / therapeutic use
  • United States


  • Radiopharmaceuticals
  • Radioisotopes